Poster Session : PS 0746 ; Rheumatology ; Frequency of Radiological Hip Involvement and total Hip Replacement in A Large Single Center Spondyloarthritis Cohort with Biological Treatments: HUr-BIo Real Life Results.

( Umut Kalyoncu ),( Abdulsamet Erden ),( Omer Karadag ),( Levent Kilic ),( Sule Apras Bilgen ),( Ali Akdogan ),( Ali Ihsan Ertenli ),( Sedat Kiraz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Total hip replacement (THR) is a favorable treatment option for severe ankylosing spondylitis (AS). Objective of this study was to assess frequency of THR and hip involvement in a single center spondyloarthritis (SpA) biological dataset. Methods: HUR-BIO(Hacettepe University Rheumatology Biologic Registry) is a single center biological registry since 2005. HUR-BIO biological data set included demographic data, co-morbidities, smoking status, baseline and follow-up disease activity parameters (such as BASDAI, BASfi, CRP, ESR). Available digital radiographic imaging of pelvis were reassesed for hip inolvement and THR. Kaplan-Meier plots and log rank tests were used to assess TNfi drug survival. Results: 768 of 1290 (59. 5%) SpA patients had available pelvis radiography. 450 of 768 (58. 6%) patients were male and mean age was 41±11 years old, mean disease duration 8. 6±6. 9 years, mean TNfi duration was 32±29 months. Frequency of hip involvement in spondyloarthritis is in Table 1. Radiological hip involvement and severe hip involvement found in 125 (16. 3%) and 65 (8. 4%) patients, respectively. Patients with severe hip involvement was older age 47±11 vs 41±11, p<0. 001, more disease duration 15±9 vs 8±6 years, p<0. 001, more frequently male 47/65(72. 3%) vs 402/702 (57. 3), p=0. 018), more frequently advanced spinal disease 18/52 (34. 6%) vs 74/576 (12. 8%), p<0. 001. Baseline disease activity parameters were similar with and without severe hip involvement, however, last visit CRP (2. 56±2. 75 vs 1. 06±1. 97 mg/dl, p<0. 001), ESR (24±25 vs 13±14 mm/hour, p<0. 001) and BASfi (4. 7±2. 8 vs 2. 4±2. 1, p<0. 001) were higher in severe hip involvement. Disease duration was found independent risk factor for severe hip inolvement (OR 1. 13(95%CI 1. 09-1. 17). In all spondyloarthritis patients, TNfi drug survival was similar with and without severe hip involvement. Conclusions: Severe hip involvemet was demonstrated either AS or other spondyloarthritis. THR performed almost 5 percent of AS, PsA and enteropathtic arthritis. On the other hand, substantial of AS patients who need THR were not operated yet. The reasons of this delay may be responsible of patients` perspective or physicians. TNfi may not refi ect any major unfavotrable effect of THR.

Antimicrobial and Antioxidant Activities of Mycelia of 10 Wild Mushroom Species

Fatih Kalyoncu,Mustafa Oskay,Hu¨sniye Sag˘lam,Tug˘c¸e Fafal Erdog˘an,A. U¨ same Tamer 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.2

Antimicrobial and antioxidant activities of mycelia obtained from 10 wild edible mushrooms—Armillaria mellea, Meripilus giganteus, Morchella costata, Morchella elata, Morchella esculenta var. vulgaris, Morchella hortensis, Morchella rotunda, Paxillus involutus, Pleurotus eryngii, and Pleurotus ostreatus—were investigated. For determination of antimicrobial activities of these mushrooms, ethanol extracts were examined with 11 test microorganisms by the agar well diffusion method. P. ostreatus and M. giganteus were the most active species against both bacteria and yeast. Antioxidant properties of ethanol extracts were studied by the 1,1-diphenyl-2-picrylhydrazyl free radical scavenging method. Among the mushroom extracts, M. elata showed the most potent radical scavenging activity. This research has shown that these 10 wild macrofungi have potential as natural antioxidants and antibiotics.

BRIEF COMMUNICATION : Solitary Rectal Ulcer Syndrome in Children: A Report of Six Cases

( Nafiye Urganc ),( Derya Kalyoncu ),( Kamile Gulcin Eken ) The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.6

Solitary rectal ulcer syndrome (SRUS) is a rare, benign dis-order in children that usually presents with rectal bleeding, constipation, mucous discharge, prolonged straining, tenes-mus, lower abdominal pain, and localized pain in the perine-al area. The underlying etiology is not well understood, but it is secondary to ischemic changes and trauma in the rectum associated with paradoxical contraction of the pelvic floor and the external anal sphincter muscles; rectal prolapse has also been implicated in the pathogenesis. This syndrome is diagnosed based on clinical symptoms and endoscopic and histological findings, but SRUS often goes unrecognized or is easily confused with other diseases such as inflammatory bowel disease, amoebiasis, malignancy, and other causes of rectal bleeding such as a juvenile polyps. SRUS should be suspected in patients experiencing rectal discharge of blood and mucus in addition to previous disorders of evacuation. We herein report six pediatric cases with SRUS. (Gut Liver 2013;7:752-755)

Poster Session : PS 0716 ; Rheumatology ; Ocular Toxicity of Hydroxychloroquine is More Frequent in Male Patients

