Endothelial nitric oxide synthase Glu298Asp gene polymorphism in the cases of idiopathic thrombocytopenic purpura

Saadet Akarsu,Feyzullah Necati Arslan,Deniz Erol 대한혈액학회 2022 Blood Research Vol.57 No.3

Background Nitric oxide (NO) can induce apoptosis in megakaryocytes. Stimulatory function of NO on platelet production may be important in the pathophysiology of idiopathic thrombocytopenic purpura (ITP). NO is produced by three isoforms of NO synthase (NOS). The endothelial nitric oxide synthase (eNOS) isoform has been detected in platelets. Polymorphism of the eNOS gene, which supplies NO synthesis, changes the functions of this enzyme. In this study, the role of eNOS Glu298Asp gene polymorphism in etiopathogenesis, its course, and treatment of ITP was investigated. Methods Sixty-six patients [51 newly diagnosed ITP (ND-ITP), 15 chronic ITP (CH-ITP), and 60 healthy controls (HC)] were enrolled in this study. Results In all patients, the frequency of the GT genotype was 48.5%. The frequency of the GG genotype was determined to be 40.9% and the TT genotype was 10.6%. The most common allele in all patients was the G allele. eNOS Glu298Asp gene polymorphism might be a risk factor in the etiopathogenesis of ITP. Patients with the GG genotype were thought to have a high intention for CH-ITP. Patients with the GG genotype responded effectively to medical treatment using IVIG therapy. The presence of the G allele was observed to have a positive effect on the medical treatment of patients with CH-ITP, whereas the T allele exhibited a negative effect. Conclusion In the present study, a significant correlation was found between ITP and eNOS Glu298Asp gene polymorphism. This correlation suggested that eNOS Glu298Asp gene polymorphism might be a risk factor in the ethiopathogenesis of ITP.

Piebaldism Associated with Cafe-au-lait Macules and Intertriginous Freckling: A Case Report and Review of the Literature

( Sevgi Akarsu ),( Turna Ilknur ),( Ceylan Avc ),( Emel Fetil ) 대한피부과학회 2019 Annals of Dermatology Vol.31 No.5

We present 9-year-old fraternal twins from a family with piebaldism, having congenital depigmented macules and meeting the diagnostic criteria for neurofibromatosis type 1 (NF1) due to the multiple cafe-au-lait macules (CALMs) and intertriginous freckling at the same time. It’s still a debatable issue that CALMs and intertriginous freckling may be seen in the clinical spectrum of piebaldism or these patients should be regarded as coexistence of piebaldism and NF1. However, based on recent literature and our patients’ findings, we suggest that this rare phenotypic variant of piebaldism may not need the careful clinical follow-up and molecular testing for NF1. Besides, it may be suitable that these individuals with piebaldism showing NF1-like clinical phenotypes should be further tested for KIT and SPRED1 gene mutations. (Ann Dermatol 31(5) 567∼570, 2019)

Preparation and Characterization of Polyethylene Glycol Functional Hydroxyapatite/Polycaprolactone Electrospun Biomembranes for Bone Tissue Engineering Applications

Emre Yavuz,Ramazan Erdem,Ertan Küçüksayan,Esin Akarsu,Murat Akarsu 한국섬유공학회 2021 Fibers and polymers Vol.22 No.5

Surfaces of previously synthesized Hydroxyapatite particles (HAP) have been modified with polyethylene glycolfunctional silane (PEG-400Si). For the surface modification of HAP, firstly, synthesis of PEG-400Si was performed byurethane reaction of hydroxyl and isocyanate groups. Then, HAP was synthesized by sol-gel method. Afterwards, surfacemodification of HAP was realized with PEG-400Si. SEM, TEM, XRD and FTIR analyses were utilized to characterize themorphology and structural properties of the synthesized and modified particles. Results revealed that the surface of HAP wasmodified successfully and the crystal structure of HAP was not changed after modification. Electrospinning process wasconducted to obtain unmodified and modified HAP incorporated nanofibrous biomembranes and the characteristics andbiological performances of these membranes have been compared to each other. SEM analysis presented that defect-free andround shape nanofibers obtained and the fiber diameter ranged from 230±114 nm to 760±291 nm. In vitro biologicalevaluations revealed that all electrospun nanofibrous biomembranes were nontoxic and the one with PCL/PEG-400Si-HAPexhibited greatest cellular protein expression approximately 1.5 times higher than the PCL biomembrane for 24 h, 48 h and72 h.

