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Çil G, Yilmaz M, Sahin Y, Ulus I, Canıtez IO, Kandıralı IE. The preoperative predictive factors for pathological T3a upstaging and positive surgical margin of clinical T1 renal cell carcinoma. Actas Urol Esp 2024; 48:311-318. [PMID: 38369290 DOI: 10.1016/j.acuroe.2024.02.004] [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] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/28/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVES The objective of this study is predict positive surgical margin (PSM) and pathological T3a (pT3a) upstaging in patients with clinical T1 (cT1) renal cell carcinoma (RCC). MATERIALS AND METHODS 159 patients who underwent radical nephrectomy (RN) or partial nephrectomy (PN) for RCC. Patients' demographic, laboratory, radiological and pathological data that could predict PSM and pT3a upstaging pre-operatively were evaluated. The categorical and continuous variables were compared between the patient groups with or without PSM and/or pT3a upstaging using Pearson's chi-square test, and independent samples t-test or the Mann-Whitney U test, respectively. RESULTS PT3a upstaging was detected in 32 (20.1%) patients, and PSM was detected in 28 (17.6%) patients. PT3a upstaging was detected in 27 and 5 patients who underwent open surgery and laparoscopic surgery, respectively (P < .001). In addition, pT3a upstaging was detected in 6 and 26 patients who underwent RN and PN, respectively (P < .001). Peritumoral fatty tissue thickness was 11.97 and 15.38 in the pT1 and pT3a patient groups, respectively (P = .022). In patients with pT3a upstaging, tumor size was larger, and renal nephrometry score and systemic immune-inflammation index (SII) were higher (P < .001, P < .001, and P = .022, respectively). It was determined that De Ritis ratio (DRR) and albumin-to-alkaline phosphatase (ALP) ratio (AAPR) parameters had significant prognostic values in predicting PSM (P = .024, and P = .001, respectively). ROC analysis indicated that tumor size predicted pT3a upstaging with 100% sensitivity and 98.6% specificity when its cut-off value was taken as 6.85 mm (AUC: 1.000, P < .001). In addition, logistic regression analysis revealed AAPR and DRR as significant predictors of PSM (P < .001, and P = .009, repsectively). CONCLUSION The findings of this study indicated that the surgical technique of choice and the type of operation, tumor size, RNS value, peritumoral fatty tissue thickness, HU values of peritumoral and tumor side fatty tissues, and DRR and SII values can predict pT3a upstaging of patients with cT1 RCC, and that AAPR and DRR values can predict PSM.
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Affiliation(s)
- G Çil
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey.
| | - M Yilmaz
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - Y Sahin
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I Ulus
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I O Canıtez
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I E Kandıralı
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
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Panchagnula S, Jin SC, Dong W, Kundishora A, Moreno-De-Luca A, Furey CG, Allocco AA, Walker R, Nelson-Williams C, Smith H, Dunbar A, Conine SB, Lu Q, Zen X, Sierant M, Knight J, Sullivan W, Phan D, DeSpenza T, Reeves B, Karimy JK, Marlier A, Castaldi C, Tikhonova I, Li B, Peña; H, Broach J, Kabachelor EM, Ssenyonga P, Hehnly C, Ge L, Keren B, Timberlake AT, Goto J, Mangano FT, Johnston JM, Butler W, Warf BC, Smith ER, Schiff SJ, Limbrick DD, Heuer GG, Jackson EM, Iskandar BJ, Mane S, Haider S, Guclu B, Bayri Y, Sahin Y, Duncan CC, Apuzzo ML, DiLuna ML, Hoffman E, Sestan N, Ment L, Alper S, Bilguvar K, Geschwind D, Günel M, Lifton RP, Kahle KT. Integrative Genomics Implicates Genetic Disruption of Prenatal Neurogenesis in Congenital Hydrocephalus. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jin SC, Dong W, Kundishora AJ, Panchagnula S, Moreno-De-Luca A, Furey CG, Allocco AA, Walker RL, Nelson-Williams C, Smith H, Dunbar A, Conine S, Lu Q, Zeng X, Sierant MC, Knight JR, Sullivan W, Duy PQ, DeSpenza T, Reeves BC, Karimy JK, Marlier A, Castaldi C, Tikhonova IR, Li B, Peña HP, Broach JR, Kabachelor EM, Ssenyonga P, Hehnly C, Ge L, Keren B, Timberlake AT, Goto J, Mangano FT, Johnston JM, Butler WE, Warf BC, Smith ER, Schiff SJ, Limbrick DD, Heuer G, Jackson EM, Iskandar BJ, Mane S, Haider S, Guclu B, Bayri Y, Sahin Y, Duncan CC, Apuzzo MLJ, DiLuna ML, Hoffman EJ, Sestan N, Ment LR, Alper SL, Bilguvar K, Geschwind DH, Günel M, Lifton RP, Kahle KT. Exome sequencing implicates genetic disruption of prenatal neuro-gliogenesis in sporadic congenital hydrocephalus. Nat Med 2020; 26:1754-1765. [PMID: 33077954 PMCID: PMC7871900 DOI: 10.1038/s41591-020-1090-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
Congenital hydrocephalus (CH), characterized by enlarged brain ventricles, is considered a disease of excessive cerebrospinal fluid (CSF) accumulation and thereby treated with neurosurgical CSF diversion with high morbidity and failure rates. The poor neurodevelopmental outcomes and persistence of ventriculomegaly in some post-surgical patients highlight our limited knowledge of disease mechanisms. Through whole-exome sequencing of 381 patients (232 trios) with sporadic, neurosurgically treated CH, we found that damaging de novo mutations account for >17% of cases, with five different genes exhibiting a significant de novo mutation burden. In all, rare, damaging mutations with large effect contributed to ~22% of sporadic CH cases. Multiple CH genes are key regulators of neural stem cell biology and converge in human transcriptional networks and cell types pertinent for fetal neuro-gliogenesis. These data implicate genetic disruption of early brain development, not impaired CSF dynamics, as the primary pathomechanism of a significant number of patients with sporadic CH.
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Affiliation(s)
- Sheng Chih Jin
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Weilai Dong
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Adam J Kundishora
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Shreyas Panchagnula
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Andres Moreno-De-Luca
- Autism & Developmental Medicine Institute, Genomic Medicine Institute, Department of Radiology, Geisinger, Danville, PA, USA
| | - Charuta G Furey
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - August A Allocco
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Rebecca L Walker
- Department of Neurology, Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Hannah Smith
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Ashley Dunbar
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Sierra Conine
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Qiongshi Lu
- Department of Biostatistics & Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Xue Zeng
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Michael C Sierant
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - James R Knight
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - William Sullivan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Phan Q Duy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Tyrone DeSpenza
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin C Reeves
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Jason K Karimy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Arnaud Marlier
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | | | - Irina R Tikhonova
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - Boyang Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Helena Perez Peña
- Department of Pharmaceutical and Biological Chemistry, University College London School of Pharmacy, London, UK
| | - James R Broach
- Institute for Personalized Medicine, The Penn State College of Medicine, Hershey, PA, USA
| | | | | | - Christine Hehnly
- Departments of Neurosurgery, Engineering Science & Mechanics, and Physics; Center for Neural Engineering and Infectious Disease Dynamics, The Pennsylvania State University, University Park, PA, USA
| | - Li Ge
- Department of Biostatistics & Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Boris Keren
- Département de Génétique, Centre de Référence Déficiences Intellectuelles de Causes Rares, Groupe Hospitalier Pitié Salpêtrière et GHUEP Hôpital Trousseau, Sorbonne Université, GRC "Déficience Intellectuelle et Autisme", Paris, France
| | - Andrew T Timberlake
- Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, NY, USA
| | - June Goto
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Francesco T Mangano
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - James M Johnston
- Department of Neurosurgery, University of Alabama School of Medicine, Birmingham, AL, USA
| | - William E Butler
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin C Warf
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward R Smith
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven J Schiff
- Departments of Neurosurgery, Engineering Science & Mechanics, and Physics; Center for Neural Engineering and Infectious Disease Dynamics, The Pennsylvania State University, University Park, PA, USA
| | - David D Limbrick
- Department of Neurological Surgery and Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory Heuer
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eric M Jackson
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bermans J Iskandar
- Department of Neurological Surgery, University of Wisconsin Medical School, Madison, WI, USA
| | - Shrikant Mane
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - Shozeb Haider
- Department of Pharmaceutical and Biological Chemistry, University College London School of Pharmacy, London, UK
| | - Bulent Guclu
- Kartal Dr. Lutfi Kirdar Research and Training Hospital, Istanbul, Turkey
| | - Yasar Bayri
- Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Yener Sahin
- Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Charles C Duncan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Michael L J Apuzzo
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Michael L DiLuna
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Ellen J Hoffman
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Nenad Sestan
- Department of Neuroscience and Kavli Institute for Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Laura R Ment
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Seth L Alper
- Division of Nephrology and Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Kaya Bilguvar
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
| | - Daniel H Geschwind
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Murat Günel
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Richard P Lifton
- Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Kristopher T Kahle
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA.
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
- Department of Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA.
