Poster Session : PS 0396 ; Infectious Disease ; A Rarely Seen Empyema Cause: Leuconostoc Mesenteroides

( Hanife Usta Atmaca ),( Feray Akbas ),( Yesim Karagoz ),( Betul Borku Uysal ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Case report: 64 year-old male patient was presented with cough, fever and sputum production. His medical history was unremarkable. He was producing and selling pickled vegetables. Only pathological fi nding in his physical examination was the reduction of pulmonary sounds in the lower part of left lung. Hemogram showed; leukocyte:5500/mm³ (neutrophil 65%, lymphocyte 30%), platelet: 287000/mm³, hematocrit 28%. Biochemical tests revealed normal, serum CRP level was 11,7 mg/dl. Pleural effusion was present in chest X-ray. Pleural ponction was performed. Gram-positive cocci and high concentration of leukocytes were seen in gram-staining in the exudative pleural fi uid. In the culture Leuconostoc mesenteroides was grown. CT showed pleural effusion and a consolidation containing air bronchogram. The patient was diagnosed with pleural empyema and drainage treatment with thorax tube and 2 grams of ceftriakson and 1 gr claritromycin daily were started. The symptoms regressed beginning from the fourth day. On the fourteenth day, CRP level returned to normal. The treatment was stopped at twenty-fi rst day with full recovery. Discussion: Leuconostocs are members of the family Streptococcacae and have only recently been recognized as potential pathogens. Infections by Leuconostoc species bacteria are uncommon, and usually affect patients with an underlying disease, or those fi tted with a venous catheter or subjects previously treated with vancomycin. Bacterias are found naturally in plants and vegetables and are used in milk, pickle and wine industries. While an underlying factor is needed for those organisms to become pathogenic, our case was completely healthy and had no invasive procedure previously. Because he was selling and directly producing pickles, it was considered that the organism could have passed directly. This case points out that; Leuconostoc mesenteroides should be considered as a causative agent in nasocomial infections, also in non- immunocompromised patients.

Poster Session:PS 0491 ; Nephrology : Congenital Agenesis of the Inferior Vena Cava in a Presenting with Acute Renal Failure

( Hanife Usta Atmaca ),( Feray Akbas ),( Yesim Karagoz ),( Ebru Pekguc ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Introduction: Agenesis of IVC (inferior vena cava) is a rare congenital anomaly which is generally incidentally found in asymptomatic patients. In patients with congenital intra-abdominal venous malformation, extreme care must be taken during radiological or surgical interventions. Case Report: A 35-year-old male patient was presented with nausea and vomiting following abdominal CT- performed for chronic abdominal pain-, presenting a subsequent decrease in urine output, and elevation of blood urea and creatinine. The patient had suffered from disseminated varicosities since the age of 15. In physical examination, intense subcutaneous venous collaterals on both lower extremities and abdomen and hepatosplenomegaly were observed. Grade 2 hydronephrosis in the right kidney and grade 4 hydronephrosis with decreased parenchymal thickness in the left kidney were present on renal ultrasonography. CT scan revealed discontinuity of contrast in the left portal vein compatible with portal vein thrombosis. On the left, ureteral continuity was not found. MR venography revealed an abnormally narrow IVC. The diagnosis was established as contrast induced nephropathy and the patient underwent hemodialysis. After 3 sessions, serum urea and creatinine levels, renal functions, and urine excretion returned to normal. The patient was discharged and a follow-up was planned. Discussion: Recognition of vascular abnormalities is important to prevent related complications. Agenesis of IVC enhances the risk of acute renal failure; regarding decreased renal fi ltration due to insuffi ciency of venous return and the mass effect on ureters, Extreme caution or even total abstinence for contrast media injection is necessary. Surgeons and interventional radiologists should be warned against potential complications.

Globalization and its challenges for developing countries: the case of Turkish higher education

Hanife Akar 서울대학교 교육연구소 2010 Asia Pacific Education Review Vol.11 No.3

This paper examines the challenges faced by the Turkish higher education system and exposes the inequities and realities educators in a developing nation must struggle with as they try to find a prestigious spot in the knowledge-production industry. After a brief overview of the literature that illustrates how globalization penetrated into each stage of development of Turkey's modern institutions of higher education, the paper presents a discussion, based on national and international statistics, of the challenges these institutions face as a result of globalization, namely increasing demands for higher education; faculty shortages; the internationalization of higher education; research and knowledge production; and the process of financing higher education.

Can BAP1 expression loss in mesothelial cells be an indicator of malignancy?

