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Demir A, Büyükgebiz A, Aydin A, Hero M. Quantification of overnight urinary gonadotropin excretion predicts imminent puberty in girls: a semi-longitudinal study. Hormones (Athens) 2024; 23:141-150. [PMID: 37934386 PMCID: PMC10847198 DOI: 10.1007/s42000-023-00499-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE We explored the alternative of using overnight fold change in gonadotropin levels by comparing the last-night-voided (LNV) and first-morning-voided (FMV) urine concentrations of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) as a conceptual analogy to the invasive gonadotropin-releasing hormone (GnRH) stimulation test setting. METHODS We investigated the nocturnal changes in the immunoreactivity levels of urinary gonadotropins between early and late prepubertal stages as well as between early and late pubertal stages in FMV and LNV urine samples from 30 girls, of whom those who were prepubertal were further investigated through follow-up visits within the 1-year period from the start of the study. RESULTS ROC analysis revealed that the FMV total U-LH and FMV U-FSH concentrations at or above 0.3 IU/L and 2.5 IU/L, respectively, were excellent predictors of forthcoming onset of puberty within 1 year (100% sensitivity, 100% specificity, AUC: 1.00, and n = 10, for both). FMV total U-LH concentration at or above 0.8 IU/L represented the cut-off for clinical signs of puberty. FMV/LNV total U-LH and FMV/LNV U-FSH ratios at or below 4.11 and 1.38, respectively, were also good predictors of the onset of clinical puberty within 1 year. An overnight increase (FMV/LNV ratio) in total U-LH concentrations and in the U-LH/U-FSH ratio at or below 1.2-fold in pubertal girls was associated with the postmenarcheal pubertal stage. CONCLUSION FMV total U-LH and U-FSH above 0.3 IU/L and 2.5 IU/L, respectively, can be used as cut-off values to predict the manifestation of the clinical signs of puberty within 1 year. FMV total U-LH concentrations 0.3-0.8 IU/L and 0.6 IU/L may represent the range and the threshold, respectively, that reflect the loosening of the central brake on the GnRH pulse generator. An overnight increase of 20% or less in total U-LH concentrations and in the U-LH/U-FSH ratio in an early pubertal girl may serve as an indicator of imminent menarche, a presumed timing of which can be unraveled by future longitudinal studies.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2 C, 6th Floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland.
| | - Atilla Büyükgebiz
- Department of Pediatrics, Division of Pediatric Endocrinology, Demiroğlu Bilim University, İstanbul, Türkiye
| | - Adem Aydin
- Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2 C, 6th Floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland
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Demir A, Büyükgebiz A, Aydin A, Hero M. Correction: Quantification of overnight urinary gonadotropin excretion predicts imminent puberty in girls: a semi-longitudinal study. Hormones (Athens) 2024; 23:151. [PMID: 38015414 PMCID: PMC10847179 DOI: 10.1007/s42000-023-00512-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- And Demir
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2 C, 6th Floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland.
| | - Atilla Büyükgebiz
- Department of Pediatrics, Division of Pediatric Endocrinology, Demiroğlu Bilim University, Istanbul, Türkiye
| | - Adem Aydin
- Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, İzmir, Türkiye
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2 C, 6th Floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland
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Demir A, Böber E, Darcan S, Aydın A, Stenman UH, Büyükgebiz A, Hero M. The negative impact of levothyroxine treatment on urinary luteinizing hormone measurements in pediatric patients with thyroid disease. Front Endocrinol (Lausanne) 2023; 14:1236710. [PMID: 38161981 PMCID: PMC10756903 DOI: 10.3389/fendo.2023.1236710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Previous studies suggest urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements by immunofluorometric assays (IFMA) as noninvasive alternatives to serum assays for puberty assessment. However, these studies excluded patients with other endocrine disorders and those taking medications. Besides, the recent discontinuation of IFMA manufacturing is a concern. We explored the utility of luminometric assays (LIA) for urinary gonadotropins and thyroid-stimulating hormone (TSH) determinations in euthyroid patients with thyroid pathologies. Methods We used LIA and IFMA assays to measure serum and first-morning-voided (FMV) urine LH, FSH, and TSH concentrations in euthyroid patients with various thyroid disorders. Of the 47 euthyroid patients with normal serum TSH (S-TSH) levels, 14 were receiving levothyroxine therapy. Results FMV total urinary LH (U-LH) concentrations correlated significantly with those measured in serum using either LIA (r=0.67, P<.001) or IFMA (r=0.83, P=.003) in patients not receiving levothyroxine treatment; however, no significant correlation could be detected in patients receiving levothyroxine regardless of the assay method (for LIA: r=0.50, P=.08 and IFMA r=0.44, P=.15). Urinary TSH (U-TSH) concentrations correlated poorly with those in serum in both the untreated and the treated groups (r=-0.13, P=.49, and r=-0.45, P=.11, respectively). Conclusion FMV total U-LH determinations by LIA can be used to assess pubertal development in patients with thyroid pathology, provided the euthyroid patient is not on levothyroxine treatment. U-TSH measurements by LIA cannot replace invasive S-TSH measurements at least in patients with normal S-TSH levels. Further research may reveal the utility of U-TSH determinations in patients with elevated S-TSH levels.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ece Böber
- Department of Pediatrics, Division of Pediatric Endocrinology, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye
| | - Sükran Darcan
- Department of Pediatrics, Division of Pediatric Endocrinology, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Adem Aydın
- Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry; University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Atilla Büyükgebiz
- Department of Pediatrics, Division of Pediatric Endocrinology, Demiroğlu Bilim University, Istanbul, Türkiye
| | - Matti Hero
- Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Demir A, Aydin A, Büyükgebiz A. Urine Sampling Protocol Recommendations for Reliable Determination of Total Urinary Luteinizing Hormone Immunoreactivity in the Pediatric Population. Children (Basel) 2023; 10:1919. [PMID: 38136121 PMCID: PMC10741787 DOI: 10.3390/children10121919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023]
Abstract
This study investigates day-to-day variations in urinary luteinizing hormone (U-LH) concentrations in children, focusing on potential minimization or correction methods. 95 children and adolescents (51 boys, 44 girls, ages 5-17) provided daytime and evening urine samples for U-LH determinations over three consecutive days. No consistent day-to-day differences in U-LH levels were observed, although random variations, particularly in adolescents aged 13 or older, were noted. The net inter-assay CV% for U-LH changes over three days showed high variability, averaging 24.6% to 28.0% for boys and 21.6% to 27.3% for girls, independent of sex, collection time, or U-LH level. To reliably determine total urinary luteinizing hormone immunoreactivity in the pediatric population, it is advisable to collect multiple first-morning voided samples for at least three consecutive days as an interim solution, pending the development of a standardized protocol or correction method for varying urine composition. Strict adherence, especially for adolescents aged 13 or older, is vital.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland
| | - Adem Aydin
- Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University, Izmir 35340, Türkiye
| | - Atilla Büyükgebiz
- Department of Pediatrics, Division of Pediatric Endocrinology, Demiroğlu Bilim University, Istanbul 34394, Türkiye