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Savran M, Asci H, Ozmen O, Erzurumlu Y, Savas HB, Sonmez Y, Sahin Y. Melatonin protects the heart and endothelium against high fructose corn syrup consumption-induced cardiovascular toxicity via SIRT-1 signaling. Hum Exp Toxicol 2019; 38:1212-1223. [PMID: 31256681 DOI: 10.1177/0960327119860188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
High fructose corn syrup (HFCS) has been shown to cause cardiovascular toxicity via oxidative stress and inflammation. The aim of this study is to demonstrate the protective effects of melatonin (MLT) against HFCS-induced endothelial and cardiac dysfunction via oxidative stress and inflammation. Thirty-two Sprague Dawley male rats were distributed into three groups as control, HFCS, and HFCS + MLT. HFCS form F55 was prepared as 20% fructose syrup solution and given to the rats through drinking water for 10 weeks, and MLT administrated 10 mg/kg/day orally for last 6 weeks in addition to F55. After decapitation, blood and half of the heart samples were collected for biochemical analysis and other half of the tissues for histopathological and immunohistochemical analysis. Aspartate transaminase, creatine kinase MB, lactate dehydrogenase, total oxidant status and oxidative stress index, and caspase-3 levels increased and total antioxidant status levels decreased significantly in HFCS group. MLT treatment reversed all these parameters. Histopathologically, hyperemia, endothelial cell damage and increased levels of angiogenin, C-reactive protein, inducible nitric oxide synthase, myeloperoxidase and decreased sirtuin-1 (SIRT-1) expressions were observed in HFCS group. MLT ameliorated all these changes. MLT has an anti-inflammatory, antioxidant, antiapoptotic effects on HFCS-induced cardiovascular toxicity through enhancing the expression of SIRT-1.
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Affiliation(s)
- M Savran
- 1 Department of Pharmacology/IDAL Laboratory, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - H Asci
- 1 Department of Pharmacology/IDAL Laboratory, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - O Ozmen
- 2 Department of Pathology, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Y Erzurumlu
- 3 Department of Biochemistry, Faculty of Pharmacy, Süleyman Demirel University, Isparta, Turkey
| | - H B Savas
- 4 Department of Medical Biochemistry, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Y Sonmez
- 5 Department of Public Health, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Y Sahin
- 1 Department of Pharmacology/IDAL Laboratory, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
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Koyun O, Gorduk S, Arvas MB, Sahin Y. Electrochemically Treated Pencil Graphite Electrodes Prepared in One Step for the Electrochemical Determination of Paracetamol. RUSS J ELECTROCHEM+ 2019. [DOI: 10.1134/s1023193518110046] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Furey CG, Jin SC, Timberlake AT, Choi J, Zeng X, Nelson-Williams C, Mansuri M, Lu Q, Duran D, Panchagnula S, Alloco A, Karimy JK, Gaillard J, Khanna A, Butler W, Smith ER, Warf BC, Limbrick DD, Storm PB, Heuer GG, Iskandar B, Johnston JM, Alper S, Guclu B, Bayri Y, Sahin Y, Duncan CC, DiLuna ML, Gunel M, Lifton RP, Kahle KT. 125 De Novo Mutations in Genes Regulating Neural Stem Cell Fate in Human Congenital Hydrocephalus. Neurosurgery 2018. [DOI: 10.1093/neuros/nyy303.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kahraman S, Sahin Y, Duzguner S, Oner G, Gokturk U, Gokdagli Sagir F, Duzguner I. A randomized clinical trial comparing the effects of transdermal and oral estrogen on clinical outcomes in patients undergoing frozen-thawed embryo transfer. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.659] [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: 11/26/2022]
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Furey CG, Choi J, Jin SC, Zeng X, Timberlake AT, Nelson-Williams C, Mansuri MS, Lu Q, Duran D, Panchagnula S, Allocco A, Karimy JK, Khanna A, Gaillard JR, DeSpenza T, Antwi P, Loring E, Butler WE, Smith ER, Warf BC, Strahle JM, Limbrick DD, Storm PB, Heuer G, Jackson EM, Iskandar BJ, Johnston JM, Tikhonova I, Castaldi C, López-Giráldez F, Bjornson RD, Knight JR, Bilguvar K, Mane S, Alper SL, Haider S, Guclu B, Bayri Y, Sahin Y, Apuzzo MLJ, Duncan CC, DiLuna ML, Günel M, Lifton RP, Kahle KT. De Novo Mutation in Genes Regulating Neural Stem Cell Fate in Human Congenital Hydrocephalus. Neuron 2018; 99:302-314.e4. [PMID: 29983323 DOI: 10.1016/j.neuron.2018.06.019] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [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: 02/13/2018] [Revised: 04/03/2018] [Accepted: 06/12/2018] [Indexed: 12/30/2022]
Abstract
Congenital hydrocephalus (CH), featuring markedly enlarged brain ventricles, is thought to arise from failed cerebrospinal fluid (CSF) homeostasis and is treated with lifelong surgical CSF shunting with substantial morbidity. CH pathogenesis is poorly understood. Exome sequencing of 125 CH trios and 52 additional probands identified three genes with significant burden of rare damaging de novo or transmitted mutations: TRIM71 (p = 2.15 × 10-7), SMARCC1 (p = 8.15 × 10-10), and PTCH1 (p = 1.06 × 10-6). Additionally, two de novo duplications were identified at the SHH locus, encoding the PTCH1 ligand (p = 1.2 × 10-4). Together, these probands account for ∼10% of studied cases. Strikingly, all four genes are required for neural tube development and regulate ventricular zone neural stem cell fate. These results implicate impaired neurogenesis (rather than active CSF accumulation) in the pathogenesis of a subset of CH patients, with potential diagnostic, prognostic, and therapeutic ramifications.
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Affiliation(s)
- Charuta Gavankar Furey
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Jungmin Choi
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Sheng Chih Jin
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Xue Zeng
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Andrew T Timberlake
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Carol Nelson-Williams
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - M Shahid Mansuri
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Qiongshi Lu
- Department of Biostatistics & Medical Informatics, University of Wisconsin, Madison, WI 53706, USA
| | - Daniel Duran
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Shreyas Panchagnula
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - August Allocco
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Jason K Karimy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Arjun Khanna
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Jonathan R Gaillard
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Tyrone DeSpenza
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Prince Antwi
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Erin Loring
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA
| | - William E Butler
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Edward R Smith
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Benjamin C Warf
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer M Strahle
- Department of Neurological Surgery and Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - David D Limbrick
- Department of Neurological Surgery and Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Phillip B Storm
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Gregory Heuer
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Eric M Jackson
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Bermans J Iskandar
- Department of Neurological Surgery, University of Wisconsin Medical School, Madison, WI 53726, USA
| | - James M Johnston
- Department of Neurosurgery, University of Alabama School of Medicine, Birmingham, AL 35233, USA
| | - Irina Tikhonova
- Yale Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | | | | | - Robert D Bjornson
- Yale Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | - James R Knight
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Yale Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | - Kaya Bilguvar
- Yale Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | - Shrikant Mane
- Yale Center for Genome Analysis, Yale University, New Haven, CT 06510, USA
| | - Seth L Alper
- Division of Nephrology and Center for Vascular Biology Research, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Shozeb Haider
- Department of Pharmaceutical and Biological Chemistry, University College London School of Pharmacy, London WC1N 1AX, UK
| | - Bulent Guclu
- Kartal Dr. Lutfi Kirdar Research and Training Hospital, Istanbul 34860, Turkey
| | - Yasar Bayri
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Neurosurgery, Division of Pediatric Neurosurgery, Istanbul 34752, Turkey
| | - Yener Sahin
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Neurosurgery, Division of Pediatric Neurosurgery, Istanbul 34752, Turkey
| | - Michael L J Apuzzo
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Charles C Duncan
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Michael L DiLuna
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Murat Günel
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Richard P Lifton
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY 10065, USA
| | - Kristopher T Kahle
- Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA; Department of Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT 06510, USA.
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Sarica C, Tanrikulu B, Sahin Y, Dağçınar A, Baltacioglu F, Bayri Y. Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient. Pediatr Neurosurg 2018; 53:247-253. [PMID: 29719303 DOI: 10.1159/000488458] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/25/2017] [Accepted: 03/13/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. CASE REPORT We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. CONCLUSION Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms.
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Affiliation(s)
- Can Sarica
- Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Bahattin Tanrikulu
- Department of Neurosurgery, Acibadem University School of Medicine, Istanbul, Turkey
| | - Yener Sahin
- Neurosurgery, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Adnan Dağçınar
- Neurosurgery, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Feyyaz Baltacioglu
- Radiology, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Yasar Bayri
- Neurosurgery, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
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Sahin Y, Evliyaoglu O, Erkan T, Cokugras FC, Ercan O, Kutlu T. The frequency of celiac disease in children with autoimmune thyroiditis. Acta Gastroenterol Belg 2018; 81:5-8. [PMID: 29562371] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIMS Although the presence of autoimmune thyroiditis (AT) in celiac disease (CD) has been well documented among adults, CD in AT has been less reported in children. We aimed to investigate the frequency of CD in children with AT. Materials and Methods : This prospective study was carried out from October 2015 to August 2016 and included 66 patients with AT. Firstly, total IgA and tissue transglutaminase antibody (tTG) IgA levels were measured. Those with increased level of tTG IgA were tested for anti-endomysium IgA antibodies (EMA). Patients with positive EMA underwent gastroduodenoscopy for a definitive diagnosis of CD. RESULTS Sixty-six patients with AT (52 female) with mean age of 14.68 ± 3.18 years were enrolled. IgA deficiency was found in four patients. Only three of 66 patients (4.5%) were positive for tTG IgA. Patients positive for tTG IgA were then tested for EMA, and only one of them (1.5%) had positive EMA antibodies. Gastroduodenoscopy was performed in this patient. The result of pathological investigation was compatible with CD. Furthermore, one patient with AT had been diagnosed with CD previously. CONCLUSIONS Two (3.0%) of 66 patients with AT were found to have CD. According to the results, we assume that there is a close relationship between CD and AT disease. However, there is a need for multicentric, prospective studies that would support our findings.
