Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders

Alper Evrensel,Mehmet Emin Ceylan 대한정신약물학회 2016 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.14 No.3

Fecal microbiota transplantation has a 1700-year history. This forgotten treatment method has been put into use again during the last 50 years. The interest in microbiota-gut-brain axis and fecal microbiota transplantation is rapidly increasing. New evidence is obtained in the etiopathogenesis of neuropsychiatric disorders. There is a large number of experimental and clinical researches in the field of gut-brain axis. There is limited information on fecal microbiota transplantation. Despite this, initial results are promising. It is commonly used in the treatment of gastrointestinal diseases such as Clostridium difficile infection, Crohn’s disease, ulcerative colitis. It is also experimentally used in the treatment of metabolic and autoimmune diseases. There are case reports that it is effective in the treatment of autism, Parkinson’s disease, multiple sclerosis, chronic fatigue syndrome and irritable bowel syndrome. Its implementation is easy, and it is a cheap and reliable treatment method. However, the long-term risks are unknown. Additionally, standard application protocols have not yet been established. There are a lot of questions to be answered. A university in Turkey has got official permission this year, and started to apply fecal microbiota transplantation. In this review, neuropsychiatric areas of use of fecal microbiota transplantation have been discussed in the light of the current information.

Neuroinflammation, Gut-Brain Axis and Depression

Alper Evrensel,Barış,Ö,nen Ü,nsalver,Mehmet Emin Ceylan 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.1

Psychiatric diseases are the manifestations that result from the individual’s genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who got psychiatric diagnosis. It is obvious that further research in different areas is needed to understand the psychopathology. The problems in the functions of immune system and the correlation of neuroinflammatory processes with psychiatric disorders have been one of the main research topics of psychiatry in recent years and have contributed to our understanding of psychopathology. Recent advances in the fields of immunology and genetics as well as rapidly increasing knowledge on the effects of immunological processes on brain functions have drawn attention to the correlations between psychiatric disorders and immune system dysfunctions. There are still unfilled gaps in the biology, pathophysiology, and treatment of major depressive disorder, which is quite prevalent among the psychiatric disorders, can lead to significant disability, and frequently has a recurrent course. It appears that low-grade chronic neuroinflammation plays a key role in forming a basis for the interaction between psychological stress, impaired gut microbiota and major depressive disorder. In this review, the role of neuroinflammation in the etiopathogenesis of depression and the mechanism of action of the gut-brain axis that leads to this are discussed in the light of current studies.

Letters to the Editor : Bupropion-Induced Erythema Multiforme

( Alper Evrensel ),( Mehmet Emin Ceylan ) 대한피부과학회 2015 Annals of Dermatology Vol.27 No.3

The Gut-Brain Axis: The Missing Link in Depression

Alper Evrensel,Mehmet Emin Ceylan 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.3

The gut microbiota is essential to human health and the immune system and plays a major role in the bidirectional communication between the gut and the brain. Based on evidence, the gut microbiota is associated with metabolic disorders such as obesity, diabetes mellitus and neuropsychiatric disorders such as schizophrenia, autistic disorders, anxiety disorders and major depressive disorders. In the past few years, neuroscientific research has shown the importance of the microbiota in the development of brain systems. Recent studies showed that the microbiota could activate the immune and central nervous systems, including commensal and pathogenic microorganisms in the gastrointestinal tract. Gut microorganisms are capable of producing and delivering neuroactive substances such as serotonin and gamma-aminobutyric acid, which act on the gut-brain axis. Preclinical research in rodents suggested that certain probiotics have antidepressant and anxiolytic activities. Effects may be mediated via the immune system or neuroendocrine systems. Herein, we present the latest literature examining the effects of the gut microbiota on depression.

