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Isik E, Aydinok Y, Albayrak C, Durmus B, Karakas Z, Orhan MF, Sarper N, Aydın S, Unal S, Oymak Y, Karadas N, Turedi A, Albayrak D, Tayfun F, Tugcu D, Karaman S, Tobu M, Unal E, Ozcan A, Unal S, Aksu T, Unuvar A, Bilici M, Azik F, Ay Y, Gelen SA, Zengin E, Albudak E, Eker I, Karakaya T, Cogulu O, Ozkinay F, Atik T. Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis. Eur J Haematol 2024. [PMID: 38556258 DOI: 10.1111/ejh.14194] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES In congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA. METHODS One hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction. RESULTS Molecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR. CONCLUSIONS In this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.
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Affiliation(s)
- Esra Isik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yesim Aydinok
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Canan Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Basak Durmus
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Zeynep Karakas
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Fatih Orhan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nazan Sarper
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Sultan Aydın
- Division of Pediatric Hematology and Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Selma Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Yesim Oymak
- Division of Pediatric Hematology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Nihal Karadas
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Aysen Turedi
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Davut Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Medical Park Samsun Hospital, Samsun, Turkey
| | - Funda Tayfun
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Deniz Tugcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serap Karaman
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahmut Tobu
- Department of Hematology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ekrem Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alper Ozcan
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sule Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tekin Aksu
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aysegul Unuvar
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Bilici
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Fatih Azik
- Department of Pediatrics, Division of Pediatric Hematology, Faculty of Medicine, Muğla Sıtkı Koçman University, Mugla, Turkey
| | - Yilmaz Ay
- Division of Pediatric Hematology and Oncology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Sema Aylan Gelen
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emine Zengin
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Esin Albudak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ibrahim Eker
- Department of Pediatric Hematology and Oncology and Pediatric Hematopoietic Stem Cell Transplantation Unit, Afyonkarahisar Health Science University Faculty of Medicine, Afyon, Turkey
| | - Taner Karakaya
- Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, Turkey
| | - Ozgur Cogulu
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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Eser HC, Ayyildiz Emecen D, Topyildiz E, Isik E, Edeer Karaca N, Atik T, Aksu G, Ozkınay F, Kutukculer N. Dual Diagnosis of Trichohepatoenteric Syndrome and Lipoid Proteinosis in a Turkish Child. Mol Syndromol 2023; 14:504-508. [PMID: 38058753 PMCID: PMC10697757 DOI: 10.1159/000531408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/31/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Trichohepatoenteric syndrome (THES) is caused by pathogenic mutations in TTC37 and SKIV2L genes and characterized by intractable diarrhea, facial dysmorphism, hair abnormality, immunodeficiency, and skin abnormalities. Lipoid proteinosis is caused by pathogenic mutations in ECM1 gene and characterized by deposition of hyaline-like material in various tissues resulting in heterogenous clinical findings. Case Presentation Four years after the diagnosis and management of THES, due to new clinical findings, another reason for underlying features of the patient was considered. WES was performed and a homozygous c.507delT (p.Arg171GlyfsTer7) mutation in the ECM1 gene was detected. Conclusion This case provides an example of co-existence of multiple genetic defects in a single patient born to consanguineous parents.
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Affiliation(s)
- Hatice Ceren Eser
- Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey
| | | | - Ezgi Topyildiz
- Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Esra Isik
- Department of Pediatric Clinical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Neslihan Edeer Karaca
- Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Tahir Atik
- Department of Pediatric Clinical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Guzide Aksu
- Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Ferda Ozkınay
- Department of Pediatric Clinical Genetics, Ege University Faculty of Medicine, Izmir, Turkey
| | - Necil Kutukculer
- Department of Pediatric Immunology, Ege University Faculty of Medicine, Izmir, Turkey
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Goksen D, Evin F, Isik E, Ozen S, Atik T, Ozkinay F, Akcan N, Ozkan B, Buyukinan M, Nuri Ozbek M, Darcan S, Onay H. Molecular diagnosis in patients with monogenic diabetes mellitus, and detection of a novel candidate gene. Diabetes Res Clin Pract 2023; 205:110953. [PMID: 37838154 DOI: 10.1016/j.diabres.2023.110953] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
AIM We aimed to investigate molecular genetic basis of monogenic diabetes (DM) and novel responsible candidate genes with targeted Next Generation Sequencing (NGS) and Whole Exome Sequencing (WES). METHODS A hundred cases presenting with clinical findings and a family history of monogenic DM were included in the study. Molecular analysis was performed using an NGS panel including 14 genes. Following targeted NGS, WES was planned in cases in whom no variant was detected. RESULTS Thirty different disease-causing variants in seven different genes were detected in thirty-five (35 %) cases with targeted NGS approach. Most common pathogenic variant was found in GCK gene in 25 (25 %) cases. Four different variants were detected in 4 (4 %) patients in ABCC8 gene. In 45 of 65 cases; WES analyses were done. A heterozygous c.2635C > T(p.Gln879Ter) variant was detected in IFIH1 gene in a patient with incidental hyperglycemia. In the segregation analysis affected mother was shown to be heterozygous for the same variant. CONCLUSION Molecular etiology was determined in 35 % cases with the NGS targeted panel. Seventeen novel variants in monogenic DM genes have been identified. A candidate gene determined by WES analysis in a case that could not be diagnosed with NGS panel in this study.
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Affiliation(s)
- Damla Goksen
- Department of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Evin
- Department of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esra Isik
- Department of Pediatric Genetics, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Samim Ozen
- Department of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Department of Pediatric Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Department of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Nese Akcan
- Department of Pediatric Endocrinology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Behzat Ozkan
- Department of Pediatric Endocrinology, Dr Behçet Uz Çocuk Training and Research Hospital, Izmir, Turkey
| | - Muammer Buyukinan
- Department of Pediatric Endocrinology, Konya Training and Research Hospital, Konya, Turkey
| | - Mehmet Nuri Ozbek
- Department of Pediatric Endocrinology, Mardin Artuklu University, Mardin, Turkey
| | - Sukran Darcan
- Department of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Huseyin Onay
- Multigen Genetic Diseases Diagnosis Center, Izmir, Turkey
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Turkut Tan T, Pariltay E, Avci Durmusaliogu E, Isik E, Cogulu O, Kavakli K, Atik T. A unique case of thrombophilia: the role of F9 gene duplication and increased factor IX activity in cerebral venous thrombosis. J Thromb Haemost 2023; 21:2913-2916. [PMID: 37414287 DOI: 10.1016/j.jtha.2023.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
Cerebral venous thrombosis (CVT) is a rare cerebrovascular disorder characterized by the obstruction of venous channels in the brain. Genetic factors play a significant role in CVT development, and recent studies have identified gain-of-function mutations in coagulation factors, including factor IX (FIX). This case report focuses on a unique neonatal case of CVT, where an X-chromosome duplication involving the F9 gene resulted in increased FIX activity. The neonate presented with feeding difficulties, weight loss, nystagmus, and seizures. Imaging and laboratory tests confirmed a 554-kb X-chromosome duplication encompassing the F9 gene. This genetic abnormality likely contributed to the elevated FIX activity level and subsequent CVT development. Understanding the relationship between coagulation factor abnormalities and CVT risk expands our knowledge of thrombophilia's genetic basis and may aid in the development of targeted treatment strategies for CVT management.