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Affiliation(s)
- Y Sahin
- Department of Pediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey
| | - O Evliyaoglu
- Department of Pediatric Endocrinology, Cerrahpasa Medical School, Istanbul University, Turkey
| | - T Erkan
- Department of Pediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey
| | - F C Cokugras
- Department of Pediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey
| | - O Ercan
- Department of Pediatric Endocrinology, Cerrahpasa Medical School, Istanbul University, Turkey
| | - T Kutlu
- Department of Pediatric Gastroenterology, Cerrahpasa Medical School, Istanbul University, Turkey
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Furey CG, Choi J, Duran D, Timberlake AT, Zeng X, Nelson-Williams C, Khanna A, Iskandar B, Butler W, Heuer GG, Bayri Y, Sahin Y, Limbrick DD, Warf BC, Duncan CC, DiLuna ML, Gunel M, Lifton RP, Kahle KT. 102 Exome Sequencing Identifies Novel Molecular Determinants of Human Congenital Hydrocephalus. Neurosurgery 2017. [DOI: 10.1093/neuros/nyx417.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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12
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Ekici C, Sahin Y, Yaykasli KO, Melekoglu R, Sahin N, Yuksel S. A CASE OF CONFINED PLACENTAL MOSAICISM WITH TRISOMY 15 ASSOCIATED WITH TURNER SYNDROME. Genet Couns 2016; 27:485-488. [PMID: 30226967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We here present a rare case of a Turner syndrome with mosaic trisomy 15 identified on chorionic villous sampling (CVS). Although there are several reports in the literature indicating confined placental mosaicism (CPM), counseling parents of a fetus with trisomy 15 mosaicism at CVS remains difficult because of the phenotypic variability. To illuminate that condition an amniocentesis or cord blood study should be offered in conjunction with genetic counseling.
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Krappe S, Sahin Y, Bindl T, Wittenberg T, Münzenmayer C. Track Q. Education and Training for Engineers and Physicians. BIOMED ENG-BIOMED TE 2015; 60 Suppl 1:s361-6. [DOI: 10.1515/bmt-2015-5015] [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: 11/15/2022]
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14
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Karaca Z, Acmaz B, Acmaz G, Tanriverdi F, Unluhizarci K, Aribas S, Sahin Y, Kelestimur F. Routine screening for Cushing's syndrome is not required in patients presenting with hirsutism. Eur J Endocrinol 2013; 168:379-84. [PMID: 23221034 DOI: 10.1530/eje-12-0938] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
CONTEXT Prevalence of Cushing's syndrome (CS) in patients presenting with hirsutism is not well known. OBJECTIVE Screening of CS in patients with hirsutism. SETTING Referral hospital. PATIENTS AND OTHER PARTICIPANTS This study was carried out on 105 patients who were admitted to the Endocrinology Department with the complaint of hirsutism. INTERVENTION All the patients were evaluated with low-dose dexamethasone suppression test (LDDST) for CS. MAIN OUTCOME MEASURE Response to LDDST in patients presenting with hirsutism. RESULTS All the patients had suppressed cortisol levels following low-dose dexamethasone administration excluding CS. The etiology of hirsutism was polycystic ovary syndrome in 79%, idiopathic hirsutism in 13%, idiopathic hyperandrogenemia in 6%, and nonclassical congenital hyperplasia in 2% of the patients. CONCLUSION Routine screening for CS in patients with a referral diagnosis of hirsutism is not required. For the time being, diagnostic tests for CS in hirsute patients should be limited to patients who have accompanying clinical stigmata of hypercortisolism.
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Affiliation(s)
- Z Karaca
- Departments of Endocrinology, Erciyes University Medical School, 38039 Kayseri, Turkey.
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15
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Simsek-Kiper PO, Topaloglu R, Sahin Y, Utine GE, Boduroglu K. Mucolipidosis type III in an adolescent presenting with atypical facial features and skeletal deformities. Genet Couns 2013; 24:7-12. [PMID: 23610860] [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: 06/02/2023]
Abstract
Mucolipidosis type III (MLIII) (MIM# 252600) is an uncommon autosomal recessive disorder that results from deficiency of the multimeric enzyme, UDP-N-acetylglucosamine-1-phosphotransferase. The enzymatic defect results in deficiencies of lysosomal degradative enzymes with concomitant intracellular accumulation of both partly degraded glycosaminoglycans and sphingolipids leading to clinical manifestations such as short stature, developmental delay and other structural abnormalities. The diagnosis is challenging since musculoskeletal presentation may mimic some of the rheumatic and metabolic disorders. We herein report on a 13-year-old adolescent who was admitted to our rheumatology clinic because of progressive joint stiffness and deformities of her hands. The clinical and radiological findings led us to the diagnosis of MLIII despite negative urinary aminoglycosyaminoglycans. Therefore we decided to check for the presence of elevated activities of alpha-mannosidase and beta-hexosaminidase A+B in the plasma which was actually the case and confirmed the clinical diagnosis ofMLIII.
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Affiliation(s)
- P O Simsek-Kiper
- Pediatric Genetics Unit, Ihsan Dogramaci Children's Hospital, Hacettepe University, Ankara, Turkey.
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Ozgun M, Kutuk M, Uludag S, Ozturk A, Aygen E, Sahin Y. M013 EFFECT OF BODY MASS INDEX ON THE RISK OF MISCARRIAGE AFTER ICSI. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Han I, Aygun M, Demir L, Sahin Y. Determination of effective atomic numbers for 3d transition metal alloys with a new semi-empirical approach. ANN NUCL ENERGY 2012. [DOI: 10.1016/j.anucene.2011.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [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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18
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Fidan M, Icbudak H, Tapramaz R, Sahin Y. Thermal and EPR spectroscopic studies of novel coordination compound trans-bis(acesulfamato)tetraaquazinc(II) with Mn(II) impurity. Spectrochim Acta A Mol Biomol Spectrosc 2011; 79:17-20. [PMID: 21419691 DOI: 10.1016/j.saa.2010.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 12/01/2010] [Accepted: 12/11/2010] [Indexed: 05/30/2023]
Abstract
The thermogravimetric analysis (TGA) and electron paramagnetic resonance (EPR) studies of powder and single crystals of bis(acesulfamato)tetraaquazinc(II), Zn(acs)(2)(H(2)O)(4), a novel coordination compound, are carried out. Previously synthesized bis(acesulfamato) tetraaquamanganese(II), Mn(acs)(2)(H(2)O)(4), is included into the host in trace amount as a paramagnetic probe for EPR analysis. Single crystal EPR spectra at room temperature are resolved and discussed. Low temperature EPR spectra down to 90K do not show remarkable change. At higher temperatures, however, the TGA and EPR spectra show changes around 335 K and 395 K; the causes and the mechanisms of changes are discussed.
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Affiliation(s)
- M Fidan
- Department of Physics, Faculty of Sciences, Ataturk University, Erzurum, Turkey.