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Demir A, Hero M, Juul A, Main KM. Sex-independent timing of the onset of central puberty revealed by nocturnal luteinizing hormone concentrations. Clin Endocrinol (Oxf) 2023; 99:552-558. [PMID: 37772429 DOI: 10.1111/cen.14974] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE We designed a longitudinal study to investigate the association between the ages of central pubertal activation and the appearance of clinical signs of puberty and determined total luteinizing hormone (LH) immunoreactivity in daytime- and nocturnal sleeptime-excreted urine samples. PATIENTS AND MEASUREMENTS Thirty healthy volunteers (17 boys and 13 girls, aged 3.4-15.2 years and 4.3-14.3 years, respectively, at the beginning of the study) were included. Male and female subjects were followed for an average of 15 visits during 5.5 and 5.8 years on average, respectively. At each visit, subjects provided 24-h urine samples divided into nocturnal sleeptime and waketime portions according to the participant's sleep-and-wake rhythm. Total urinary LH (U-LH) concentrations were measured in duplicate by Delfia® IFMA (Wallac), which has been designed specifically to detect intact LH as well as the beta subunit and its core fragment, but not the human chorionic gonadotropin. RESULTS The initial increases in nocturnal sleeptime total U-LH concentrations over the cutoff value of 0.7 IU/L occurred at around the same time (around 9-10 years of age) in both sexes, which could not be detected in waketime urine samples. The mean first age for the nocturnal sleeptime total U-LH concentrations to reach or surpass the cutoff was 10.7 years (range: 10.2-11.6 years) in boys and 11.8 years (range: 10.7-13.4 years) in girls, showing no statistically significant difference between the sexes (p = .15). The mean time span from the age at which sleeptime total U-LH concentration first exceeded the 0.7 IU/L level to observing pubertal stage 2 was 1.5 years in boys and 0.1 years in girls. CONCLUSIONS Findings in our population with a limited sample size suggest that the timing of central pubertal activation is a sex-independent phenomenon, which can be observed by monitoring the nocturnal sleeptime total LH concentrations in urine. The lag time from central pubertal activation of gonadotropin secretion to the clinical onset of puberty is significantly longer in boys.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Çelebi Çelik F, Soyöz Ö, Sancaklı Ö, Özen Bölük S, Taşkırdı İ, Kaya M, Akay Hacı İ, Demir A, Karkıner C, Can D. The effect of the COVID-19 pandemic lockdown on symptom severity in school children with house dust mite-sensitized allergic rhinitis. Rev Fr Allergol (2009) 2022; 62:678-683. [PMID: 35875051 PMCID: PMC9289125 DOI: 10.1016/j.reval.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/11/2022] [Indexed: 01/25/2023]
Abstract
Study objective The lockdown imposed on children due to the COVID-19 pandemic and their inability to attend school increased their exposure to indoor allergens by causing them to spend more time indoors. In this study, the aim was to reveal the effect of the pandemic and increased exposure to indoor aeroallergens on the symptom severity of school-age children with house dust mite-sensitized allergic rhinitis (AR). Patients and methods Patients between the ages of 6-18-years old, who were followed-up with the diagnosis of perennial AR sensitized to only mites were questioned about their sinonasal symptoms. The Total Nasal Symptom Score (TNSS) questionnaire was performed. The clinical findings, drug usage, frequency of infections and attacks were evaluated and compared during COVID-19 lockdown and the same time frame in 2019. Results Sixty-five patients had AR, and 33 patients (50.8%) had AR with asthma. TNSS of the patients improved during the pandemic (P < 0.001) and their medication scores decreased significantly (P < 0.001). The frequency of respiratory tract infections and asthma attacks decreased significantly (P < 0.001). In multivariate analysis, risk factors were evaluated for the 'group with worsening TNSS' and coal/wood burning was detected to be an independent risk factor (P = 0.006; OR = 10.09 (95% CI: 1.97-51.87)). Conclusion Although the increased stay at home, it is surprising that nasal symptoms improved in our patients. This result suggests that whereas allergen sensitivity is responsible for the pathogenesis of AR, exposure to pollution and viral infections which are reduced by masking and social distance may also play an important role in the pathogenesis.
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Okutan M, Coşkun R, Yalçın O, Babuçoğlu A, Demir A. Investigation of the Dielectric and Optic Properties of Rosehip Seed Extract Loaded Hydrogels. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.134480] [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: 11/06/2022]
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Soyoz O, Sancakli O, Celik F, Boluk S, Taskirdi I, Haci I, Kaya M, Demir A, Karkiner C, Can D. Cold urticaria in children may be the cause of anaphylaxis: Clinical findings of our patients. Revue Française d'Allergologie 2022. [DOI: 10.1016/j.reval.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Karadas U, Saylam GS, Yilmaz N, Kir M, Kizilca Ö, Demircan T, Ugurlu B, Ünal N, Demir A. Assessment of ventricular septal defects by real-time three-dimensional echocardiography and comparison with surgical measurements. Progress in Pediatric Cardiology 2022. [DOI: 10.1016/j.ppedcard.2022.101546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Demir A, Hero M, Alfthan H, Passioni A, Tapanainen JS, Stenman UH. Identification of the LH surge by measuring intact and total immunoreactivity in urine for prediction of ovulation time. Hormones (Athens) 2022; 21:413-420. [PMID: 35614178 PMCID: PMC9464748 DOI: 10.1007/s42000-022-00368-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 04/07/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In our earlier study, we separated three different molecular forms of urinary LH-ir (U-LH-ir) by gel filtration and identified them by immunoassay in urine from regularly menstruating women on periovulatory days. U-LH-ir is composed of intact luteinizing hormone (LH), its free beta-subunit (LHβ), and the core fragment of LHβ (LHβcf), the latter two establishing the non-intact portion of LH-ir. The aim was to determine whether timing of ovulation can be improved by detecting different molecular forms of U-LH-ir in women of reproductive age. METHODS We determined intact and total U-LH-ir in 14 regularly menstruating women on consecutive periovulatory days during the menstrual cycle. Non-intact LH-ir was calculated as the arithmetic difference between total and intact LH-ir. In addition, LH-ir was determined in both serum and urine from four of the women throughout the menstrual cycle. RESULTS During the LH surge, U-LH-ir consisted mainly of intact LH and presented with an abrupt increase. Intact U-LH-ir dropped rapidly within 1 day after the surge, reaching baseline levels at the end of the luteal phase. In contrast, LHβcf in urine increased further 1 day after the surge. After this, most of the U-LH-ir consisted of LHβcf and it remained strongly elevated (over fivefold compared to intact LH) for the first 3 days after the LH surge, moderately elevated (over threefold) thereafter until day + 5, and mildly elevated until day + 7. CONCLUSIONS Total and non-intact LH-ir are potential add-on characteristics which can be utilized in ovulation predictor kits to measure LH-ir in urine beyond the LH surge during a broader time frame, thereby paving the way for more precise prediction of the timing of ovulation than that obtained with currently available products.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum II, 6th floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland.
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum II, 6th floor, Tukholmankatu 8 A, FIN-00290, Helsinki, Finland
| | | | - Amro Passioni
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Medical Research Center, PEDEGO Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
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Yiğit Özay H, Demir A, Balci E, Bahçecitapar M, Özgök A. The effects of total intravenous and inhalation anesthesia maintenance on tissue oxygenation in coronary artery bypass graft surgery. Eur Rev Med Pharmacol Sci 2022; 26:4279-4288. [PMID: 35776028 DOI: 10.26355/eurrev_202206_29066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the effect of total intravenous anesthesia (TIVA) and inhalational anesthesia techniques on tissue oxygenation in cardiac surgery. We compared the effects of midazolam-based TIVA and sevoflurane-based (SEVO) inhalation anesthesia maintenance on intraoperative central and regional tissue oxygenation parameters. PATIENTS AND METHODS A total of 104 adult patients who were scheduled for elective isolated coronary bypass surgery were included in the study. All patients were divided into two groups: the TIVA group consisted of total intravenous anesthesia maintenance patients (n=52) and the SEVO group consisted of patients with inhalation anesthesia with sevoflurane maintenance (n=52). Tissue oxygenation values were observed with left-right cerebral and somatic left forearm Near-Infrared Spectroscopy (NIRS) sensors. The hemodynamic parameters, NIRS StO2, central (ScvO2) and peripheral venous oxygen saturations of the patients were recorded at six intraoperative time points. RESULTS The effects of midazolam-based TIVA and sevoflurane-based inhalation anesthesia maintenance on intraoperative central and peripheral tissue oxygenation parameters were compared and it was found that in the left forearm NIRS StO2 and ScvO2 values were higher in the SEVO group than the TIVA group. Although not significantly different, forearm regional venous oxygen saturation was also higher in the SEVO group. CONCLUSIONS The effects of anesthetic drugs on regional tissue oxygenation can become important in critical patients and challenging surgeries. Sevoflurane-based anesthesia provides better tissue oxygenation than TIVA in patients undergoing coronary bypass surgery.
