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Yavuz R, Aras O, Çiyiltepe H, Çakır T, Ensari CÖ, Gömceli İ. Effect of Robotic Inferior Mesenteric Artery Ligation Level on Low Anterior Resection Syndrome in Rectum Cancer. J Laparoendosc Adv Surg Tech A 2024. [PMID: 38574307 DOI: 10.1089/lap.2023.0472] [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] [Indexed: 04/06/2024] Open
Abstract
Background: Life expectancy of patients with rectal cancer is increasing day by day with innovative treatments. Low anterior resection syndrome (LARS), which disrupts the comfort of life in these patients, has become a serious problem. We aimed to evaluate the effect of high ligation (HL) and low ligation (LL) techniques on LARS in rectal cancer surgery performed with the robotic method. Materials and Methods: The data of patients diagnosed with mid-distal rectal cancer between 2016 and 2021 who underwent robotic low anterior resection by the same team in the same center with neoadjuvant chemoradiotherapy were retrospectively evaluated. Patients were divided into two groups as those who underwent HL and LL procedures. Preoperative, 8 weeks after neoadjuvant treatment, 3 and 12 months after ileostomy closure were evaluated. Results: A total of 84 patients (41 HL, 43 LL) were included in the study. There was no statistically significant difference between the demographic characteristics and pathology data of the patients. Although there was a decrease in LARS scores after neoadjuvant treatment, there was a statistically significant difference between the two groups at 3 and 12 months after ileostomy closure (P: .001, P: .015). Conclusions: In patients who underwent robotic low anterior resection, there is a statistically significant difference in the LARS score in the first 1 year with the LL technique compared with that of the HL technique, and the LL technique has superiority in reducing the development of LARS between the two oncologically indistinguishable methods.
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Affiliation(s)
- Rıdvan Yavuz
- Antalya Training and Research Hospital, Gastroenterology Surgery Department, Antalya, Turkey
| | - Orhan Aras
- Antalya Training and Research Hospital, Gastroenterology Surgery Department, Antalya, Turkey
| | - Hüseyin Çiyiltepe
- Antalya Training and Research Hospital, Gastroenterology Surgery Department, Antalya, Turkey
| | - Tebessüm Çakır
- Antalya Training and Research Hospital, Gastroenterology Surgery Department, Antalya, Turkey
| | - Cemal Özben Ensari
- Antalya Training and Research Hospital, Gastroenterology Surgery Department, Antalya, Turkey
| | - İsmail Gömceli
- Antalya Bilim University, Vocational School of Health Services, Antalya, Turkey
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2
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Aras O, Yavuz R. Can the surgeon prolong the remaining life of the patient in pancreaticoduodenectomy surgery? or Is the surgeon helpless? CIR CIR 2022; 90:287-294ancreas cancer. [PMID: 35259757 DOI: 10.24875/ciru.21000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND We aimed to evaluate the effects of R0 and R1 resections after pancreatic surgery. METHODS Data of 130 patients were evaluated. Re-resection was performed in patients who were found to have R1 resection after frozen section (FS). Overall survival (OS), disease free survival (DFS) among patients with R1 resection in paraffin section (PS) (n:28, Group1) and patients who underwent re-resection after FS and achieved the R0 resection goal in PS (n:16, Group 2) (DFS), local recurrence and systemic metastasis results were compared. RESULTS Tumor diameter, differentiation, age and complications were found to negatively affect OS. It was observed that DFS increased (p:0.02) and local recurrence rates decreased (p:0.037) in group 2 compared but there was no difference between the two groups in terms of OS (p:0.420) and systemic metastasis (p:0.467). CONCLUSIONS R0 resection obtained by surgical margin resection of the neck in pancreatic head adenocarcinomas decreases local recurrence and increases the duration of DFS. However, it has no effect on preventing OS and systemic metastasis.