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Ozgun MT, Uludag S, Oner G, Batukan C, Aygen EM, Sahin Y. The influence of obesity on ICSI outcomes in women with polycystic ovary syndrome. J OBSTET GYNAECOL 2011; 31:245-9. [DOI: 10.3109/01443615.2010.546906] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Jiang Y, Zhao J, Hua M, Zhen X, Yan G, Hu Y, Sun H, Selvaggi L, Zannoni GF, Tagliaferri V, De Cicco S, Vellone VG, Romualdi D, Lanzone A, Guido M, Fassbender A, Vodolazkaia AV, Bossuyt XB, Kyama MK, Meuleman CM, Peeraer KP, Tomassetti CT, D'Hooghe TM, Lumini A, Nanni L, Manna C, Pappalardo S, Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A, Manna C, Crescenzi F, Farrag A, Sallam HN, Zou L, Ding G, Zhang R, Sheng J, Huang H, von Kleinsorgen C, Wilson T, Thiel-Moder U, Ebert AD, Reinfandt M, Papadopolous T, Melo AS, Rodrigues JK, Dib LA, Andrade AZ, Donabela FC, Ferriani RA, Navarro PA, Tocci A, Royo P, Lucchini C, Ramos P, Alcazar JL, Habara T, Terada S, Yoshioka N, Hayashi N, Haouzi D, Assou S, Monzo C, Anahory T, Dechaud H, De Vos J, Hamamah S, Gonzalez-Ramos R, Rojas C, Rocco J, Poch A, Sovino H, Kohen P, Munoz A, Devoto L, Aygen MA, Atakul T, Oner G, Ozgun MT, Sahin Y, Ozturk F, Li R, Qiao J, Zhylkova I, Feskov A, Feskova I, Somova O, Chumakova N, Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson NP, Motta A, Colaci D, Horton M, Faut M, Bisioli C, Kopcow L, de Zuniga I, Wiener-Megnazi Z, Khaytov M, Lahav - Baratz S, Shiloh H, Koifman M, Oslander R, Dirnfeld M, Sundqvist J, Andersson KL, Scarselli G, Gemzell-Danielsson K, Lalitkumar PGL, Tokushige N, Markham R, Crossett B, Ahn S, Nelaturi V, Khan A, Fraser IS, Van Vaerenbergh I, Fatemi HM, Blockeel C, Van Lommel L, In't Veld P, Schuit F, Kolibianakis EM, Devroey P, Bourgain C, Sugino N, Tamura I, Lee R, Maekawa R, Gelbaya T, Gordts S, D'Hooghe TN, Gergolet M, Nardo LG, Yu H, Wang H, Huang H, Lee C, Soong Y, Kremenska Y, Masliy Y, Goncharova Y, Kremenskoy M, Veselovskyy V, Zukin V, Sudoma I, Delgado-Rosas F, Gomez R, Tamarit S, Abad A, Simon C, Pellicer A, Racicot M, Dean NL, Antaki R, Menard S, Kadoch IJ, Garcia-Guzman R, Cabrera Romero L, Hernandez J, Palumbo A, Marshall E, Lowry J, Maybin JA, Collins F, Critchley HOD, Saunders PTK, Chaudhury K, Jana SK, Banerjee P, Mukherjee S, Chakravarty BN, Allegra A, Marino A, Lama A, Santoro A, Agueli C, Mazzola S, Volpes A, Delvoux B, de Graaff AA, D'Hooghe TM, Kyama CM, Dunselman GAJ, Romano A, Caccavo D, Pellegrino NM, Totaro I, Panzarino M, Nardelli C, Depalo R, Flores R, Montanana V, Monzo A, Polo P, Garcia-Gimeno T, Cabo A, Rubio JM, Pellicer A, de Graaff AA, Dunselman GAJ, Beets GL, van Lankveld JJ, Kim HY, Lee BS, Cho SH, Choi YS, Seo SK, Lee KE, Yang HI, Abubakirov A, Vacheyshvili T, Krechetova L, Ziganshina M, Demura T, Nazarenko T, Fulop I, Rucz A, Herczegh SZ, Ujvari A, Takacs SZ, Szakonyi T, Lopez - Muniz A, Zamora L, Serra O, Guix C, Lopez-Teijon M, Benadiva C, Alvarez JG, Goudakou M, Karkanaki A, Kalogeraki A, Mataliotakis I, Kalogiannidis I, Prapas I, Hosie M, Thomson KJ, Penny CB, Thomson KJ, Penny C, Hosie MJ, McKinnon B, Klaeser B, Bersinger N, Mueller MD, Horcajadas JA, Martinez-Conejero JA, Montesinos M, Morgan M, Fortuno S, Simon C, Pellicer A, Yi KW, Shin JH, Park HT, Kim T, Kim SH, Hur JY, Chan RWS, Chan YY, Ng EHY, Yeung WSB, Santulli P, Borghese B, Chopin N, Marcellin L, de Ziegler D, Chapron C, Elnashar A, Badawy A, Mosbah A, Tzioras S, Polyzos NP, Messini CI, Papanikolaou EG, Valachis A, Patavoukas E, Mauri D, Badawy A, Messinis IE, Acar N, Hirota Y, Tranguch S, Daikoku T, Burnum KE, Xie H, Kodama A, Osuga Y, Ustunel I, Friedman DB, Caprioli RM, Dey SK, Mitra A, Sahu R, Pal M, Bhattachrayya AK, Bhattachrya J, Ferrero S, Remorgida V, Rollandi GA, Biscaldi E, Cho S, Choi YS, Kim HY, Seo SK, Yang HI, Lee KE, Shin JH, Lee BS, Arena E, Morando A, Remorgida V, Ferrero S, Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E, Valenzano Menada M, Biscaldi E, Remorgida V, Morotti M, Venturini PL, Rollandi GA, Ferrero S, Dimitriadis E, Salamonsen LA, Hannan N, O'Connor O, Rombauts L, Stoikos C, Mahmoudi M, Shaikh A, Mousavifar N, Rastin M, Baharara J, Tabasi N, Takemura Y, Fujimoto A, Osuga Y, Tsutsumi R, Ooi N, Yano T, Taketani Y, Karkanaki A, Goudakou M, Kalogiannidis I, Panagiotidis I, Prapas Y, Zhang D, Lv PP, Ding GL, Zhang RJ, Zou LB, Xu GF, Gao HJ, Zhu YM, Sheng JZ, Huang HF, Martinez-Conejero JA, Labarta E, Alama P, Pellicer A, Horcajadas JA, Bosch E. Posters * Endometriosis, Endometrium and Implantation. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arslan-Alaton I, Kabdash I, Sahin Y. Effect of Operating Parameters on the Electrocoagulation of Simulated Acid Dyebath Effluent. ACTA ACUST UNITED AC 2008. [DOI: 10.2174/1875040000801010001] [Citation(s) in RCA: 22] [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: 11/22/2022]
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Han I, Sahin M, Demir L, Sahin Y. Measurement of K X-ray fluorescence cross-sections, fluorescence yields and intensity ratios for some elements in the atomic range 22⩽Z⩽68. Appl Radiat Isot 2007; 65:669-75. [PMID: 17353129 DOI: 10.1016/j.apradiso.2007.01.009] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Revised: 01/10/2007] [Accepted: 01/16/2007] [Indexed: 11/22/2022]
Abstract
The Kalpha, Kbeta, and total K X-rays fluorescence cross-sections, as well as the average fluorescence yields for 24 elements with 22 <or= Z <or= 68 have been measured at an excitation energy 59.54 keV gamma-rays from an Am-241 filtered point source. Furthermore, the I(Kalpha)/I(Kbeta) intensity ratios for these elements have been investigated. The K X-rays emitted by samples have been counted by a Si(Li) detector. Experimental values of the K X-ray fluorescence cross-sections, fluorescence yields, and the I(Kalpha)/I(Kbeta) intensity ratios have been compared with theoretical values. In most cases, there is an agreement between the experimental and theoretical values within the standard uncertainties.
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Affiliation(s)
- I Han
- Faculty of Arts and Sciences, Department of Physics, Atatürk University, 25240 Erzurum, Turkey.
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Abstract
Erectile dysfunction (ED) is more frequent among end-stage renal failure patients than the normal population. Sildenafil citrate has been successfully used for the symptomatic treatment of erectile dysfunction. The aim of this study was to determine the efficacy and safety of sildenafil citrate in the treatment of ED in patients on hemodialysis. Fifty-five hemodialysis patients above 18 years suffering from ED with steady sexual partners were included in the study. The first five and fifteenth questions of the International Index of Erectile Function were employed to evaluate ED in the patient group. A Single 50-mg sildenafil citrate tablet was prescribed for each patient. The patients were encouraged to take it on the day after hemodialysis and 1 hour before sexual intercourse. The erectile function of the patients after the treatment was re-evaluated in the same manner by International Index of Erectile Function. The ages of the patients ranged between 30 and 73 years (mean 50.6 +/- 10.9). The overall response rate was 74.5% (38/51). Side effects were nausea (n = 2), palpitation (n = 2), flushing (n = 1), and angina (n = 1). Sildenafil citrate (50 mg) was observed to be safe and effective for treatment of hemodialysis patients with careful evaluation and proper patient selection.
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Affiliation(s)
- Y Sahin
- Başkent University, Faculty of Medicine, Department of Urology, Ankara, Turkey
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Sudhop T, Sahin Y, Lindenthal B, Hahn C, Lüers C, Berthold HK, von Bergmann K. Comparison of the hepatic clearances of campesterol, sitosterol, and cholesterol in healthy subjects suggests that efflux transporters controlling intestinal sterol absorption also regulate biliary secretion. Gut 2002; 51:860-3. [PMID: 12427790 PMCID: PMC1773453 DOI: 10.1136/gut.51.6.860] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [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: 12/08/2022]
Abstract
BACKGROUND Recently identified ABCG5/8 transporters are responsible in part for the different absorption rates of campesterol, sitosterol, and cholesterol. These transporters are also expressed in the liver and might regulate biliary sterol secretion. AIMS This study was therefore conducted to determine the biliary secretion rates and hepatic clearances of campesterol, sitosterol, and cholesterol. SUBJECTS Six healthy, male volunteers. METHODS Deuterium labelled sitosterol and campesterol, and unlabelled sitostanol were constantly infused together with a liquid formula using a duodenal perfusion technique. Biliary secretion and hepatic clearance rates were calculated from hourly bile and plasma samples. RESULTS Plasma concentrations of cholesterol, campesterol, and sitosterol averaged 167.5 (50) mg/dl (SD), 0.50 (0.22) mg/dl, and 0.30 (0.10) mg/dl, respectively. Sitosterol showed a significantly higher biliary secretion rate (1.23 (0.87) mg/h) than campesterol (0.76 (0.54) mg/h, p=0.0321), but both plant sterols had significantly lower biliary secretion rates compared with cholesterol (47.7 (17.5) mg/h; p=0.001 for both). Hepatic clearance of cholesterol (0.31 (0.18) dl/h) was significantly lower compared with campesterol (2.11 (2.51) dl/h) and sitosterol (4.97 (4.70) dl/h; p=0.028 for both), and the clearance of campesterol was significant lower compared with sitosterol (p=0.028). CONCLUSION The observed inverse relation between hepatic clearance and known intestinal absorption of cholesterol, campesterol, and sitosterol supports the hypothesis that the ABCG5/8 transporters regulating intestinal sterol absorption might also be involved in biliary sterol excretion.