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Affiliation(s)
- H Yiğit Özay
- Anesthesiology and Reanimation Department, Health Sciences University, Ankara City Hospital, Ankara, Turkey.
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Demir A, Hero M, Alfthan H, Passioni A, Tapanainen JS, Stenman UH. Intact luteinizing hormone (LH), LHβ, and LHβ core fragment in urine of menstruating women. Minerva Endocrinol (Torino) 2022:S2724-6507.22.03565-5. [PMID: 35166468 DOI: 10.23736/s2724-6507.22.03565-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
OBJECTIVES We examined different molecular forms of luteinizing hormone (LH) in urine samples taken during periovulatory days with the aim of revealing different forms of LH immunoreactivity (LH-ir) in normally menstruating women. METHODS Serum and first-morning-voided urine serum samples were obtained from six healthy, 22 to 38 years old, regularly menstruating women during their periovulatory days based on their previous menstrual cycles. The day of the LH surge was determined on the basis of serum LH concentrations and confirmed by an at least two-fold increase in urinary concentrations of intact LH on consecutive days. Different molecular forms of LH-ir were identified by gel filtration of first-morning-voided urine samples obtained from regularly menstruating women on periovulatory days. RESULTS Different forms of LH immunoreactivity (LH-ir) were distinguished as intact LH, its free beta-subunit (LHβ), and the core fragment of LHβ (LHβcf) according to their molecular sizes. The latter two are also called non-intact LH. Intact LH was the dominating form on the day before and on the day of LH surge while LHβcf was the major form of LH immunoreactivity after the LH surge for the following 5-7 days. LHβ was detected on the day of the LH surge as well as on the following day. CONCLUSIONS These results indicate that LH is degraded in the kidneys and excreted as LHβ, and mainly as LHβcf for 7 days following the LH peak.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland -
| | - Matti Hero
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Amro Passioni
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, Department of Obstetrics and Gynecology, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Helsinki University Hospital, Helsinki, Finland
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Demir A, Hero M, Holopainen E, Juul A. Quantification of urinary total luteinizing hormone immunoreactivity may improve the prediction of ovulation time. Front Endocrinol (Lausanne) 2022; 13:903831. [PMID: 36277692 PMCID: PMC9581300 DOI: 10.3389/fendo.2022.903831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/19/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Most of the currently available ovulation prediction kits provide a relatively rough estimation of ovulation time with a short fertility window. This is due to their focus on the maximum probability of conception occurring one day before ovulation, with no follow-up after LH surge until ovulation nor during the subsequent days thereafter. Earlier studies have shown that urine of reproductive age women contains at least 3 different molecular forms of luteinizing hormone (LH); 1) intact LH, 2) LH beta-subunit (LHβ) and a 3) small molecular weight fragment of LHβ, LHβ core fragment (LHβcf). The proportion of these LH forms in urine varies remarkably during the menstrual cycle, particularly in relation to the mid-cycle LH surge. In this exploratory study, we studied the potential implications of determining the periovulatory course of total LH immunoreactivity in urine (U-LH-ir) and intact LH immunoreactivity in serum (S-LH-ir) in the evaluation of the fertility window from a broader aspect with emphasis on the post-surge segment. METHODS We determined total U-LH-ir in addition to intact S-LH-ir, follicle-stimulating hormone (FSH), progesterone, and estradiol in 32 consecutive samples collected daily from 10 women at reproductive age. Inference to the non-intact U-LH-ir levels was made by calculating the proportion of total U-LH-ir to intact S-LH-ir. RESULTS Total U-LH-ir increased along with LH surge and remained at statistically significantly higher levels than those in serum for 5 consecutive days after the surge in S-LH-ir. S-LH-ir returned to follicular phase levels immediately on the following day after the LH surge, whereas the same took 7 days for total U-LH-ir. CONCLUSIONS The current exploratory study provides preliminary evidence of the fact that U-LH-ir derived from degradation products of LH remains detectable at peak levels from the LH surge until ovulation and further during the early postovulatory period of fecundability. Thus, non-intact (or total) U-LH-ir appears to be a promising marker in the evaluation of the post-surge segment of the fertility window. Future studies are needed to unravel if this method can improve the prediction of ovulation time and higher rates of fecundability in both natural and assisted conception.
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Affiliation(s)
- And Demir
- New Childrenʼs Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: And Demir,
| | - Matti Hero
- New Childrenʼs Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elina Holopainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University – Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Demir A, Özdemir Karadas N, Karadas U. Effect of Breastfeeding and Preterm Births on the Severity of Lower Respiratory Tract Infections and Associated Risk of Hospitalization in Infants and Toddlers. Glob Pediatr Health 2022; 9:2333794X221089762. [PMID: 35747896 PMCID: PMC9210102 DOI: 10.1177/2333794x221089762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
We studied the effect of duration of breastfeeding and history of prematurity on the duration of hospitalization in infants with lower respiratory tract infections (LRTI) because these may reflect the severity of illness as well as sizable direct and indirect healthcare costs. One hundred twenty-five patients (49 girls, 76 boys; aged 1-24 months) were hospitalized for LRTI during a period of 102 days and studied prospectively. We found a significant difference ( P = .045) between the durations of hospitalization of the 92 patients breastfed for at least six months, compared to the other group of 33 patients who were breastfed for less than six months. The durations of hospitalization among the groups with and without a history of prematurity were not statistically different ( P = .78). A history of breastfeeding for more than six months had significant effect on the duration of hospitalization, but this was not true for children with a history of preterm birth.
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Affiliation(s)
- And Demir
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Ulas Karadas
- Dr. Behçet Uz Children’s Hospital, Izmir, Turkey
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15
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Demir A, Özdemir Karadas N, Karadas U. Clinical Utility of Respiratory Scores at Admission for Estimating the Definitive Microbiological Diagnosis in Lower Respiratory Tract Infections in Infants. Glob Pediatr Health 2022; 9:2333794X221098830. [PMID: 35784807 PMCID: PMC9244933 DOI: 10.1177/2333794x221098830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
We aimed at determining the clinical utility of respiratory scores and the durations of wheezing or respiratory distress during hospitalization in infants with lower respiratory tract infections (LRTI) at admission for estimating the definitive microbiological diagnosis. We obtained data from a study population of 201 patients, 79 girls and 122 boys. There was a significant divide in the causative agents of LRTI among patients younger and older than 6 months of age (P = .002), and significantly different respiratory score findings were determined in infants with viral LRTI: a low respiratory score in a younger-than-6 month infant suggests Adenovirus as the causative agent and a high respiratory score suggests Parainfluenza 1 or 2; as for infants of 6 months of age or older, a low respiratory score indicates Influenza A or B or a mixed infection, whereas a high respiratory score is likely an indication of Parainfluenza 3 or RSV.