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Affiliation(s)
| | - Erhan Pariltay
- Department of Medical Genetics, Ege University, Bornova, Türkiye
| | | | - Esra Isik
- Department of Pediatric Genetics, Ege University, Bornova, Türkiye
| | - Ozgur Cogulu
- Department of Pediatric Genetics, Ege University, Bornova, Türkiye
| | - Kaan Kavakli
- Department of Pediatric Hematology and Oncology, Ege University, Bornova, Türkiye
| | - Tahir Atik
- Department of Pediatric Genetics, Ege University, Bornova, Türkiye
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Karamik G, Tuysuz B, Isik E, Yilmaz A, Alanay Y, Sunamak EC, Durmusalioglu EA, Ozkinay F, Cetin GO, Ozturk N, Mihci E, Nur B. The clinical phenotype of Koolen-de Vries syndrome in Turkish patients and literature review. Am J Med Genet A 2023. [PMID: 37053206 DOI: 10.1002/ajmg.a.63207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/28/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
Koolen-de Vries syndrome (KdVS) is a rare multisystemic disorder caused by a microdeletion on chromosome 17q21.31 including KANSL1 gene or intragenic pathogenic variants in KANSL1 gene. Here, we describe the clinical and genetic spectrum of eight Turkish children with KdVS due to a de novo 17q21.31 deletion, and report on several rare/new conditions. Eight patients from unrelated families aged between 17 months and 19 years enrolled in this study. All patients evaluated by a clinical geneticist, and the clinical diagnosis were confirmed by molecular karyotyping. KdVS patients had some common distinctive facial features. All patients had neuromotor retardation, and speech and language delay. Epilepsy, structural brain anomalies, ocular, ectodermal, and musculoskeletal findings, and friendly personality were remarkable in more than half of the patients. Hypertension, hypothyroidism, celiac disease, and postaxial polydactyly were among the rare/new conditions. Our study contributes to the clinical spectrum of patients with KdVS, while also provide a review by comparing them with previous cohort studies.
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Affiliation(s)
- Gokcen Karamik
- Department of Pediatrics, Division of Pediatric Genetics, Akdeniz University, Antalya, Turkey
| | - Beyhan Tuysuz
- Department of Pediatrics, Division of Pediatric Genetics, Cerrahpaşa University, Istanbul, Turkey
| | - Esra Isik
- Department of Pediatrics, Division of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Aysegul Yilmaz
- Department of Pediatrics, Division of Pediatric Genetics, Ondokuz Mayıs University, Samsun, Turkey
| | - Yasemin Alanay
- Department of Pediatrics, Division of Pediatric Genetics, Acıbadem University, Istanbul, Turkey
| | - Evrim Cifci Sunamak
- Department of Pediatrics, Division of Pediatric Genetics, Cerrahpaşa University, Istanbul, Turkey
| | | | - Ferda Ozkinay
- Department of Pediatrics, Division of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Gokhan Ozan Cetin
- Department of Medical Genetics, Pamukkale University, Denizli, Turkey
| | - Nuray Ozturk
- Department of Pediatrics, Division of Pediatric Genetics, Akdeniz University, Antalya, Turkey
| | - Ercan Mihci
- Department of Pediatrics, Division of Pediatric Genetics, Akdeniz University, Antalya, Turkey
| | - Banu Nur
- Department of Pediatrics, Division of Pediatric Genetics, Akdeniz University, Antalya, Turkey
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Ozbaran NB, Ozyasar SC, Dogan N, Kafali HY, Isik E, Satar A, Kose S, Atik T, Cogulu O. Evaluation of social cognition, autistic traits, and dysmorphology in comorbid specific learning disorder and attention-deficit/hyperactivity disorder. Clin Child Psychol Psychiatry 2022; 27:991-1005. [PMID: 35658687 DOI: 10.1177/13591045221095428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research on areas such as social cognition, autistic traits, and minor physical anomalies in comorbid Specific Learning Disorder (SLD) and attention-deficit/hyperactivity disorder (ADHD) is limited. In this study, we compared these areas in children aged between 8 and 14 with comorbid SLD and ADHD and their typically developed peers. Emotion recognition and social cognition were evaluated by Faces Test, Reading the Mind in the Eyes Test, Comprehension Test, and Difficulties in Emotion Regulation Scale. Autism Spectrum Screening Questionnaire and Social Responsiveness Scale were used for screening of autism spectrum disorder in children. Furthermore, autistic traits in parents were measured by Autism-Spectrum Quotient. The MPAs of all the subjects were determined by pediatric geneticists. We detected that children with comorbid SLD and ADHD performed worse than controls in all social cognition tests and maternal AQ score had a strong correlation with the Faces Test, DERS, and SRS scores. Also, the total ASSQ score in the comorbid SLD and ADHD group was significantly higher than controls. Finally, MPAs were significantly more frequent in the comorbid SLD and ADHD group. Impairment in social cognition and evaluation of autistic traits and dysmorphology in children with comorbid SLD and ADHD may provide useful information on neurodevelopmental disorders.