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Affiliation(s)
- T Sudhop
- Department of Clinical Pharmacology, University of Bonn, Germany
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Serin IS, Ozçelik B, Bekyurek T, Ozturk F, Koc N, Sahin Y. Effects of pentoxifylline in the prevention of ovarian hyperstimulation syndrome in a rabbit model. Gynecol Endocrinol 2002; 16:355-9. [PMID: 12587528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
Tumor necrosis factor alpha (TNF-alpha) and other cytokines have been implicated in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). Pentoxifylline, a methylxanthine derivative, was found to inhibit TNF-alpha synthesis. The aim of this study was to evaluate whether the use of pentoxifylline would prevent the occurrence of OHSS in a rabbit model. Thirteen rabbits were divided into two groups. The first group (n = 6) were given pentoxifylline 15 mg/kg intravenously and the second group (n = 7) were given physiological serum 15 mg/kg before ovulation induction. Ovarian hyperstimulation was induced in rabbits by 200 IU equine chorionic gonadotropin on day 1 and 100 IU human chorionic gonadotropin on day 3. Blood samples were analyzed for TNF-alpha on days 1, 3 and 5. All animals were autopsied on day 6 to evaluate the ovarian weight, ascites formation and histopathological changes. There was no difference between groups regarding weight gain, ascites formation and plasma TNF-alpha levels (p < 0.05). Ovarian weight and number of ovulations were significantly lower in the pentoxifylline group than the control group (p < 0.05). Pentoxifylline did not prevent ascites formation despite the observed decrease in ovarian weight and number of ovulations in OHSS in a rabbit model.
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Affiliation(s)
- I S Serin
- Department of Obstetrics and Gynecology, Erciyes University Medical Faculty, Kayseri, Turkey
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Abstract
OBJECTIVE To compare the clinical efficacy and safety of the combination of Diane 35 (2 mg of cyproterone acetate, and 35 microg of ethinyl estradiol) plus finasteride (5 mg), and Diane 35 alone in the treatment of hirsutism. DESIGN Prospective randomized clinical study. SETTING Outpatients in Erciyes University Medical School. PATIENT(S) Forty women with hirsutism were selected. INTERVENTION(S) For 1 year, group 1 patients (n = 20) were treated with Diane 35 alone (2 mg of cyproterone acetate and 35 microg of ethinyl estradiol) daily on days 5 to 25 of the menstrual cycle and group 2 patients (n = 20) with Diane 35 plus finasteride (5 mg daily). MAIN OUTCOME MEASURE(S) Hirsutism was graded at 6-month intervals using the Ferriman-Gallwey method. The basal hormone levels of total and free testosterone (T), androstenedione, DHEAS, and sex-hormone-binding globulin (SHBG) were measured by radioimmunoassay before the study. Total T, free T, SHBG, and DHEAS were also measured at 6-month intervals for 1 year. Multiscreen blood chemistry and side effects were evaluated during the treatment. RESULT(S) Thirty-four patients completed the 12-month study period. A significant decrease in the hirsutism score as compared to baseline was observed after 12 months with both Diane 35 treatment (mean +/- SD, 15.62 +/- 4.89 vs. 9.75 +/- 3.97) and Diane 35 plus finasteride treatment (16.27 +/- 6.90 vs. 8.38 +/- 4.44). The percentage decreases in the hirsutism score (mean percent +/- SD) were 30.26 +/- 14.56 vs. 34.70 +/- 11.60 at 6 months, 38.09 +/- 11.46 vs. 48.14 +/- 14.27 at 12 months in the Diane 35 and the Diane 35 plus finasteride groups, respectively. The percentage reduction in the hirsutism score in the Diane 35 plus finasteride group at 12 months was greater than in the Diane 35 group (P <.05). CONCLUSION(S) The percentage decrease in the hirsutism score at 12 months was higher in the Diane 35 plus finasteride group than in the Diane 35 group. We believe that Diane 35 plus finasteride is an effective and safe combination for the treatment of hirsutism.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Erciyes University, Kayseri, Turkey
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Affiliation(s)
- F Kelestimur
- Departments of; Endocrinology; Obstetrics and Gynecology; Nuclear Medicine, Erciyes University School of Medicine, Kayseri, Turkey
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Keleştimur F, Sahin Y. Relationship of ovarian stromal volume and serum 17-hydroxyprogesterone concentrations in patients with PCOS. Hum Reprod 1999; 14:2177. [PMID: 10438447 DOI: 10.1093/humrep/14.8.2177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Unlühizarci K, Keleştimur F, Bayram F, Sahin Y, Tutuş A. The effects of metformin on insulin resistance and ovarian steroidogenesis in women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 1999; 51:231-6. [PMID: 10468995 DOI: 10.1046/j.1365-2265.1999.00786.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [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: 01/03/2023]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a form of functional ovarian hyperandrogenism and affects approximately 5-10% of women of reproductive age. Insulin resistance and hyperinsulinaemia appear to be almost universal feature of the polycystic ovary syndrome. Abnormal regulation of cytochrome P450c17alpha causes the exaggerated secretion of ovarian androgens in PCOS. The aim of the present study was to determine whether reduction of insulin levels by metformin would attenuate FSH, LH, 17-Hydroxyprogesterone (17-OHP) and androstenedione hyperresponsiveness to buserelin testing in PCOS women. DESIGN The presence of hyperinsulinaemia in 16 women with PCOS was demonstrated by an oral glucose tolerance test (OGTT) and results were compared with 13 healthy women. PCOS women were also evaluated with insulin tolerance test (ITT) for the assessment of insulin sensitivity. FSH, LH, 17-OHP and androstenedione responses to buserelin testing were measured in all the women with PCOS. PCOS patients were given metformin (500 mg, orally, two times daily) for 12 weeks and re-evaluated at the end of the treatment period. RESULTS Women with PCOS were hyperinsulinaemic (basal insulin 92.1+/-14.3 vs. 44.0+/-4.0 pmol/l; AUCinsulin 68087.4+/-8862.3 vs. 13075.5+/-1327.6 pmol/lx120 min) compared with healthy women. Metformin therapy improved menstrual disturbances in 25% of the women with PCOS and also resulted in some improvement in insulin sensitivity and reduced basal and post glucose load insulin levels. However, FSH, LH, 17-OHP and androstenedione responses to buserelin testing were unaltered in response to metformin. CONCLUSION It is clear that PCOS is often associated with profound insulin resistance and hyperinsulinaemia. These abnormalities explain the increased prevalence of glucose intolerance in women with PCOS and metformin has beneficial effects on insulin sensitivity in women with PCOS. Amelioration of hyperinsulinaemia has no significant effect on ovarian cytochrome P450c17alpha enzyme activity. However, it can be used in obese women with PCOS as an adjuvant therapy and long term studies should be performed to evaluate the endocrine effects of metformin in women with PCOS.
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Affiliation(s)
- K Unlühizarci
- Departments of Endocrinology, Erciyes University School of Medicine, Kayseri, Turkey
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Abstract
This study was performed to confirm the favourable therapeutic effects of finasteride in hirsute women as described by previous publications of different research groups. Our study was a non-randomized, prospective clinical trial. Thirty five patients with hirsutism were included in the study. The patients received 5 mg finasteride orally once per day over a period of 12 months. Hirsutism score, FSH, LH, E2, total T, free T, androstenedione (A), DHEAS, 17-hydroxyprogesterone (17-OHP) and sex hormone-binding globulin (SHBG) levels were determined in all the patients before treatment and every 6 months during treatment. The modified Ferriman-Gallwey score decreased from a mean of 19.06 +/- 6.12 to 11.31 +/- 4.93 during the study. Clinical improvement in the degree of hirsutism was observed in 26 of 35 patients. The percent reductions in hirsutism scores (mean% +/- SD) at 6 and at 12 months were 25.8 +/- 11.3 and 41.3 +/- 18.5, respectively. During the finasteride therapy E2 and SHBG were increased significantly while DHEAS was decreased significantly at 12 months. There were no significant changes in the values of the other hormones and no serious side effects were observed in the study. In conclusion, finasteride is a well tolerated therapeutic agent without significant side pathological laboratory findings and can be used in the treatment of hirsutism.