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Affiliation(s)
- Orhan Aras
- Gastroenterology Surgery Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Rıdvan Yavuz
- Gastroenterology Surgery Department, Antalya Training and Research Hospital, Antalya, Turkey
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3
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Aras O, Gömceli İ. Can the Falciform Ligament Be the Most Ergonomic Patch in Portal Vein Reconstruction? Indian J Surg 2021. [DOI: 10.1007/s12262-020-02532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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4
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Karakaya G, Kan O, Tazegul G, Aras O. Changes in mean platelet volume in the course of upper gastrointestinal bleeding. Med-Science 2020. [DOI: 10.5455/medscience.2020.10.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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5
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Nurili F, Acar T, Derman S, Bas A, Yurdaisik I, Ozkanli S, Caymaz I, Cakiroglu H, Aras O. 04:21 PM Abstract No. 12 Transarterial embolization of prostate with biodegradable flutamide-loaded PLA/PLGA microspheres for benign prostate hyperplasia: preliminary study in a normal swine model. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.048] [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: 11/25/2022] Open
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6
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Nurili F, Bekaroglu G, Isci S, Caymaz I, Bas A, Ozkanli S, Yurdaisik I, Cakiroglu H, Aras O. 03:00 PM Abstract No. 383 Multifunctional iron oxide nanoparticle-embedded PVP-HEC microparticles as a drug-eluting embolic material. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.458] [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] Open
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7
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Nurili F, Bekaroglu G, Isci S, Bas A, Caymaz I, Yurdaisik I, Ozkanli S, Cakiroglu H, Aras O. 03:45 PM Abstract No. 340 Embolization of rabbit renal arteries to test feasibility and effects of CT-visible doxorubicin-eluting montmorillonite microparticles. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.410] [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: 10/27/2022] Open
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8
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Nurili F, Acar T, Derman S, Bas A, Caymaz I, Ozkanli S, Cakiroglu H, Yurdaisik I, Aras O. 03:09 PM Abstract No. 24 Catheter-directed gastric artery embolization with octreotide acetate loaded PLA/PLGA (poly[lactide-co-glycolide] acid) microspheres with slow sustained-release properties suppresses the plasma concentration of ghrelin, which results in weight loss. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.062] [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: 10/27/2022] Open
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9
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Abstract
Aims: Mixed adeno-neuroendocrine carcinoma is a rare entity, diagnosed with immunohistochemical studies. Literature mainly includes case reports and series which are very few. In our study, we aimed to report a case series from a tertiary hospital with demographics of the patients, detailed tumor and clinical findings and follow-up plus survival conditions. Methods: Pathology database was explored for patients with the pathological diagnosis of ‘mixed adeno-neuroendocrine carcinoma’ and patients were identified retrospectively and evaluated in means of demographics, histopathological examination, tumor properties. Results: Ten patients had been diagnosed with mixed adeno-neuroendocrine carcinoma in our center, diagnosed at a mean age of 64.7. Stomach was found to be the most common localization. Five patients (50%) were diagnosed as grade 3. Following surgery, median follow-up was 15 months with a median survival time of 20.6 months. Conclusion: This case series may contribute to the literature on the pathological and clinical aspects of the mixed adenoneuroendocrine carcinoma of the gastrointestinal system.
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Affiliation(s)
- Yiğit Düzköylü
- Clinic of Gastroenterological Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Orhan Aras
- Clinic of Gastroenterological Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Erdal Birol Bostancı
- Clinic of Gastroenterological Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Tülay Keklik Temuçin
- Clinic of Pathology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - Murat Ulaş
- Clinic of Gastroenterological Surgery, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
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Hanson NQ, Bakanay SM, Tsai MY, Gulec S, Aras O. Endothelial Nitric Oxide Gene Polymorphism (Glu298Asp) Is not Associated with Coronary Artery Disease in Turkish Population. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Aydın MT, Alahdab YÖ, Aras O, Karip B, Onur E, İşcan Y, Memişoğlu K. Endoscopic stenting for laparoscopic sleeve gastrectomy leaks. Ulus Cerrahi Derg 2016; 32:275-280. [PMID: 28149125 DOI: 10.5152/ucd.2016.3122] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 05/19/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Laparoscopic sleeve gastrectomy is a widely accepted and effective bariatric surgery method. The rate of leakage at the staple-line has been reported to be between 1.5 and 5%. Aside from the use of percutaneous drainage, re-laparoscopy, or abdominal sepsis control by laparotomy, endoscopic esophagogastric stent placement is increasingly preferred as a treatment method. Because laparoscopic sleeve gastrectomy is a widely used modality in our hospital, we aimed to evaluate the rate of leaks and the results of stent placements in our patients. MATERIAL AND METHODS Between January 1st 2010 and August 31st 2014, laparoscopic sleeve gastrectomy was performed on 236 patients by three surgeons. The demographic information and postoperative discharge summaries were collected and analyzed with the permission of the hospital ethics committee. Information about leak treatment management was also collected. RESULTS Leaks after laparoscopic sleeve gastrectomy in four patients were stented in the first postoperative month. Short (12 cm) Hanora® (M.I.Tech, Gyeonggi-do, Korea) self-expandable coated stents were placed in two patients, and long (24 cm) Hanora® self-expandable coated stents were placed in the other two. The stents were removed after one month in two patients, two and a half months later in one, and five months later in another patient. The leaks were demonstrated to be healed in all patients after stent removal. Endoscopic stent revision was performed in one patient due to migration of the stent and in another for stent breakage. CONCLUSION The success rate of treatment of leaks after laparoscopic sleeve gastrectomy by stent placement has been variable in the literature. The success in early stent placement has been shown to be related to physician expertise. According to the results of our patients, we suggest that endoscopic stent placement in the early stage after controlling sepsis is an effective method in the management of leaks.
