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Hergenc G, Onat A, Uyarel H, Yazici M, Tuncer M, Dogan Y, Rasche K. PO13-342 OBSTRUCTIVE SLEEP APNEA SYNDROME IN TURKISH ADULTS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71352-1] [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: 11/27/2022]
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52
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Kocak H, Mahsereci E, Ermis C, Ceken K, Suleymanlar G, Ersoy F, Tuncer M. YI-834 PERITONEAL DIALYSIS PATIENTS WITH LEFT VENTRICULAR HYPERTROPHY ARE CHARACTERIZED BY INCREASED OXIDATIVE STRESS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71844-5] [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: 11/29/2022]
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53
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Türker KS, Sowman PF, Tuncer M, Tucker KJ, Brinkworth RSA. The role of periodontal mechanoreceptors in mastication. Arch Oral Biol 2007; 52:361-4. [PMID: 17222796 DOI: 10.1016/j.archoralbio.2006.11.014] [Citation(s) in RCA: 24] [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] [Received: 07/13/2006] [Revised: 11/23/2006] [Accepted: 11/23/2006] [Indexed: 10/23/2022]
Abstract
The aim of this review is to discuss what is known about the reflex control of the human masticatory system by the periodontal mechanoreceptors and to put forward a method for standardised investigation. To deliver mechanical stimulus in a reproducible way, the following precautions are suggested: the stimulus should be brought into secure contact with the area of stimulation, and slack between the probe and the area to be stimulated should be taken up by the application of a preload. It is also important to ensure that there is minimal simultaneous activation of receptor systems other than the periodontal mechanoreceptors. It is also necessary to standardise the method for recording and analysing the response.
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Affiliation(s)
- Kemal S Türker
- Research Centre for Human Movement Control, University of Adelaide, SA 5005, Australia.
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Abstract
The Hoffmann (H) reflex is elicited by electrical stimulation of a mixed nerve and is used to measure the excitability of the spindle-motoneuron synapse. Recent investigations have indicated a positive correlation between increases in bite force and H-reflex facilitation. However, these investigations did not examine the H-reflex in detail or the possible role of periodontal mechanoreceptors (PMRs) in this facilitation. The current investigation was performed to determine whether PMRs play a role in H-reflex facilitation during tooth clench (TC). The H-reflex was elicited in the soleus muscle of human subjects while bite level was maintained at rest (0 N), 40 N, 80 N and maximal TC. The front teeth that contributed to the (40 N and 80 N) bite force were then locally anaesthetised (LA), and the protocol was repeated. The current data suggest that the effect of TC on the H-reflex amplitude in the human limb muscles is variable from one subject to the next. Statistical analysis has shown that the H-reflex was significantly smaller during the rest condition than during the 80 N bite (p<0.05) in both non-LA and LA conditions. Since LA did not alter the response, our results do not support that the PMRs play a major role in the facilitation of distal muscle activity.
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Affiliation(s)
- Meltem Tuncer
- Hacettepe University, Faculty of Medicine, Department of Physiology, Sihhiye, Ankara 06100, Turkey
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Brinkworth RSA, Tuncer M, Tucker KJ, Jaberzadeh S, Türker KS. Standardization of H-reflex analyses. J Neurosci Methods 2007; 162:1-7. [PMID: 17257686 DOI: 10.1016/j.jneumeth.2006.11.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2006] [Revised: 11/23/2006] [Accepted: 11/30/2006] [Indexed: 11/15/2022]
Abstract
Variability in the H-reflex can make it difficult to identify significant changes using traditional pooled analysis techniques. This study was undertaken to introduce a normalisation approach to calculate both the relative size and the relative stimulus intensity required to elicit the H-reflex response so that comparisons can be made not only with results obtained during different experimental session but also between different subjects. This normalisation process fits the size of the measured M-responses and H-reflexes over the entire stimulus range with model curves to better facilitate the calculation of important parameters. This approach allows normalisation of not only the size of the response but also the relative stimulus intensity required to elicit the response. This eases the comparison of the reflex responses under various situations, and is capable of bringing out any genuine differences in the reflex in a reliable manner not previously possible. This study illustrates that comparison of the reflex between days is problematic, even in the same subject, as both the reflex size and the relative stimulus intensity required to obtain this reflex changed in all subjects. We suggest that H-reflex studies need to use normalisation not only for size of the reflex but also for the stimulus intensity, and also that all experiments for a single subject should be performed in the same session or during the same day using some level of background muscle activity in the muscle concerned as the variability of the muscle at rest was found to be larger.
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Affiliation(s)
- R S A Brinkworth
- Research Centre for Human Movement Control, School of Molecular and Biomedical Sciences, Discipline of Physiology, University of Adelaide, SA 5005, Australia
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56
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Soydan G, Tekes E, Tuncer M. Investigation of serotonin receptors in the isolated penile bulb of rats. Int J Impot Res 2006; 18:510-6. [PMID: 16528294 DOI: 10.1038/sj.ijir.3901456] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate serotonin (5-HT) receptors in the penile bulb, which have been suggested to play a role in penile erection. Serotonin (10(-7)-3 x 10(-4) M) contracted penile bulbs in a concentration-dependent manner. Ketanserin (5-HT(2A) antagonist, 10(-9)-10(-7) M) and prazosin (alpha(1)-adrenergic receptor blocker, 10(-9)-10(-7) M) suppressed the lower and upper parts of concentration-response curves to 5-HT, respectively. Guanethidine (adrenergic neuron blocker, 5 x 10(-5) M) reduced the responses to 5-HT at only 10(-4) and 3 x 10(-4) M concentrations. NAN-190 (5-HT(1A) antagonist, 10(-8), 10(-7) M) shifted the concentration-response curve to the right with a reduction in the maximum response to 5-HT. While ondansetron (5-HT(3) antagonist, 10(-6)-10(-5) M) and GR55562 (5-HT(1B/1D) antagonist, 10(-6)-10(-5) M) had no effect on the concentration-response curve to 5-HT. The 5-HT(1A) agonist 8-OH-DPAT (10(-7)-3 x 10(-4) M) contracted penile bulbs in a concentration-dependent manner with a lower pD(2) value than that of 5-HT. Sumatriptan (5-HT(1B/1D) agonist, 10(-8)-10(-4) M) did not produce any contractile response in the penile bulbs. Prucalopride, a selective 5-HT(4) agonist (R093877, 10(-7)-3 x 10(-4) M) produced concentration-dependent relaxation in penile bulbs contracted by phenylephrine (10(-5) M). 5-HT(4) agonists cisapride (10(-7)-10(-4) M) and metoclopramide (10(-7)-3 x 10(-4) M) also relaxed the tissue, concentration-dependently. Selective 5-HT(4) antagonists GR125487 (10(-6)-10(-5) M) and GR113808 (10(-6)-10(-5) M) slightly, but not significantly, decreased prucalopride- and cisapride-induced relaxation. Propranolol (beta-adrenergic receptor blocker, 10(-6)-10(-5) M) and L-NOARG (nitric oxide synthase inhibitor, 10(-4) M) had no effect on prucalopride-induced relaxation. These results suggest the existence of alpha(1)-adrenergic, 5-HT(1A) and 5-HT(2A) serotonergic receptors in the penile bulb of rats, which are responsible for 5-HT-induced contraction. Additionally, a serotonergic receptor resembling a 5-HT(4)-type plays a role in the relaxation. The latter receptor is activated by 5-HT(4) agonists, but is not antagonized by 5-HT(4) antagonists.
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Affiliation(s)
- G Soydan
- Department of Pharmacology, Hacettepe University, Faculty of Medicine, Shhiye, Ankara, Turkey
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Akbas SH, Bilgen T, Keser I, Tuncer M, Yucetin L, Tosun O, Gultekin M, Luleci G. The effect of MDR1 (ABCB1) polymorphism on the pharmacokinetic of tacrolimus in Turkish renal transplant recipients. Transplant Proc 2006; 38:1290-2. [PMID: 16797284 DOI: 10.1016/j.transproceed.2006.02.079] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [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: 07/20/2005] [Indexed: 12/01/2022]
Abstract
There is marked interindividual variability in trough blood levels of tacrolimus (TRL) following standard dosing. TRL is a substrate for P-glycoprotein (P-gp), the product of the multidrug resistance-1 (MDR1)(ABCB1) gene. P-gp acts as a membrane efflux pump, which affects TRL absorption from the gut. Some of the single nucleotide polymorphisms (SNP) of ABCB1 gene are associated with pharmacokinetic characteristics of TRL. The objective of this study was to determine the role of ABCB1 C3435T polymorphism on TRL dose requirements, trough values and dose-adjusted trough TRL concentrations among Turkish renal transplant recipients. Renal transplant recipients receiving TRL (n=92) were genotyped for ABCB1. TRL daily doses, trough concentrations, dose-adjusted trough concentrations, demographic features, and clinical data were obtained at 1, 6, and 12 months after renal transplantation. The frequency of the ABCB1 3435 CC genotype was 30.4%, whereas 47.8% of patients were 3435 CT and 21.7% of patients were 3435 TT. TRL daily doses were significantly lower among patients with the 3435 TT genotype at months 1 and 6. At 6 and 12 months after transplantation patients who were homozygous for the ABCB1 3435 CC showed significantly lower dose-adjusted trough TRL concentrations compared with subjects of 3435 TT and CT genotypes. Knowledge of ABCB1 genotype may be useful to adjust the optimal dose of TRL in transplant patients, thereby rapidly achieving target concentrations.