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Affiliation(s)
- Nazli Burcu Ozbaran
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, 60521Ege University, Izmir, Turkey
| | - Senay Celenay Ozyasar
- Department of Child and Adolescent Psychiatry, 233010Adiyaman Education and Research Hospital, Adiyaman, Turkey
| | - Nurhak Dogan
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, 60521Ege University, Izmir, Turkey
| | - Helin Yilmaz Kafali
- Department of Child and Adolescent Psychiatry, 536164Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Esra Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, 60521Ege University, Izmir, Turkey
| | - Aysegul Satar
- Department of Child and Adolescent Psychiatry, Ardahan State Hospital, Ardahan, Turkey
| | - Sezen Kose
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, 60521Ege University, Izmir, Turkey
| | - Tahir Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, 60521Ege University, Izmir, Turkey
| | - Ozgur Cogulu
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, 60521Ege University, Izmir, Turkey
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Ece Solmaz A, Isik E, Atik T, Ozkinay F, Onay H. Mutation spectrum of the NF1 gene and genotype-phenotype correlations in Turkish patients: Seventeen novel pathogenic variants. Clin Neurol Neurosurg 2021; 208:106884. [PMID: 34418705 DOI: 10.1016/j.clineuro.2021.106884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 08/05/2021] [Accepted: 08/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Neurofibromatosis type 1 is one of the most common autosomal dominant diseases caused by heterozygous mutation in the NF1 gene. Wide spectrum of NF1-related clinical manifestations and mutation distribution makes genetic counselling difficult. METHODS The study enrolled 58 unrelated Turkish patients with clinically suspected NF1 referred to the Department of Medical Genetics. Individuals were eligible if they 1) met at least two of the main National Institutes of Health criteria or 2) had multiple café-au-lait macules as a child. RESULTS Fourty-one different disease-causing variants were identified in 42 (72.4%) individuals, including 17 novel variants. Twenty-four (58.2%) of the NF1 patients had de novo variants. Café-au-lait macules were observed in all patients (100%). Intracranial hamartoma was the second most common phenotype, found in 52.3% (22/42) of the patients. Other common manifestations were neurofibromas (35.7%), axillary or inguinal freckling (28.5%), and Lisch nodules (28.5%). Additionally, one patient had intra-abdominal malignant peripheral nerve sheath tumours and another patient underwent surgery for serous papillary ovarian cancer. CONCLUSION In conclusion, this study is one of the largest studies from Turkey to investigate the NF1 mutation spectrum and genotype-phenotype correlations.
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Affiliation(s)
- Asli Ece Solmaz
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey.
| | - Esra Isik
- University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| | - Tahir Atik
- University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| | - Ferda Ozkinay
- University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| | - Huseyin Onay
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey
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Avci Durmusalioglu E, Isik E, Ayyildiz Emecen D, Goksen D, Ozen S, Onay H, Kose M, Atik T, Darcan S, Cogulu O, Ozkinay F. The utility of reverse phenotyping: a case of lysinuric protein intolerance presented with childhood osteoporosis. J Pediatr Endocrinol Metab 2021; 34:957-960. [PMID: 33823103 DOI: 10.1515/jpem-2021-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/18/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Childhood osteoporosis is often a consequence of a chronic disease or its treatment. Lysinuric protein intolerance (LPI), a rare secondary cause of the osteoporosis, is an autosomal recessive disorder with clinical features ranging from minimal protein intolerance to severe multisystemic involvement. We report a case diagnosed to have LPI using a Next Generation Sequencing (NGS) panel and evaluate the utility of reverse phenotyping. CASE PRESENTATION A fifteen-year-old-boy with an initial diagnosis of osteogenesis imperfecta, was referred due to a number of atypical findings accompanying to osteoporosis such as splenomegaly and bicytopenia. A NGS panel (TruSight One Sequencing Panel) was performed and a novel homozygous mutation of c.257G>A (p.Gly86Glu) in the SLC7A7 gene (NM_001126106.2), responsible for LPI, was detected. The diagnosis was confirmed via reverse phenotyping. CONCLUSIONS Reverse phenotyping using a multigene panel shortens the diagnostic process.
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Affiliation(s)
- Enise Avci Durmusalioglu
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esra Isik
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Durdugul Ayyildiz Emecen
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Damla Goksen
- Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Samim Ozen
- Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Huseyin Onay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Melis Kose
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Sukran Darcan
- Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozgur Cogulu
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Pediatric Genetics Subdivision, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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Kose M, Isik E, Aykut A, Durmaz A, Kose E, Ersoy M, Diniz G, Adebali O, Ünalp A, Yilmaz Ü, Karaoğlu P, Edizer S, Tekin HG, Özdemir TR, Atik T, Onay H, Özkınay F. The utility of next-generation sequencing technologies in diagnosis of Mendelian mitochondrial diseases and reflections on clinical spectrum. J Pediatr Endocrinol Metab 2021; 34:417-430. [PMID: 33629572 DOI: 10.1515/jpem-2020-0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/11/2020] [Accepted: 12/10/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Diagnostic process of mitochondrial disorders (MD) is challenging because of the clinical variability and genetic heterogeneity of these conditions. Next-Generation Sequencing (NGS) technology offers a high-throughput platform for nuclear MD. METHODS We included 59 of 72 patients that undergone WES and targeted exome sequencing panel suspected to have potential PMDs. Patients who were included in the analysis considering the possible PMD were reviewed retrospectively and scored according to the Mitochondrial Disease Criteria Scale. RESULTS Sixty-one percent of the patients were diagnosed with whole-exome sequencing (WES) (36/59) and 15% with targeted exome sequencing (TES) (9/59). Patients with MD-related gene defects were included in the mito group, patients without MD-related gene defects were included in the nonmito group, and patients in whom no etiological cause could be identified were included in the unknown etiology group. In 11 out of 36 patients diagnosed with WES, a TES panel was applied prior to WES. In 47 probands in 39 genes (SURF1, SDHAF1, MTO1, FBXL4, SLC25A12, GLRX5, C19oRF12, NDUFAF6, DARS2, BOLA3, SLC19A3, SCO1, HIBCH, PDHA1, PDHAX, PC, ETFA, TRMU, TUFM, NDUFS6, WWOX, UBCD TREX1, ATL1, VAC14, GFAP, PLA2G6, TPRKB, ATP8A2, PEX13, IGHMBP2, LAMB2, LPIN1, GFPT1, CLN5, DOLK) (20 mito group, 19 nonmito group) 59 variants (31 mito group, 18 nonmito group) were detected. Seven novel variants in the mito group (SLC25A12, GLRX5, DARS2, SCO1, PC, ETFA, NDUFS6), nine novel variants in the nonmito group (IVD, GCDH, COG4, VAC14, GFAP, PLA2G6, ATP8A2, PEX13, LPIN1) were detected. CONCLUSIONS We explored the feasibility of identifying pathogenic alleles using WES and TES in MD. Our results show that WES is the primary method of choice in the diagnosis of MD until at least all genes responsible for PMD are found and are highly effective in facilitating the diagnosis process.