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Affiliation(s)
- F Bayram
- Department of Endocrinology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
OBJECTIVE To assess the activity of the enzyme cytochrome P450c17alpha in patients with polycystic ovary syndrome (PCOS). DESIGN Prospective clinical study. SETTING Outpatients at Erciyes University Medical School, Kayseri, Turkey. PATIENT(S) Twenty-eight women with PCOS aged 25.44 +/- 4.37 years (mean +/- SD) and 18 normal women aged 26.94 +/- 3.17 years. MAIN OUTCOME MEASURE(S) Serum levels of 11-deoxycortisol, androstenedione (A), and 17alpha-hydroxy progesterone were measured before and 30 and 60 minutes after ACTH (0.25 mg i.v.) injection. RESULT(S) There was a statistically significant correlation between basal levels of 11-deoxycortisol (4.05 +/-1.16 ng/mL) and A (3.36 +/- 0.97 ng/mL) (r = 0.539). The peak level of 11-deoxycortisol (7.82 +/- 2.36 ng/mL) was also significantly correlated with the peak level of A (6.66 +/- 1.32 ng/mL) (r = 0.570) in women with PCOS. There was no statistically significant correlation between basal A (2.33 +/- 0.50 ng/mL) and basal 11-deoxycortisol (2.71 +/- 0.59 ng/mL) or between peak A (3.38 +/- 0.50 ng/mL) and peak 11 -deoxycortisol (3.68 +/- 0.48 ng/mL) levels in control subjects. CONCLUSION(S) We believe that PCOS is characterized by enhanced activity of 17,20-lyase enzyme in an alternate pathway between 11-deoxycortisol and A in the adrenal glands.
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Affiliation(s)
- F Keleştimur
- Department of Endocrinology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Unlühizarci K, Keleştimur F, Sahin Y, Bayram F. The treatment of insulin resistance does not improve adrenal cytochrome P450c17alpha enzyme dysregulation in polycystic ovary syndrome. Eur J Endocrinol 1999; 140:56-61. [PMID: 10037253 DOI: 10.1530/eje.0.1400056] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine whether metformin. when given to non-diabetic women with polycystic ovary syndrome (PCOS), results in a reduction of insulin resistance and hyperinsulinemia while body weight is maintained. Also we aimed to see whether the reduction in insulin levels attenuates the activity of adrenal P450c17alpha enzyme in patients with PCOS. DESIGN We investigated the 17-hydroxyprogesterone (17-OHP) and androstenedione responses to ACTH, insulin responses to an oral glucose tolerance test (OGTT) and glucose disposal rate in an insulin tolerance test before and after metformin therapy (500 mg, orally, twice daily, for 12 weeks). METHODS The presence of hyperinsulinemia in 15 women with PCOS was demonstrated by an OGTT and results were compared with those of 10 healthy women. Insulin sensitivity was measured by the rate of endogenous glucose disposal after i.v. bolus injection of insulin. 17-OHP and androstenedione responses to ACTH were measured in all the women with PCOS and the normal women. RESULTS Women with PCOS were hyperinsulinemic (102.0+/-13.0 (S.E.M.) VS 46.2+/-4.4 pmol/l) and hyperandrogenemic (free testosterone 15.3+/-1.7 vs 7.9+/-0.6 nmol/l; androstenedione 11.8+/-0.8 vs 8.2+/-0.6 nmol/l) and more hirsute (modified Ferriman-Gallwey score, 17.7+/-1.6 vs 3.0+/-0.3) than healthy women. In addition, women with PCOS had higher 17-OHP and androstenedione responses to ACTH when compared with healthy women. Metformin therapy resulted in some improvement in insulin sensitivity and reduced the basal and post-glucose load insulin levels. But 17-OHP and androstenedione responses to ACTH were unaltered in response to metformin. CONCLUSIONS PCOS is characterized by hyperactivity of the adrenal P450c17alpha enzyme and insulin resistance. It seems that there is no direct relationship between insulin resistance and adrenal P450c17alpha enzyme dysregulation.
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Affiliation(s)
- K Unlühizarci
- Department of Endocrinology, Erciyes University School of Medicine, Kayseri, Turkey
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Keleştimur F, Sahin Y. Effect of ovarian steroid production on adrenal steroidogenesis? Fertil Steril 1998; 70:1187-9. [PMID: 9848324] [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: 02/09/2023]
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Abstract
The aim of this study was to compare the clinical efficacy and safety of low dose cyproterone acetate-estrogen combination (Diane) and the 5 alpha-reductase inhibitor finasteride in the treatment of hirsutism. Fourty-two women with hirsutism were included in the study. Twenty-one patients treated with cyproterone acetate (CPA) 2 mg and ethinyl estradiol (E) 35 micrograms daily on days 5-25 of the menstrual cycle, 21 with finasteride 5 mg daily. Hirsutism score, hormone levels, multiscreen blood chemistry and side effects were evaluated at three-monthly intervals for 9 months. A significant decrease in hirsutism score as compared to baseline was observed after 9 months with either CPA + E (Diane) (mean +/- SE, 15.81 +/- 1.19 vs 8.38 +/- 1.21) or finasteride treatment (17.81 +/- 1.05 vs 10.86 +/- 0.91) (p < 0.0005). The reductions in hirsutism scores (mean% +/- SE) were 14.23 +/- 2.29 vs 19.77 +/- 2.22 (p < 0.05) at 3, 40.23 +/- 4.58 vs 29.49 +/- 2.69 (p < 0.02) at 6 and 50.99 +/- 4.13 vs 39.87 +/- 3.30 (p < 0.02) at 9 months in CPA + E and finasteride groups, respectively. No significant changes were observed in hormone levels during finasteride treatment. Serum free testosterone significantly decreased at the third month of treatment, and remained suppressed for the duration of treatment in CPA + E group. DHEAS levels also decreased significantly after 6 and 9 months of therapy with CPA + E. SHBG significantly increased during CPA + E treatment. We conclude that both drugs are effective and well tolerated, but CPA + E appears to be more effective than 5 alpha-reductase inhibitor finasteride in long-term treatment of hirsute women. Diane is also a cost-effective drug.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
OBJECTIVE To compare the clinical efficacy and safety of Diane 35 (cyproterone acetate [2] mg and ethinyl estradiol [35 microg]) plus spironolactone [100 mg] combination and Diane 35 alone in the treatment of hirsutism. DESIGN Prospective clinical study. SETTING Outpatients in Erciyes University Medical School. PATIENT(S) Fifty women with hirsutism. INTERVENTION(S) Group I patients (n = 22) were treated with Diane 35 alone and group II patients (n = 28) with Diane 35 plus spironolactone [100 mg]. MAIN OUTCOME MEASURE(S) The basal hormone levels total and free T, androstenedione, DHEAS, sex hormone-binding globulin (SHBG), and prolactin (PRL) were measured by RIA before the study. Free T, SHBG, and DHEAS were also measured at 6-month intervals for 12 months. Hirsutism was graded at 6-month intervals. RESULT(S) The basal hormone levels were similar between the groups. Hirsutism score significantly decreased at the end of the therapy in both groups. The reduction in hirsutism score in group II at 12 months was greater than in group I. But the scores before the treatment, at 6 and 12 months were similar between the groups. CONCLUSION(S) Although the actual hirsutism score and free T concentration are not significantly different between the two groups at 12 months, percentage change in the hirsutism score at 12 months was higher in the Diane 35 plus spironolactone group. Therefore, the addition of spironolactone to Diane 35 may have a synergistic effect on hirsutism score.