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Affiliation(s)
- And Demir
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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16
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Dahlberg J, Adok C, Bümming P, Demir A, Hedbäck G, Nilsson B, Nilsson M, Jansson S. Incidence, detection and outcome of differentiated thyroid cancer in Western Sweden. BJS Open 2021; 5:6408929. [PMID: 34686878 PMCID: PMC8536871 DOI: 10.1093/bjsopen/zrab099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/24/2021] [Indexed: 11/12/2022] Open
Abstract
Background It is unclear whether the increasing incidence of thyroid cancer (TC) due to increased diagnosis of small and indolent tumours might mask a real increase of clinically significant cancers. The aim of this study was to correlate surgery, pathology and outcome data of individual patients to the mode of primary detection (palpation, by imaging or incidental) to assess if TC incidence has increased. Methods The Swedish Cancer Registry identified all patients with TC in Västra Götaland County representing approximately 1.6 million inhabitants. Clinical information was retrieved from medical records of patient cohorts from three study intervals (2001–2002, 2006–2007 and 2011–2014) comprising 60 per cent of all TC patients. Data were also obtained from the NORDCAN registry to compare of TC incidence with other Nordic countries. Results Between 2001 and 2014, the annualized standard incidence rate/100 000 population (ASR) of TC increased from 3.14 to 10.71 in women and from 1.12 to 3.77 in men. This was higher than the mean incidence for Sweden but similar to that in Norway and Finland. Differentiated TC (DTC) increased more than threefold. The majority of tumours (64 per cent) were detected by palpation. Larger tumours (10–20, 21–40 and greater than 40 mm) increased as much as microcarcinomas (less than 10 mm). Only 5 per cent of the tumours were detected by imaging. All disease-specific deaths (8.5 per cent of DTC in the first two cohorts) and most patients with recurrent or persistent disease (6.6 per cent of DTC cases) were diagnosed due to tumour-related symptoms. Conclusion DTC in Western Sweden gradually increased between 2001 and 2014. The majority of tumours were detected by palpation suggesting a real increase in the incidence of clinically significant thyroid malignancies.
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Affiliation(s)
- J Dahlberg
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.,Regional Cancer Centre West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - C Adok
- Regional Cancer Centre West, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P Bümming
- Department of Surgery Skaraborg Hospital, Skaraborgs Sjukhus, Skövde, Sweden
| | - A Demir
- Department of Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - G Hedbäck
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - B Nilsson
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - M Nilsson
- Sahlgrenska Centre for Cancer Research, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - S Jansson
- Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
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Demir A, Altundağ Y. Surgical treatment of nictitans gland prolapse and cartilage eversion accompanying the nictitating membrane (third eyelid) rotation in cats. Pol J Vet Sci 2021; 23:627-636. [PMID: 33480503 DOI: 10.24425/pjvs.2020.135811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The third eyelid rotation associated with the nictitans gland prolapse and third eyelid cartilage eversion is a rarely encountered ocular disorder. The present retrospective study includes the distribution of the relevant deformations in the cartilage and nictitans gland accompanying the third eyelid rotation in the cat according to breed, age, and gender-based differences, as well as the clinical manifestations, surgical therapeutic approach (partial resection of the scrolled car- tilage portion combined with the Morgan pocket technique), and the outcome of the procedure, concurrently monitoring whether or not the functions of the nictitating membrane were preserved after the procedure, the likelihood of relapse and the potential complications. A total of sixteen eyes surgically treated with the above-mentioned surgical method that belonged to thirteen cats diagnosed with the nictitans gland prolapse and cartilage eversion accompanying the third eyelid rotation were included in the study. The most common breeds were Persian (38.4%) and British shorthair (38.4%), with five cases from each. Three cats (20%) were bilaterally affected, while there was a unilateral involvement in ten of the cases (80%). Out of the ten cases with a unilateral lesion, the right eye was affected in 6 (60%) individuals, while the left eye was involved in four (40%). Nine cats were male, and four were female. The study was conducted in an attempt to surgically correct the third eyelid cartilage eversion and prolapsed nictitans gland responsible for the nictitating membrane rotation in cats by the partial removal of the everted cartilage com- bined with the Morgan pocket technique. Follow-ups were performed twice every other week in the postoperative period, followed by a one-time clinical inspection at the end of the first, third, and sixth months.
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Affiliation(s)
- A Demir
- Faculty of Veterinary Medicine, University of Istanbul-Cerrahpasa, Department of Surgery, TR-34320 Avcilar, Istanbul, Turkey
| | - Y Altundağ
- Faculty of Veterinary Medicine, University of Istanbul-Cerrahpasa, Department of Surgery, TR-34320 Avcilar, Istanbul - Turkey
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Demir A, Aydın A, Büyükgebiz A, Stenman UH, Hero M. Urinary gonadotropin measurements by enhanced luminometric assays (LIA) for the evaluation of pubertal development. J Pediatr Endocrinol Metab 2021; 34:859-866. [PMID: 33913305 DOI: 10.1515/jpem-2020-0598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 03/16/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Determination of LH in urine has proved to be a reliable method for evaluation of pubertal development. The human LH assay based on time-resolved immunofluorometric (IFMA) technology (AutoDELFIA, PerkinElmer, Wallac) has been found to be suitable for this purpose thanks to its high sensitivity but other assays have not been evaluated. We have analyzed our data obtained by another potentially sensitive detection technique, enhanced luminometric assay (LIA) with the objective of finding a viable alternative to IFMA since these may not be available in the future. METHODS LIA was used to measure LH and FSH in serum and urine samples from 100 healthy subjects of each Tanner stage and both genders, whose pubertal development has been determined. RESULTS Urinary gonodotropin concentrations measured by LIA correlated well with Tanner stage [(r=0.93 for girls, r=0.81 for boys; p<0.01 for LH) and (r=0.81 for girls, r=0.73 for boys; p<0.01 for FSH)]. LIA determinations revealed the increase in U-LH concentrations during the transition from Tanner stage 1-2 in both girls and boys (p<0.001), whereas U-FSH and S-LH were able to detect the increase from Tanner stage 1-2 only in boys or girls, respectively (both p<0.001). CONCLUSIONS Measurement of urinary gonadotropin concentrations by LIA may be useful for the evaluation of overall pubertal development and also in the detection of transition from prepuberty to puberty.
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Affiliation(s)
- And Demir
- New Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Adem Aydın
- Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | | | - Ulf-Håkan Stenman
- Department of Clinical Chemistry; Helsinki University Central Hospital, Helsinki, Finland
| | - Matti Hero
