Performance of F-18 Fluorocholine PET/CT for Detection of Hyperfunctioning Parathyroid Tissue in Patients with Elevated Parathyroid Hormone Levels and Negative or Discrepant Results in Conventional Imaging

Lebriz Uslu-Bes¸li,Kerim Sonmezoglu,Serkan Teksoz,Elife Akgun,Emre Karayel,Huseyin Pehlivanoglu,Baresh Razavi Khosroshahi,Meltem Ocak,Levent Kabasakal,Sait Sager,Yusuf Bukey 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.2

Objective: Our aim was to assess the diagnostic performance of F-18 fluorocholine (FCH) positron emission tomography/ computed tomography (PET/CT) in detecting hyperfunctioning parathyroid tissue (HPT) in patients with elevated parathyroid hormone levels with negative or inconclusive conventional imaging results and to compare the findings with those obtained using technetium-99m sestamibi (MIBI) scintigraphy and neck ultrasonography (US). Materials and Methods: Images of 105 patients with hyperparathyroidism who underwent FCH PET/CT, dual-phase MIBI parathyroid scintigraphy (median interval: 42 days), and neck US were retrospectively analyzed. The gold standard was histopathological findings for 81 patients who underwent parathyroidectomy and clinical follow-up findings in the remaining 24 patients. Sensitivities, positive predictive values (PPVs), and accuracies were calculated for all imaging modalities. Results: Among the 81 patients who underwent parathyroidectomy, either parathyroid adenoma (n = 64), hyperplasia (n = 9), neoplasia (n = 4), or both parathyroid adenoma and hyperplasia (n = 1) were detected, except 3 patients who did not show HPT. Of the 24 (23%) patients who were followed-up without operation, 22 (92%) showed persistent hyperparathyroidism. FCH PET/CT showed significantly higher sensitivity than MIBI scintigraphy and US in detection of HPT (p < 0.01). Sensitivity, PPV, and accuracy of FCH PET/CT were 94.1% (95/101), 97.9% (95/97), and 92.4% (97/105), respectively. The corresponding values for MIBI scintigraphy and US were 45.1% (46/102), 97.9% (46/47), and 45.7% (48/105) and 44.1% (45/102), 93.8% (45/48), and 42.9% (45/105), respectively. Among the 35 patients showing negative MIBI scintigraphy and neck US findings, 30 (86%) showed positive results on FCH PET/CT. FCH PET/CT could demonstrate ectopic locations of HPT in 11 patients whereas MIBI and US showed positive findings in only 6 and 3 patients, respectively. Conclusion: FCH PET/CT is an effective imaging modality for detection of HPT with the highest sensitivity among the available imaging techniques. Therefore, FCH PET/CT can be recommended especially for patients who show negative or inconclusive results on conventional imaging.

An Investigation on Process Capability Analysis for Fused Filament Fabrication

Elif Elçin Günay,Anusha Velineni,Kijung Park,Gül E. Okudan Kremer 한국정밀공학회 2020 International Journal of Precision Engineering and Vol.21 No.4

Additive manufacturing (AM) has become a popular manufacturing technology today. Many companies have been investingin AM technologies and skill development to carefully integrate them into their capabilities. Despite its benefi ts, AM hasseveral disadvantages that require in-depth analysis and process engineering. This research focuses on the reproducibilityissue of fused fi lament fabrication (FFF) for polylactic acid printing to reveal whether the AM technology can produce partscomparable to those by traditional or subtractive manufacturing. For this purpose, identifi cation of optimal process parametersand process capability analysis are integrated to achieve repeatable minimum deviation from target dimensions. First,a design of experiments is planned and performed to determine the optimal combination of signifi cant factors to ensuredimensional accuracy. Then, process capability analysis under optimal factor settings is performed to examine whether theprinted part dimensions satisfy the target performance levels. Findings from this study show the FFF process can match thereproducibility of manufacturing parts produced by traditional manufacturing technologies.

Pure Uterine Lipoma, a Very Rare Benign Tumor

Elif Ülker Akyildiz,Sema Ozuysal,Akgül Arici,Mehmet Aral Atalay 대한병리학회 2010 Journal of Pathology and Translational Medicine Vol.44 No.6

Pure lipomas of the uterus are very rare tumors that may be misdiagnosed on radiological examination due to their rarity and fat content. We present here the case of a 57-year-old postmenopausal woman who presented to the hospital with lower abdominal pain. Abdominal hysterectomy and bilateral salpingo-oophorectomy were performed under the prediagnoses of benign cystic ovarian teratoma or leiomyoma. On the histopathological examination of tissue samples, the tumor was composed of mature fat cells. There were a few smooth muscle cells confined to the periphery. Pure uterine lipoma may be asymptomatic or it may have symptoms similar to those of leiomyoma such as vaginal bleeding or pelvic pain. A pure lipoma should be diagnosed only if smooth muscle cells are confined to the periphery.

A Rare Cause of Recurrent Acute Pancreatitis in a Child: Isovaleric Acidemia with Novel Mutation

Elif Sag,Alper Han Cebi,Gulay Kaya,Gulay Karaguzel,Murat Cakir 대한소아소화기영양학회 2017 Pediatric gastroenterology, hepatology & nutrition Vol.20 No.1

Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or heredi-tary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, “the odor of sweaty feet,” abdominal pain, vomit-ing, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.