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Affiliation(s)
- Mehmet Timuçin Aydın
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Yeşim Özen Alahdab
- Clinic of Gastroenterology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Orhan Aras
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Bora Karip
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Ender Onur
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Yalın İşcan
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Kemal Memişoğlu
- Clinic of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
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12
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Timucin Aydin M, Aras O, Karip B, Memisoglu K. Staple Line Reinforcement Methods in Laparoscopic Sleeve Gastrectomy: Comparison of Burst Pressures and Leaks. JSLS 2016; 19:JSLS.2015.00040. [PMID: 26175554 PMCID: PMC4487958 DOI: 10.4293/jsls.2015.00040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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] [Indexed: 12/19/2022] Open
Abstract
Background and Objectives: Laparoscopic sleeve gastrectomy is a technically simple and popular bariatric operation with acceptable results. However, leaks can occur in long staple lines, for which various reinforcement methods are used. We compared nonreinforced stapling in laparoscopic sleeve gastrectomy with 3 staple line reinforcement methods: suturing, absorbable buttressing material, and fibrin glue. Methods: From March 1 until September 30, 2014, 118 patients with body mass index >40 kg/m2 underwent sleeve gastrectomy and were enrolled in 4 groups, depending on the type of reinforcement used. The resected stomach specimens were treated with the same methods of reinforcement as used in the surgeries in the corresponding patients and then insufflated until a burst occurred. The burst pressures of the resected stomach specimens and adverse postoperative events were recorded. Results: Five postoperative leaks occurred in the reinforcement groups (fibrin glue, 2; absorbable buttresses, 2; sutures, 1); no leaks were evident in the no-reinforcement group. Suturing afforded the highest burst pressure and took the longest to perform of the methods. There was no correlation between the leaks and burst pressures. All of the leaks occurred in the proximal fundus in the resected stomach specimens and in the affected patients. Discussion: Although most surgeons use additional reinforcement on long staple lines in sleeve gastrectomy, there is no consensus about its necessity. We did not show any benefit of such reinforcement methods over proper stapling technique alone. Conclusion: Laparoscopic sleeve gastrectomy without staple line reinforcement is safe and avoids additional costs for reinforcement materials.
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Affiliation(s)
- M Timucin Aydin
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Orhan Aras
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Bora Karip
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Kemal Memisoglu
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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13
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Pantin JM, Hoyt RF, Aras O, Sato N, Chen MY, Hunt T, Clevenger R, Eclarinal P, Adler S, Choyke P, Childs RW. Optimization of intrabone delivery of hematopoietic progenitor cells in a swine model using cell radiolabeling with [89]zirconium. Am J Transplant 2015; 15:606-17. [PMID: 25656824 PMCID: PMC8391069 DOI: 10.1111/ajt.13007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/15/2014] [Accepted: 08/28/2014] [Indexed: 01/25/2023]
Abstract
Intrabone (IB) hematopoietic cell transplantation (HCT) of umbilical cord blood in humans remains experimental and the technique has not been optimized. It is unknown whether hematopoietic progenitor cells (HPCs) injected IB are initially retained in the marrow or rapidly enter into the venous circulation before homing to the marrow. To develop an IB-injection technique that maximizes HPC marrow-retention, we tracked radiolabeled human HPCs following IB-injection into swine. We developed a method to radionuclide-label HPCs using a long-lived positron emitter (89) Zr and protamine sulfate that resulted in cellular-retention of low-dose radioactivity. This approach achieved radioactivity levels sufficient for detection by positron emission tomography with both high sensitivity and spatial resolution when fused with computed tomography. We found that conditions utilized in pilot IB-HCT clinical trials conducted by others led to both rapid drainage into the central venous circulation and cellular extravasation into surrounding muscle and soft tissues. By optimizing the needle design, using continuous real-time intra-marrow pressure monitoring, and by reducing the infusion-volume and infusion-rate, we overcame this limitation and achieved high retention of HPCs in the marrow. This method of IB cellular delivery is readily applicable in the clinic and could be utilized in future investigational IB-HCT trials aimed at maximizing marrow retention of HPCs.