- New Children's Hospital, Pediatric Research Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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Senkal N, Kiyan E, Kocasoy-Orhan E, Demir A, Aydogan M, Yalçinkaya Y, Gul A, Inanc M, Ocal ML, Artim-Esen B. AB0331 PULMONARY INVOLVEMENT IN A SINGLE CENTER COHORT OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The prevalence of SLE pulmonary involvement varies depending on several factors, including diagnostic methods [1].Objectives:We aimed to determine the frequency of involvement with different diagnostic methods in a single center cohort.Methods:300 SLE patients were included. Chest x-ray (CXR), lung spirometry, carbonmonoxide diffusion test (DLCOc) and echocardiography were performed. High resolution thorax computed tomography (HRCT) was done for a definite diagnosis of interstitial lung disease (ILD) whilst diagram electromyography (EMG), ultrasonography (USG) and magnetic resonance imaging (MR) were utilized to diagnose shrinking lung syndrome (SLS).Results:The mean age and follow-up time were 43 and 11,5 years respectively. Of 300 patients, 16% had ILD, 6,7% had pulmonary hypertension (PHT), 3% had SLS, 0,3% had pulmonary infarction. At the start of the study, patients’ records showed that 4% had ILD, 5% PHT, 0,3% SLS and 0,3% pulmonary infarction. The median age, mean duration of disease and follow-up time were significantly higher and longer in patients with ILD compared to patients without (p<0.05). Forced expiratory volume (FEV1), forced vital capacity (FVC), DLCOc and total lung capacity (TLC) were significantly lower in patients with ILD and with SLS (p<0,001). Patients with ILD had significantly higher frequency of arthritis, serositis, Raynaud myositis and anti-Scl70 positivity. Avascular necrosis, diabetes and malignancy were significantly more frequent in those patients. All patients with suspected SLS undergone diagram EMG, USG and MR. Out of 10 suspected cases, in 6 EMG, in 5 USG and in 9 MR was compatible with SLS diagnosis. 5 patients had 3 of the diagnostic methods positive to diagnose SLS. Muscle atrophy and weakness, avascular necrosis were more frequent in this group of patients (p<0.05). There were more patients treated with mycophenolate mofetil (MMF) and cyclophosphamide in the SLS group whilst more with MMF in the ILD group. Significantly higher frequency of patients had stopped using hydroxychloroquine (HCQ) in the ILD group (p=0,04).Conclusion:Interstitial lung disease is common in patients with SLE and considerable number of patients have SLS [2]. Spirometry, DLCOc and CXR are simple but valuable to diagnose pulmonary involvement in SLE patients. Diaphragm MR, USG and EMG are complementary methods for definite diagnosis in SLS [2]. Considering the significant difference of prevalence between the start and the end of the study, one of the possibbilities is the underrecognition of SLE pulmonary disease due to its being part of a multisystemic presentation. Higher usage of immunosuppressives in these patients may support a multisystemic active disease. Although drug effect is another concern, it is hard to establish a causal relationship due to the study’s cross-sectional design. HCQ may have a role in ILD prevention.References:[1]Keane MP, Lynch JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax 2000;55:159-166.[2]Singh R, Huang W, Menon Y, Espinoza LR. Shrinking lung syndrome in systemic lupus erythematosus and Sjogren’s syndrome. J Clin Rheumatol. 2002 Dec;8(6):340-5.Table 1.Spirometry; DLCO; diaphragm EMG, USG and MRI results of patients with SLS.Patient/Age/Sex1/44/F2/57/F3/39/F4/38/M5/23/F6/60/F7/58/F8/37/F9/66/F10/28/FFEV1 (%)47655963676271537039FVC (%)56735962797072556237DLCO (%)45504465535547656245TLC (%)61716566786454636245USG deep inspiration (L)4,704,742,593,013,063,065,734,172,121,59USG deep inspiration (R)3,721,982,262,242,772,174,672,834,622,49USG diaphragm thickness (L)4,823,002,482,842,551,592,093,181,621,44USG diaphragm thickness R(R)1,231,041,841,802,191,311,791,972,081,63MR high sideRRRRRRRLLMR height difference4,926,192,872,641,672,451,730,950,78EMG resting AMP (R)0,20,30,60,50,60,40,10,80,90,7EMG resting LAT (R)76,47,166,786,154,7565,8EMG resting AMP (L)0,40,50,80,71,20,60,31,20,50,5EMG resting LAT (L)6,355,756,855,66,05664,355,26,15Disclosure of Interests:None declared
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Acar E, Gokcen H, Demir A, Yildirim B. Comparison of inflammation markers with prediction scores in patients with community-acquired pneumonia. BRATISL MED J 2021; 122:418-423. [PMID: 34002616 DOI: 10.4149/bll_2021_069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The lymphocyte-to-C-reactive protein ratio (LCRP) and Systemic Immune-Inflammation Index (SII) can successfully predict 28-day mortality rates with community-acquired pneumoniaMETHODS: This prospective study was conducted in 2018. Hospitalized patients underwent follow-up evaluations 28 days after admission. RESULTS A total of 345 patients with CAP were enrolled in this study. All-cause mortality at the 28th day of follow-up was 13.6 %. There were statistically significant results between the 2 groups (survivors and non-survivors), in terms of the LCRP, SII, PSI, and CURB-65 values. Moreover, the optimal LCRP cutoff for predicting 28-day mortality was determined to be 4, with 89 % sensitivity, 73 % specificity. Based on the average SII>3551for predicting 28-day mortality, the sensitivity, specificity was 63.8 %, 68.1 % respectively. When the value of the cutoff PSI was ≥130 points, the sensitivity, specificity was 68 %, 65 %, respectively. Based on 3 points and above as the cutoff value of the CURB-65 score, the sensitivity, specificity was 80 %, 68 %, respectively. ROC curve analysis revealed that the areas of LCRP, SII, PSI, and CURB-65 under the AUC in terms of 28-day mortality were 0,820,0,737,681, and 0,773, respectively,CONCLUSIONS: LCRP and SII level are valuable for predicting the mortality rate among patients with CAP at ED admission (Tab. 3, Fig. 3, Ref. 27).
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Olmez O, Bilici A, Er Ö, Sevinç A, Akman T, Uslu R, Mandel N, Yalçın Ş, Teomete M, Görümlü G, Demir A, Namal E, Alıcı S, Selçukbiricik F, Bavbek S, Paksoy F, Başaran G, Özer L, Şener N, Harputluoğlu H. 2008P The effect of the use of complex molecular profiling in advanced solid organ tumours on clinical decision: Turkey molecular profiling in advanced cancers trial (TUMPACT). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tomarken SL, Cao Y, Demir A, Watanabe K, Taniguchi T, Jarillo-Herrero P, Ashoori RC. Electronic Compressibility of Magic-Angle Graphene Superlattices. Phys Rev Lett 2019; 123:046601. [PMID: 31491239 DOI: 10.1103/physrevlett.123.046601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Indexed: 06/10/2023]
Abstract
We report the first electronic compressibility measurements of magic-angle twisted bilayer graphene. The evolution of the compressibility with carrier density offers insights into the interaction-driven ground state that have not been accessible in prior transport and tunneling studies. From capacitance measurements, we determine the chemical potential as a function of carrier density and find the widths of the energy gaps at fractional filling of the moiré lattice. In the electron-doped regime, we observe unexpectedly large gaps at quarter- and half-filling and strong electron-hole asymmetry. Moreover, we measure a ∼35 meV minibandwidth that is much wider than most theoretical estimates. Finally, we explore the field dependence up to the quantum Hall regime and observe significant differences from transport measurements.
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Affiliation(s)
- S L Tomarken
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Cao
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Demir
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - K Watanabe
- National Institute of Materials Science 1-1 Namiki, Tsukuba 305-0044, Japan
| | - T Taniguchi
- National Institute of Materials Science 1-1 Namiki, Tsukuba 305-0044, Japan
| | - P Jarillo-Herrero
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R C Ashoori
- Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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Demir A, Pekiner FN. Radiographic findings of bisphosphonate-related osteonecrosis of the jaws: Comparison with cone-beam computed tomography and panoramic radiography. Niger J Clin Pract 2019; 20:346-354. [PMID: 28256491 DOI: 10.4103/1119-3077.183241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The aim of this study is to assess radiographic findings of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and to evaluate the efficiency of cone-beam computed tomography (CBCT) and panoramic radiography (PR) by comparing with each other. MATERIALS AND METHODS The data of 46 patients treated with bisphosphonates for at least 1 to 10 years were retrospectively examined. 27 patients were selected for study group. The first inclusion criteria was an available CBCT or PR. The patients had at least one clinical symptom of exposed bone, intraoral or extraoral swelling and purulent secretion or fistula formation. In accordance with the position papers of the American Association of Oral and Maxillofacial Surgeons, the patients were classified into stages. CBCT and PR images were evaluated by dividing the jaws in 6 segments. Presence of bone sclerosis, cortex irregularity, persistent sockets, periosteal response, sequestration, and osteolysis were recorded. RESULTS The radiographic findings of BRONJ were mostly determined at posterior mandible with Stage 2 predominancy. Fifteen patients (55.6%) had previous tooth extraction. 9 of them had exposed bone at the same time. Seven patients had exposed bone without extraction. CBCT findings (P < 0.01) except persistent socket (P = 0.157) were found statistically significant by comparison with PR. Extraction socket finding was detected the same in segments with a percentage of 90.9%. CONCLUSION This study showed that CBCT findings except extraction socket were significantly higher than PR. CBCT combined with clinical examination can be used effectively to determine the borders of effected areas especially at advanced cases.