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Affiliation(s)
- Melis Kose
- Department of Pediatrics, Division of Inborn Errors of Metabolism, İzmir Katip Çelebi University, Izmir, Turkey.,Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Esra Isik
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Ayça Aykut
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Asude Durmaz
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Engin Kose
- Department of Pediatrics, Division of Inborn Errors of Metabolism, Ankara University, Ankara, Turkey
| | - Melike Ersoy
- Department of Pediatrics, Division of Inborn Errors of Metabolism, Health Sciences University, Bakırkoy Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Gulden Diniz
- Department of Pathology, İzmir Democrasy University, Izmir, Turkey
| | - Ogun Adebali
- Adebali Lab, Molecular Biology, Genetics and Bioengineering Program, Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Aycan Ünalp
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Ünsal Yilmaz
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Pakize Karaoğlu
- Department of Pediatric Neurology, Health Sciences University Dr. Behçet Uz Children Research and Training Hospital, Izmir, Turkey
| | - Selvinaz Edizer
- Department of Pediatrics, Division of Pediatric Neurology, Kanuni Sultan Suleyman University, Istanbul, Turkey
| | - Hande Gazeteci Tekin
- Department of Pediatrics, Division of Pediatric Neurology, Çiğli Training and Research Hospital, Izmir, Turkey
| | - Taha Reşid Özdemir
- Department of Medical Genetics, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tahir Atik
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
| | - Hüseyin Onay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Ferda Özkınay
- Department of Pediatrics, Division of Genetics, Ege University, Izmir, Turkey
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10
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Araci MB, Akgun B, Atik T, Isik E, Ak G, Barutcuoglu B, Ozkinay F. Clinical and molecular findings in children and young adults with persistent low alkaline phosphatase concentrations. Ann Clin Biochem 2021; 58:335-341. [PMID: 33601892 DOI: 10.1177/00045632211000102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hypophosphatasia is a rare inherited metabolic disease resulted by ALPL gene mutations. It is characterized by defective bone and teeth mineralization. The phenotypic spectrum is highly variable ranging from lethal perinatal form to mild forms which are only diagnosed in adulthood or remain undiagnosed despite persistently low concentrations of ALP. The aim of this study is to evaluate the clinical phenotype and frequency of ALPL mutations in a group of patient with hypophosphatasaemia. METHODS Thirty individuals with alkaline phosphatase values below 40 IU/L in at least two assessments and having no alternative explanation for their low ALP concentrations were included in the study. The clinical features and radiological data of the study group were re-investigated for hypophosphatasia-related findings. ALPL sequence analysis was performed using Sanger sequencing. RESULTS No patient in the study group had severe symptoms, nor had they initially been diagnosed as having hypophosphatasia. Four different heterozygous ALPL mutations (c.542C>T, c.648 + 1G>A, c.657G>T and c.862 + 1G>C) were found in four patients. One splice site mutation (c.862 + 1G>C) was reported for the first time in this study. CONCLUSION ALPL sequence analysis may help to diagnosing genetic defects in individuals with persistently low ALP concentrations and provide to take preventive measures before symptoms appear. As in the other populations, HPP displays allelic heterogeneity in our population.
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Affiliation(s)
- Mehmet Bilal Araci
- Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Bilcag Akgun
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esra Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gunes Ak
- Department of Biochemistry, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Burcu Barutcuoglu
- Department of Biochemistry, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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11
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Ozkinay F, Emecen DA, Kose M, Isik E, Bozaci AE, Canda E, Tuysuz B, Zubarioglu T, Atik T, Onay H. Clinical and genetic features of 13 patients with mucopolysaccarhidosis type IIIB: Description of two novel NAGLU gene mutations. Mol Genet Metab Rep 2021; 27:100732. [PMID: 33747789 PMCID: PMC7966861 DOI: 10.1016/j.ymgmr.2021.100732] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/25/2022] Open
Abstract
Aim Mucopolysaccharidosis type III B (MPS IIIB) is an autosomal recessive lysosomal storage disease caused by mutations in the NAGLU gene which codes the lysosomal enzyme alpha-N-acetylglucosaminidase. The major symptoms of the disease are cognitive and neurological defects. In this study, the molecular spectrums of 13 MPS IIIB patients were evaluated. Material and methods Thirteen MPS IIIB patients from 11 families were included in this study. All patients were both clinically and molecularly diagnosed. NAGLU gene sequencing was performed using a next generation sequencing platform (Illumina MiSeq). Demographic, clinical and laboratory findings of the patients were obtained via the hospital records. Results Ten different mutations from the 13 MPS IIIB patients were identified. Eight of the 10 mutations were missense, one was splice site, and one large deletion was also observed. Two mutations c.509G>T (p.Gly170Val) and c.700C>G (p.Arg234Gly) have been defined for the first time in this study. Conclusion Our study expanded the mutation spectrum of the NAGLU gene thereby contributing to the improved genetic counselling of MPS IIIB patients. Confirming the literature, missense mutations were also found to be the most common NAGLU mutations in our study.
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Affiliation(s)
- F Ozkinay
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - D A Emecen
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - M Kose
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - E Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A E Bozaci
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - E Canda
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - B Tuysuz
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Cerrahpasa University, Izmir, Turkey
| | - T Zubarioglu
- Subdivision of Pediatric Metabolism, Department of Pediatrics, Faculty of Medicine, Cerrahpasa University, Izmir, Turkey
| | - T Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - H Onay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
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12
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Ayyildiz Emecen D, Isik E, Utine GE, Simsek-Kiper PO, Atik T, Ozkinay F. Clinical and Molecular Spectrum of Four Patients Diagnosed with Mowat-Wilson Syndrome. Mol Syndromol 2020; 11:296-301. [PMID: 33510600 PMCID: PMC7802445 DOI: 10.1159/000511609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/11/2020] [Indexed: 11/19/2022] Open
Abstract
Mowat-Wilson syndrome (MWS) is a rare autosomal dominant syndrome characterized by distinctive facial features, congenital heart defects, Hirschsprung disease, genitourinary anomalies, various structural brain anomalies, and intellectual disability. Pathogenic mutations that result in haploinsufficiency in the ZEB2 gene cause MWS. In this study, we aimed to evaluate the clinical features and molecular analysis results of 4 MWS patients. All patients were examined by an expert clinical geneticist. Dysmorphological abnormalities were recorded. Data including demographic, clinical, and laboratory findings were obtained from hospital records. ZEB2 gene analysis was performed using a Sanger sequencing method. All patients had typical facial features of MWS such as widely spaced eyes, broad eyebrows with a medial flare, low-hanging columella, prominent or pointed chin, open-mouth expression, and uplifted earlobes. Four different heterozygous mutations were identified; 2 mutations were frameshift (c.246_247delGGinsC, c.980_980delG), 1 was nonsense (c.2083C>T), and 1 was splice site (c.808-2A>G). Two of them (c.246_247delGGinsC, c.980_980delG) have not been previously reported in the literature. By defining 2 novel mutations, this study contributes to the molecular spectrum of MWS, while also providing a further insight for genetic counseling. It also demonstrates the importance of dysmorphological examination in clinical diagnosis.