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Affiliation(s)
- J. M. Pantin
- Division of Hematology and Medical Oncology, Georgia Regents University, Augusta, GA
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - R. F. Hoyt
- Laboratory of Animal Medicine and Surgery, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
- Laboratory Animal Sciences Program, Leidos Biomedical Research, Inc., Frederick National Laboratory, Frederick
| | - O. Aras
- Imaging Sciences Training Program, Diagnostic Radiology Department, Warren Magnuson Clinical Center, National Institutes of Health, Bethesda, MD
| | - N. Sato
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - M. Y. Chen
- Advanced Cardiovascular Imaging Laboratory, Cardiovascular and Pulmonary Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - T. Hunt
- Laboratory of Animal Medicine and Surgery, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - R. Clevenger
- Laboratory of Animal Medicine and Surgery, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | - S. Adler
- Leidos Biomedical Research, Inc., Reston, VA
| | - P. Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - R. W. Childs
- Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
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Galli F, Histed S, Aras O. NK cell imaging by in vitro and in vivo labelling approaches. Q J Nucl Med Mol Imaging 2014; 58:276-283. [PMID: 25265248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Natural killer (NK) cells are a particular lymphocyte subset with a documented cytotoxic activity against cancer cells. Evidence of NK antitumoral effect led researchers to focus on the development of immunotherapies aimed at augmenting NK recruitment and infiltration into tumor and their anti-cancer functions. Studies in animal models proved that the right combination of drugs, cytokines, chemokines and other factors might be used to enhance or suppress tumor targeting by NK cells. Therefore, it would be necessary to have a tool to non-invasively monitor the efficacy of such novel therapies. Available imaging techniques comprise magnetic resonance, optical and nuclear medicine imaging with a pool of compounds that ranges from radiolabelled nanoparticles and radiopharmaceuticals to fluorescent probes. Each tracer and technique has its own pros and cons, but till now, no one emerged as superior among the others.
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Affiliation(s)
- F Galli
- Nuclear Medicine, Unit Faculty of Medicine and Psychology, Department of Medical-Surgical Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Italy -
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15
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Topaloglu S, Inci I, Calik A, Aras O, Oztuna F, Ak H, Bulbul Y, Arslan M, Arslan MK. Intensive pulmonary care after liver surgery: a retrospective survey from a single center. Transplant Proc 2013; 45:986-92. [PMID: 23622605 DOI: 10.1016/j.transproceed.2013.02.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Prevention from postoperative pulmonary complications (PPCs) has been an important topic. The aims of this study were to determine the risk factors for PPC after liver surgery and to analyze the efficacy of postoperative pulmonary care on PPC prevention. MATERIALS AND METHODS We retrospectively analyzed variables of 81 patients who underwent hepatectomy and 4 transplantations between January 2007 and March 2012. RESULTS Nineteen patients suffered PPCs (22.4%). Bivariate analysis identified four risk factors: preoperative anemia (odds ratio [OR] = 5.69), the American Society of Anesthesiologists (ASA) score of 3 or 4 (OR = 5.36), blood transfusion (OR = 2.81), and prolonged operative time (OR = 1.01). Upon multivariate analysis, only prolonged operative time was an independent risk factor for PPC (OR = 1.01). Pulmonary function test (PFT) was performed for 22 of 41 patients with an ASA score ≥ 2 (53.7%); there was no significant relationship between abnormal PFTs (n = 13) and the development of PPCs (P = .12). CONCLUSIONS The elimination of risk factors may reduce the incidence of PPCs. Postoperative intensive pulmonary care should be given to all patients after liver surgery but particularly to patients with high ASA scores and those with abnormal PFTs irrespective of age.
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Affiliation(s)
- S Topaloglu
- Department of Surgery, Karadeniz Technical University, School of Medicine, Farabi Hospital, Trabzon, Turkey.