Hanife Gulnihal Ozdemir,Sermin Coban Kokten,Nagehan Ozdemir Barisik 대한병리학회 2020 Journal of Pathology and Translational Medicine Vol.54 No.6

Background: Malignant mesothelioma is a highly aggressive tumor that can be confused with a benign mesothelial lesion, especially cytomorphologic lesions. BRCA1-associated protein 1 (BAP1) acts as a tumor suppressor. In this study, we aim to investigate the value of BAP1 staining of malignant mesothelioma cases with expression loss and diagnosis in cell block and biopsy tissue. Methods: Between January 2009 and March 2017, 64 mesotheliomas, 117 reactive mesothelial hyperplasias, and 20 fibrinous pleuritis/pericarditis were diagnosed with morphologic and immunohistochemical findings in our pathology clinic and were included in the study. Formalin-fixed, paraffin-embedded tissues were immunohistochemically examined for BAP1. Inflammatory and stromal cells were used as positive internal controls. BAP1 was assessed for nuclear staining in mesothelial cells. Results: Examinations of the relationship between patient diagnosis and BAP1 biopsy status showed that the BAP1 loss rate (76.6%) was significantly higher in malignant mesothelioma cases than in other benign diseases (0%) (p < .001). Sensitivity and specificity were 76.56% and 100%, respectively, for biopsy tissue from malignant mesothelioma. Sensitivity and specificity were both 100% for BAP1 test on cell block tissue. Furthermore, the consistency between BAP1 cell block and biopsy results was excellent (ĸ = 0.90) and the correlation was significant (p < .001). Conclusions: This study shows that BAP1 expression loss in both cytology and biopsy tissue in biopsy-confirmed malignant mesothelioma cases is an essential parameter for malignant mesothelioma diagnosis.

Modified Atmosphere Packaging (MAP) Effects on Quality Maintenance and Storage Life Extension of Local Iranian Apple “Golab Kohanz”

Hanife S. Hajizadeh,Younes Mostofi,Ali reza Talaie 한국원예학회 2006 한국원예학회 기타간행물 Vol.- No.-

Poster Session:PS 0186 ; Endocrinology : Neutrophil to Lymphocyte Ratio as an Infl ammatory Marker in Obesity

( Hanife Usta Atmaca ),( Feray Akbas ),( Ilker Nihat Okten ),( Eda Nuhoglu Kantarci ),( Berrin Belcik Inal ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Obesity is a disease known to stimulate low grade infl ammation. N/L ratio has been started to be used as an indicator of systemic infl ammation. This study aims to examine the relationship between obesity and N/L ratio over anthropometric measurements, obesity grade, and some biochemical parameters. Methods: 96 obese patients (mild-moderate and severe) who are being monitored in obesity outpatient clinic, who have no concomitant disease, and who do not have a history of smoking and drug use, and as the control group, 20 patients of normal weight with the same characteristics were included in the study. Anthropometric measurements were recorded, and BMI was calculated. Biochemical tests and total blood counts were performed. N/L ratio was obtained by dividing neutrophil count by lymphocyte count. The results were evaluated using SPSS statistical analysis program. Results: A signifi cant increase was present in neutrophils and lymphocyte counts of morbid obese group compared to control groups. Due to both increased neutrophil and lymphocyte counts, even though L/N ratio increased, it was not found statistically signifi cant. The increase in total leucocyte count of morbid obese was statistically signifi cant compared to mild obese. While N/L ratio demonstrated a strongly positive correlation with total leucocyte count and neutrophil count, it demonstrated a weakly positive correlation with waist circumference and with hip circumference. Conclusions: N/L ratio increases by obesity grade and reveals that concomitant infl ammatory response increases. High count of circulating neutrophil in obese patients might be considered as an acute infl ammatory response to a chronic infl ammatory state. Therefore, N/L ratio might be used as an infl ammatory marker in obese patients, and might be helpful in the prediction of cardiovascular and metabolic risks for the patient.

Effect of Self-Efficacy on Turkish Children's Perceptions of the Advantages/Disadvantages of Smoking

Ulgen, Hanife,Ozturk, Candan,Armstrong, Merry Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.3

Objective: This descriptive, cross sectional study was conducted to examine the effect of levels of self-efficacy on children's perceptions of pros and cons of smoking. Methodology: The sample was 233 fifth-grade students. Data were collected in September 2010 using the Socio-Demographic Data Collection Form, Self Efficacy Scale Child Form and Child Decision Balance Scale and analyzed via percentage calculations and t test with the SPSS 11.00 statistical package program. Results: Average age of the students participating in the research was $11.1{\pm}0.41$, 49.8 % (n: 116) being female and 50.2 % (n:117) male. The difference between the score averages of the pros of smoking perceptions of children with a high self-efficacy level and of those with a low self efficacy level (t=2.117, p=.042) and the difference between the score averages of the cons of smoking perceptions of children with a high self-efficacy level and of those with a low self-efficacy level (t=2.206, p=.035) were found to be statistically significant. Conclusions: Children's positive perceptions of smoking were low and negative perceptions high when their self efficacy levels were high. Conversely, children's positive perceptions of smoking were high when their self efficacy levels were low.