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Affiliation(s)
- A Demir
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - F N Pekiner
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Esin E, Oksuzoglu B, Bilici A, Cicin I, Kostek O, Kaplan MA, Aksoy S, Aktas BY, Ozdemir O, Alacacioglu A, Cabuk D, Sumbul AT, Sakin A, Paydas S, Yetisir E, Er O, Korkmaz T, Yildirim N, Sakalar T, Demir H, Artac M, Karaagac M, Harputluoglu H, Bilen E, Erdur E, Degirmencioglu S, Aliyev A, Cil T, Olgun P, Basaran G, Gumusay O, Demir A, Tanrikulu E, Yumuk PF, Imamoglu I, Oyan B, Cetin B, Haksoyler V, Karadurmus N, Erturk I, Evrensel T, Yilmaz H, Beypinar I, Kocer M, Pilanci KN, Seker M, Urun Y, Yildirim N, Eren T, Demirci U. Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naïve breast cancer: real-life practice outcomes. Cancer Chemother Pharmacol 2018; 83:131-143. [PMID: 30377778 DOI: 10.1007/s00280-018-3712-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/25/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE In this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. METHODS This study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers. RESULTS Median age was 51 (22-82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. CONCLUSIONS Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/secondary
- Docetaxel/administration & dosage
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Metastasis
- Paclitaxel/administration & dosage
- Practice Patterns, Physicians'
- Prognosis
- Retrospective Studies
- Survival Rate
- Trastuzumab/administration & dosage
- Young Adult
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Affiliation(s)
- Ece Esin
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey.
| | - B Oksuzoglu
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
| | - A Bilici
- Departmant of Medical Oncology, Medipol University International Health Center, Istanbul, Turkey
| | - I Cicin
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - O Kostek
- Department of Medical Oncology, Trakya University, Edirne, Turkey
| | - M A Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - S Aksoy
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - B Y Aktas
- Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - O Ozdemir
- Department of Medical Oncology, Ataturk Education and Research Hospital, İzmir K.C. University, Izmir, Turkey
| | - A Alacacioglu
- Department of Medical Oncology, Ataturk Education and Research Hospital, İzmir K.C. University, Izmir, Turkey
| | - D Cabuk
- Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Izmit, Turkey
| | - A T Sumbul
- Department of Medical Oncology, Baskent University Adana Hospital, Adana, Turkey
| | - A Sakin
- Department of Medical Oncology, Istanbul Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - S Paydas
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - E Yetisir
- Department of Medical Oncology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - O Er
- Department of Medical Oncology, Acibadem Maslak Hospital, Acibadem MAA University, Istanbul, Turkey
| | - T Korkmaz
- Department of Medical Oncology, Acibadem Altunizade Hospital, Acibadem MAA University, Istanbul, Turkey
| | - N Yildirim
- Department of Medical Oncology, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - T Sakalar
- Department of Medical Oncology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - H Demir
- Department of Medical Oncology, Kayseri Education and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - M Artac
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - M Karaagac
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - H Harputluoglu
- Department of Medical Oncology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - E Bilen
- Department of Medical Oncology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey
| | - E Erdur
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
| | - S Degirmencioglu
- Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - A Aliyev
- Department of Medical Oncology, Faculty of Medicine, Bezmialem University, Istanbul, Turkey
| | - T Cil
- Department of Medical Oncology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - P Olgun
- Department of Medical Oncology, Adana City Hospital, University of Health Sciences, Adana, Turkey
| | - G Basaran
- Department of Medical Oncology, Acibadem Maslak Hospital, Acibadem MAA University, Istanbul, Turkey
| | - O Gumusay
- Department of Medical Oncology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - A Demir
- Department of Medical Oncology, Istanbul Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - E Tanrikulu
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - P F Yumuk
- Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Inanc Imamoglu
- Department of Medical Oncology, Ankara Diskapi Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - B Oyan
- Department of Medical Oncology, Acibadem Altunizade Hospital, Acibadem MAA University, Istanbul, Turkey
| | - B Cetin
- Department of Medical Oncology, Faculty of Medicine, RTE University, Rize, Turkey
| | - V Haksoyler
- Department of Medical Oncology, Diyarbakir G.Y. Education and Research Hospital, University of Health Sciences, Diyarbakir, Turkey
| | - N Karadurmus
- Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - I Erturk
- Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - T Evrensel
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - H Yilmaz
- Department of Medical Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
| | - I Beypinar
- Department of Medical Oncology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - M Kocer
- Department of Medical Oncology, Faculty of Medicine, Isparta S.D University, Isparta, Turkey
| | - K N Pilanci
- Department of Medical Oncology, Haseki Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - M Seker
- Department of Medical Oncology, Ankara Bayindir Hospital, Ankara, Turkey
| | - Y Urun
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - N Yildirim
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - T Eren
- Department of Medical Oncology, Numune Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - U Demirci
- Department of Medical Oncology, Dr. A. Y. Ankara Oncology Education and Research Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey
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Peker N, Demir A, Aydın C, Biler A, Gundogan S. Adolescent pregnancies and perinatal outcomes: a study at tertiary hospital at the eastern part of Turkey. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog3904.2018] [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: 11/01/2022]
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Gundogdu S, Pisheh HS, Demir A, Gunoven M, Aydinli A, Sirtori C. Time resolved Fabry-Perot measurements of cavity temperature in pulsed QCLs. Opt Express 2018; 26:6572-6580. [PMID: 29609345 DOI: 10.1364/oe.26.006572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/21/2018] [Indexed: 06/08/2023]
Abstract
Temperature rise during operation is a central concern of semiconductor lasers and especially difficult to measure during a pulsed operation. We present a technique for in situ time-resolved temperature measurement of quantum cascade lasers operating in a pulsed mode at ~9.25 μm emission wavelength. Using a step-scan approach with 5 ns resolution, we measure the temporal evolution of the spectral density, observing longitudinal Fabry-Perot modes that correspond to different transverse modes. Considering the multiple thin layers that make up the active layer and the associated Kapitza resistance, thermal properties of QCLs are significantly different than bulk-like laser diodes where this approach was successfully used. Compounded by the lattice expansion and refractive index changes due to time-dependent temperature rise, Fabry-Perot modes were observed and analyzed from the time-resolved emission spectra of quantum cascade lasers to deduce the cavity temperature. Temperature rise of a QCL in a pulsed mode operation between -160 °C to -80 °C was measured as a function of time. Using the temporal temperature variations, a thermal model was constructed that led to the extraction of cavity thermal conductivity in agreement with previous results. Critical in maximizing pulsed output power, the effect of the duty cycle on the evolution of laser heating was studied in situ, leading to a heat map to guide the operation of pulsed lasers.
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Asiri S, Güner S, Demir A, Yildiz A, Manikandan A, Baykal A. Synthesis and Magnetic Characterization of Cu Substituted Barium Hexaferrites. J Inorg Organomet Polym Mater 2017. [DOI: 10.1007/s10904-017-0735-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Demir A, Voutilainen R, Stenman UH, Dunkel L, Albertsson-Wikland K, Norjavaara E. First Morning Voided Urinary Gonadotropin Measurements as an Alternative to the GnRH Test. Horm Res Paediatr 2017; 85:301-8. [PMID: 27011314 DOI: 10.1159/000440955] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/08/2015] [Indexed: 11/19/2022] Open
Abstract
AIMS We studied whether first morning voided (FMV) urinary gonadotropin measurements could be used as a noninvasive alternative to the GnRH test in the assessment of the hypothalamic-pituitary-gonadal function in children. METHODS In a single-center study, we compared FMV urinary gonadotropin concentrations with basal and GnRH-stimulated serum gonadotropin levels in 274 children and adolescents (78 girls, 196 boys) aged 5-17 years referred for growth and pubertal disorders. The concordance between FMV urinary gonadotropin concentrations and GnRH test results was assessed. RESULTS FMV urinary LH (U-LH), urinary FSH (U-FSH) and their ratios correlated well with the corresponding basal and GnRH-stimulated serum parameters (r ≥ 0.66, p < 0.001). Receiver operating characteristic curve analyses using urinary and serum LH and FSH concentrations showed that FMV U-LH and U-LH/U-FSH performed equally well as the GnRH test in the differentiation of early puberty (Tanner stage 2) from prepuberty (Tanner stage 1) (area under the curve 0.768-0.890 vs. 0.712-0.858). FMV U-LH and U-LH/U-FSH performed equally well as basal serum LH in predicting a pubertal GnRH test result (area under the curve 0.90-0.93). CONCLUSION FMV U-LH determination can be used for the evaluation of pubertal development and its disorders, reducing the need for invasive GnRH stimulation tests.