Recent Advances in Autism Spectrum Disorders: Applications of Whole Exome Sequencing Technology

Elif Funda Sener,Halit Canatan,Yusuf Ozkul 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.3

Autism spectrum disorders (ASD) is characterized by three core symptoms with impaired reciprocal social interaction and communication, a pattern of repetitive behavior and/or restricted interests in early childhood. The prevalence is higher in male children than in female children. As a complex neurodevelopmental disorder, the phenotype and severity of autism are extremely heterogeneous with differences from one patient to another. Genetics has a key role in the etiology of autism. Environmental factors are also interacting with the genetic profile and cause abnormal changes in neuronal development, brain growth, and functional connectivity. The term of exome represents less than 1% of the human genome, but contains 85% of known disease-causing variants. Whole-exome sequencing (WES) is an application of the next generation sequencing technology to determine the variations of all coding regions, or exons of known genes. For this reason, WES has been extensively used for clinical studies in the recent years. WES has achieved great success in the past years for identifying Mendelian disease genes. This review evaluates the potential of current findings in ASD for application in next generation sequencing technology, particularly WES. WES and whole-genome sequencing (WGS) approaches may lead to the discovery of underlying genetic factors for ASD and may thereby identify novel therapeutic targets for this disorder.

Design Principles for Wind Turbine Earthquake and Wind Load Combinations

Elif Altunsu,Onur Gunes,Ali Sarı 한국강구조학회 2022 International Journal of Steel Structures Vol.22 No.3

With the ongoing changes in the modern world, the usage of renewable energy sources is increasing. The negative impact of fossil fuels on global warming has led to the search for clean energy sources. Wind energy, which is the most widely used of those sources, is discussed in this study. Numerous studies have been undertaken in this regard, but seismic eff ects are only newly being considered. In addition to having strong wind zones, Turkey is located in a geographical position through which active fault lines pass. The presence of high wind zones overlapping with these fault lines necessitates seismic analysis for turbines planned to be built in the country. Analysis of wind and seismic load simulation is diffi cult with traditional structural design programs. In this study, coeffi cients including wind loads are suggested for civil engineers who plan to analyze wind turbines with only seismic eff ects. For this purpose, a horizontal axis steel wind turbine with a 5 MW scale is analyzed in this work considering a series of wind and seismic loads in the area around Gelibolu. These environmental eff ects are evaluated under diff erent operating conditions of the turbine, including normal operation with no earthquake loads, park condition with earthquake loads, idling condition with wind loads, normal operation with earthquake loads, and idling condition with earthquake and wind loads. The full system model of the turbine is developed with the FAST fi nite element program employing a special code for wind turbines developed by the National Renewable Energy Laboratory. As a result of the analysis, it is concluded that seismic loads acting with the wind signifi cantly change the internal forces. Damping eff ects occur when seismic and wind loads act at the same time. For this reason, wind loads need to be reduced by a certain coeffi cient in some cases. Coeffi cients are proposed here for application in initial designs and load combinations for certain wind and earthquake conditions.

The effect of acrylamide incorporation on the thermal and physical properties of denture resins

Elif Aydogan Ayaz,Rukiye Durkan,Bora Bagi 대한치과보철학회 2013 The Journal of Advanced Prosthodontics Vol.5 No.2

PURPOSE Polymethyl methacrylate (PMMA) is the most commonly used denture base material despite typically low in strength. The purpose of this study was to improve the physical properties of the PMMA based denture base resins (QC-20, Dentsply Ltd., Addlestone, UK; Stellon, AD International Ltd, Dentsply, Switzerland; Acron MC; GC Lab Technologies Inc., Alsip, Japan) by copolymerization mechanism. MATERIALS AND METHODS Control group specimens were prepared according to the manufacturer recommendations. In the copolymer groups; resins were prepared with 5%, 10%, 15% and 20% acrylamide (AAm) (Merck, Hohenbrunn, Germany) content according to the moleculer weight ratio, respectively. Chemical structure was characterized by a Bruker Vertex-70 Fourier transform infrared spectroscopy (FTIR) (Bruker Optics Inc., Ettlingen, Germany). Hardness was determined using an universal hardness tester (Struers Duramin, Struers A/S, Ballerup, Denmark) equipped with a Vickers diamond penetrator. The glass transition temperature (Tg) of control and copolymers were evaluated by Perkin Elmer Diamond DSC (Perkin Elmer, Massachusetts,USA). Statistical analyses were carried out using the statistical package SPSS for Windows, version 15.0 (SPSS, Chicago, IL, USA). The results were tested regarding the normality of distribution with the Shapiro Wilk test. Data were analyzed using ANOVA with post-hoc Tukey test (P<.01). RESULTS The copolymer synthesis was confirmed by FTIR spectroscopy. Glass transition temperature of the copolymer groups were higher than the control groups of the resins. The 10%, 15% and 20% copolymer groups of Stellon presented significantly higher than the control group in terms of hardness. 15% and 20% copolymer groups of Acron MC showed significantly higher hardness values when compared to the control group of the resin. Acrylamide addition did not affect the hardness of the QC-20 resin significantly. CONCLUSION Within the limitation of this study, it can be concluded that copolymerization of PMMA with AAm increased the hardness value and glass transition temperature of PMMA denture base resins.