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Turkbey B, Mena E, Aras O, Garvey B, Grant K, Choyke PL. Functional and molecular imaging: applications for diagnosis and staging of localised prostate cancer. Clin Oncol (R Coll Radiol) 2013; 25:451-60. [PMID: 23722008 DOI: 10.1016/j.clon.2013.05.001] [Citation(s) in RCA: 14] [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: 03/17/2013] [Accepted: 05/02/2013] [Indexed: 01/13/2023]
Abstract
Prostate cancer is currently the most common solid organ cancer type among men in the Western world. Currently, all decision-making algorithms and nomograms rely on demographics, clinicopathological data and symptoms. Such an approach can easily miss significant cancers while detecting many insignificant cancers. In this review, novel functional and molecular imaging techniques used in the diagnosis and staging of localised prostate cancer and their effect on treatment decisions are discussed.
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Affiliation(s)
- B Turkbey
- Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA.
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17
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Kaya B, Aras O, Bat O, Bulut NE, Memisoglu K. Steroid-induced sigmoid diverticular perforation in a patient with temporal arteritis: a rare clinical pathology. Clin Med Insights Pathol 2012; 5:11-4. [PMID: 22493565 PMCID: PMC3320117 DOI: 10.4137/cpath.s7924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Corticosteroids are used in the treatment of many rheumatological diseases including temporal arteritis. The gastrointestinal perforation during corticosteroid treatment is a serious complication. Colon perforation after steroid use was first reported by Beck et al in 1950.1 Although the pathophysiological mechanism is not understood clearly, it is claimed that steroids probably by disturbing the intestinal mucosal barrier, facilitate the intestinal perforation. The long term treatment with corticosteroids increases the risk of colon perforation. We are presenting a patient who was taking corticosteroid due to temporal arteritis for two years and operated with sigmoid diverticular perforation.
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Affiliation(s)
- Bulent Kaya
- Fatih Sultan Mehmet Training and Research Hospital, Department of General Surgery, Istanbul, Turkey
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Gülec S, Aras O, Akar E, Tutar E, Omürlü K, Avci F, Dinçer I, Akar N, Oral D. Methylenetetrahydrofolate reductase gene polymorphism and risk of premature myocardial infarction. Clin Cardiol 2009; 24:281-4. [PMID: 11303694 PMCID: PMC6654870 DOI: 10.1002/clc.4960240405] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Elevated plasma homocysteine level is an independent risk factor for cardiovascular disease. A common mutation (nucleotid 677C-T) in the gene coding for methylenetetrahydrofolate reductase (MTHFR) has been reported to reduce the enzymatic activity of MTHFR and is associated with elevated plasma levels of homocysteine, especially in subjects with low folate intake. HYPOTHESIS Methylenetetrahydrofolate reductase T/T genotype may be a risk factor for premature MI in Turkish population who are known to have low folate levels. METHODS The study group was comprised of 96 men (aged <45 years) with premature myocardial infarction (MI) and 100 age- and gender-matched controls who had no history or clinical evidence of coronary artery disease (CAD) and/or MI. DNA was extracted from peripheral blood and genotypes were determined by polymerase chain reaction, restriction mapping with HinfI, and gel electrophoresis. Conventional risk factors for CAD were prospectively documented. RESULTS Allele and genotype frequencies among cases and control subjects were compatible with Hardy-Weinberg equilibrium. The frequencies of T/T, C/T, and C/C genotypes among patients with MI and control subjects were 15.6, 40.6, and 43.8%, and 5, 35, and 60%, respectively. Multivariate analyses identified smoking, MTHFR C/T polymorphism, diabetes mellitus, family history of CAD, and hypertension as the independent predictors of premature MI. Defining patients with non-T/T genotype (C/C and C/T combined) as reference, the relative risk of MI for subjects with T/T genotype was 5.94 (95% confidence interval: 1.96-18.02, p = 0.0016). CONCLUSIONS Our findings suggest that C677T transition in the MTHFR gene may be a risk factor for premature MI in Turkish men.