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Affiliation(s)
- S H Akbas
- Central Laboratory, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
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Kocak H, Ceken K, Dinckan A, Mahsereci E, Yavuz A, Yucetin L, Akbas SH, Gurkan A, Erdogan O, Ersoy F, Yakupoglu G, Demirbas A, Tuncer M. Assessment and comparison of endothelial function between dialysis and kidney transplant patients. Transplant Proc 2006; 38:416-8. [PMID: 16549135 DOI: 10.1016/j.transproceed.2006.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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
Dialysis and kidney transplant patients display endothelial dysfunction. Previous studies concerning comparisons of endothelial function in dialysis and kidney transplant patients included subjects with cardiovascular risk factor(s) that alone may lead to endothelial dysfunction. In this study, we compared endothelial function between dialysis and transplant patients who did not show known cardiovascular risk factors that lead to endothelial dysfunction. We studied age- and gender-matched cohorts: 30 hemodialysis (HD), 30 peritoneal dialysis (PD), and 30 kidney transplant patients. We also included 20 age- and gender-matched healthy controls. We assessed the endothelial function of patients and controls by a noninvasive technique. Serum biochemistry profiles of patients were also similar to controls in terms of lipid profile and fasting blood glucose level. Although mean FMD% levels of HD and PD patients were similar (6.6% +/- 3.1% vs 6.8% +/- 3.0%, P > .05), the mean percent of flow-mediated endothelium-dependent dilatation (FMD%) level in transplant patients was higher than those in HD or PD patients (10.50% +/- 3.0% vs 6.6% +/- 3.1% and 6.8% +/- 3.0%, respectively; P < .01). In addition, the mean FMD% level in healthy controls was higher than those in HD, PD, and transplant patients (14.0% +/- 2.3% vs 6.6% +/- 3.1%, 6.8% +/- 3.0% and 10.50% +/- 3.0%; P < .01, respectively). In conclusion, endothelial functions in transplant patients were better than those in dialysis patients.
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Affiliation(s)
- H Kocak
- Internal Medicine, Renal Division, Department of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey.
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Akbas SH, Yurdakonar E, Yucetin L, Senol Y, Tuncer M, Kocak H, Akbas M, Gurkan A, Demirbas A, Gultekin M. Relation of C-2 monitoring with serum lipid profile in stable renal transplant patients. Transplant Proc 2006; 38:460-2. [PMID: 16549147 DOI: 10.1016/j.transproceed.2005.12.088] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
C-2 monitoring has been proposed as a more effective strategy than C-0 to predict the risk of acute rejection in the early stages posttransplantation. However, cyclosporine (CsA) is associated with posttransplant dyslipidemia. The aim of this retrospective study was to evaluate the correlations of C-0 and C-2 levels with atherogenic risk factors in the first 6 months versus after 6 months posttransplantation. We evaluated the data from 127 stable renal transplant recipients (89 males, 38 females) of mean age 38.10 +/- 12.79 years who received Neoral-based immunosuppression to investigate the relation of C-2 levels to serum lipid profile compared with C-0 values in the early and late posttransplantation periods. Receiver operating characteristic (ROC) analyses were performed to define a C-2 cutoff level that identified subjects with hypercholesterolemia, defined as a total cholesterol (TC) >200 mg/dL. There were significant positive correlations between both C-0 and C-2 levels and TC as well as the ratio of total cholesterol/HDL cholesterol (TC/HDL) in the late period. When the C-2 levels in the late posttransplantation period were stratified, serum TC concentrations showed statistically significant differences between the groups. Whole blood C-2 levels above 850 ng/mL were associated with increased serum TC concentrations; the C-2 cutoff level leading to hypercholesterolemia was 888 ng/mL. Maintenance immunosuppressive therapy under the proposed whole blood C-2 level of 888 ng/mL seemed to preserve graft function while preventing atherogenic risks for cardiovascular diseases in the late posttransplantation period.
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Affiliation(s)
- S H Akbas
- Central Laboratory, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
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60
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Aytaç-Elmas S, Çetin M, Tuncer M, Hiçsönmez C. Evaluation of children with myelodysplastic syndrome; A single center experience. Leuk Res 2006. [DOI: 10.1016/s0145-2126(06)80028-7] [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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61
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Kuşkonmaz B, Tavil B, Tuncer M, Hiçsönmez G, Çetin M, Uçkan D. Allogeneic bone marrow transplantation for children with myelodysplastic syndrome and very high risk features. Leuk Res 2006. [DOI: 10.1016/s0145-2126(06)80058-5] [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: 10/24/2022]
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62
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Timurağaoğlu A, Uğur-Bilgin A, Colak D, Tuncer M, Gölbaşi I, Hazar V, Kiliçarsłan B, Undar L, Demirbaş A. Posttransplant Lymphoproliferative Disorders in Transplant Recipients. Transplant Proc 2006; 38:641-5. [PMID: 16549195 DOI: 10.1016/j.transproceed.2005.12.093] [Citation(s) in RCA: 16] [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] [Indexed: 11/16/2022]
Abstract
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of organ transplantation, with a reported incidence between 0.8% and 32%. The incidence of PTLD mainly depends on the transplanted organ, the immunosuppressive drugs, the viral serology, and the age of the recipient. The aim of our study was to analyze our patients diagnosed with PTLD. Among 1040 transplantations, including 931 renal, 14 heart, 55 liver and 40 allogeneic peripheral blood stem cell (PBSC), 8 patients (7 male, 1 female) were diagnosed with PTLD. Five patients had undergone renal, one cardiac, one liver, and one PBSC transplantations. Four patients were diagnosed within the first year of transplantation. Six patients presented with abdominal disease, one with convulsions, and one with peripheral lymph node involvement. According to the World Health Organization classification system, six patients were diagnosed as diffuse large B-cell lymphoma, one patient Burkitt's lymphoma, and one polymorphic PTLD. At the time of diagnosis, 7 patients showed positive Epstein-Barr virus (EBV) and cytomegalovirus (CMV) Ig G and negative Ig M; one patient, positive EBV Ig M and negative CMV Ig G and M. EBV viral load was extremely high in the plasma of two patients by polymerase chain reaction. One of these patient's pathologic tissue revealed positive EBV DNA, which was not detected in six of the other eight patients. This patient was an 8-year-old boy diagnosed with Burkitt's lymphoma at 31 months after liver transplantation. Seven patients died of disease or complications of chemotherapy. Only one patient survived after the diagnosis of PTLD. In conclusion, even with treatment the mortality rate was high among our patients with PTLD. To decrease the incidence of PTLD and related mortality, risk factors must be evaluated in multicenter studies.
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Affiliation(s)
- A Timurağaoğlu
- Department of Haematology, School of Medicine, Akdeniz University, Antalya, Turkey.
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63
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Kocak H, Yakupoglu U, Karatas GU, Yavuz A, Gurkan A, Erdogan O, Ersoy FF, Yakupoglu G, Demirbas A, Tuncer M. Tacrolimus plus low-dose mycophenolate mofetil in renal transplant recipients: better 2-year graft and patient survival than with a higher mycophenolate mofetil dose. Transplant Proc 2006; 37:3009-11. [PMID: 16213288 DOI: 10.1016/j.transproceed.2005.07.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Mycophenolate mofetil (MMF) has become more widely prescribed in recent years, but its adverse effects on the gastrointestinal system and bone marrow restrict its use in certain settings. The aim of this study was to compare the demographic features and clinical data for 173 renal transplant recipients who received tacrolimus (TAC) plus 1 g/d MMF (group I, n = 112) versus TAC plus 2 g/d MMF (group II, n = 61 patients) over a 2-year period. Each patient received similar TAC doses. METHODS We compared demographic data and clinical data for each case: acute rejection (AR) episodes, chronic rejection (CR) episodes, death, graft loss, development of posttransplantation diabetes mellitus (PTDM), and posttransplantation hypertension rates. RESULTS Demographic features were similar. There were also no significant differences between groups I and II with respect to number of AR episodes (17/112 vs 12/61, respectively), number of CR episodes (4/112 vs 1/61, respectively), PTDM, and hypertension rate (P > .05). Kaplan-Meier survival analysis revealed 2-year graft survival rates of 94% in group I versus 83% in group II. The corresponding 2-year patient survival rates were 100% in group I versus 91% in group II. The graft survival and patient survival rates in group I were significantly higher than those in group II (log-rank 0.005 and 0.001, respectively). CONCLUSIONS The 2-year graft and patient survival rates for the renal transplant recipients in this study suggest that the combination of a full TAC dose with 1 g/d MMF is a better choice than 2 g/d MMF.
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Affiliation(s)
- H Kocak
- Department of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey.
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Kizilates F, Colak D, Gunseren F, Ongut G, Demirbas A, Tuncer M, Gultekin M. Human herpesvirus-8 seroprevalence in renal transplant recipients in Antalya, Turkey. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80869-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The soleus is the most commonly used muscle for H-reflex studies in humans, while limited comparable data have been produced from the gastrocnemii muscles. This article reviews the fundamental differences between the structure and function of the human soleus and gastrocnemii muscles, including recent data published about their complex innervation zones. Protocols for eliciting, recording, and assessing the H-reflex and M-wave magnitude in the human triceps surae are also discussed.