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Affiliation(s)
- Durdugul Ayyildiz Emecen
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Esra Isik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gulen E. Utine
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Pelin O. Simsek-Kiper
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tahir Atik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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13
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Isik E, Arican D, Atik T, Ooi JE, Darcan S, Ozen S, Simsek Kiper PO, Utine E, Cogulu O, Ozkinay F. A rare cause of syndromic short stature: 3M syndrome in three families. Am J Med Genet A 2020; 185:461-468. [PMID: 33258289 DOI: 10.1002/ajmg.a.61989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/21/2020] [Accepted: 11/14/2020] [Indexed: 11/11/2022]
Abstract
3M syndrome is a rare autosomal recessive genetic disorder characterized by severe growth retardation, dysmorphic facial features, skeletal dysplasia, and normal intelligence. Variants in CUL7, OBSL1, and CCDC8 genes have been reported to be responsible for this syndrome. In this study, the clinical and molecular findings of four 3M syndrome cases from three families are presented. All cases had growth retardation, relative macrocephaly, and typical dysmorphic facial features. Their neurological developments were normal. Sequencing of CUL7, OBSL1, and CCDC8 genes revealed two different novel homozygous variants in CUL7 in Families 1 and 3 and a previously reported homozygous pathogenic variant in OBSL1 in Family 2. In conclusion, a comprehensive dysmorphological evaluation should be obtained in individuals presenting with short stature and in such individuals with typical facial and skeletal findings, 3M syndrome should be considered. Our report expands the genotype of 3M syndrome and emphasizes the importance of thorough physical and dysmorphological examination.
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Affiliation(s)
- Esra Isik
- Faculty of Medicine, Department of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Duygu Arican
- Faculty of Medicine, Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Tahir Atik
- Faculty of Medicine, Department of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Joo Enn Ooi
- University of Manchester, School of Medicine, Manchester, UK
| | - Sukran Darcan
- Faculty of Medicine, Department of Pediatric Endocrinology, Ege University, Izmir, Turkey
| | - Samim Ozen
- Faculty of Medicine, Department of Pediatric Endocrinology, Ege University, Izmir, Turkey
| | | | - Eda Utine
- Department of Pediatric Genetics, Hacettepe University, Ankara, Turkey
| | - Ozgur Cogulu
- Faculty of Medicine, Department of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Faculty of Medicine, Department of Pediatric Genetics, Ege University, Izmir, Turkey
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14
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Isik E, Yilmaz S, Atik T, Aktan G, Onay H, Gokben S, Ozkinay F. The utility of whole exome sequencing for identification of the molecular etiology in autosomal recessive developmental and epileptic encephalopathies. Neurol Sci 2020; 41:3729-3739. [DOI: 10.1007/s10072-020-04619-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/19/2020] [Indexed: 12/15/2022]
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15
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Isik E, Simsir OS, Solmaz AE, Onay H, Atik T, Aykut A, Durmaz A, Cogulu O, Ozkinay F. Clinical and molecular aspects of
PTEN
mutations in 10 pediatric patients. Ann Hum Genet 2020; 84:324-330. [DOI: 10.1111/ahg.12380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/09/2019] [Accepted: 01/10/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Esra Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine Ege University Izmir Turkey
| | - Ozguc Semih Simsir
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine Ege University Izmir Turkey
| | - Asli Ece Solmaz
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
| | - Huseyin Onay
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
| | - Tahir Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine Ege University Izmir Turkey
| | - Ayca Aykut
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
| | - Asude Durmaz
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
| | - Ozgur Cogulu
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine Ege University Izmir Turkey
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
| | - Ferda Ozkinay
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine Ege University Izmir Turkey
- Department of Medical Genetics Faculty of Medicine, Ege University Izmir Turkey
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16
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Isik E, Onay H, Atik T, Canda E, Cogulu O, Coker M, Ozkinay F. Clinical utility of a targeted next generation sequencing panel in severe and pediatric onset Mendelian diseases. Eur J Med Genet 2019; 62:103725. [DOI: 10.1016/j.ejmg.2019.103725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/01/2019] [Accepted: 07/13/2019] [Indexed: 02/03/2023]
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Isik E, Aykut A, Atik T, Cogulu O, Ozkinay F. Biallelic TOR1A mutations cause severe arthrogryposis: A case requiring reverse phenotyping. Eur J Med Genet 2018; 62:103544. [PMID: 30244176 DOI: 10.1016/j.ejmg.2018.09.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022]
Abstract
Heterozygous mutations in TOR1A gene are known to be responsible for DYT1 dystonia with incomplete penetrance. Autosomal recessive TOR1A disease is a very recently described syndrome characterized by severe arthrogryposis, developmental delay, strabismus and tremor. A 2 month-old boy with severe arthrogryposis and developmental delay was referred to our department for genetic counseling. Dystonic movements were observed on physical examination. Whole exome sequencing revealed a homozygous nonsense variant in exon 5 of TOR1A (c.862C > T, p.Arg288*). Our results expand the phenotypic and mutational spectrum of biallelic TOR1A disease, while emphasizing the importance of reverse phenotyping in the diagnosis of rare genetic disorders.
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Affiliation(s)
- Esra Isik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Ayca Aykut
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozgur Cogulu
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey; Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Subdivision of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey; Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, Turkey
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18
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Isik E, Onay H, Atik T, Akgun B, Cogulu O, Ozkinay F. Clinical and genetic features of L1 syndrome patients: Definition of two novel mutations. Clin Neurol Neurosurg 2018; 172:20-23. [DOI: 10.1016/j.clineuro.2018.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 05/24/2018] [Accepted: 06/09/2018] [Indexed: 11/15/2022]
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19
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Serin HM, Simsek E, Isik E, Gokben S. WWOX-associated encephalopathies: identification of the phenotypic spectrum and the resulting genotype-phenotype correlation. Neurol Sci 2018; 39:1977-1980. [PMID: 30094525 DOI: 10.1007/s10072-018-3528-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/06/2018] [Indexed: 02/03/2023]
Abstract
Epileptic encephalopathies are a group of disorders in which epileptiform abnormalities cause progressive deterioration in cerebral function. Genetic causes have been described in several of the epileptic encephalopathies, and many previously unknown genes have been identified. WW domain-containing oxidoreductase (WWOX) has recently been implicated in autosomal recessive spinocerebellar ataxia type 12 (SCAR12) and severe early-onset epileptic encephalopathy. With whole-exome sequencing, we identified a homozygous WWOX missense mutation, p.Leu239Arg, in a girl from a consanguineous family with psychomotor developmental delay, acquired microcephaly, and epileptic seizures. WWOX-related epileptic encephalopathy is a rare condition but it should be considered in cases having early epileptic spasms and parental consanguinity.