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Affiliation(s)
- S Gülec
- Medical School of Ankara University, Turkey
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Oktay MF, Topcu I, McKinney A, Turunz V, Aras O. Isolated hemifacial hypertrophy: a case with upper airway obstruction and sensorineural hearing loss. J Laryngol Otol 2006; 120:691-3. [PMID: 16700954 DOI: 10.1017/s0022215106001381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2005] [Indexed: 11/06/2022]
Abstract
Hemifacial hypertrophy is an uncommon developmental disorder characterized by facial asymmetry that involves abnormal bone development and facial enlargement. Many cases of hemihypertrophy have been reported since the first case was reported by Wagner in 1839. We identified a child diagnosed with hemifacial hypertrophy and sensorineural hearing loss who presented with upper airway obstruction and cyanosis. We discuss treatment selection and review the associated head and neck symptoms.
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Affiliation(s)
- M F Oktay
- Department of Otolaryngology, Otitis Media Research Center, University of Minnesota, Minneapolis, USA.
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Gülec S, Aras O, Atmaca Y, Akyürek O, Hanson NQ, Sayin T, Tsai MY, Akar N, Oral D. Deletion polymorphism of the angiotensin I converting enzyme gene is a potent risk factor for coronary artery ectasia. Heart 2003; 89:213-4. [PMID: 12527685 PMCID: PMC1767548 DOI: 10.1136/heart.89.2.213] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Aras O, Hanson NQ, Bakanay SM, Tsai MY, Gulec S. Endothelial nitric oxide gene polymorphism (Glu298Asp) is not associated with coronary artery disease in Turkish population. Thromb Haemost 2002; 87:347-9. [PMID: 11858501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Abstract
The association of moderately elevated total homocysteine (tHcy) levels with coronary artery disease is increasingly being recognized. However, the role of genetic influence on plasma tHcy levels is not completely understood. We studied 1,055 individuals with respect to the effect of two silent polymorphisms, the 699C--> T and the 1080C-->T, of the cystathionine beta-synthase (CBS) gene on plasma tHcy levels. Individuals who were heterozygous or homozygous for the T699 allele had lower post-methionine load (PML) tHcy levels when compared to individuals with the C/C genotype. This association was statistically significant (p = 0.005) for the T/T genotype compared to the C/C genotype and became even more significant (p = 0.000002) when individuals carrying the 68-bp insertion (844ins68) and the T1080 allele were excluded from the analysis. With regard to the 1080C-->T polymorphism, the T1080 allele was associated with significantly lower PML tHcy levels only when individuals carrying the 844ins68 and T699 allele were excluded from the study (p = 0.01 for 1080T/T genotype compared to 1080C/C genotype). We speculate that the 699C-->T and 1080C-->T polymorphisms may be in linkage disequilibrium with regulatory elements that upregulate CBS gene transcription.
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Affiliation(s)
- O Aras
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, USA
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Gürlek A, Güleç S, Karabulut H, Bokesoy I, Tutar E, Pamir G, Alpman A, Toydemir R, Aras O, Oral D. Relation between the insertion/deletion polymorphism of the angiotensin I converting enzyme gene and restenosis after coronary stenting. J Cardiovasc Risk 2000; 7:403-7. [PMID: 11155292 DOI: 10.1177/204748730000700602] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Observations with intravascular ultrasound demonstrated that neointimal hyperplasia is the predominant factor responsible for in-stent restenosis. Experimental data suggest that angiotensin I converting enzyme (ACE) plays a role in the thickening of neointima after balloon denudation. Insertion/deletion (I/D) polymorphism of the ACE gene is significantly associated with plasma level of ACE and subjects with D/D genotype have significantly higher plasma levels of ACE than normal. OBJECTIVE To investigate whether this polymorphism influences the risk of restenosis after coronary stenting. METHODS We genotyped 158 patients who had undergone single-vessel coronary stenting for the ACE I/D polymorphism. RESULTS Of the 158 patients, 56 (35%) had the D/D genotype, 71 (45%) had the I/D genotype and 31 (20%) had the I/I genotype. Prevalences of genotypes were compatible with Hardy-Weinberg equilibrium and distributions of ACE genotype among patients and 132 healthy controls from the same geographic area did not differ. At follow-up (after a median duration of 5.4 months), overall rates of angiographic restenosis and of revascularization of target lesion (RTL) were 32.3 and 22.8%, respectively. Of 51 patients with angiographic restenosis, 31 (60.8%) had focal and 20 (39.2%) had diffuse patterns of restenosis. Diffuse in-stent restenosis was significantly more prevalent among patients with D/D genotype (P = 0.016). Multiple stepwise logistic regression analysis identified ACE I/D polymorphism as the independent predictor of angiographic restenosis and RTL. Relative risk of angiographic restenosis was 6.29 [95% confidence interval (CI), 1.80-22.05, P = 0.0004] for D/D genotype and 3.88 (95% CI 1.11-13.12, P = 0.029) for I/D genotype, whereas relative risk of RTL was 7.44 (95% CI 1.60-34.58, P = 0.01) for D/D genotype and 3.88 (95% CI 0.083-18.15, P = 0.085) for I/D genotype. CONCLUSIONS The ACE I/D polymorphism is significantly associated with risk of angiographic and clinical restenosis after coronary stenting. Angiographic pattern of restenosis is also significantly associated with I/D polymorphism, diffuse type being more prevalent among subjects with D/D genotype.