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Affiliation(s)
- And Demir
- Children's Hospital, Helsinki, Finland
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Ertürk A, Şaylan A, Kara D, Tezcan B, Demir A, Karadeniz Ü, Özgök A. Blood and blood product transfusion management experiences of Turkish anaesthesiologists: a multicentre survey study. J Cardiothorac Vasc Anesth 2017. [DOI: 10.1053/j.jvca.2017.02.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Aydogdu IO, Demir A, Keles MK, Yapici O, Yildizy L, Demirtas Y. Pedicled Vascularized Lymph Node Transfer Treats Lymphedema in Rat Hind Limb: A Simple Experimental Study Design. Lymphology 2017; 50:27-35. [PMID: 30231305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Vascularized lymph node transfer is a new and promising technique for the physiologic treatment of lymphedema and several clinical and experimental studies have been conducted in recent years. However, the exact mechanism of vascularized lymph node transfer is still unknown. In this study, we aimed to investigate treatment efficacy through the design of a simple and feasible experimental lymphedema model for testing a vascularized lymph node transfer technique. After a pilot study, 30 male Sprague-Dawley rats were divided into two groups and lymphedema was induced in the hindlimb of both groups. In Group 1 (control, n=15) no treatment was applied while pedicled lymph node transfer was applied in Group 2 (experimental, n=15). Model dynamics were assessed with lymphoscintigraphy, limb measurement, and histological analysis. A statistically significant limb circumference reduction at the ankle was seen on days 30 and 90 in Group 2 as compared to Group 1, p<0.05, and lymphatic tracer transport improved in 13 out of the 15 animals in Group 2. A statistically significant reduction in histological scores was achieved in Group 2, p<0.05. In this rat hindlimb lymphedema model, our vascularized lymph node transfer technique is an effective physiologic surgical treatment and represents a feasible experimental model for future studies.
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Affiliation(s)
- I O Aydogdu
- International Medicana Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Samsun, Turkey
| | - A Demir
- Ondokuz Mayis University, Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Samsun, Turkey
| | - M K Keles
- Diskapi Yildirim Beyazit Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Turkey
| | - O Yapici
- Ondokuz Mayis University, Faculty of Medicine, Department of Nuclear Medicine, Samsun, Turkey
| | - L Yildizy
- Ondokuz Mayis University, Faculty of Medicine, Department of Pathology (LY), Samsun, Turkey
| | - Y Demirtas
- Lymphest Plastic Surgery Clinic, Istanbul, Turkey
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Karakoc-Sokmensuer L, Hacivelioglu S, Demir A, Kose M, Kaymaz F, Cakir D, Bozdag G. Histopathology of ipsilateral and contralateral ovaries and plasma interleukin 6 levels after unilateral ovarian torsion. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2037.2016] [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: 11/01/2022]
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Karakoc-Sokmensuer L, Hacivelioglu S, Demir A, Köse M, Kaymaz FF, Cakir DU, Bozdag G. Histopathology of ipsilateral and contralateral ovaries and plasma interleukin 6 levels after unilateral ovarian torsion. CLIN EXP OBSTET GYN 2016; 43:82-87. [PMID: 27048023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the time-dependent histopathologic changes in both ovaries and to determine the time-dependent levels of plasma interleukin 6 (IL-6) after unilateral ovarian torsion. MATERIALS AND METHODS An experimental animal study included 48 female Sprague-Dawley rats which were distributed to six groups: control group (Group 1), sham-operated control group (Group 2), and four unilateral ovarian torsion groups with torsion duration of three, six, 12, and 24 hours (Group 3, 4, 5, and 6, respectively). Histopathologic criteria (follicular degeneration, vascular congestion, hemorrhage, inflammatory cell infiltration, and total tissue damage score) were evaluated in both ovaries, and plasma IL-6 levels were measured. RESULTS At 24 hours after torsion began, mean total tissue damage score was similar between ovaries that had torsion and contralateral ovaries. Mean plasma IL-6 level did not change during the 24 hours after torsion began (p = 0.584). CONCLUSIONS In addition to ovaries that had torsion, histopathologic abnormalities also occurred in contralateral ovaries. These results suggest that contralateral ovaries are not quiescent after unilateral ovarian torsion. Plasma IL-6 levels did not change significantly during the 24 hours after ovarian torsion began, resulting in a limitation of its diagnostic use in the early course of the disease.
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Kaya F, Kismet K, Ozer H, Soylu VG, Duymus ME, Akgun YA, Demir A, Celepli P, Guclu T, Bolat S, Ertas E. Can platelet-rich plasma be used safely in intra-abdominal operations? ACTA ACUST UNITED AC 2016; 117:525-529. [DOI: 10.4149/bll_2016_102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gul A, Bozkurt Y, Demir A, Erman B. Unified modeling of Familial Mediterranean Fever and Cryopyrin Associated Periodic Syndromes. Pediatr Rheumatol Online J 2015. [PMCID: PMC4596958 DOI: 10.1186/1546-0096-13-s1-o43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Acar E, Demir A, Alatas ÖD, Beydilli H, Yıldırım B, Kırlı U, Hazer DB, Kılınç MR, Karagöz Ü, Derin S. Evaluation of hematological markers in minor head trauma in the emergency room. Eur J Trauma Emerg Surg 2015; 42:611-616. [DOI: 10.1007/s00068-015-0579-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 10/05/2015] [Indexed: 11/30/2022]
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Ozkan B, Demir A, Kaba E, Erus S, Duman S, Cimenoglu B, Toker A. P-207SHOULD RADICAL SURGERY BE A PART OF MULTIMODALITY THERAPY FOR MASAOKA STAGE IVA THYMOMA? Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ay D, Erdolu B, Yumun G, Demir A, Aydin U, Ozkan H, Erkoc K, Tiryakioglu O. The effect of anatomical factors on mortality rates after endovascular aneurysm repair. Cardiovasc J Afr 2015. [PMID: 26207946 PMCID: PMC4816930 DOI: 10.5830/cvja-2015-057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective The objective of this study was to investigate the effect of anatomical characteristics on mortality rates after endovascular aneurysm repair (EVAR). Methods We investigated 56 EVAR procedures for infrarenal aortic aneurysms performed between January 2010 and December 2013, and the data were supplemented with a prospective review. The patients were divided into two groups according to the diameter of the aneurysm. Group I (n = 30): patients with aneurysm diameters less than 6 cm, group II (n = 26): patients with aneurysm diameters larger than 6 cm. The pre-operative anatomical data of the aneurysms were noted and the groups were compared with regard to postoperative results. Results There were no correlations between diameter of aneurysm (p > 0.05), aneurysm neck angle (p > 0.05) and mortality rate. The long-term mortality rate was found to be high in patients in whom an endoleak occurred. Conclusion We found that aneurysm diameter did not have an effect on postoperative mortality rates. An increased EuroSCORE value and the development of endoleaks had an effect on long-term mortality rates.
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Affiliation(s)
- D Ay
- Department of Cardiovascular Surgery, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - B Erdolu
- Department of Cardiovascular Surgery, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - G Yumun
- Department of Cardiovascular Surgery, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - A Demir
- Department of Cardiovascular Surgery, Yalova State Hospital, Yalova, Turkey
| | - U Aydin
- Department of Cardiovascular Surgery, Bursa Yüksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - H Ozkan
- Department of Cardiovascular Surgery, Bahcesehir University Medical Faculty and Medical Park Bursa Hospital, Bursa, Turkey
| | - K Erkoc
- Department of Cardiovascular Surgery, Medical Park Bursa Hospital, Bursa, Turkey
| | - O Tiryakioglu
- Department of Cardiovascular Surgery, Bahcesehir University Medical Faculty and Medical Park Bursa Hospital, Bursa, Turkey.