( Omer Karadag ),( Abdulsamet Erden ),( Levent Kilic ),( Umut Kalyoncu ),( Ali Akdogan ),( Sule Apras Bilgen ),( Sedat Kiraz ),( Ihsan Ertenli ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Hydroxychloroquine(HQ) is widely used to treat for rheumatoid arthritis( RA) and connectice tissue disorders. Due to the potential of ocular toxicity,routine ophtalmological assessment(ROA) is essential for sight safety. Methods: In our outpatient clinic, patients with RA and connective tissue disorders such as systemic lupus erythematosus (SLE), sjogren syndorme (SS) and overlap were assessed consecutively for drug status of HQ by a standard questionnaire between December 2013 and January 2014. Patients who used HQ less than 1 year (13. 6%) were excluded from study. Ocular toxicity was taken from patients` reported. If ophthalmologist advised to cease HQ due to ocular toxicity,we accepted as ocular side effect. Patients with ocular toxicity were not reevaluated by an ophthalmologist. Cumulative HQ dosage and risk factors for ocular toxicity were assessed by using Mann-Whitney U test. Results: A total of 266 patients(90. 6% female) were enrolled. Mean age was 50±13. 5 years and median disease duration was 8 years(1-50). Median duration of HQ treatment was 6 years(1-28) and median dose was 400 mg/day. Of 46(17. 3%) patients were ceased HQ. The reasons of cease of HQ were ocular toxicity 22(47. 8%), patient non-adherence 9(19. 6%),dermatological side effect 3(6. 5%),others 12(26. 1%). 22 of all 266(%8. 3) patients developed ocular toxicity. Ocular toxicity was found more frequently in male 5/20(20%) vs 17/241(7%),p=0. 025). Median cumulative HQ dosage in patients with ocular toxicity was 864 gram (108-2160) in other words 12. 9 gr per kilogram( 1. 2-40). Older age (58±10 vs 50±13,p=0. 008),longer disease duration (14. 8±11. 5 vs 9. 2±7. 1 years,p=0. 013), and longer HQ duration (10±6. 3 vs 7. 1±5. 6 years,p=0. 023)were associated with ocular toxicity. Conclusions: Among regularly follow-up patients, ocular toxicity of HQ was not rare in a rheumatology outpatient clinic. Cumulative toxicity for ocular toxicity was 13 gram/kilogram;however, certain patients developed toxicity in 1 gram/kg/day. Although, important part of our patients was female, ocular toxicity was seen more frequently in male patients. Other risk factors such as longer disease duration,longer HQ usage and older age were also demonstrated in our patients.

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.

Endoscopic Findings of Children with Familial Mediterranean Fever

Sag, Elif,Demir, Ferhat,Saygin, Ismail,Kalyoncu, Mukaddes,Cakir, Murat The Korean Society of Pediatric Gastroenterology 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.

Early and Late Complications after Inguinofemoral Lymphadenectomy for Vulvar Cancer

Cirik, Derya Akdag,Karalok, Alper,Ureyen, Isin,Tasci, Tolga,Kalyoncu, Rukiye,Turkmen, Osman,Kose, M Faruk,Tulunay, Gokhan,Turan, Taner Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.13

Background: We aimed to determine the frequency of early and late complications following groin surgery for vulvar cancer and analyze possible risk factors. Materials and Methods: This retrospective cohort study included 99 women who underwent for vulvar cancer. The early (${\leq}1$ month) complications were wound infection, breakdown and lymphocyst and late (>1 month) complications were lower limb lymphedema, incontinence and erysipelas. The risk factors for developing each of the complications were analyzed with regression analysis. Results: In the entire cohort, 29 (29.3%) women experienced early and 12 (12.1%) had late complications. Wound complications including infection and breakdown were the leading early complications (23.2%). In the multivariate analysis, both obesity (body mass index ${\geq}30kg/m^2$) and advanced age (${\geq}65years$) were found as independent predictive factors for early complications. Obese women of advanced age had 6.32 times more risk of experiencing any of the early complications, when compared to non-obese and young women (55.6% vs 8.7%). The most common late complication was lower limb lymphedema (10.1%) that was more frequently seen in young women. However, neither age nor lymph node count were significantly associated with the occurrence of lower limb lymphedema. Conclusions: More than 40% of the women suffered from postoperative complications after inguinofemoral lymphadenectomy in the current study. While advanced age and obesity were the significant predictors for any of the early complications, there was no identified risk factor for lower limb lymphedema.

Experimental evaluation of different spectral methods for damage estimation of an electrical panel bracket mounted on a military wheeled vehicle

Mehmet Sefa Gümüş,Abdullah Erdemir,Veysel Alver,Mete Kalyoncu 대한기계학회 2021 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.35 No.12

This study evaluates different frequency domain vibration fatigue methods by verifying the results of the analyses with the experimental data on the bracket of an electrical panel mounted on a military vehicle. Loadings are defined considering composite wheeled vehicle vibration exposure as stated in the MIL-STD-810G Standard. The electrical panel and the bracket are simulated by FEM. Response PSDs are created on critical points. The experiment is carried out by using a uniaxial electrodynamic shaker. In this study, the Dirlik method proposes the most reliable and accurate fatigue life, while the Wirsching-Light method overestimates. Ortiz-Chen has made a very conservative prediction among other methods in this case study.