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Affiliation(s)
- Kylie J Tucker
- Discipline of Physiology, School of Molecular and Biomedical Sciences, University of Adelaide, SA 5005, Australia
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66
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Yakupoglu YK, Dinckan A, Gurkan A, Tuncer M, Erdogan O, Altunbas H, Yakupoglu U, Sari R, Demirbas A. Kidney-pancreas transplantation: single-center experience at a university hospital in Turkey. Transplant Proc 2005; 37:3205-8. [PMID: 16213349 DOI: 10.1016/j.transproceed.2005.07.035] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION One treatment option for patients with type 1 diabetes mellitus with end-stage nephropathy is combined pancreas-kidney transplantation, which can be performed either simultaneously (SPK) or following kidney transplantation (PAK). PATIENTS AND METHODS Between February 2003 and November 2004, 14 patients, including 10 males and 4 females of overall mean age of 31.3 +/- 6.1 years (range, 23-44 years), presented with end-stage renal disease secondary to type 1 diabetes mellitus. Five patients (35.7%) received SPK; 7 patients (50%) received PAK; and 2 patients (14.3%) received simultaneous pancreas and living-related kidney (SPLK) transplantations. RESULTS Two among 14 pancreas grafts were lost in the early postoperative period secondary to venous thrombosis despite anticoagulation including 1 with poor portal drainage. Insulin therapy was reinitiated in 1 patient after a second rejection episode in the seventh postoperative month. By the ninth median follow-up month (range, 1-21 months), all kidney grafts were functioning. CONCLUSION Our single-center short-term experience with 14 consecutive kidney-pancreas transplantations suggests that while the pancreas transplant is effective and safe to reestablish normoglycemia, this transplant creates additional surgical and immunosuppressive stresses on the patient.
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Affiliation(s)
- Y K Yakupoglu
- Akdeniz University Organ Transplantation Center, Antalya, Turkey.
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67
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Tuncer M, Gurkan A, Erdogan O, Yucetin L, Demirbas A. Lack of Impact of Human Leukocyte Antigen Matching in Living Donor Kidney Transplantation: Experience at Akdeniz University. Transplant Proc 2005; 37:2969-72. [PMID: 16213277 DOI: 10.1016/j.transproceed.2005.07.043] [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: 11/22/2022]
Abstract
Lack of expansion of the deceased donor supply has resulted in a severe shortage of organs worldwide. Spousal donors are one possible alternative organ source for patients on the kidney transplant waiting list. Despite human lymphocyte antigen (HLA) matching between recipients and unrelated donors being poor, the reported survival rates for these grafts, including spouses, are comparable to those for grafts from living related donors and higher than those for deceased donor kidneys. In 2000, our renal transplantation program began accepting living donor-recipient pairs with one or zero HLA matches. The purpose of this study was to assess this policy for accepting living unrelated donors. The 3-year graft survival rates for the transplants from living unrelated donors were similar to that for transplants from living related donors (log-rank = 0.078). The number of HLA mismatches did not significantly influence the survival rates for either of these groups of living donor transplants. Multivariate analysis revealed that dialysis duration (P = .057) and recipient age (P = .066) negatively influenced patient survival in living donor kidney transplantation. The graft and patient survival rates for the donor transplantations were higher than those for deceased donor transplantations. In light of these findings and considering the increasing problem of organ shortage, we conclude that living unrelated kidney transplantation should be performed, with strict guidelines. Spousal donation is the most favorable form of living unrelated renal transplantation.
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Affiliation(s)
- M Tuncer
- Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey.
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68
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Karatas GU, Yakupoglu U, Yakupoglu YK, Kocak H, Yavuz A, Dinckan A, Tuncer M, Demirbas A, Yakupoglu G, Ersoy FF, Gurkan A. Sirolimus as Primary Immunosuppression Agent in Kidney Transplant Recipients: Akdeniz University Experience. Transplant Proc 2005; 37:3006-8. [PMID: 16213287 DOI: 10.1016/j.transproceed.2005.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 10/25/2022]
Abstract
OBJECTIVES Recently usage of sirolimus as the primary immunosuppressant is widening among kidney transplant recipients. We reviewed the clinical follow-up of patients transplanted at our center using sirolimus protocols. METHODS Sirolimus including primary immunosuppressive treatment protocols were begun in February 2002. Among the 21 patients (15 men, six women) who received sirolimus, six patients were prescribed sirolimus + prednisolone; seven, sirolimus + mycophenolate mofetil + prednisolone; and eight, sirolimus + cyclosporine + prednisolone. The mean age of the patients was 32.9 +/- 7.3 years and the mean posttransplantation follow-up, 13.2 +/- 4.5 months. RESULTS Three patients experienced acute rejection episodes, which were treated successfully with steroids. None of the patients had either hematologic or wound healing problems. Lymphoceles developed in eight patients. Serum creatinine level was 1.4 +/- 0.5 mg/dL at 12 months. There was a serious increase in serum cholesterol and triglyceride levels starting from the first month posttransplant (total cholesterol levels pretransplant and at 1 month, respectively: 159.3 +/- 29.5 and 255.7 +/- 52.3 mg/dL, P = .0001; triglycerides pretransplant and at 1 month, respectively: 146.9 +/- 89.5 and 215.1 +/- 102.5 mg/dL, P = .001). Despite routine antihyperlipemic treatment those high levels were maintained for 12 months. CONCLUSIONS We achieved 100% graft and patient survival rates for 1 year among patients who were using sirolimus. But the most important role in defining the morbidity and mortality in this group of patients is cardiovascular events; for this reason the abnormalities in the lipid profile must be taken seriously.
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Affiliation(s)
- G U Karatas
- Akdeniz University Organ Transplantation Center, Antalya, Turkey
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Yakupoglu U, Kocak H, Karatas GU, Yakupoglu YK, Dinckan A, Kececioglu N, Gurkan A, Demirbas A, Yegin O, Tuncer M. Simvastatin Therapy in Lymphocyte Cross-Match–Positive Kidney Transplantation Candidates. Transplant Proc 2005; 37:2933-5. [PMID: 16213265 DOI: 10.1016/j.transproceed.2005.07.034] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Recent identification of several mechanisms by which statins decrease recruitment of monocytes and T cells into the arterial wall and inhibit both T-cell and B-cell activation and proliferation in vitro prompted us to study the immunomodulatory effects of statins. In this study, we examined the effect of simvastatin therapy on lymphocyte cross-match positivity in kidney transplantation candidates. METHODS Simvastatin therapy (20 mg/d) was administered to 25 patients (18 men, 7 women of mean age 34 +/- 11.7 years who displayed positive lymphocyte cross-matches between July 2002 and October 2004. The etiologies of end-stage renal disease were vesicoureteral reflux (n = 5), urinary stone disease (n = 4), glomerulonephritis (n = 6), amyloidosis secondary to familial Mediterranean fever (n = 1), and unknown (n = 9). RESULTS The lymphocyte cross-match became negative in 10 patients 4-9 months, and successful kidney transplantation was performed in 6 of them. The serum creatinine levels of these patients ranged between 0.8 and 1.4 mg/dL. Two patients required higher doses, but none suffered from adverse effects. The remaining 4 patients are still undergoing pretransplantation evaluation. CONCLUSION Simvastatin therapy seems to be a cost-effective and useful method for lymphocyte cross-match-positive kidney transplantation candidates compared with immunoadsorption or intravenous immunoglobulin use.
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Affiliation(s)
- U Yakupoglu
- Akdeniz University Organ Transplantation Center, Antalya, Turkey.
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70
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Uckan D, Cetin M, Yigitkanli I, Tezcan I, Tuncer M, Karasimav D, Oguz KK, Topçu M. Life-threatening neurological complications after bone marrow transplantation in children. Bone Marrow Transplant 2005; 35:71-6. [PMID: 15531898 DOI: 10.1038/sj.bmt.1704749] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [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: 11/08/2022]
Abstract
Neurological complications may occur in BMT recipients (11-59%), frequently contributing to morbidity or mortality. They are the main causes of death in 10-15%. Life-threatening neurological complications were seen in 11 out of 113 (9.7%) children who underwent BMT from HLA-matched family (n=7) or mismatched donors (n=4) at our institution. Diagnoses of patients with neurological complications were acute myeloblastic leukemia (AML) (five), thalassemia major (two), Fanconi anemia (two), Omenn syndrome (one) and leukodystrophy (one), and the neurological events were seen between days +13 and +85 after transplantation. Minor symptoms including reversible, nonrepetitive seizures were excluded. Cyclosporine A toxicity was diagnosed in six children. The rest of the complications were brain abscess/meningoencephalitis (two), severe hypomagnesemia (one), busulfan toxicity (one), sustained hypertension (three), and intracranial hemorrhage (three). Six patients with neurological complications suffered from >grade II graft-versus-host disease (GvHD), and all were high risk for transplant-related complications. In this study, risk status of the underlying disease, mismatched transplantation, a diagnosis of AML (advanced stage), older age and >grade II GvHD were important adverse factors for the development of severe life-threatening neurological complications.
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Affiliation(s)
- D Uckan
- Department of Pediatrics, Units of Bone Marrow Transplantation and Hematology, Hacettepe University Faculty of Medicine, Children's Hospital, Yenisehir, Ankara 06100, Turkey.