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Demir A, Aydınlı B, Toprak H, Karadeniz Ü, Yılmaz F, Züngün C, Uçar P, Güçlü Ç, Bostancı E, Yılmaz S. Impact of 6% Starch 130/0.4 and 4% Gelatin Infusion on Kidney Function in Living-Donor Liver Transplantation. Transplant Proc 2015; 47:1883-9. [DOI: 10.1016/j.transproceed.2015.05.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/04/2015] [Accepted: 05/14/2015] [Indexed: 11/16/2022]
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Kucukgoncu S, Sungur Z, Demircan F, Kuseyri I, Demir A, Senturk M. Comparison of crystalloid and colloid solutions on extravascular lung water in lung resection. J Cardiothorac Vasc Anesth 2015. [DOI: 10.1053/j.jvca.2015.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kuloglu Z, Kansu A, Serwas N, Demir A, Yaman A, Ensari A, Boztug K. INFLAMMATORY BOWEL DISEASE-LIKE PHENOTYPE IN A YOUNG GIRL WITH PROLIDASE DEFICIENCY: A NEW SPECTRUM OF CLINICAL MANIFESTATION. Genet Couns 2015; 26:205-211. [PMID: 26349190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Prolidase deficiency (PD) is an inherited disorder associated with cutaneous ulcers, intellectual disability, unusual facial appearance, skeletal deformities, hematological anomalies, splenomegaly, and chronic infections. We report a girl with PD who presented with early inflammatory bowel disease (IBD). A 2-month-old girl with a dysmorphic face presented with recurrent respiratory tract infections, vomiting, diarrhea and hepatosplenomegaly. She had steatorrhea, abnormal liver enzymes, hypergammaglobulinemia, autoantibody positivity and steatohepatitis in liver biopsy. On follow-up, skin lesions, pruritus and developmental delay were added. At the age of 21 months, IBD was diagnosed with persistent diarrhea, fever, hypoalbuminemia, elevated inflammatory markers, fecal leukocytes and aphthous ulcers in colon. Remission was achieved with prednisone and continued with mesalasine. Thrombocytopenia developed after 3 years. Her findings prompted us to further investigations. PD as the underlying molecular cause of the disease was detected by exome sequencing. In conclusion, PD should be considered in the differential diagnosis of some IBD patients.
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Demir A, Köse MK, Bozdag G, Sokmensuer LK, Sever A, Gunalp S. Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles? CLIN EXP OBSTET GYN 2014. [DOI: 10.12891/ceog18952014] [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: 11/01/2022]
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Kavas H, Baykal A, Demir A, Toprak MS, Aktaş B. ZnxCu(1−x)Fe2O4 Nanoferrites by Sol–Gel Auto Combustion Route: Cation Distribution and Microwave Absorption Properties. J Inorg Organomet Polym Mater 2014. [DOI: 10.1007/s10904-014-0069-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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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Abstract
OBJECTIVES To successfully meet expectations on facial esthetics, it is important to understand normal craniofacial growth and the impact of orthodontic treatment thereon. To date, there have been few studies documenting changes in facial esthetics through photography. The objective of this study was to compare facial soft tissue esthetics before and after orthodontic treatment by means of photographic analysis. MATERIALS AND METHODS The 45 children were divided into 3 groups according to Angle's classification: Groups I, II, and III comprised children with class I, II, and III malocclusion, respectively. Photographs were analyzed with a software. Twenty-one soft tissue landmarks were identified on profile and frontal photographs, ratios and angles were calculated. RESULTS For group I, there was no difference between pre- and post-treatment facial analysis. For group II, there were significant changes in 5 values. The most significant changes were observed for A-N-B and Al-Me/Ch-Me. For group III, we noted significant changes for 5 values. The most significant change was observed for N-Pn-Pog. CONCLUSION There were significant changes in facial soft tissue esthetics after orthodontic treatment for class II and III cases. Changes in A-N-B and nose tip angle (N-Pn-Cm) were observed for class II and class III subjects.
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Affiliation(s)
- S Aksakalli
- Department of Orthodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
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Ozkan B, Demir A, Kapda l M, Sungur Ulke Z, Duman S, Cimenoglu B, Toker A. P-221 * RESULTS OF VIDEOTHORACOSCOPIC THYMECTOMY IN CHILDREN: ANALYSIS ON 40 PATIENTS. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Melek H, Demir A, Bayram AS, Ozkan B, Cetinkaya G, Kapdagli M, Erol MM, Sarihan S, Toker A, Gebitekin C. P-126 * NEOADJUVANT CHEMORADIATION VERSUS CHEMOTHERAPY FOLLOWED BY SURGERY FOR NON-SMALL-CELL LUNG CANCER: DOWNSTAGING FROM STAGE IIIA TO STAGE I. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Demir A, Akyüz F, Gokturk S, Evirgen S, Gulluoglu M, Erer B, Kamali S, Gul A. THU0360 Small Bowel Mucosal Findings in Familial Mediterranean Fever. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Köse M, Sokmensuer LK, Demir A, Bozdag G, Gunalp S. Manual versus computer-automated semen analysis. CLIN EXP OBSTET GYN 2014; 41:662-664. [PMID: 25551959] [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: 06/04/2023]
Abstract
OBJECTIVE To evaluate agreement of conventional sperm analysis with computer-aided semen analysis (CASA) regarding concentration, motility, and morphology using samples from infertile men. MATERIALS AND METHODS In this study a total of 195 male partners of couples who underwent evaluation of infertility were included. All semen samples were examined by conventional method and CASA in terms of morphology, motility, and concentration. Pearson correlation analysis and the Bland-Altman method were used to assess correlation and agreement between conventional semen analysis and CASA measurements. RESULTS When the two methods were compared in terms of concentration, motility, and morphology, there was a statistically significant correlation in all variables. The best correlation was obtained for sperm concentration. However, there was a poor correlation for sperm morphology between conventional method and CASA. Sperm concentration and morphology obtained by CASA were 14% and 87% lower, respectively; motility was 21% higher than the conventional method. CONCLUSION Although CASA systems are objective and rapid, they should be evaluated in terms of cost-effectiveness, however they may be useful in over-loaded assisted reproductive technique (ART) clinics.
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Affiliation(s)
- M Köse
- Afyon State Hospital, Department of Obstetrics and Gynecology, Turkey
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Demir A, Köse M, Bozdag G, Sokmensuer LK, Sever A, Gunalp S. Can combination of Day 3 and Day 5 embryo morphology be useful to predict pregnancy in in-vitro fertilization cycles? CLIN EXP OBSTET GYN 2014; 41:685-688. [PMID: 25551963] [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: 06/04/2023]
Abstract
OBJECTIVE To determine whether embryos having all top qualified both on Day 3 and Day 5 have higher pregnancy rates than the oth- ers. MATERIALS AND METHODS The study included 143 consecutive cycles were recruited in which Day 5 embryo transfer was available. Cleavage stage embryos were graded according to 1 to 4 scoring system, based on fragmentation, cell symmetry, and blastomere num- ber. Among cleavage stage embryos, Grade 1 and Grade 2a/2b were further stratified as 'top quality' embryos to be transferred, others were defined as control group. Blastocyst stage embryos were graded from 1 to 6 according to intracellular mass (ICM) and trophec- toderm (TE). Day 5 fresh embryo transfer was performed in all cases using soft catheter. Positive pregnancy test was accepted when serum beta-human chorionic gonadotrophin (1-hCG) exceeded 20 mIU/ml. RESULTS On the cleavage stage, top quality embryo was available in 47 of 143(32.9%) cases. Of the 47 embryos, the number of cases reaching any Grade 4, 3 quality, and early blastocyst on Day 5 were 22 (46.8%), 15 (31.9%), and 10 (21.3%). The respective figures on the control group (n = 96) were 33 (34.4%), 37 (38.5%), and 26 (27.1%) (p > 0.05). The pregnancy rates were also similar. CONCLUSION All top qualified embryos both on Day 3 and 5 did not reveal higher pregnancy rate than the others.
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Affiliation(s)
- A Demir
- Department of Obstetrics and Gynecology, Elaziğ Training and Research Hospital, Turkey
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