Novel Compound Heterozygous Mutations of TGM1 Gene Identified in a Turkish Collodion Baby Diagnosed with Non-Bullous Congenital Ichthyosiform Erythroderma

( Elif Keleş Gülnerman ),( Nurcan Hanedan ),( Merve Akillioglu ),( Gülsüm Kayhan ),( Esra Adişen ),( Özlem Erdem ),( İbrahim Murat Hirfanoğlu ),( Ebru Ergenekon ),( Eray Esra Önal ),( Canan Türkyilmaz 대한피부과학회 2023 Annals of Dermatology Vol.35 No.7

Autosomal recessive congenital ichthyosis (ARCI) is a group of diseases presenting as collodion baby at birth. ARCI is categorized as Harlequin ichthyosis, lamellar ichthyosis, and non-bullous congenital ichthyosiform erythroderma (NBCIE), bathing suit icthyosis (BSI) and others. We describe the case of a male newborn with NBCIE whose whole exome sequencing revealed two variants of TGM1 gene (NM_000359.3) in a compound heterozygous state: c.790C>T (p.Arg264Trp) in exon 5 and c.2060G>A (p.Arg687His) in exon 13. In the literature, the Arg264Trp variant has been reported as homozygous or compound heterozygous with other variants in patients with BSI. In contrast, the Arg687His variant has been reported only as homozygous in patients with BSI. To the best of our knowledge, this is the first case whose two compound heterozygous variants, exhibiting the NBCIE phenotype, instead of the BSI.

Endoscopic Findings of Children with Familial Mediterranean Fever

Elif Sağ,Ferhat Demir,İsmail Saygın,Mukaddes Kalyoncu,Murat Çakır 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4

Purpose: Familial Mediterranean fever (FMF) is an auto inflammatory disease characterized by periodic fever, synovitis and serositis. Patients may be admitted to gastroenterology units due to gastrointestinal symptoms. In this study; we aimed to analyze endoscopic findings and diagnostic utility of endoscopic procedure in children with FMF. Methods: Patient with FMF that was performed endoscopy for the gastrointestinal symptoms were included to the study (39 of 164 patients, 53 procedure). A control group was randomly designed as age and gender matched four endoscopic procedures per one endoscopic procedure of patients with FMF (n=212). Results: No different was found between the patients and control group in esophagogastroscopy findings. However, the diagnosis of gastrointestinal pathology was made by esophagogastroscopy in 46.2% patients. Colonoscopic examination revealed that the frequency of inflammatory bowel disease (IBD) was higher in undiagnosed patients compared to both the control group (50.0% vs. 6.9%, p<0.05, odds ratio [OR]:13.4 and 95% confidence inteval [95% CI]: 2.1-84.3) and the patients under colchicine treatment (50.0% vs. 8.3%, p<0.05, OR: 11 and 95% CI: 0.8-147.8). Colonoscopic procedure that was made after the diagnosis was found to provide contribution by 16.7% in determining the etiology of the additional symptoms. Conclusion: Patients with FMF may be admitted to pediatric gastroenterology outpatient clinic prior to diagnosis or during the follow-up period. The frequency of IBD is high in undiagnosed patients with FMF. Endoscopic procedures may be helpful in these patients for the diagnosis accompanying mucosal lesions.

Examining the relationship between socioeconomic structure and urban transport network efficiency: a circuity and spatial statistics based approach

Elif Su Karaaslan,K. Mert Cubukcu 대한공간정보학회 2023 Spatial Information Research Vol.31 No.5

Access to urban public transportation services is crucial for all city residents. Undoubtedly, more efficient public transportation services should be provided for the needy ones. The study aims to develop a simple yet efficient analytical approach to spatially determine the urban areas that receive inefficient public transportation services. In this study, the spatial distribution of the efficiency of public transportation and its relation to socioeconomic variables (per capita income level and population density) are examined at the neighborhood in Izmir, Turkey, level using circuity. The results from univariate and bivariate Global and Local Moran’s I analyses reveal that the high-efficiency levels are spatially clustered, Higher-income neighborhoods have better public transportation systems compared to lower-income ones. According to Bivariate Local Moran’s I analyses, among the 348 neighborhoods at least 31 and at most 81 neighborhoods are either in a High-High or Low-Low cluster for the four time periods considered. As for the relationship between circuity and density, at least 21 and at most 75 neighborhoods are a part of a cluster. The fact that there is a significant relationship between the efficiency of public transportation and socioeconomic variables calls for alteration in the planning policies regarding urban public transportation supply. Although the variation in public transport efficiency levels across the neighborhoods can partly be attributed to physical conditions, the city should provide equal accessibility and efficiency regardless of the socio-economic status of the neighborhoods. The findings can well be generalized for cities of similar sizes in developing countries.