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71
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Vincenti F, Tuncer M, Castagneto M, Klinger M, Friman S, Scheuermann EH, Wiecek A, Russ GR, Martinek A, Nonnast-Daniel B. Prospective, Multicenter, Randomized Trial to Compare Incidence of New-Onset Diabetes Mellitus and Glucose Metabolism in Patients Receiving Cyclosporine Microemulsion Versus Tacrolimus After De Novo Kidney Transplantation. Transplant Proc 2005; 37:1001-4. [PMID: 15848604 DOI: 10.1016/j.transproceed.2004.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
New-onset diabetes mellitus (NODM) is associated with increased risk of graft failure and death in renal transplant recipients. Some clinical studies have indicated that NODM risk is higher with tacrolimus than cyclosporine, but no comparative trial has used American Diabetic Association (ADA)/World Health Organization (WHO) criteria for diagnosis of diabetes mellitus. The Diabetes Incidence After Renal Transplantation, Neoral C2 Monitoring Versus Tacrolimus (DIRECT) study is a 6-month open-label, multicenter trial comparing the impact of tacrolimus and Neoral (cyclosporine microemulsion) on glucose metabolism in 700 de novo kidney transplant recipients, based on ADA/WHO criteria. Patients are randomized to tacrolimus (C0 monitoring) or Neoral (C2 monitoring), stratified by baseline diabetic status and ethnicity. All patients receive basiliximab, corticosteroids, and mycophenolate mofetil or enteric-coated mycophenolate acid (myfortic). Pooled interim 3-month results from a subset of 115 patients receiving either tacrolimus or Neoral showed that the primary efficacy end-point (biopsy-proven acute rejection [BPAR], graft loss or death) occurred in 11 patients (10%). There were four graft losses and only one death, which occurred after graft loss. Eight patients experienced BPAR (7.3%). Among 99 patients who were nondiabetic at baseline, 14 developed NODM by month 3, 17 developed impaired fasting glucose or impaired glucose tolerance, and another 5 patients received hypoglycemic treatment for at least 14 consecutive days or at the month 3 visit, resulting in a 36% incidence of impaired glucose metabolism. At 3 months, median GFR (Nankivell) was 63.7 mL/min; median serum creatinine was 137 micromol/L. Full complete results are expected in December 2005.
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Affiliation(s)
- F Vincenti
- Kidney Transplant Service, UCSF, San Francisco, California 94143, USA.
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72
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Demirbaş A, Tuncer M, Yavuz A, Gürkan A, Kaçar S, Cetinkaya R, Tekin S, Akbaş SH, Akaydin M, Ersoy F, Yakupoğlu G. Influence of tacrolimus plus mycophenolate mofetil regimens on acute rejection rate and diabetes mellitus development in renal transplant recipients. Transplant Proc 2004; 36:175-7. [PMID: 15013338 DOI: 10.1016/j.transproceed.2003.11.053] [Citation(s) in RCA: 3] [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] [Indexed: 11/24/2022]
Abstract
In this study we investigated the influence of a tacrolimus (TAC) plus mycophenolate mofetil (MMF) immunosuppressive regimen on the acute rejection rate and side effect profile in renal transplant recipients. The study included 80 living-related and 40 cadaveric donor renal transplant recipients (82 men, 38 women) of mean age 35 +/- 10 years (range, 16 to 58) who were operated between August 1999 and September 2002. The mean HLA mismatches was 3 +/- 1 (range, 0 to 5). All patients received prednisolone, MMF (2 g/d for the first 14 days posttransplant and then 1 g/d) plus TAC (0.2 mg/kg/d). They were followed for the development of rejection attacks and side effects. Diabetes mellitus developed in 13 patients (9 men, 4 women; 10.8%). Initially, patients required insulin therapy but after 6 months, 5 recipients no longer needed insulin therapy and were switched to oral hypoglycermic agents and diet control. Hypertension was diagnosed in 58 patients (48.3%). Neither gender nor donor origin (P =.14; P =.79, respectively) produced a significant difference in diabetes mellitus development. Biopsy proven acute rejection episodes were observed in 16 out of 120 patients (13.3%). Six out of 120 patients lost their grafts throughout the study period including one death because of suicide, one because of cytomegalovirus disease and hemophagocytic syndrome, one due to posttransplant lymphoproliferative disease and two to a cardiac arrhythmia. Only one patient lost his graft due to acute accelerated vascular rejection. Biopsy-proven chronic rejection appeared in one patient. In conclusion, although the incidence of insulin-dependent diabetes mellitus during posttransplant 6 months, seems high it decreased to 1.6% upon reduction of the TAC dosage. TAC plus MMF immunosuppression seems effective and safe in terms of acute rejection rates and side effect profiles.
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Affiliation(s)
- A Demirbaş
- Department of General Surgery, Akdeniz University, Antalya, Turkey
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73
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Abstract
Cigarette smoking may adversely influence patient and graft survival. In Europe and the United States the prevalence of cigarette smoking in dialysis patients is 35% to 40% and 25%, respectively. In Turkey, the estimated prevalence of cigarette smoking rate in the normal population is 26%. This study evaluated the rate of smoking in 63 cadaveric, and 158 living-related renal transplant recipients including (150 men, and 76 women of 38 +/- 12 years; range, 8 to 70) who were operated between 1986 and 2001. Demographic data were collected with a questionnaire delivered to patients during their routine outpatient visits. During this time period, 8 patients had died, 4 from hemophagocytic syndrome, 2 from cardiovascular disease, 1 from Kaposi sarcoma and 1 from a cerebrovascular accident. Twenty-three patients have lost their grafts. While at the time of transplantation 97 (42%) were smoking cigarettes, only 29 (12%) continued smoke after transplantation. Male gender significantly correlated with cigarette smoking (P =.000). Twelve smokers were single but 85 out of 97 were married, a statistically significant difference (P =.010). In contrast there was no significant relationship between pretransplant smoking and educational status (P =.354); graft loss and smoking (P =.129); or mortality and smoking (P =.224). There was a significant relationship between pretransplant and posttransplant smoking (P =.000). There was no relationship between pre- and post-transplant smoking and development of diabetes mellitus or hypertension. Interestingly the posttransplant serum albumin level was lower among smokers than nonsmokers (4.44 +/- 0.02 g/dL vs 4.30 +/- 0.02 g/dL; P =.019). There was a close relationship between transplantation duration and smoking.
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Affiliation(s)
- A Yavuz
- Akdeniz University, Faculty of Medicine, Department of Nephrology, Antalya, Turkey
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74
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Tuncer M, Kuru A, Isikli M, Sahin N, Celenk FG. Optimization of extracellular endoxylanase, endoglucanase and peroxidase production by Streptomyces sp. F2621 isolated in Turkey. J Appl Microbiol 2004; 97:783-91. [PMID: 15357728 DOI: 10.1111/j.1365-2672.2004.02361.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [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: 11/29/2022]
Abstract
AIMS To determine the effect of environmental conditions on the production of extracellular lignocellulose-degrading enzymes by Streptomyces sp. F2621 and to assess the potential use of these enzymes in the hydrolysis of lignocellulose material. METHODS AND RESULTS The production of extracellular lignocellulose-degrading enzymes, endoxylanase, endoglucanase and peroxidase during the growth of Streptomyces sp. F2621 in basal salts-yeast extract medium containing different carbon sources and the effect of a number of environmental parameters (e.g. carbon sources and concentrations, pH and temperature) were investigated. The highest endoxylanase (22.41 U ml(-1)) and peroxidase (0.58 U ml(-1)) activities were obtained after 2-4 days of incubation at 30 degrees C in a basal salts medium containing 0.4% (w/v) oat spelt xylan and 0.6% (w/v) yeast extract, corresponding to C : N ratio of 6 : 1. Cell-free extracellular enzyme preparations from the strain were capable of releasing both sugar and aromatic compounds during incubation with eucalyptus paper pulp, straw and xylan. Overall, 9.3% hydrolysis of xylan occurred after 24-h incubation. However the rates of hydrolysis of paper pulp and straw were approximately twofold less than xylan hydrolysis, although the total percentage hydrolysis of available substrate (24.5% and 16.3%, respectively) was greater than xylan hydrolysis. CONCLUSIONS The high levels of enzyme production achieved under batch cultivation conditions, coupled with no significant production of endoglucanase during the growth phase of organism and the release of both sugar and aromatic compounds from paper pulp and straw signify the suitability for these enzymes for industrial applications such as pulp and paper production. SIGNIFICANCE AND IMPACT OF THE STUDY The results highlight the environmental conditions for the production of extracellular lignocellulose-degrading enzymes by Streptomyces sp. F2621 and suggest the use of streptomycetes and/or their enzymes in industrial processes.
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Affiliation(s)
- M Tuncer
- Biyoloji Bölümü, Fen-Edebiyat Fakültesi, Mersin Universitesi, Ciftlikköy, Mersin, Turkey.