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Affiliation(s)
- Hepsen Mine Serin
- Department of Pediatrics, Division of Child Neurology, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey.
| | - Erdem Simsek
- Department of Pediatrics, Division of Child Neurology, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey
| | - Esra Isik
- Department of Pediatrics, Division of Pediatric Genetics, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey
| | - Sarenur Gokben
- Department of Pediatrics, Division of Child Neurology, Ege University Faculty of Medicine, Bornova, 35100, Izmir, Turkey
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20
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Tekeli-Yesil S, Isik E, Unal Y, Aljomaa Almossa F, Konsuk Unlu H, Aker AT. Determinants of Mental Disorders in Syrian Refugees in Turkey Versus Internally Displaced Persons in Syria. Am J Public Health 2018; 108:938-945. [PMID: 29771613 DOI: 10.2105/ajph.2018.304405] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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
OBJECTIVES To compare frequencies of some mental health disorders between Syrian refugees living in Turkey and internally displaced persons in Syria, and to identify factors associated with posttraumatic stress disorder and major depressive disorder. METHODS We carried out a field survey in May 2017 among 540 internally displaced persons in Syria and refugees in Turkey. RESULTS The study revealed that mental disorders were highly prevalent in both populations. Major depressive disorder was more frequent among refugees in Turkey than among internally displaced persons in Syria; other mental disorders, including posttraumatic stress disorder, were more prevalent in the latter than in the former. Posttraumatic stress disorder was also associated with postmigration factors. Major depressive disorder was more likely among refugees in Turkey. In addition, the likelihood of major depressive disorder was predicted by stopping somewhere else before resettlement in the current location. CONCLUSIONS The resettlement locus and the context and type of displacement seem to be important determinants of mental health disorders, with postmigration factors being stronger predictors of conflict-related mental health. Internally displaced persons may benefit more from trauma-focused approaches, whereas refugees may derive greater benefit from psychosocial approaches.
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Affiliation(s)
- Sidika Tekeli-Yesil
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
| | - Esra Isik
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
| | - Yesim Unal
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
| | - Fuad Aljomaa Almossa
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
| | - Hande Konsuk Unlu
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
| | - Ahmet Tamer Aker
- Sidika Tekeli-Yesil is with the Swiss Tropical and Public Health Institute, Department of Medicine, Clinical Research Unit, Basel, Switzerland. Esra Isik is with Kocaeli University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Kocaeli, Turkey. Yesim Unal and Ahmet Tamer Aker are with Istanbul Bilgi University, Institute of Health Sciences, Department of Disaster and Trauma Mental Health, Istanbul, Turkey. Fuad Aljomaa Almossa is with Gaziantep University, Institute of Health Sciences, Gaziantep, Turkey. Hande Konsuk Unlu is with Hacettepe University, Institute of Public Health, Ankara, Turkey
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21
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Ozkinay F, Atik T, Isik E, Gormez Z, Sagiroglu M, Sahin OA, Corduk N, Onay H. A further family of Stromme syndrome carrying CENPF
mutation. Am J Med Genet A 2017; 173:1668-1672. [DOI: 10.1002/ajmg.a.38173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/16/2017] [Accepted: 01/18/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Ferda Ozkinay
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine; Ege University; Izmir Turkey
| | - Tahir Atik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine; Ege University; Izmir Turkey
| | - Esra Isik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine; Ege University; Izmir Turkey
| | - Zeliha Gormez
- Advanced Genomics and Bioinformatics Research Center; TUBITAK-BILGEM; Kocaeli Turkey
| | - Mahmut Sagiroglu
- Advanced Genomics and Bioinformatics Research Center; TUBITAK-BILGEM; Kocaeli Turkey
| | - Ozlem Atan Sahin
- Biochemistry and Molecular Biology, Institude of Health Sciences; Acibadem University; Istanbul Turkey
| | - Nergul Corduk
- Department of Pediatric Surgery, Faculty of Medicine; Pamukkale University; Denizli Turkey
| | - Huseyin Onay
- Department of Medical Genetics, Faculty of Medicine; Ege University; Izmir Turkey
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22
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Deng J, Isik E, Fernandes SM, Brown JR, Letai A, Davids MS. Bruton's tyrosine kinase inhibition increases BCL-2 dependence and enhances sensitivity to venetoclax in chronic lymphocytic leukemia. Leukemia 2017; 31:2075-2084. [PMID: 28111464 PMCID: PMC5555835 DOI: 10.1038/leu.2017.32] [Citation(s) in RCA: 128] [Impact Index Per Article: 18.3] [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: 10/04/2016] [Revised: 01/05/2017] [Accepted: 01/13/2017] [Indexed: 02/07/2023]
Abstract
Although the BTK inhibitor ibrutinib has transformed the management of patients with CLL, it does not induce substantial apoptosis in vitro, and as such the mechanisms underlying its ability to kill CLL cells are not well understood. Acalabrutinib, a more specific BTK inhibitor now in development, also appears to be highly effective in CLL, but the connection of its mechanism with CLL cell death is also unclear. Using dynamic BH3 profiling, we analyzed alterations in the function of the mitochondrial apoptotic pathway induced by ibrutinib and acalabrutinib. We studied CLL patient samples treated ex vivo with both drugs, as well as primary samples from CLL patients on clinical trials of both drugs. We found that BTK inhibition enhances mitochondrial BCL-2 dependence without significantly altering overall mitochondrial priming. Enhancement of BCL-2 dependence was accompanied by an increase in the pro-apoptotic protein BIM. In contrast, treatment with the selective BCL-2 inhibitor venetoclax enhanced overall mitochondrial priming without increasing BCL-2 dependence. Pre-treatment of CLL cells with either BTK inhibitor, whether ex vivo or in vivo in patients, enhanced killing by venetoclax. Our data suggest that BTK inhibition enhances mitochondrial BCL2 dependence, supporting the ongoing development of clinical trials combining BTK and BCL-2 inhibition.
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Affiliation(s)
- J Deng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - E Isik
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S M Fernandes
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - J R Brown
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - A Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - M S Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Ozkan M, Baysan O, Erinc K, Koz C, Yokusoglu M, Uzun M, Sag C, Genc C, Karaeren H, Isik E. Brain Natriuretic Peptide and the Severity of Aortic Regurgitation: Is There Any Correlation? J Int Med Res 2016; 33:454-9. [PMID: 16104449 DOI: 10.1177/147323000503300411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 ± 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 age-matched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild ( n = 16); group C, ≥ 3 and < 6 mm, moderate ( n = 26); group D, ≥ 6 mm, severe ( n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.
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Affiliation(s)
- M Ozkan
- Faculty of Medicine, Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey.