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Affiliation(s)
- F Keleştimur
- Department of Endocrinology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
OBJECTIVE To determine the frequency of late-onset adrenal hyperplasia (LOCAH) due to 21-hydroxylase (21-OH) and 11 beta-hydroxylase (11 beta-OH) deficiency in women with clinical and biochemical features of polycystic ovary syndrome (PCOS). DESIGN Eighty-three consecutively selected women with PCOS and eighteen normal women were included in the study. METHODS Ultrasound, clinical and hormonal parameters were used to define PCOS. Basal FSH, LH, testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG) and cortisol levels were measured. Serum 17-hydroxyprogesterone (17-OHP) and 11-deoxycortisol (11-DOC) levels were also measured before, 30 and 60 min after a single bolus injection of 0.25 mg ACTH (1-24) at 0900 h during the mid-follicular phase of the cycle. ACTH-stimulated 17-OHP levels > 30 nmol/l were considered as the criteria of 21-OH deficiency. The diagnosis 11 beta-OH deficiency was made if the adrenal 11-DOC response to ACTH stimulation exceeded threefold the 95th percentile of controls. RESULTS Basal serum testosterone, free testosterone, androstenedione, DHEA-S, cortisol and 11-DOC levels were significantly higher in PCOS than in control subjects. ACTH-stimulated 17-OHP (P < 0.05) and 11-DOC (P < 0.0005) levels were found to be significantly higher in patients with PCOS than in controls. Seven (8.4%) patients had an 11-DOC response to ACTH higher than threefold the 95th percentile of controls, while no patients showed evidence of 21-OH deficiency. CONCLUSIONS We have found that 8.4% of the women with clinical and biochemical features of PCOS could be presumed to have 11 beta-OH deficiency. No patients among the women with PCOS showed evidence of 21-OH deficiency. 11 beta-OH deficiency is unexpectedly more common than 21-OH deficiency in women with PCOS.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
OBJECTIVE To compare the effects of flutamide at 250 mg/d and 500 mg/d in the treatment of hirsutism. DESIGN Randomized, prospective clinical study. PATIENT(S) Sixty-five patients with moderate to severe hirsutism. INTERVENTION(S) Group I (n = 35) patients were treated with flutamide, 250 mg/d, and group II (n = 30) patients were treated with flutamide, 500 mg/d, for 12 months. Baseline hormone levels, body mass index, and hirsutism scores were similar between the groups. Hirsutism score, hormone levels, and multiscreen blood chemistry were measured at 3-month intervals for 12 months. RESULT(S) The modified Ferriman-Gallwey scores for hirsutism decreased significantly at months 6 and 12 from a mean +/- SEM of 17.8 +/- 0.9 to 6.0 +/- 0.6 (P < 0.001) and 17.8 +/- 0.9 to 4.8 +/- 0.7 (P < 0.001) in group I and from 17.0 +/- 0.9 to 6.6 +/- 0.7 and 17.0 +/- 0.9 to 5.2 +/- 0.7 (P < 0.001) in group II, respectively. The reductions in hirsutism scores (mean +/- SEM) were similar in group I at 6 months (64.6% +/- 2.5%) and at 12 months (71.2% +/- 2.2%) and in group II at 6 months (62.1% +/- 3.0%) and at 12 months (70.3% +/- 3.0%). The percent reductions in hirsutiam scores at 6 and at 12 months were similar within group I (64.6% +/- 2.5% and 71.2% +/- 2.2%) and group II (62.1% +/- 3.0% and 70.3% +/- 3.0%), respectively. The decreases in hirsutism scores in the first 6 months were more significant than in the last 6 months of treatment in both groups. There were no significant differences in any of the hormone levels during therapy in either group. One patient in group II was excluded from the study because of liver dysfunction. CONCLUSION(S) This study shows that two different doses of flutamide (250 mg/d and 500 mg/d) are similarly effective in reducing hair growth. Flutamide at a dose of either 250 mg/d or 500 mg/d has no further effect after 6 months. We conclude that if flutamide is administered at a dose of 250 mg/d it may represent an effective and well tolerated treatment with reduced cost for the patient.
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Affiliation(s)
- I I Müderris
- Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Sahin Y, Kontaş O, Müderris II, Cankurtaran M. Effects of angiotensin converting enzyme inhibitor cilazapril and angiotensin II antagonist saralasin in ovarian hyperstimulation syndrome in the rabbit. Gynecol Endocrinol 1997; 11:231-6. [PMID: 9272418 DOI: 10.3109/09513599709152539] [Citation(s) in RCA: 15] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We investigated the possible effects of the angiotensin converting enzyme (ACE) inhibitor cilazapril and angiotensin II antagonist saralasin on ovulation, ovarian steroidogenesis and ascites formation in the ovarian hyperstimulation syndrome (OHSS) in the rabbit model. OHSS was induced in rabbits by human menopausal gonadotropin (hMG) and intermittent human chorionic gonadotropin (hCG). In the cilazapril group (n = 10), animals also received cilazapril 2 mg/kg intraperitoneally daily for 7 days. In the saralasin group (n = 8), animals received saralasin intraperitoneally 1 h before or 1 h after hCG administration. Control animals (n = 8), received intraperitoneal saline solution. Serial blood samples were drawn on days 1, 5, 7 and 9 to measure serum estradiol and progesterone levels. On day 9, all rabbits underwent surgical exploration. Peritoneal and pleural fluid formation, ovarian weights and number of ovulations were determined. The volume of the ascitic and pleural fluids after hyperstimulation were not statistically different between the control, cilazapril and saralasin groups. The weight gains and ovarian weights of animals were similar between treatment and control groups. Saralasin significantly (p < 0.05) inhibited ovulation, but cilazapril did not. Cilazapril and saralasin did not affect progesterone production. Only cilazapril significantly decreased estradiol production (p < 0.05). In conclusion, the ACE inhibitor cilazapril and angiotensin II antagonist saralasin did not prevent ascites formation in OHSS. The ovarian renin-angiotensin system may not be the only factor acting in ascites formation in the OHSS.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Sahin Y, Keleştimur F. 17-Hydroxyprogesterone responses to gonadotrophin-releasing hormone agonist buserelin and adrenocorticotrophin in polycystic ovary syndrome: investigation of adrenal and ovarian cytochrome P450c17alpha dysregulation. Hum Reprod 1997; 12:910-3. [PMID: 9194638 DOI: 10.1093/humrep/12.5.910] [Citation(s) in RCA: 14] [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: 02/04/2023] Open
Abstract
Abnormal regulation of cytochrome P450c17alpha causes the exaggerated secretion of ovarian androgens in polycystic ovary syndrome (PCOS). This enzyme is active in both the ovaries and adrenal glands. We examined whether there is an abnormal regulation of cytochrome P450c17alpha in the adrenal gland by investigating the relationship of 17-hydroxyprogesterone (17-OH progesterone) hyperresponsiveness to the gonadotrophin releasing hormone (GnRH) agonist, buserelin, testing with 17-OH progesterone response to adrenocorticotrophic hormone (ACTH) in PCOS. In all, 68 women with PCOS and 24 normal women were included in the study. Ultrasound, clinical and hormonal parameters were used to define PCOS. 17-OH progesterone response to ACTH was measured in all the women. In 52 of the 68 women with PCOS, 17-OH progesterone response to buserelin was measured. The mean basal 17-OH progesterone concentrations were similar in both PCOS and control groups. PCOS women had significantly higher net increment in 17-OH progesterone after ACTH administration (P<0.02). No significant correlations were found between the peak 17-OH progesterone values, the net increments in 17-OH progesterone and the area under the 17-OH progesterone-response curves after ACTH stimulation and buserelin test. Although 17-OH progesterone response to ACTH was significantly higher in the patients with PCOS than in the control subjects, the lack of relationship between 17-OH progesterone response to GnRH agonist buserelin and 17-OH progesterone response to ACTH stimulation suggests that the dysregulation of the cytochrome P450c17alpha enzyme may not play a role in adrenal androgen excess seen in PCOS.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynaecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Sahin Y, Ayata D, Keleştimur F. Lack of relationship between 17-hydroxyprogesterone response to buserelin testing and hyperinsulinemia in polycystic ovary syndrome. Eur J Endocrinol 1997; 136:410-5. [PMID: 9150702 DOI: 10.1530/eje.0.1360410] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine whether hyperinsulinism affects cytochrome P450c17 alpha activity by investigating the correlation between 17-hydroxyprogesterone (17-OHP) hyper-responsiveness to the gonadotropin-releasing hormone (GnRH) agonist, buserelin, and the insulin response to oral glucose in polycystic ovary syndrome (PCOS). DESIGN Ultrasound, clinical and hormonal parameters were used to define PCOS in this prospective clinical study. We investigated the correlation between the 17-OHP response to buserelin testing and the insulin response to oral glucose in PCOS. METHODS Twenty-eight women with PCOS and eighteen normal women were included in the study. 17-OHP response to buserelin, and insulin and C-peptide responses to oral glucose were measured. RESULTS Twenty-five women with PCOS had an increased 17-OHP response. The PCOS patients showed significantly higher mean post-glucose load insulin and C-peptide levels than controls (P < 0.05). No significant correlations were found between basal 17-OHP and fasting insulin or fasting C-peptide, between peak 17-OHP and fasting insulin, peak insulin or peak C-peptide, between 17-OHP area under the curve (AUC) and insulin AUC or C-peptide AUC, and between percent increment in 17-OHP and insulin AUC or C-peptide AUC (P > 0.05). CONCLUSIONS Lack of a relationship between the 17-OHP response to the GnRH agonist buserelin and hyperinsulinism suggests that hyperinsulinism may not play a role in the dysregulation of the cytochrome P450c17 alpha enzyme seen in PCOS.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Keleştimur F, Sahin Y, Ayata D, Tutuş A. The prevalence of non-classic adrenal hyperplasia due to 11 beta-hydroxylase deficiency among hirsute women in a Turkish population. Clin Endocrinol (Oxf) 1996; 45:381-4. [PMID: 8959074 DOI: 10.1046/j.1365-2265.1996.8150825.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The present study was designed to determine the prevalence of 11 beta-hydroxylase deficiency in adult women with hirsutism in a Turkish population. DESIGN AND PATIENTS One hundred and twenty-four consecutive unselected hirsute patients were studied. An ACTH stimulation test was performed in the midfollicular phase of the cycle on the patients and 20 age-matched controls by administration of a single bolus of 0.25 mg ACTH (1-24) at 0900 h. MEASUREMENTS Serum 11-deoxycortisol levels were measured before, 30 and 60 minutes after ACTH injection. Basal free testosterone (fT), SHBG, cortisol and androstenedione (A) were also measured. The diagnosis of 11 beta-hydroxylase deficiency has been presumed when the serum 11-deoxycortisol response to ACTH stimulation exceeded three times the 95th percentile of controls. RESULTS Basal hormone levels including fT and A were significantly higher in the hirsute women than in the healthy women. SHBG was significantly lower in the hirsute patients. Basal and ACTH stimulated 11-deoxycortisol levels were found to be significantly increased in the patients compared with the controls. Eight patients (6.5%) had an 11-deoxycortisol response higher than three times the upper normal limit. CONCLUSIONS Using stringent diagnostic criteria, we have found that 6.5% of the hirsute women in a Turkish population could be presumed to have 11 beta-hydroxylase deficiency.