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75
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Yavuz A, Akbaş SH, Tuncer M, Kolağasi O, Cetinkaya R, Gürkan A, Demirbaş A, Gultekin M, Akaydin M, Ersoy F, Yakupoğlu G. Influence of inflammation on the relation between markers of iron deficiency in renal replacement therapy. Transplant Proc 2004; 36:41-3. [PMID: 15013295 DOI: 10.1016/j.transproceed.2003.11.054] [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] [Indexed: 11/24/2022]
Abstract
Iron deficiency is an important factor in the management of anemia in both dialysis and transplant patients. Serum ferritin and transferrin saturation (TS) may be influenced by the presence of inflammation. Recently, the soluble transferrin receptor (s-TfR) has been considered to be a marker of functional iron stores. In this study, parameters of the iron state were investigated in terms of agreement (assessed by kappa) with the diagnosis of iron deficiency and with inflammation. The study was performed in 38 hemodialysis, 31 continuous ambulatory peritoneal dialysis, and 21 anemic renal transplant patients. CRP and amyloid A protein (AAP) were studied as markers of inflammation. Iron deficiency was defined as ferritin <100 mg/L, TS <20%, or s-TfR >1.76 mg/mL. We observed that s-TfR levels were significantly related to both dialysis duration (r = 0.28 in dialysis and r = 0.60 in transplant patients, both P <.05) and PTH levels (r = 0.23 in dialysis and r = 0.55 in transplant patients, both P <.05). Among the transplant group, ferritin and TS, as well as TS and s-TfR were significantly related (r = 0.84 and r = -0.64, respectively), but not s-TfR and ferritin. Among the dialysis group, ferritin and TS, and also TS and s-TfR, were significantly related (r = 0.35 and r = -0.30, respectively), whereas s-TfR and ferritin were not. In the transplant group, the kappa value for agreement between ferritin and TS in the diagnosis of iron deficiency was 0.76 (P =.006), and 0.33 (P =.04), respectively. Among patients with CRP levels <0.3 mg/L or AAP levels <6.4 mg/L, the relation between parameters of iron state was more robust. The kappa value for agreement between ferritin and s-TfR was 0.49 (P =.006) in the dialysis group and 1 (P =.002) for that between ferritin and TS in the transplant group. Our results suggest that PTH levels may influence s-TfR levels. Discordance between ferritin, TS, and s-TfR as markers of iron deficiency might be explained by the effects of inflammation.
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Affiliation(s)
- A Yavuz
- Akdeniz University, Department of Nephrology, Antalya, Turkey
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76
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Akbas SH, Yavuz A, Tuncer M, Ruhi C, Gurkan A, Cetinkaya R, Demirbas A, Gultekin M, Akaydin M, Ersoy F. Serum cystatin C as an index of renal function in kidney transplant patients. Transplant Proc 2004; 36:99-101. [PMID: 15013312 DOI: 10.1016/j.transproceed.2003.11.024] [Citation(s) in RCA: 16] [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: 10/26/2022]
Abstract
Management of renal transplant patients requires periodic measurement of renal function, which is usually assessed by measuring the glomerular filtration rate (GFR). The most commonly used marker for GFR is serum creatinine, although muscle wasting and tubular secretion may lead to overestimation of the actual GFR. Serum concentrations of the low-molecular-weight proteins, cystatin C and beta(2)-microglobulin (B(2)M), may afford useful markers to determine a reduced GFR. We investigated whether these molecules provide reliable indicators of renal function in 75 renal transplant patients. Cystatin C and B(2)M correlated significantly with creatinine (r =.648, P <.05 and r =.578, P <.05, respectively). Inverse serum creatinine was superior to inverse cystatin C and inverse B(2)M when renal function equations were used (r =.95, P <.05, according to MDRD; r =.87, P <.05, according to Cockroft-Gault). Receiver operating characteristic (ROC) analysis was performed to quantitate the accuracy of the different markers to detect reduced GFR using a cutoff value of 70 mL/min. No significant difference between the areas under the ROC curves comparing cystatin C and B(2)M was observed; however, serum creatinine demonstrated a significantly greater value than cystatin C (.981 vs.724, P =.001). We conclude that serum creatinine is a more efficacious marker than serum cystatin C to assess renal function.
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Affiliation(s)
- S H Akbas
- Central Laboratory, Akdeniz University Faculty of Medicine, Antalya, Turkey.
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77
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Ongut G, Yavuz A, Ogunc D, Tuncer M, Ozturk F, Mutlu D, Donmez L, Colak D, Ersoy F, Yakupoglu G, Gultekin M. Seroprevalence of antibodies to legionella pneumophila in hemodialysis patients. Transplant Proc 2004; 36:44-6. [PMID: 15013296 DOI: 10.1016/j.transproceed.2003.11.061] [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] [Indexed: 11/20/2022]
Abstract
Patients with chronic renal failure are at increased risk for infections because of impaired cellular immunity. This study was designed to determine the prevalence of antibodies to Legionella pneumophila serogroups 1 to 6 and to evaluate the possible risk factors for Legionnaires' disease in hemodialysis patients. Serum samples to be screened for antibodies against L pneumophila and risk factor data were collected from 252 hemodialysis patients. The overall prevalence of L pneumophila antibodies in hemodialysis patients was found to be 5.16% There was no statistically significant difference between L pneumophila seropositivity and potential risk factors. Further studies are needed to determine possible risk factors for Legionnaires' disease in hemodialysis patients.
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Affiliation(s)
- G Ongut
- Department of Clinical Microbiology, Akdeniz University, Antalya, Turkey
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78
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Akbas SH, Yavuz A, Tuncer M, Yurdakonar E, Akcit F, Gurkan A, Demirbas A, Gultekin M, Ersoy F, Akaydin M. Evaluation of the new EMIT tacrolimus assay in kidney and liver transplant recipients. Transplant Proc 2004; 36:86-8. [PMID: 15013308 DOI: 10.1016/j.transproceed.2003.11.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 10/26/2022]
Abstract
Tacrolimus (FK506) is a potent macrolide immunosuppressant used for prevention of organ transplant rejection following transplantation. Monitoring of blood tacrolimus concentrations is essential to assess organ rejection and toxicity, because of the agent's narrow therapeutic range, wide inter- and intraindividual pharmacokinetic variability as well as drug interactions mediated by alteration in cytochrome P450. Several methods have been developed to monitor tacrolimus; immunoassays, bioassays, and HPLC/MS. The purpose of this study was to compare two analytical methods: the well-established MEIA II tacrolimus immunoassay using the IMx analyzer and the new EMIT 2000 tacrolimus immunoassay on the Cobas Integra 400 system. Tacrolimus results obtained using the two methods have been compared on 180 whole blood samples from kidney and liver transplant patients. The analytical sensitivities of both methods were defined as 1.2 ng/mL for EMIT and 1.5 ng/mL for MEIA II. The within-run CVs (n = 15) obtained with four-level controls were 9.08%, 9.41%, 5.23% and 4.4% for EMIT 2000. The comparison showed the following relationship between two methods: MEIA = 1.08.EMIT + 0.20 (r =.893). In conclusion, the EMIT 2000 tacrolimus immunoassay is a reliable alternative for the MEIA II method to monitor tacrolimus in organ transplant recipients. It provides a valid quantitative measurement of tacrolimus with comparable % CVs in quality-control as well as patient blood samples. Additionally, the EMIT 2000 method provides a rapid analysis of a large number of samples in one run with a low turnaround time and possibilities to reanalyze critical samples.
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Affiliation(s)
- S H Akbas
- Department of Central Laboratory, Akdeniz University, Antalya, Turkey
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79
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Akbas SH, Tuncer M, Gurkan A, Yucetin L, Yavuz A, Demirbas A, Ersoy F, Gultekin M, Yakupoglu G, Akaydin M. Plasma homocysteine levels in renal transplant patients on tacrolimus therapy. Transplant Proc 2004; 36:159-60. [PMID: 15013332 DOI: 10.1016/j.transproceed.2003.11.059] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Increased plasma total homocysteine levels afford an independent risk factor to assess cardiovascular morbidity in patients with normal and impaired renal function, including stable transplant recipients. The purpose of this study was to evaluate plasma homocysteine levels and factors known to influence homocysteine metabolism (folate and Vitamin B(12)) in renal transplanted patients treated with tacrolimus. Plasma homocysteine, serum folate and serum vitamin B(12) concentrations were measured in 18 cadaveric renal transplant patients with stable function both before and 3 months after the renal transplantation. While the mean plasma homocysteine level in the renal transplant group was significantly higher than in the control group, no significant change was observed following renal transplantation under tacrolimus therapy (16.84 +/- 6.43 micromol/L vs 16.02 +/- 6.54 micromol/L). The levels of folate before and after transplantation were considerably lower than the control group; a significant effect of tacrolimus has not been observed (7.32 +/- 4.68 ng/mL and 7.55 +/- 5.20 ng/mL). Serum vitamin B(12) levels in the transplant group were significantly lower than the control group; a significant decline was seen 3 months after the renal transplantation (448.94 +/- 230.03 pg/mL vs 334.38 +/- 240.61 pg/mL). Consequently, although plasma homocysteine levels of renal transplant recipients are higher, a lowering effect of tacrolimus therapy was not observed on plasma homocysteine levels. The lower levels of folate and Vitamin B(12) in the transplant group compared to a control group supports therapy with folate and Vitamin B(12) to decrease homocysteine concentrations.
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Affiliation(s)
- S H Akbas
- Akdeniz University, Faculty of Medicine, Central Laboratory, Clinical Biochemistry Unit, Antalya, Turkey.