한·터 증거성 표현 대조 연구

에브렌셀 펠린 에브림(Evrensel Pelin Evrim) 우리말학회 2019 우리말연구 Vol.59 No.-

본 논문은 한국어와 터키어 두 언어의 증거성 표현을 대조적 관점에서 접근하고, 터키인 한국어 학습자들이 한국어 학습에 주는 시사점을 제시하였다. 본고에서는 한국어의 증거성 표지를 직·간접 증거로 분류되어, 직접증거 표지에는 ‘–더, -네, -길래’ 등, 추론을 통해 얻은 정보를 경우 ‘–겠-, –나/은가 보-, -을/은 모양이-’ 등, 전언 표지에는 ‘–다(고 하)-’ 등을 분석했다. 한국어 증거성 체계는 정보를 획득한 주체와 정보를 획득한 방법으로 나누어져 있으며, 정보를 획득한 주체가 화자인 경우와 화자가 아닌 다른 사람으로부터 들은 것을 엄격히 구분한다. 아울러 직접 지각하여 정보를 획득하는 것과 추론을 통해서 정보를 획득하는 경우로 나누며 이를 표현하는 형태들이 잘 발달되어 있다. 반면, 터키어에서는 과거 시제의 어미인 ‘-mIş-’가 유일하다. 터키어에서는 ‘-mIş-’는 기본적으로 과거의 의미를 나타내는데 양태와 증거성을 나타내는 측면에서 한국어와 달리 하나의 행태로서의 화자가 직접적으로 정보를 얻거나 추론을 통해 얻거나 또는 타인한테 들어서 알게 된 정보를 얻을 때도 쓰인다. 한국어의 증거성 어미들이 의미와 기능면에서 유사점을 가지고 있어서, 터키인 한국어 학습자는 증거성 어미의 의미와 사용을 이해하고 구별하는 데 어려움을 겪는다. This paper analyzises the expression of evidence in both Korean and Turkish languages from a contrasting point of view, and puts forward the implications that Turkish learners of Korean language have suggested Korean language learning. In this paper, evidence markers in Korean were classified as direct and indirect evidence, and the direct evidence markers were analyzed ‘te, -ney and killay’ as direct evidential markers and for information obtained through inference ‘-keyss-, -ul kesi-, -na/unka po-’ and ‘–ul/un moyangi-’, and for information obtained through hearsay ‘–ta(ko ha)’. The Korean evidence system is divided into the method who obtained the information and the method by which the information was obtained. First of all, strictly distinguishes between speaker has obtained the information and those who have heard it from someone else. In addition, the forms of expressing information are well developed by dividing it into those directly perceived to obtain information and those obtained through inference. On the other hand, ‘-mIş-’ the past tense, is the only Turkish ending. In Turkish, ‘-mIş-’ not only represents the meaning of the past, but it can also represent modalities and evidence. The main view about the‘-mIş-’ that speaker s belief in the content of the proposition can express directly or indirectly. The similarity between the meaning and function of the Korean language s endings, the Turkish learner has difficulty understanding and distinguishing the meaning and use of them.

Long-Term Use of Escitalopram and a High Level of Carcinoembryonic Antigen

Mehmet Emin Ceylan,Alper Evrensel,Barış Önen Ünsalver 대한가정의학회 2016 Korean Journal of Family Medicine Vol.37 No.6

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Hyperamylasemia Related to Sertraline

Mehmet Emin Ceylan,Alper Evrensel,Barış Önen Ünsalver 대한가정의학회 2016 Korean Journal of Family Medicine Vol.37 No.4

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Prognostic Significance of Human Epidermal Receptor (HER)-3 Immunohistochemical Expression in Patients with Metastatic Breast Cancer

Olmez, Omer Fatih,Evrensel, Turkkan,Cubukcu, Erdem,Ugras, Nesrin,Avci, Nilufer,Canhoroz, Mustafa,Deligonul, Adem,Hartavi, Mustafa,Olmez, Fatma,Cubukcu, Sinem,Tolunay, Sahsine,Kurt, Ender,Kanat, Ozkan Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.7