The Relationship between the Number of Manic Episodes and Oxidative Stress Indicators in Bipolar Disorder

Sü,leyman Akarsu,Abdullah Bolu,Emre Aydemir,Selma Bozkurt Zincir,Yasemin Gü,lcan Kurt,Serkan Zincir,Murat Erdem,Ö,zcan Uzun 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.5

Objective Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4– 5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study. Methods Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC. Results There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group. Conclusion Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.

Low-dose Clozapine-induced Seizure: A Case Report

Abdullah Bolu,Süleyman Akarsu,Erdal Pan,Emre Aydemir,Taner Oznur 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.2

Seizures are believed to be a dose-dependent side effect of clozapine. In this case report, we describe a patient who had tonic-clonic seizures after using a low dose clozapine who did not have any seizure risk. The 29-year-old male patient had been followed-up with a diagnosis of schizophrenia for about 5 years. When using clozapine 200 mg/day he had a tonic-clonic seizure with bilateral diffuse epileptic activity in electroencephalography (EEG). In the literature, there are a few case reports about low-dose clozapine-induced seizure. Seizures were observed in our case with a low dose of clozapine (200 mg/day) making this case remarkable. EEG monitoring at regular intervals and examination of plasma levels of clozapine could be useful in preventing the development of seizures.

Effect of intraoperative neuromonitoring on efficacy and safety using sugammadex in thyroid surgery: randomized clinical trial

Mehmet Emin Gunes,Ahmet Cem Dural,Cevher Akarsu,Deniz Guzey,Nuri Alper Sahbaz,Evrim Kucur Tulubas,Sezer Bulut,Turgut Donmez 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.6

Purpose: The use of nondepolarizing neuromuscular blocking agents (NMBAs) may affect intraoperative neuromonitoring (IONM) during anesthesia used during thyroid and parathyroid surgery. Methods: The use of sugammadex was evaluated in a prospective clinical study during thyroid surgery. Between July 2018 and January 2019, 129 patients were prospectively randomized to either the sugammadex group (group B) or the control group (group A). Group A patients underwent standardized IONM during thyroidectomy, while group B patients used an NMBA-reversal protocol comprised of rocuronium (0.6 mg/kg) in anesthesia induction and sugammadex (2 mg/kg) after first vagal stimulation (V0). A peripheral nerve stimulator was used to monitor the neuromuscular transmission. Results: In our clinical study, it took 26.07 ± 3.26 and 50.0 ± 8.46 minutes to reach 100% recovery of laryngeal electromyography at injection of the sugammadex group (2 mg/kg) and the control group, respectively (P < 0.001). The train-of-four ratio recovered from 0 to >0.9 within 4 minutes after administering 2 mg/kg of sugammadex at the beginning of resection. Surgery time was significantly shorter in group B than in group A (P < 0.001). Transient recurrent laryngeal nerve (RLN) paralysis was detected in 4 patients from group A and in 3 patients from group B (P = 0.681). There was no permanent RLN paralysis in the 2 groups. Conclusion: Our clinical study showed that sugammadex effectively and rapidly improved the inhibition of neuromuscular function induced by rocuronium. The implementation of the nondepolarizing neuromuscular block recovery protocol may lead to tracheal intubation as well as favorable conditions for IONM in thyroid surgery.

Efficacy of Omalizumab in a Patient with Angioedema Clinically Resembling a Hereditary Angioedema

( Ali Kutlu ),( Ercan Karabacak ),( Ersin Aydın ),( Selim Akarsu ),( Sami Ozturk ) 대한피부과학회 2016 Annals of Dermatology Vol.28 No.3

Evaluation of changes in the maxillary alveolar bone after incisor intrusion

Ezgi Atik,Hande Gorucu-Coskuner,Bengisu Akarsu-Guven,Tulin Taner 대한치과교정학회 2018 대한치과교정학회지 Vol.48 No.6