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80
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Yavuz A, Tuncer M, Erdoğan O, Gürkan A, Cetinkaya R, Akbaş SH, Keçecioğlu N, Demirbas A, Akaydin M, Ersoy F, Yakupoğlu G. Is there any effect of compliance on clinical parameters of renal transplant recipients? Transplant Proc 2004; 36:120-1. [PMID: 15013319 DOI: 10.1016/j.transproceed.2003.11.052] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [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: 11/16/2022]
Abstract
Noncompliance with regard to diet, medications and routine physician visits is frequently observed among some patient groups. This results in late graft dysfunction and behavior loss. In the present study, we defined compliance as attendance at 80% or more outpatient visits. The study included 63 cadaveric and 158 living-related renal transplant recipients namely, 150 men and 76 women of 8 to 70 years of age (median 38 +/- 12) who were operated between 1986 and 2001. Demographic data, number of visits attended per month, cigarette smoking, and alcohol intake were probed with a questionnaire that was delivered to the patients, 8 of whom died; hemophagocytic syndrome (n = 4), cardiovascular disease (n = 2), Kaposi' sarcoma (n = 1), and cerebrovascular bleeding (n = 1). Twenty-three patients had lost their graft. Compliance among men was lower than among women, a result that trended toward statistical significance (P =.087). Compliance was not related to marital status (P =.297), but tended to increase with educational background (P =.059). Graft loss (P =.546) and aging (P =.509) were not related to compliance. There was no relationship between compliance and mortality rate (P =.526). Interestingly, living-related kidney transplant recipients showed lower compliance than cadaveric kidney recipients, a result that was statistically significant (P =.04). Noncompliance was also related to cigarette smoking during the pre- and posttransplant periods (P =.008 and P =.03, respectively), as well as alcohol intake (P =.000). In conclusion, male gender and living-related donation are related to noncompliance, but (in contrast with literature) not young age, graft loss, or mortality. Compliance increases with educational status of the patients. Smoking and alcohol intake are closely related to noncompliance.
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Affiliation(s)
- A Yavuz
- Akdentz University, Faculty of Medicine, Department of Nephrology, Antalya, Turkey
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81
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Oğünç G, Tuncer M, Oğünç D, Yardimsever M, Ersoy F. Laparoscopic omental fixation technique versus open surgical placement of peritoneal dialysis catheters. Surg Endosc 2003; 17:1749-55. [PMID: 12811666 DOI: 10.1007/s00464-002-8586-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [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: 05/17/2002] [Accepted: 02/03/2003] [Indexed: 03/03/2023]
Abstract
BACKGROUND Continuous ambulatory peritoneal dialysis (CAPD) is an effective form of treatment for patients with end-stage renal disease. Open insertion of peritoneal dialysis (PD) catheters is the standard surgical technique, but it is associated with a relatively high incidence of catheter outflow obstruction and dialysis leak. Omental wrapping is the most common cause of mechanical problems. The purpose of this study was to determine the efficacy of the laparoscopic omental fixation technique to prevent the obstruction caused by omental wrapping and also to compare this laparoscopic technique with open peritoneal dialysis catheter insertion with respect to postoperative discomfort, complication rates, and catheter survival. METHODS Between March 1998 and October 2001, 42 double-cuff, curled-end CAPD catheters were placed in 42 patients. The outcomes of the 21 patients in whom the PD catheters were placed laparoscopically with omental fixation technique were compared with those of the 21 patients in whom the catheters were placed with open surgical technique. Recorded data included patient demographics, catheter implantation method, early and late complications, catheter survival, and catheter outcome. RESULTS Early peritonitis episodes occurred in 8 of 21 patients (38.0%) in the open surgical group (OSG) versus 2 of 21 patients (9.5%) in the laparoscopic omental fixation group (LOFG) ( p < 0.05); late peritonitis episodes occurred in 3 of 21 patients (14.2%) in the OSG versus 1 of 21 patients (4.7%) in the LOFG ( p < 0.05). Early exit site infection occurred in 8 of 21 patients (38.0%) in the OSG versus 4 of 21 patients (19.0%) in the LOFG ( p < 0.05), with many catheter-related problems in the conventional surgical group. There was no outflow obstruction in the LOFG. The conventional procedure was faster than the laparoscopic omental fixation technique. Analgesic requirements and hospital stay were less in the laparoscopic group. Laparoscopic surgery also enabled diagnosis of intraabdominal pathologies and treatment of the accompanying surgical problems during the same operation. Occult inguinal hernia was diagnosed in 2 patients, inguinal hernioplasty was performed in 4 patients, adhesiolysis was performed in 8 patients who had previous abdominal surgery, and liver biopsy was taken in 2 patients. Ovarian cystectomy was performed in another patient during laparoscopic CAPD catheter placement. CONCLUSION The laparoscopic omental fixation technique (described by Oğünç and published in 1999) is a highly effective and successful method for preventing obstruction due to omental wrapping with a better catheter survival. Laparoscopic surgery also allows the diagnosis and treatment of the accompanying surgical pathologies during the same operation.
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Affiliation(s)
- G Oğünç
- Department of General Surgery, Akdeniz University Medical School, Dumlupinar Bulvari, 07070, Antalya, Turkey
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82
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Ozaltin F, Besbas N, Uckan D, Tuncer M, Topaloglu R, Ozen S, Saatci U, Bakkaloglu A. The role of apoptosis in childhood Henoch?Schonlein purpura. Clin Rheumatol 2003; 22:265-7. [PMID: 14576987 DOI: 10.1007/s10067-003-0718-1] [Citation(s) in RCA: 7] [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] [Received: 12/24/2002] [Accepted: 03/17/2003] [Indexed: 11/24/2022]
Abstract
The pathogenesis of vasculitis is complex and is yet to be fully elucidated, although it is known that inflammatory cells play a major role. Dysregulation of apoptosis and defective clearance of inflammatory cells could lead to the persistence of inflammation and excessive tissue injury. In this study we aimed to investigate Fas (CD95) and apoptosis on peripheral blood (PB) neutrophil and lymphocytes in Henoch-Schonlein purpura, both in the acute phase and after resolution to determine the role of apoptosis in this self-limited vasculitis. Leukocytoclastic vasculitis presenting with Henoch-Schonlein purpura (HSP) was diagnosed according to ACR 1990 criteria and confirmed by skin biopsy. Thirty-seven patients (22 boys, 15 girls) aged 2.5-17 years (9 +/- 3.3) were enrolled in the study. Expression of CD95 and apoptosis were investigated by the annexin/PI method on peripheral blood neutrophils and lymphocytes in both the acute and the resolution phases of the disease. The mean neutrophil and lymphocyte CD95 expression was 65.4 +/- 37.6% and 33.3 +/- 7.3%, respectively, in the acute stage and 62.8 +/- 44.2% and 41 +/- 20%, respectively, in the resolution ( P > 0.05). The percentage of apoptotic peripheral blood neutrophils and lymphocytes as determined by annexin positivity was 13.3 +/- 11.31% and 8.6 +/- 9.5%, respectively, during the acute phase and 4.6 +/- 3.4% and 3.1 +/- 3.1%, respectively, in the resolution (P = 0.002, P = 0.008). These results suggest that increased apoptotic process in the immune effector cells in the acute phase of the disease may play an important role in the early control of inflammatory response and repair in leukocytoclastic vasculitis, thereby contributing to the self-limited nature of the disease.
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Affiliation(s)
- F Ozaltin
- Hacettepe University Faculty of Medicine, Ankara, Turkey.
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83
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Tuncer M, Ball AS. Co-operative actions and degradation analysis of purified xylan-degrading enzymes from Thermomonospora fusca BD25 on oat-spelt xylan. J Appl Microbiol 2003; 94:1030-5. [PMID: 12752811 DOI: 10.1046/j.1365-2672.2003.01943.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To determine and quantify the products from the degradation of xylan by a range of purified xylan-degrading enzymes, endoxylanase, beta-xylosidase and alpha-l-arabinofuranosidase produced extracellularly by Thermomonospora fusca BD25. METHODS AND RESULTS The amounts of reducing sugars released from oat-spelt xylan by the actions of endoxylanase, beta-xylosidase and alpha-l-arabinofuranosidase were equal to 28.1, 4.6 and 7% hydrolysis (as xylose equivalents) of the substrate used, respectively. However, addition of beta-xylosidase and alpha-l-arabinofuranosidase preparation to endoxylanase significantly enhanced (70 and 20% respectively) the action of endoxylanase on the substrate. The combination of purified endoxylanase, beta-xylosidase and alpha-l-arabinofuranosidase preparations produced a greater sugar yield (58.6% hydrolysis) and enhanced the total reducing sugar yield by around 50%. The main xylooligosaccharide products released using the action of endoxylanase alone on oat-spelt xylan were identified as xylobiose and xylopentose. alpha-l-Arabinofuranosidase was able to release arabinose and xylobiose from oat-spelt xylan. In the presence of all three purified enzymes the hydrolysis products of oat-spelt xylan were mainly xylose, arabinose and substituted xylotetrose with lesser amount of substituted xylotriose. CONCLUSIONS The addition of the beta-xylosidase and alpha-l-arabinofuranosidase enzymes to purified xylanases more than doubled the degradation of xylan from 28 to 58% of the total substrate with xylose and arabinose being the major sugars produced. SIGNIFICANCE AND IMPACT OF THE STUDY The results highlight the role of xylan de-branching enzymes in the degradation of xylan and suggest that the use of enzyme cocktails may significantly improve the hydrolysis of xylan in industrial processes.