Background: Previous reports have shown that human epidermal receptor (HER)-3 overexpression may be associated with poor prognosis in patients with breast cancer, but results have been conflicting. In this study, we sought to investigate the prognostic significance of HER-3 immunohistochemical expression in patients with metastatic breast cancer. Methods: We retrospectively analyzed HER-3 immunohistochemical expression profiles in 45 paraffin-embedded specimens from patients who had been treated between 1996 and 2006 in the Department of Oncology of the Uludag University School of Medicine, Bursa, Turkey. Membranous or cytoplasmic dominant expression patterns of HER-3 were analyzed using the Rajkumar score and a cytoplasmic 4-point scoring system, respectively. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: The median PFS in the study participants was 9 months (interquartile range: 4.5-13 months), whereas the median OS was 20 months (interquartile range: 7.5-28 months). Categorization of the patient population according to HER-3 positive immunohistochemical expression did not reveal any statistically significant difference in terms of both PFS (p=0.70) and OS (p=0.81). The results of multivariable Cox regression analysis indicated that tumor size was the only independent predictor of PFS, whereas estrogen and progesterone receptor status was independently associated with OS. Conclusions: HER-3 immunohistochemical expression did not correlate with outcomes in Turkish patients with metastatic breast cancer. Although our results suggest that HER-3 expression in cancer specimens is not of prognostic significance, further prospective studies are warranted to confirm these results.

Polydipsia as a Precursor of Manic Episode in Bipolar Affective Disorder Patients with Alcohol Use Disorder

Mehmet Emin Ceylan,Bariş Önen Ünsalver,Alper Evrensel 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.1

Bipolar affective disorder (BD) diagnosis and initiation of appropriate treatment are often delayed, and this is associated with poorer outcomes, such as rapid cycling or cognitive decline. Therefore, identifying certain warning signs of a probable successive episode during the inter-episode phase is important for early intervention. We present the retrospective data of three cases of BD. Our first case had a history of alcohol use disorder (AUD), where he drank in a dipsomaniac manner, and the other two cases had dipsomaniac alcohol use before their manic attacks, and none of them had any AUD after the mood episode was over. Two brothers also had hypertensive episodes during the manic attacks. None of the cases reported increased fluid intake when they were euthymic. We suggest that polydipsia in BD may be a warning sign of an upcoming manic episode, especially in those patients with AUD. Polydipsia in BD may be caused or facilitated by a combination of hyperdopaminergic activity, hypothalamic dysfunction, and dysregulated renin-angiotensin system. To be able to prevent new episodes, a patient’s drinking habits and change in fluid intake should be asked at every visit. Those patients with a history of alcohol abuse should especially be informed about polydipsia and manic episode association.

Association of miR-1266 with Recurrence/Metastasis Potential in Estrogen Receptor Positive Breast Cancer Patients

Sevinc, Elif Demirdogen,Egeli, Unal,Cecener, Gulsah,Tezcan, Gulcin,Tunca, Berrin,Gokgoz, Sehsuvar,Tasdelen, Ismet,Tolunay, Sahsine,Evrensel, Turkkan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.1

The Homeobox B13 (HOXB13):Interleukin 17 Receptor B (IL17BR) index of estrogen receptor (ER)-positive breast cancer (ER (+) BC) patients may be a potential biomarker of recurrence/ metastasis. However, effects of microRNA (miRNA) binding to the 3' untranslated region (3' UTR) of HOXB13 and IL17BR and its function on recurrence/metastasis in ER (+) BC remains elusive. The aims of this study were to determine the expression of miRNAs that bind to 3' UTR of HOXB13 and IL17BR in ER (+) BC patients and asess the effects of these miRNAs on recurrence/metastasis. The expression profiles of HOXB13 and IL17BR were evaluated using RT-PCR in tumors and normal tissue samples from 40 ER (+) BC patients. The expression level of 4 miRNAs, which were predicted to bind the 3' UTR of HOXB13 and IL17BR using TargetScan, microRNA.org and miRDB online databases, were further evaluated with RT-PCR. Our findings demonstrated that high miR-1266 levels might be significant prognostic factor for recurrence/metastasis occurrence (3.05 fold p=0.004) and tamoxifen response (3.90 fold; p=0.2514) in ER (+) BC cases. Although we suggest that modulation of miR-1266 expression may be an important mechanism underlying the chemoresistance of ER (+) BC, advanced studies and validation are required.