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Yildiz G, Izli N, Uylaser V, Isik E. Effect of different drying methods on drying characteristics, colour, total phenolic content and antioxidant activity of sliced green table olives. Quality Assurance and Safety of Crops & Foods 2014. [DOI: 10.3920/qas2013.0272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- G. Yildiz
- Faculty of Agriculture, Department of Food Engineering, Uludag University, 16059 Bursa, Turkey
| | - N. Izli
- Faculty of Agriculture, Department of Biosystems Engineering, Uludag University, 16059 Bursa, Turkey
| | - V. Uylaser
- Faculty of Agriculture, Department of Food Engineering, Uludag University, 16059 Bursa, Turkey
| | - E. Isik
- Faculty of Agriculture, Department of Biosystems Engineering, Uludag University, 16059 Bursa, Turkey
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Sahin S, Isik E, Demir C. Prediction of Total Phenolic Content in Extracts of Prunella Species from HPLC Profiles by Multivariate Calibration. ACTA ACUST UNITED AC 2012. [DOI: 10.5402/2012/120780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The multivariate calibration methods—principal component regression (PCR) and partial least squares (PLSs)—were employed for the prediction of total phenol contents of four Prunella species. High performance liquid chromatography (HPLC) and spectrophotometric approaches were used to determine the total phenol content of the Prunella samples. Several preprocessing techniques such as smoothing, normalization, and column centering were employed to extract the chemically relevant information from the data after alignment with correlation optimized warping (COW). The importance of the preprocessing was investigated by calculating the root mean square error (RMSE) for the calibration set of the total phenol content of Prunella samples. The models developed based on the preprocessed data were able to predict the total phenol content with a precision comparable to that of the reference of the Folin-Ciocalteu method. PLS model seems preferable, because of its predictive and describing abilities and good interpretability of the contribution of compounds to the total phenol content. Multivariate calibration methods were constructed to model the total phenol content of the Prunella samples from the HPLC profiles and indicate peaks responsible for the total phenol content successfully.
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Affiliation(s)
- Saliha Sahin
- Department of Chemistry, Faculty of Science and Arts, University of Uludağ, 16059 Bursa, Turkey
| | - Esra Isik
- Department of Chemistry, Faculty of Science and Arts, University of Uludağ, 16059 Bursa, Turkey
| | - Cevdet Demir
- Department of Chemistry, Faculty of Science and Arts, University of Uludağ, 16059 Bursa, Turkey
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Cansev⁎ M, Orenlili E, Kanar F, Isik E, Ulus I. Effect of exogenous uridine administration on brain extracellular uridine nucleotide concentrations in vivo. Eur J Pharmacol 2011. [DOI: 10.1016/j.ejphar.2011.09.261] [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: 11/28/2022]
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Celik T, Yuksel UC, Bugan B, Celik M, Fici F, Iyisoy A, Kilic S, Sonmez A, Yaman H, Isik E. P-wave dispersion and its relationship to aortic elasticity in young prehypertensive patients. Am J Hypertens 2009; 22:1270-5. [PMID: 19779469 DOI: 10.1038/ajh.2009.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Prolonged P-wave duration (P(dur)) and increased P-wave dispersion (PWD) are independent predictors of atrial fibrillation (AF) in patients with hypertension. This study was designed to evaluate the possible relationship between aortic elasticity and PWD in young prehypertensive patients. METHODS Twenty-five newly diagnosed prehypertensive patients (18 men, mean age = 34 +/- 6 years) and 25 healthy control subjects (16 men, mean age = 33 +/- 6 years) were enrolled in the study. The P(dur) measurements were calculated using a 12-lead surface electrocardiogram (ECG). Aortic elasticity parameters were derived from aortic diameters measured by echocardiography, and simultaneous blood pressure (BP) measurements by sphygmomanometry. RESULTS The baseline characteristics of patients with prehypertension were homogeneous with those of the controls. PWD and P(maximum) values were found to be higher in patients with prehypertension as compared to those of the controls (PWD; 65 ms vs. 35 ms, P < 0.001; P(maximum); 110 ms vs. 80 ms, P < 0.001). However, P(minimum) values were not significantly different between the two groups (40 ms vs. 45 ms, P = 0.358). Also, a moderate positive correlation was found between stiffness index (SI) and PWD (r = 0.500, P = 0.011), and a moderate negative correlation between aortic elasticity parameters (aortic distensibility and strain indexes) and PWD (for aortic distensibility, r = -0.498, P = 0.011; for strain index, r = -0.578, P = 0.002), in patients with prehypertension. CONCLUSIONS Young patients with prehypertension have increased PWD and arterial stiffness. These parameters are correlated and may pose additional risk factors for future cardiovascular events.
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Hasimi A, Koz C, Baysan O, Yokusoglu M, Uzun M, Celebi H, Isik E. THE EFFECT OF DIAGNOSTIC CORONARY ANGIOGRAPHY ON INFLAMMATUAR MARKERS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70720-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Celik T, Iyisoy A, Yuksel UC, Kursaklioglu H, Isik E. Bilateral coronary–pulmonary artery fistulae associated with severe aortic insufficiency: an interesting association causing myocardial ischemia. Ir J Med Sci 2007; 177:399-400. [PMID: 17703336 DOI: 10.1007/s11845-007-0071-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 07/11/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Coronary artery fistula (CAF) is defined as a direct communication of a coronary artery with a cardiac chamber, great vessel or other vascular structure, bypassing the myocardial capillary bed. Congenital CAFs joining into the pulmonary artery are rare cardiac anomalies. CAFs arising from two coronary arteries are even more rare especially when combined with valvular heart disease. The coincidence of CAFs with aortic insufficiency is relatively rare and sometimes might cause myocardial ischemia. RESULTS We present a case of bilateral coronary-pulmonary artery fistula combined with severe aortic insufficiency causing myocardial ischemia and who subsequently underwent fistula ligation during aortic valve surgery.
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Affiliation(s)
- T Celik
- Department of Cardiology, Gulhane Military Medical Academy, School of Medicine, 06018, Etlik-Ankara, Turkey.
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Abstract
Primary chylopericardium is a rare entity. Here we describe a 36-year-old, asymptomatic male in whom pericardial effusion was detected by chest X-ray and echocardiography on routine health control. After pericardiocentesis that revealed the chylous nature of the fluid, partial pericardiectomy without duct ligation was carried out. In the follow-up period, there was no evidence of pericardial fluid on chest X-ray and echocardiography, at three months after the procedure.
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Affiliation(s)
- M Yokusoglu
- Department of Cardiology, Gulhane Military Medical School, Etlik-Ankara, Turkey.