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Affiliation(s)
- M Tuncer
- University of Essex, Department of Biological Sciences, John Tabor Laboratories, Wivenhoe Park, Colchester, UK
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84
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Uckan D, Cetin M, Dincer N, Kalkan G, Tuncer M, Tezcan I. Serum zinc and alkaline phosphatase values in pediatric bone marrow transplantation patients. Pediatr Hematol Oncol 2003; 20:265-71. [PMID: 12746158] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Zinc (Zn) plays an important role in the maintenance of immune functions, including cellular/humoral immunity, and in the prevention of oxidative injury. Therefore, the maintenance of a normal Zn status may be important in bone marrow transplantation (BMT) patients. Serum Zn levels were determined in 35 children during the BMT period. In addition, as Zn-related factors, serum Cu levels and alkaline phosphatase (AP) activity were also measured. There was a significant decrease in Zn and AP values during the immediate post-transplant period (lowest at day +7) when compared to pre-BMT levels (p <.01). The patients who developed hypozincemia were more likely to be transplanted for a diagnosis of malignant disorder and were younger, and adverse events appeared to occur more frequently. This preliminary study suggests that maintaining a normal Zn status may be important in BMT patients and that Zn deficiency may be a risk factor for adverse events.
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Affiliation(s)
- D Uckan
- Hacettepe University Children's Hospital, Bone Marrow Transplantation Unit, Ankara, Turkey.
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85
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Uçkan D, Yetgin S, Cetin M, Ozyürek E, Okur H, Aslan D, Tuncer M. The effects of high dose methylprednisolone on apoptosis in children with acute lymphoblastic leukemia. Clin Lab Haematol 2003; 25:35-40. [PMID: 12542440 DOI: 10.1046/j.1365-2257.2003.00475.x] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Rapid leukemic cell kill at initial diagnosis of patients with acute lymphoblastic leukemia (ALL) has been shown to be associated with a favorable outcome. The aim of the present study was to investigate the effect of high dose methylprednisolone (HDMP) on in vivo blast cell apoptosis in children with ALL. Annexin V-binding and Fas (CD95), Fas ligand (FasL; CD95L), and Bcl-2 expression in PB blasts were determined in newly diagnosed children with ALL before and 4, 24, 96 h after initiation of HDMP treatment (n=20) or conventional dose steroids (CDS) (n=10) as the control group. A decrease in absolute blast count (from 40.8 x 09 to 21.4 x 109/l) associated with an increase in apoptosis (14.2 to 26.9%) (P < 0.05) was detected 4 h after initiation of HDMP. A significant increase in Fas and FasL expression was detected 96 h after HDMP. There was no significant change in apoptosis, Fas and FasL expression from baseline in the control group treated with CDS. The changes in Bcl-2 expression after treatment was not significant in both groups. The results of this preliminary study have shown that HDMP treatment was effective in inducing immediate (within 4 h) blast cell apoptosis. The contribution of Fas/FasL interaction in the rapid component of cell kill remains to be determined, as the increase in the expression of these molecules was evident later.
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Affiliation(s)
- D Uçkan
- Division of Paediatric Haematology, Ihsan Dogramac Children's Hospital, Hacettepe University, Ankara,
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86
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Abstract
Thermomonospora fusca produced a relatively high level of alpha-L-arabinofuranosidase when growing on oat spelt xylan as the main carbon and energy source. The enzyme exhibited maximum relative activity (0.136 U/g protein) at pH 9.0 with 54 and 55% activity remaining at pH of 4.5 and 11.0, respectively. The apparent Km value for the crude alpha-L-arabinofuranosidase preparation was 180 mumol/L 4-nitrophenyl alpha-L-arabinofuranoside; the upsilon lim value was the release of 40 mumol/L 4-nitrophenol per min. Enzyme activity was eluted as a single peak (HPLC gel filtration chromatography) corresponding to molar mass of approximately 92 kDa. Native electrophoresis of crude cell lysate confirmed the presence of a single active intracellular alpha-L-arabinofuranosidase component. SDS-PAGE of this enzyme, developed as zymogram, did not demonstrate any activity; denaturing gel was stained and a protein band of relative molar mass of 46 kDa was revealed. Isoelectric focusing of a purified alpha-L-arabinofuranosidase yielded a single protein band for the corresponding activity zone with pI 7.9. The enzyme was purified approximately 21-fold the mean overall yield was about 16%.
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Affiliation(s)
- M Tuncer
- Biyoloji Bölümü, Fen-Edebiyat Fakültesi, Mersin Universitesi, 33342 Mersin, Turkey.
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87
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Gurkan A, Tuncer M, Erdogan O, Colak T, Akaydin M, Yakupoglu G. Effect of HCV infection on graft survival in renal transplant patients. Transplant Proc 2002; 34:2129-30. [PMID: 12270340 DOI: 10.1016/s0041-1345(02)02878-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Gurkan
- Akdeniz University Medical School Transplantation Center, Department of Nephrology and General Surgery, Antalya, Turkey.
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88
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Tuncer M, Gürkan A, Yücetin L, Ersoy F, Demirbaş A, Akaydin M, Yakupoglu G. Evaluation of transplantation in one center: Akdeniz University model. Transplant Proc 2002; 34:2012-3. [PMID: 12270295 DOI: 10.1016/s0041-1345(02)02833-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M Tuncer
- Akdeniz University, Antalya, Turkey.
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89
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Affiliation(s)
- A Gurkan
- Akdeniz University Medical School Transplantation Center, Department of Nephrology, Antalya, Turkey.
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90
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Tuncer M, Gürkan A, Erdoğan O, Demirbaş A, Süleymanlar G, Ersoy FF, Akaydin M, Yakupoğlu G. Mycophenolate mofetil in renal transplantation: five years experience. Transplant Proc 2002; 34:2087-8. [PMID: 12270324 DOI: 10.1016/s0041-1345(02)02861-0] [Citation(s) in RCA: 8] [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: 11/20/2022]
Affiliation(s)
- M Tuncer
- Akdeniz University Medical School, Department of Nephrology, Antalya, Turkey
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91
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Erdoğan O, Yücetin L, Tuncer M, Keçecioğlu N, Gürkan A, Akaydin M, Yakupoğlu G. Attitudes and knowledge of Turkish physicians about organ donation and transplantation. Transplant Proc 2002; 34:2007-8. [PMID: 12270293 DOI: 10.1016/s0041-1345(02)02831-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- O Erdoğan
- Akdeniz University Medical School Transplant Center, Antalya, Turkey
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92
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Gurkan A, Tuncer M, Colak T, Erdoğan O, Demirbas A, Dosemeci L, Yakupoglu G. Comparison of tacrolimus and neoral-based immunosuppressive regimens in renal transplantation patients: singles-center experience. Transplant Proc 2002; 34:1661-2. [PMID: 12176525 DOI: 10.1016/s0041-1345(02)02970-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alihan Gurkan
- Department of General Surgery, Akdeniz University Medical School, 07070 Antalya, Turkey
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93
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Usta MF, Tuncer M, Baykal A, Ciftçioğlu MA, Erdoğru T, Köksal IT, Ersoy FF, Baykara M. Impact of chronic renal failure and peritoneal dialysis fluids on advanced glycation end product and iNOS levels in penile tissue: an experimental study. Urology 2002; 59:953-7. [PMID: 12031393 DOI: 10.1016/s0090-4295(01)01674-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 10/16/2022]
Abstract
OBJECTIVES To investigate the impact of chronic renal failure (CRF) on advanced glycation end product and inducible nitric oxide synthase (iNOS) in penile tissue, we examined the advanced glycation end product 5-hydroxy methyl furfural (5-HMF) content and iNOS expression in rats in which uremia had been produced by greater than 85% nephrectomy. In addition, the contribution of peritoneal dialysis (PD) fluids to the elevation of penile tissue 5-HMF levels and iNOS staining scores has been investigated. METHODS Adult male Wistar rats, aged between 10 and 12 weeks and weighing 200 to 330 g, were divided into five groups that each included 6 animals. The first group served as a control group. In the second group, CRF was induced and a peritoneal catheter was implanted, but PD was not performed. In group 3, CRF was induced and PD was performed using dialysis fluids containing 1.36% glucose and icodextrin. In group 4, CRF was also induced and PD was performed using 3.86% glucose and icodextrin. Finally, in group 5, without CRF, an indwelling catheter was implanted, and the PD procedure was performed using dialysis fluids containing 3.86% glucose and icodextrin. RESULTS The elevation in 5-HMF levels and iNOS staining scores in penile tissue from groups 2, 3, 4, and 5 was significant compared with group 1 (P <0.05). The elevation in 5-HMF levels and iNOS staining scores was also significant between groups 2 and 3, 2 and 4, 3 and 4, 3 and 5, and 4 and 5 (P <0.05). Moreover, the correlation between the 5-HMF levels and iNOS staining scores was statistically significant (r = 0.525, P = 0.003). CONCLUSIONS In the present experimental study, we found that 5-HMF levels and iNOS staining scores were significantly elevated in rat penile tissue in which uremia had been produced compared with the groups without CRF. Additionally, PD fluids containing glucose had an effect on the elevation of penile tissue 5-HMF levels and iNOS staining scores.