An Update on Contraception in Polycystic Ovary Syndrome

Seda Hanife Oguz,Bulent Okan Yildiz 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.2

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patientsdiagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.

Poster Session : PS 0276 ; Gastroenterology : Gastrointestinal Tract Hemorrhage Due to Angiodysplasia in Hutchinson Gilfort Progeria Syndrome

( Serife Hanife Aktas ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Hutchinson Gilfort Progeria Syndrome (HGPS) is an aging disease which encounters in childhood and includes a higher risk for atherosclerosis, cerebrovascular event, stroke and coronary artery disease. Angiodysplasia in the gastrointestinal (GIS) tract can be seen as a cause of hemorrhage rarely. 15 years female Progeria patient which the diagnose was established before. The patient admitted our center with dyspeptic symtoms such as neusea, vomit, bloating and described the blackness in the stool. In the patient`s history, GIS tract hemorrhage was occured and treated in the another region hospital, two months ago. In the physical examination, decreased subcutaneous fat tissue, thin skin structure, micrognaty, thin top and bottom lip structure were inspected. Cardiovascular and respiratory system examination displayed normal fi ndings. Melena was not examinated in rectal examination. Laboratory fi ndings were normal between ranges except mild hypochromic anemia and hypothyroidism; hemoglobin:12 g/dL (12 - 18), hematocrit: 38 % (37 -48), ferritin: 139 ng/mL (4. 6 - 204), iron: 19 μg/dL (50 - 170), TIBC:269(141-519) thyroidstimulan hormone (TSH) : 6. 1 mIU/L (0. 4 - 3. 4), free T4: 1. 0 ng/dL (0. 9 - 1. 5), anti thyroglobulin: 113 IU/mL (0 - 57), anti thyroid peroxidase:267 IU/mL (0 - 64), sedimentation: 39 mm/hour. Intact and diffuse type angiodysplasia on the gastric mucosa was identifi ed by the gastroscopy. There were no any bleeding signs and medical treatment (proton pump inhibitor and sucralfate) was applied. Also, hypothyroidism was treated by the levo-thyroxin preparate. For the mild hypochromic and iron defi cient anemia, iron containing preparate added to the treatment after discharge. In the literature, there was not coincided HGPS case with hemorrhagic angiodisplasia, commonly. This case report was represented to emphasize HGPS associated angiodisplasia as a rare cause of anemia and GIS tract hemorrhage.

Poster Session : PS 0154 ; Diabetes : Do Diabetic Patients Use Their Glucometers Effectively: Awareness of the Importance of Self-Monitoring in Diabetes

( Feray Akbas ),( Hanife Usta Atmaca ),( Ilker Nihat Okten ),( Eda Nuhoglu ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Home glucose monitoring is vital for diabetic patients to maintain acceptable glucose levels. We aimed to demonstrate how effective home glucose monitoring was among diabetic patients who were followed in internal medicine outpatient clinics of our hospital. Methods: Randomly selected 89 diabetic patients who were admitted to internal medicine outpatient clinic in a week and who had glucometers were included in the study and a questionnaire was administered. The answers were categorized and the results were evaluated with SPSS. Results: The questions and the percentage of answers are shown in Table 1. Although diabetes duration of the patients was mostly more than 5 years, only half of them had a glucometer for that period. Most of the patients didn`t calibrate their devices. Most strikingly, only 25% of the patients in general were given a proper education for the usage of glucometers. 72% of patients who claimed to have been educated were mostly given instructions by a pharmacist that cannot be considered as education and only 35% of this group were educated by a diabetes nurse or a doctor. Only 40% of the patients monitored their glucose levels regularly, rest of the patients used their glucometers rarely or none. Conclusions: Home monitoring of glucose levels for diabetic patients would approve blood glucose levels by making necessary treatment adjustments available. Providing the optimal treatment would prevent/delay diabetes related complications, improve quality of life and contribute to decrease health costs. Thus; it`s necessary to educate and follow our diabetic patients better and assure that they use their glucometers more effectively and frequently. To include the patients to the treatment and to monitoring of diabetes seems to be the only way to achieve a better outcome of the disease.