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Affiliation(s)
- A Gürlek
- University of Ankara, Ankara, Turkey.
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Georgopoulos A, Aras O, Tsai MY. Codon-54 polymorphism of the fatty acid-binding protein 2 gene is associated with elevation of fasting and postprandial triglyceride in type 2 diabetes. J Clin Endocrinol Metab 2000; 85:3155-60. [PMID: 10999802 DOI: 10.1210/jcem.85.9.6791] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Patients with type 2 diabetes are frequently dyslipidemic or hypertriglyceridemic. To assess whether increased intestinal triglyceride input leads to elevated fasting and postprandial triglycerides in type 2 diabetes, we used the codon 54 polymorphism of the fatty acid-binding protein 2 gene, which results in the substitution of threonine (Thr) for alanine and is associated with increased intestinal input of triglyceride. Of the 287 diabetic patients screened, 108 (37.6%) were heterozygous and 31 (10.8%) were homozygous for the Thr-54 allele. Mean (+/-SEM) fasting plasma triglyceride levels in patients with the wild-type (n = 80), those heterozygous for the Thr-54 allele (n = 57), and those homozygous for it (n = 18) were 2.0 +/- 0.09, 2.7 +/- 0.20, and 3.8 +/- 0.43 mmol/L, respectively. A linear relationship of mean fasting plasma triglyceride levels (r2 = 0.97) between the 3 groups was found. After fat ingestion, the postprandial area under the curve of plasma triglyceride (P = 0.025) and chylomicrons (Sf > 400, P = 0.013) was higher in the Thr-54/Thr-54 (n = 6) than in the wild-type (n = 9). Our results are consistent with the hypothesis that, in type 2 diabetes, increased intestinal input of triglyceride can lead to elevated fasting and postprandial plasma triglycerides.
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Affiliation(s)
- A Georgopoulos
- Minneapolis Veterans Affairs Medical Center, University of Minnesota, 55417, USA.
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Gümüş B, Aras O, Ateşçi YZ, Müezzinoğlu T. Aetiological factors of bladder cancer in the Aegean region of Turkey between the years 1985-1996. Int Urol Nephrol 1999; 31:197-202. [PMID: 10481964 DOI: 10.1023/a:1007176708888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A great majority of urological cases are bladder tumours. The purpose of this study is to bring out the aetiological factors related to bladder tumours. The parameters such as age, sex, profession, age at tumour occurrence, smoking, drinking habits, such as the level of consumption of tea and coffee, and accompanying urological diseases were evaluated. Three hundred and forty-seven patients with bladder tumours were included in this study. Of them 332 (95.6%) were males and 15 (4.4%) females. The average age was 62.1 (22-87) years. Of the patients 326 (93.9%) smoked, 175 (50.4%) lived in cities and the other 49.6% lived in the countryside. Of the tumours 89.9% were transitional cell carcinomas. In conclusion, bladder tumours are closely related to consumption of tobacco factors and profession. The risk of tumour development increases progressively in people who are exposed to industrial agents and agricultural chemicals.