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Issever H, Hapcioglu B, Ozdilli K, Kocyigit E, Kaymakcalan H, Yegenoglu Y, Ozturk O, Agkoc S, Topuzoglu A, Onoglu N, Isik E, Susever S, Calak B, Gurtekin B. Assessment of nasal flora and respiratory function tests of bakery workers working under modern conditions. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kursaklioglu H, Iyisoy A, Amasyali B, Celik T, Ozturk C, Kose S, Isik E. Spironolactone does not prevent restenosis after coronary stenting in humans. Ann Acad Med Singap 2004; 33:769-74. [PMID: 15608836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION In animal studies, aldosterone enhanced neointimal proliferation by increasing extracellular accumulation of collagen and potentiating the effects of angiotensin II. Spironolactone, an aldosterone antagonist, is a potent inhibitor of neointimal proliferation. We conducted a placebo-controlled, double-blind, randomised study to assess the effect of spironolactone on angiographic 6-month in-stent restenosis. MATERIALS AND METHODS Of the 310 randomised patients with significant coronary artery disease, 258 patients were available for analysis: 128 constituted the placebo group and 130 were assigned to receive spironolactone. Eligible patients were randomly assigned to receive a dose of 50 mg spironolactone or placebo orally twice a day for 6 months. The primary endpoint was the angiographic restenosis (>50% stenosis) rate at follow-up angiography. RESULTS At 6-month follow-up angiography after stenting, there was no difference between the 2 groups in minimal lumen diameter, percent diameter stenosis, late loss, and net gain. Angiographic restenosis occurred in 46 (35.4%) of 130 patients receiving spironolactone and 50 (39.0%) of 128 in the placebo group with an odds ratio (OR) of 0.85 with a 95% confidence interval (CI) of 0.49 to 1.46 (P = 0.62). Restenosis rate was found in 60 (32.9%) of 182 lesions in the spironolactone group, and 61 (35.5%) of 172 lesions in the placebo group with an OR of 0.89 with a 95% CI of 0.56 to 1.42 (P = 0.89). CONCLUSIONS Spironolactone did not reduce the incidence of in-stent restenosis as compared with placebo in human, contrary to the fact that reduction of neointimal formation in animal models has been observed upon administration of spironolactone.
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Affiliation(s)
- H Kursaklioglu
- Cardiac Catheterization Laboratory, Department of Cardiology, Gulhane Military Medical Academy, Turkey.
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Abstract
The authors discuss the use of a wire system in chronic total occlusion, noting the factors that affect primary success and the clinical results. Percutaneous transluminal coronary angioplasty was performed on 29 patients with single-vessel disease. The mean age of the patients was fifty-three +/- three years. The authors used routine angioplastic techniques with the wire system. Fifteen of the lesions were functional and the others were in total anatomic occlusion. The primary success rate was 69%. Primary success was 88%, 48%, and 75%, in the left anterior descending, left circumflex, and right coronary artery, respectively. In 4 cases the wire did not cross the occlusion. One patient required direct-current cardioversion for ventricular fibrillation during the procedure, and 1 patient sustained a non-Q wave myocardial infarction following the procedure. There were no deaths.
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Affiliation(s)
- O Pektas
- Gulhane Military Medical Academy, Ankara, Turkey
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Gülekon A, Atik FL, Isik E, Gürer MA, Arikan Z. P 035 Sleep pattern in Behçet's disease. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)82337-9] [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: 12/01/2022]
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Abstract
Percutaneous mitral valvuloplasty (PMV) was performed in 57 patients with mitral stenosis. Twenty-three women and 34 men (mean age 28 +/- 10 mean +/- SD) were included in the study. A single-balloon (trefoil or bifoil) technique was used in 49 patients and a double-balloon (trefoil + monofoil) technique in eight. After a 3-month follow-up period, right- and left-sided cardiac catheterization was repeated. In the single-balloon group there was improvement in the mitral valve gradient (16.10 +/- 5.99 to 4.41 +/- 2.03 mm Hg), mean left atrial pressure (22.65 +/- 6.13 to 9.76 +/- 3.01 mm Hg), and mitral valve area (0.89 +/- 0.22 to 1.95 +/- 0.46 cm2/m2). Mean pulmonary artery pressure and mean pulmonary wedge pressure decreased to 19.33 +/- 4.19 mm Hg and 10.73 +/- 2.60 mm Hg from 32.94 +/- 7.90 mm Hg and 21.49 +/- 5.98 mm Hg. Cardiac output increased to 6.86 +/- 0.56 L/min from 5.57 +/- 0.66. All improvements were statistically significant (p less than 0.001). In the double-balloon study group, mitral valve gradient (23.75 +/- 2.77 to 4.50 +/- 1.94 mm Hg), mean left atrial pressure (31.63 +/- 3.57 to 9.50 +/- 1.94 mm Hg), mean pulmonary artery pressure (44.00 +/- 6.36 to 18.88 +/- 7.10), and mean pulmonary wedge pressure (29.25 +/- 3.73 to 10.25 +/- 1.85 mm Hg) all improved significantly (p less than 0.001). Mitral valve area and cardiac output increased from 0.89 +/- 0.15 to 2.44 +/- 0.44 cm2/m2 (p less than 0.001) and from 5.46 +/- 0.76 to 7.15 +/- 0.52 L/min (p less than 0.002), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- O Pektas
- Section of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey
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Isik E, Etevenon P, Verdeaux J, Bioux P, Pidoux B, Verdeaux G. [Multivariate correspondence analysis of a visually screened EEG. Application to a study of psychotropic drugs compared with placebos (author's transl)]. Rev Electroencephalogr Neurophysiol Clin 1982; 12:86-95. [PMID: 7048451 DOI: 10.1016/s0370-4475(82)80013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Eighty-seven EEG recordings were obtained from 9 healthy volunteers, medical students who were part of a controlled, double-blind, randomized study. After a first control recording, they received orally, at 1 week interval, either 3 placebos or 3 compounds: yohimbine chlorhydrate (4 mg), propranolol (40 mg), a psychotropic compound in experimentation. The polygraphic recordings were obtained 2 or 6 h after placebos or active compounds. Four EEG channels were recorded simultaneously (T4-C4, T3-C3, P4-O2, P3-O1). The EEGs were sampled at 200 Hz, for 120 successive epochs, free of artifacts. The recordings of 5 min were then submitted to spectral analysis followed by data reduction providing characteristic spectral parameters. A descriptive questionnaire of EEG made of 100 items was filled out by two electroencephalographists for each of 87 recordings. The items, with dichotomic choices, described 4 EEG frequency bands: delta, theta, alpha, and fast frequencies (beta). For each frequency band the following was evaluated: frequency, amplitude, asymmetry, morphology, relative abundance, irregularity, lability of frequency, diffusion, dominant localization, EMG activity and superposition of rhythms. The number of periods of drowsiness in 5 min and fluctuations of rhythms were also ascertained in the same way. The items were coded on punch cards and submitted to a first analysis of correspondences. The 3 factorial planes were plotted with the projections of each item together with the centers of gravity of placebos and treatments. The first factor can be interpreted as a bipolar axis 'mental activation-diffused vigilance', the first pole being characterized by a 'beta cluster' and the second by alpha and theta superimposed clusters. The second factor can be also considered as a bipolar axis 'drowsiness -quiet wakefulness', the first pole being characterized by a 'theta cluster' and a larger 'delta cluster' containing a smaller 'alpha cluster' of labile alpha rhythm intermingled with slower rhythms. In respect to the barycentric centers of gravity, yohimbine and propranolol are opposed to the placebo center along the factor-two axis. This may be considered as an 'anti-sedation effect'. However, along the first factor axis, the propranolol center can be associated with a greater diffusion of vigilance than the yohimbine center.
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