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Affiliation(s)
- M F Usta
- Department of Urology, Akdeniz University Faculty of Medicine, Antalya, Turkey
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94
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Tuncer M, Ball AS. Degradation of lignocellulose by extracellular enzymes produced by Thermomonospora fusca BD25. Appl Microbiol Biotechnol 2002; 58:608-11. [PMID: 11956742 DOI: 10.1007/s00253-001-0894-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [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: 10/04/2001] [Accepted: 10/26/2001] [Indexed: 10/27/2022]
Abstract
Degradation products from the addition of extracellular enzymes from Thermomonospora fusca BD25 to ball-milled wheat straw, oat spelt xylan and solubilised kraft pulps were characterised by HPLC and TLC. Overall, a high percentage hydrolysis of oat spelt xylan (28.9%) occurred after 26 h incubation. However, the rates of hydrolysis of ball-milled wheat straw and kraft pulp were approximately 4-6-fold less than xylan hydrolysis, although the total percentage hydrolysis of available substrate was similar (22.2% and 25.9% respectively). Incubation of kraft pulp and ball-milled wheat straw by crude extracellular enzymes of T. fusca BD25 resulted in the detection of aromatic compounds at concentrations of 0.6 microg ml(-1) and 8.7 microg ml(-1), respectively. Hydrolysis of oat spelt xylan by T. fusca BD25 extracellular enzymes yielded a mixture of xylose, xylotriose and putative substituted-xylotriose, while the products of ball-milled wheat straw hydrolysis were xylose, glucose and a small oligomer present in the digest. The results highlight the ability of culture supernatant from T. fusca to release both simple sugars and aromatic compounds from lignocellulosic substrates and suggest a role for this organism in the biobleaching of pulp.
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Affiliation(s)
- M Tuncer
- Mersin Universitesi, Fen-Edebiyat Fakültesi, Biyoloji Bölümü, Ciftlikköy Kampüsü, 33342 Mersin, Turkey
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95
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Canbakan B, Canbakan M, Oz V, Tuncer M, Demir M. [Blindness as a complication of hepatic encephalopathy]. Wien Med Wochenschr 2002; 151:477-80. [PMID: 11817261] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Hepatic (portal-systemic) encephalopathy is a complex neuropsychiatric syndrome characterized by disturbances in consciousness and behaviour, personality changes, fluctuating neurologic signs, asterixis or "flapping tremor" and distinctive electroencephalographic changes (11). We report a case of hepatic-encephalopathy accompanied by transient cortical blindness.
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Affiliation(s)
- B Canbakan
- Abteilung für Gastroenterologié, Universitätsklinik Cerrahpaşa, Istanbul, Türkei
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96
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Hiçsönmez G, Cetin M, Yenicesu I, Olcay L, Koç A, Aktaş D, Tunçbilek E, Tuncer M. Evaluation of children with myelodysplastic syndrome: importance of extramedullary disease as a presenting symptom. Leuk Lymphoma 2001; 42:665-74. [PMID: 11697496 DOI: 10.3109/10428190109099328] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [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: 11/13/2022]
Abstract
Thirty-three children diagnosed with primary myelodysplastic syndrome (MDS) in a single institution over an 8 year period were evaluated with special emphasis on children who presented with extramedullary disease (EMD). EMD was present at diagnosis in 12 (36%) of the 33 children with MDS. Three patients with juvenile myelomonocytic leukemia (JMML) and 2 patients with chronic myelomonocytic leukemia (CMML) presented with pleural effusion. Pericardial effusion was present in 3 of these patients, two of whom also had thrombosis. Pyoderma gangrenosum, relapsing polychondritis were the initial findings in another two cases with JMML. Lymphadenopathy (n=1), gingival hypertrophy (n=2), orbital granulocytic sarcoma (n=1) and spinal mass (n=1) were the presenting findings in 5 patients with refractory anemia with excess of blasts in transformation. Since high-dose methylprednisolone (HDMP, 20-30 mg/kg/day) has been shown to induce differentiation and apoptosis of myeloid leukemic cells in children with different morphological subtypes of acute myeloid leukemia in vivo and in vitro, 25 children with de novo MDS were treated with combined HDMP and cytotoxic chemotherapy. Dramatic improvement of EMD and decrease in blast cells both in the peripheral blood and bone marrow were obtained following administration of short-course HDMP treatment alone as observed in children with AML. HDMP, combined with low-dose cytosine arabinoside and mitoxantrone were used for the remission induction. Remission was achieved in 8 (80%) of 10 children who presented with EMD and in 9 (60%) of 15 children without EMD. Long-term remission (>6 years) was obtained in 4 (two with JMML and two with CMML), three of whom presented with EMD. In conclusion EMD can be a presenting finding in childhood MDS as observed in adults. In addition, the beneficial effect of HDMP combined with more intensive chemotherapy should be explored as alternative therapy in children with MDS not suitable for bone marrow transplantation.
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Affiliation(s)
- G Hiçsönmez
- Department of Pediatric Hematology, Ihsan Dogramaci Children's Hospital, Hacettepe University, Ankara, Turkey
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97
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Süleymanlar G, Tuncer M, Sarikaya M, Ersoy F, Aktan S, Yakupoğlu G, Karpuzoğlu T. The cost effectiveness of mycophenolate mofetil in the first year after living related renal transplantation. Transplant Proc 2001; 33:2780-1. [PMID: 11498158 DOI: 10.1016/s0041-1345(01)02189-3] [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: 11/28/2022]
Affiliation(s)
- G Süleymanlar
- Department of Nephrology, Akdeniz University Medical School, Antalya, Turkey
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98
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Yetgin S, Yenicesu I, Cetin M, Tuncer M. Clinical importance of serum vascular endothelial and basic fibroblast growth factors in children with acute lymphoblastic leukemia. Leuk Lymphoma 2001; 42:83-8. [PMID: 11699225 DOI: 10.3109/10428190109097679] [Citation(s) in RCA: 39] [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] [Indexed: 11/13/2022]
Abstract
The aim of this study is to evaluate, for the first time serum levels of vascular endothelial growth factor (s-VEGF), and basic fibroblast growth factor (s-b FGF) in children with acute lymphoblastic leukemia (ALL), and its relation to clinical manifestations of the disease. Although VEGF and b FGF have been suggested to be reliable prognostic indicators and important tools for treatment approach in malignant haematopoietic and solid tumours, experience in childhood ALL has been limited to only one study on angiogenesis and urine b FGF. All 31 ALL patients included in the present study at the time of diagnosis and in remission, and all 10 control children had detectable serum levels of VEGF and b FGF. The median level of s-VEGF at the time of diagnosis was significantly lower than in the control group and at the time of remission (respectively p = 0.005, p = 0.0001). Twenty six of 31 patients had an increasing trend of s-VEGF levels in remission reaching control values compared with the levels obtained at diagnosis. S-b FGF median levels at the time of diagnosis were the same as those of the control group, significantly lower than the median s-b FGF values in remission (p = 0.001). In patients with lower platelet counts (< 50 x 10(9)/L) growth factors (VEGF and b FGF) were lower than in patients with higher platelet counts (p = 0.0009 and p = 0.002 respectively). In patients with hepatosplenomegaly (longitudinal size > 3 cm) b FGF levels were higher than patients without hepatosplenomegaly (P = 0.003). We concluded that the increment in both s-VEGF and s-b FGF in patients in remission may be related to the renewal of normal haematopoiesis. The increase in s-VEGF values in 26 out of 31 patients in remission compared to normal control values, may also suggest that there is clinical significance in ALL patients.
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Affiliation(s)
- S Yetgin
- Department of Pediatric Haematology, Ihsan Dogramaci Children's Hospital, Hacettepe University, 06100, Ankara, Turkey.
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99
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Affiliation(s)
- M Tuncer
- Dept. of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey
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100
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Emre-Aydíngöz S, Erdem SR, Tuncer M. Relaxation induced by serotonin and sumatriptan in isolated guinea pig gallbladder strips. Res Exp Med (Berl) 2001; 200:175-82. [PMID: 11426669] [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: 02/20/2023]
Abstract
The effects of 5-hydroxytryptamine (5-HT) and sumatriptan were investigated on isolated guinea pig gallbladder strips. While 0.1 microM-50 mM of 5-HT exhibited contractile and/or relaxant effects in quiescent preparations, the same concentrations of sumatriptan did not. On the other hand, carbachol-precontracted tissues were relaxed by the same amounts of 5-HT and sumatriptan in a concentration-dependent manner. The relaxant responses to 5-HT were not antagonized or changed by tetrodotoxin, indomethacin, capsaicin, NG-nitro-L-arginine (L-NOARG), GR55562 [(+/-)-propranolol, 3-[3-(N,N-dimethylamino)propyl 1-4-hydroxy-N-[4-(pyridin-4-yl)phenyl]benzamide , S(-)-propranolol, methysergide, ketanserin. tropisetron, GR 113808 ([1-[2-(methylsulphonylamino)ethyl -4-piperidinyl]methyl-1-methyl-1H-indole-3-carboxylate maleate salt). pargyline, and fluvoxamine. The relaxant responses to sumatriptan were antagonized by GR55562 but not by S(-)-propranolol. These results suggest that 5-HT and sumatriptan cause relaxation in carbachol-precontracted isolated guinea pig gallbladder strips by yet undefined mechanisms.
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Affiliation(s)
- S Emre-Aydíngöz
- Hacettepe University, Faculty of Medicine, Department of Pharmacology, Sihhiye, Ankara, Turkey
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