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Affiliation(s)
- B Gümüş
- Department of Urology, University of Celal Bayar, Manisa, Turkey
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Tsai MY, Yang F, Bignell M, Aras O, Hanson NQ. Relation between plasma homocysteine concentration, the 844ins68 variant of the cystathionine beta-synthase gene, and pyridoxal-5'-phosphate concentration. Mol Genet Metab 1999; 67:352-6. [PMID: 10444346 DOI: 10.1006/mgme.1999.2874] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A moderately elevated plasma total homocysteine (tHcy), whether measured during fasting or post-methionine load (PML), is recognized as a risk factor for coronary artery diseases (CAD). Cystathionine beta-synthase (CBS), a key enzyme in the transsulfuration pathway, is important for the metabolism of homocysteine. In recent years, a relatively prevalent mutation, the 844ins68 (68-bp insertion), was found to be carried by about 12% of the general population. In the current investigation, we studied 741 individuals with respect to the effect of the 68-bp insertion of the CBS gene on fasting and PML tHcy, and also determined the level of pyridoxal-5'-phosphate (vitamin B(6)), a cofactor of the CBS enzyme. Our results showed that the mean fasting and PML increase in tHcy levels were lower in individuals carrying the 844ins68 variant compared to those without the insertion; although only the difference in PML increase in tHcy reached statistical significance (P = 0.02). When these individuals were divided into two groups based on vitamin B(6) concentration, the PML increase in tHcy was significantly lower in individuals heterozygous for the insertion compared to those without the insertion only in the group of individuals whose vitamin B(6) concentrations were below the sample median (38.0 nmol/L). We speculate that the 68-bp insertion is associated with somewhat higher levels of CBS enzyme activity, and that the effect of this becomes more pronounced in the presence of relatively low concentrations of pyridoxal-5'-phosphate, a cofactor of the CBS enzyme.
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Affiliation(s)
- M Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota 55455-0392, USA.
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Nergizoğlu G, Keven K, Gürses MA, Aras O, Ertürk S, Duman N, Ateş K, Akar H, Akar N, Karatan O, Erbay B, Ertuğ AE. Carotid intima-media thickness and ACE-gene polymorphism in hemodialysis patients. J Nephrol 1999; 12:261-5. [PMID: 10493570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Carotid artery intima-media thickness (CIMT) has been used as a marker of atherosclerosis. An insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with various cardiovascular diseases. This study is aimed at evaluating early atherosclerotic involvement of carotid vessels and the relation to known risk factors and ACE gene I/D in hemodialysis (HD) patients. METHODS We measured CIMT using high-resolution B-mode ultrasonography in 51 non-diabetic HD patients and in 70 age- and sex-matched healthy controls, and evaluated the factors influencing CIMT. An I/D polymorphism in intron 16 of the gene coding for ACE was analysed by polymerase chain reaction. RESULTS The mean CIMT was significantly higher in HD patients than in healthy subjects (p<0.0001). In multiple regression analysis, independent risk factors for increased CIMT in HD patients were predialysis systolic blood pressure (p<0.001) and ACE D allele (p<0.01). CONCLUSIONS The present data suggest that CIMT is enlarged in HD patients. The ACE gene seems to be a candidate for influencing the CIMT and might therefore be involved in an HD patient's predisposition to the development of atherosclerosis.
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Affiliation(s)
- G Nergizoğlu
- Department of Nephrology, Ankara University School of Medicine, Turkey
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Akar N, Aras O, Omürlü K, Cin S. Deletion polymorphism at the angiotensin-converting enzyme gene in Turkish patients with coronary artery disease. Scand J Clin Lab Invest 1998; 58:491-5. [PMID: 9832341 DOI: 10.1080/00365519850186292] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Coronary artery disease (CAD) is a multifactorial disease in which genetic and environmental factors play an important role. These factors differ in each population. This study was carried out to determine whether there is an association between insertion/deletion (I/D) polymorphism and CAD in Turkish patients from Ankara. An I/D polymorphism in intron 16 of the gene coding for the angiotensin-converting enzyme (ACE) has been used to study the role of this gene in the aetiology of coronary atherosclerosis and hypertension. As there are no existing data for the Turkish population, we studied the I/D polymorphism of the ACE gene in 218 patients with CAD and 107 controls. Polymerase chain reaction (PCR) was used for genotyping the I and D alleles. The DD polymorphism of the ACE gene was significantly different between CAD subjects (0.733) and controls (0.612) (p=0.002). The observed heterozygosity was 29.3% and 43.9% and D allele frequency was 0.733 and 0.612, respectively. There was a significantly higher D allele (p=0.03) in 111 patients with myocardial infarction (MI) compared with controls. Furthermore, MI localization also gave a significance of p=0.002 for inferior MI but not for anterior MI (p=0.83). Forty-three hypertension patients had a D allele frequency of 0.767 which was significantly different from control (p=0.01). These data provide further evidence for the association of D allele and CAD in a Turkish population.
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Affiliation(s)
- N Akar
- Department of Pediatric Molecular Genetics, Ankara University, Turkey.
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