Objective: This study was performed to investigate the changes in alveolar bone after maxillary incisor intrusion and to determine the related factors in deep-bite patients. Methods: Fifty maxillary central incisors of 25 patients were evaluated retrospectively. The maxillary incisors in Group I (12 patients; mean age, 16.51 ± 1.32 years) were intruded with a base-arch, while those in Group II (13 patients; mean age, 17.47 ± 2.71 years) were intruded with miniscrews. Changes in the alveolar envelope were assessed using pre-intrusion and post-intrusion conebeam computed tomography images. Labial, palatal, and total bone thicknesses were evaluated at the crestal (3 mm), midroot (6 mm), and apical (9 mm) levels. Buccal and palatal alveolar crestal height, buccal bone height, and the prevalence of dehiscence were evaluated. Two-way repeated measure ANOVA was used to determine the significance of the changes. Pearson’s correlation coefficient analysis was performed to assess the relationship between dental and alveolar bone measurement changes. Results: Upper incisor inclination and intrusion changes were significantly greater in Group II than in Group I. With treatment, the alveolar bone thickness at the labial bone thickness (LBT, 3 and 6 mm) decreased significantly in Group II (p < 0.001) as compared to Group I. The LBT change at 3 mm was strongly and positively correlated with the amount of upper incisor intrusion (r = 0.539; p = 0.005). Conclusions: Change in the labial inclination and the amount of intrusion should be considered during upper incisor intrusion, as these factors increase the risk of alveolar bone loss.

Intramural hematomas of the gastrointestinal system

Osman Kones,Ahmet Cem Dural,Murat Gonenc,Mehmet Karabulut,Cevher Akarsu,Ilhan Gok,M. Abdussamet Bozkurt,Mehmet Ilhan,Halil Alıs 대한외과학회 2013 Annals of Surgical Treatment and Research(ASRT) Vol.85 No.2

Purpose: Although spontaneous intramural hematomas of the gastrointestinal tract are very rare, they may be observed with the use of oral anticoagulant, though less frequently in cases of hematological malignancy and other bleeding disorders. Cases diagnosed as spontaneous intramural hematoma have been assessed in our clinic. Methods: The cases, which were diagnosed as spontaneous intramural hematoma in the gastrointestinal tract (SIHGT) following anamnesis, physical examination, biochemical, radiological and endoscopic findings from July 2008 to July 2012, have been assessed retrospectively. Results: Seven out of 13 cases were women and the mean age was 65.1 years (34 to 82 years). The most frequent complaint on admission was abdominal pain. The most frequent location of SIHGT was the ileum (n = 8). Oral anticoagulant use was the most common cause of etiology (n = 12). In 10 cases, International normalized ratio values were higher than treatment range (2 to 3, where mechanical valve replacement was 2.5 to 3.5) and mean value was 7.6 (1.70 to 23.13). While 12 cases were discharged without problems with medical treatment, one case with acute myeloid leukemia died in the intensive care unit following cerebrovascular attack. Conclusion: Spontaneus bleeding and hematomas that may arise in connection with bleeding diathesis may be fatal in cases with long-term oral anticoagulant treatment and insufficient follow-up. In management of these cases, it may be necessary to arrange conservative follow up and/or initialize low molecular weight heparin, and administer vitamin K as well as replace blood products and coagulation factors when indicated.

Effects of Definitive Chemoradiotherapy on Respiratory Function Tests and Quality of Life Scores During Treatment of Lung Cancer

Duman, Evrim,Yildirim, Mustafa,Kaya, Vildan,Ozturk, Duriye,Inal, Aysun,Akarsu, Zeynep,Gunduz, Seyda,Yildiz, Mustafa Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

Background: Chemoradiotherapy is an important treatment modality for lung cancers. The aim of this study was to investigate alterations in, as well as the interrelationship between, lung function and quality of life of patients receiving chemoradiotherapy due to locally advanced non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) limited to the thorax. Materials and Methods: The study included patients receiving definitive chemoradiotherapy for lung carcinoma. The respiratory function of the patients was assessed by measuring forced expiratory volume in 1 s per unit (FEV1) and forced expiratory volume in 1s per unit of vital capacity (FEV1/VC) before, in the middle of and after treatment. During the study, EORTC QLQ C30 and LC13 questionnaires developed by the Committee of the European Organization for Research and Treatment of Cancer (EORTC) were employed to evaluate the quality of life on the same day as respiratory function tests (RFT). Findings: The study included 23 patients in total: 19 (82.6%) diagnosed with NSCLC and 4 (17.4%) with SCLC. The average percentage FEV1 was $55.6{\pm}21.8%$ in the pre-treatment period, $56.2{\pm}19.2%$ in the middle of treatment and $60.4{\pm}22%$ at the end of treatment. The improvement in functional scores, symptom scores and general health scores during treatment was not statistically significant (P= 0.568, P= 0.734, P= 0.680, P=0.757 respectively). Conclusions: Although this study showed an improvement in respiratory function and quality of life of patients during treatment with thoracic chemoradiotherapy, no statistically significant results were obtained. While evaluating the effectiveness of treatments for lung carcinoma, the effects of treatment on respiratory function and quality of life should be considered.