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Affiliation(s)
- F Keleştimur
- Department of Endocrinology, Erciyes University, Medical School Hospital, Kayseri, Turkey
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Abstract
OBJECTIVE To investigate the effects of low dose flutamide (250 mg/d) on hirsutism score and hormone levels in women with hirsutism. DESIGN Nonrandomized, prospective clinical trial. PATIENTS Forty-one patients with moderate-severe hirsutism were included in the study. INTERVENTION Hirsute patients received 250 mg/d flutamide for a period of 6 months. MAIN OUTCOME MEASURES Hirsutism score, FSH, LH, E2, total T, free T, androstenedione, DHEAS, PRL, 17-hydroxyprogesterone, and sex hormone-binding globulin levels were detected in all the patients before treatment and every 3 months during treatment. RESULTS Treatment with the antiandrogen flutamide resulted in a particularly rapid and marked decrease in the hirsutism score, which decreased from 17.48 +/- 5.35 to 5.07 +/- 2.89 after 6 months. No significant changes in the levels of hormone and no serious side effects were observed in the study. CONCLUSION The low-dose flutamide, 250 mg/d, is a cost-effective drug in the treatment of hirsutism. Low-dose flutamide may be used in place of high-dose flutamide, 500 to 750 mg/d.
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Affiliation(s)
- I I Müderris
- Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
A young male patient, who previously was presumed inoperable due to an existing hepatic mass with multiple cerebral metastases, was referred to us from an oncology clinic ith signs of transtentorial herniation. An operation was performed promptly; the right parietal mass, which was totally removed, proved to be an alveolar hydatid cyst. He refused the operation proposed for the hepatic lesion and was discharged.
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Affiliation(s)
- C Topsakal
- Department of Neurosurgery, Taksim Hospital, Istanbul, Turkey
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45
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Abstract
OBJECTIVE To evaluate adhesion formation after classic abdominal myomectomy and the role of early, second-look laparoscopic adhesiolysis in the management of post-myomectomic pelvic adhesions in a prospective study. METHOD Forty-eight patients with infertility, recurrent abortion or symptomatic myoma underwent second-look laparoscopy (SLL) 8 days after abdominal myomectomy. The degree of adnexal adhesions were scored according to the American Fertility Society Classification and were lyzed laparoscopically. The success of the SLL was evaluated in 18 patients who underwent a third-look procedure (cesarean section or laparoscopy) RESULTS Myomectomy incisions on the posterior uterine wall were associated with more adhesions than that on the fundus or anterior wall (P < 0.01). Myomectomies performed on uteri larger than 13 weeks gestation resulted in significantly higher adhesion scores than smaller ones (P < 0.001) and mainly intra-mural myomas than only sub-serous ones (P < 0.01). More than one uterine incision was found to result in more adhesions (P < 0.05), while the number of myomas removed were not found to affect adhesion formation (P > 0.05). In the patients who underwent a third-look procedure, adhesion scores were found to be significantly lower than the SLL (6.2 +/- 6.4 vs. 3.1 +/- 3.4) (P < 0.01). CONCLUSION Myomectomy operations frequently result in pelvic adhesions, which may impair fertility. Early laparoscopy and adhesiolysis after myomectomy is useful for assessing the degree of adhesions, technical ease in performing adhesiolysis and resulting in lower adhesion scores as shown by third-look procedures.
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Affiliation(s)
- M Uğur
- Dr. Zekai Tahir Burak Women's Hospital, Ankara, Turkey
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46
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Erzeneoglu S, Kurucu Y, Durak R, Sahin Y. Measurements of atomic form factors at 4.283-Å-1 photon-momentum transfer. Phys Rev A 1995; 51:4628-4630. [PMID: 9912152 DOI: 10.1103/physreva.51.4628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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47
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Sahin Y, Saglam A. Synergistic effects of carboxymethylcellulose and low molecular weight heparin in reducing adhesion formation in the rat uterine horn model. Acta Obstet Gynecol Scand 1994; 73:70-3. [PMID: 8304032 DOI: 10.3109/00016349409013399] [Citation(s) in RCA: 28] [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: 01/29/2023]
Abstract
OBJECTIVE To investigate the effect of sodium carboxymethylcellulose (SCMC) and the combination of low molecular weight heparin (LMWH) with SCMC in the prevention of intraperitoneal adhesion. DESIGN Thirty-eight rats underwent bilateral surgical injury to the uterine horn and the parietal peritoneum. In 13 rats, a solution of SCMC was instilled at laparotomy. In 11 rats, LMWH was delivered on to serosal and peritoneal defects, and SCMC was instilled. As a control group 14 rats were included in the study. SETTING Surgical Research Laboratory, Erciyes University. PARTICIPANTS Female Wistar-Albino rats, weighing 200 to 250 g each. MAIN OUTCOME MEASURES Adhesions between the uterine horn and the abdominal sidewall were scored for extent and severity two weeks after the initial surgery. RESULTS Although the mean adhesion score both in the SCMC group (2.8, s.d. 1.15) and in the SCMC with LMWH group (1.6, s.d 1.18) was found to be significantly lower than in the control group (3.4, s.d. 0.89) (p < 0.05 and p < 0.001, respectively), more favorable adhesion prophylaxis was achieved in the SCMC with LMWH group in comparison with the SCMC treatment group without any hemorrhagic complications (p < 0.001). CONCLUSION We conclude that SCMC with LMWH are highly effective in reducing postoperative adhesions in this animal model. SCMC with LMWH appears promising in adhesion prophylaxis.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Erciyes University School of Medicine, Kayseri, Turkey
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48
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Abstract
Maternal thyroid function was investigated in 37 preeclamptic and 8 eclamptic patients and 45 normal pregnant women in the third trimester as controls. There were significant correlations between maternal values of total thyroxine (TT4), total triiodothyronine (TT3), thyroxine-binding globulin, free thyroxine index and birth weight of newborns in the patients with preeclampsia-eclampsia, but there was no correlation in the controls. Also, the maternal free thyroxine, free triiodothyronine, triiodothyronine uptake and thyroid stimulating hormone values showed no correlation with the birth weights of babies in both groups. The reduced serum concentrations of TT4 and TT3 may reflect the severity of preeclampsia.
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Affiliation(s)
- E Kaya
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
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49
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Abstract
OBJECTIVE We determined the 17-hydroxyprogesterone (17-OH P) response to buserelin, a GnRH agonist, and its relation to ovarian volume in the patients with polycystic ovary syndrome (PCOS). DESIGN We compared 17-OH P response to buserelin in a large group of patients with that in a control group of healthy women. We also investigated whether there is any relation between LH-induced 17-OH P production in response to buserelin and ovarian volume. PATIENTS Ten normal women and 31 women with PCOS were included in the study. MEASUREMENT Pelvic ultrasound examination by abdominal or vaginal transducer was performed. Serum basal levels of LH, FSH, free testosterone and 17-OH P were measured by radioimmunoassay. 17-OH P responses to both ACTH and buserelin were detected. Cortisol levels were measured before and after dexamethasone suppression. RESULTS The subcutaneous administration of 1 mg buserelin produced an increase in serum 17-OH P, which peaked within 24 hours in all groups. The mean +/- SEM level of 17-OH P, 24 hours after buserelin stimulation in the women with PCOS (15.94 +/- 1.31 nmol/l) was significantly higher (P < 0.001) than in the control group (6.75 +/- 0.69 nmol/l). The women with PCOS had increases in 17-OH P levels exceeding 10.15 nmol/l 24 hours after buserelin testing. The increased 17-OH P responses to buserelin were unchanged by pretreatment with dexamethasone to suppress adrenal function. The 17-OH P response was significantly related to ovarian volume (r = 0.53, P < 0.01). CONCLUSIONS Our findings suggest that the serum 17-OH P response to a 1-mg subcutaneous test dose of buserelin may be a diagnostic and practical test for PCOS. increased ovarian volume in PCOS may be responsible for the elevated 17-OH P response to buserelin, a GnRH agonist, at least in some patients.
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Affiliation(s)
- Y Sahin
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Erciyes, Kayseri, Turkey
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50
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Abstract
We describe a woman with acromegaly who had acanthosis nigricans and hirsutism. Serum growth hormone (GH) and testosterone levels were markedly elevated. Standard oral glucose tolerance test (OGTT) showed a diabetic curve and no suppressed GH levels. Fasting insulin levels were very high while plasma glucose levels were not hypoglycemic. Insulin tolerance test revealed blunted hypoglycemic response. Acanthosis nigricans was present in the right axilla and face. Ultrasonogram demonstrated bilateral polycystic changes in the ovaries. From the above findings this patient's condition is characteristic of a very rare syndrome consisting of acromegaly, polycystic ovaries (PCO), hyperandrogenism, hirsutism, insulin resistance and acanthosis nigricans.
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Affiliation(s)
- A Unal
- Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
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