Atrial Electromechanical Coupling in Patients with Lichen Planus

Mehmet Yaman,Osman Beton,Lale Dinç Asarcıklı,Aytekin Aksakal,Orhan Dogdu,Uğur Arslan 대한심장학회 2016 Korean Circulation Journal Vol.46 No.4

Background and objectives: A chronic inflammatory disease, lichen planus may cause disturbance of atrial electromechanical coupling and increase the risk of atrial fibrillation. The aim of this study was to evaluate atrial electromechanical delay with both electrocardiography (ECG) and echocardiography in patients with lichen planus (LP). Subjects and Methods: Seventy-two LP patients (43 males [59.7%], mean age: 44.0±16.7 years) were enrolled in this cross-sectional casecontrol study. The control group was selected in a 1:1 ratio from 70 patients in an age and sex matched manner. P wave dispersion was measured by ECG to show atrial electromechanical delay. All of the patients underwent transthoracic echocardiography for measuring inter- and intra-atrial electromechanical delays. Results: The baseline characteristics of the patients and the control group were similar except for the presence of LP. P-wave dispersion measured by ECG was significantly higher in patients with LP (p<0.001). Patients with LP had significantly prolonged intra- and interatrial electromechanical delays when compared to the control group (p<0.001). In addition, all of these variables were significantly correlated with high sensitive C-reactive protein (hsCRP) levels. Conclusion: Atrial electromechanical coupling, which is significantly correlated with increased hsCRP levels, is impaired in patients with LP.

Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease

Mehmet Yaman,Uğur Arslan,Hasan Ali Gümrükçüoğlu,Musa Şahin,Hakkı Şimşek,Serkan Akdağ 대한심장학회 2016 Korean Circulation Journal Vol.46 No.3

Background and Objectives: Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value forarrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects oftrimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease. Subjects and Methods: One hundred patients (23 females, mean age 55.6±9.2 years) with stable ischemic heart disease were included inthe study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patientswere stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for aminimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWAvalues were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography. Results: After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63±8 μV vs. 53±7 μV, p<0.001). Abnormal MTWA waspresent in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001). Conclusion: Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parametersrelated with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmiccomplications and improve myocardial functions in patients with stable coronary artery disease.

Kyphosis After Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Onur Yaman,Mehmet Zileli,Salim Şentürk,Kemal Paksoy,Salman Sharif 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

Thoracolumbar fractures change the biomechanics of the spine. Load distribution causes kyphosis by the time. Treatment of posttraumatic kyphosis is still controversial. We reviewed the literature between 2010 and 2020 using a search with keywords “thoracolumbar fracture and kyphosis.” We removed osteoporotic fractures, ankylosing spondylitis fractures, non-English language papers, case reports, and low-quality case series. Up-to-date information on posttraumatic kyphosis management was reviewed to reach an agreement in a consensus meeting of the World Federation of Neurosurgical Societies (WFNS) Spine Committee. The first meeting was conducted in Peshawar in December 2019 with WFNS Spine Committee members’ presence and participation. The second meeting was a virtual meeting via the internet on June 12, 2020. We utilized the Delphi method to administer the questionnaire to preserve a high degree of validity. We summarized 42 papers on posttraumatic kyphosis. Surgical treatment of thoracolumbar kyphosis due to unstable burst fractures can be done via a posterior only approach. Less blood loss and reduced surgery time are the main advantages of posterior surgery. Kyphosis angle for surgical decision and fusion levels are controversial. However, global sagittal balance should be taken into consideration for the segment that has to be included. Adding an intermediate screw at the fractured level strengthens the construct.

Oral Etoposide for Platinum-Resistant and Recurrent Epithelial Ovarian Cancer: a Study by the Anatolian Society of Medical Oncology

Kucukoner, Mehmet,Isikdogan, Abdurrahman,Yaman, Sebnem,Gumusay, Ozge,Unal, Olcun,Ulas, Arife,Elkiran, Emir T.,Kaplan, Muhammed A.,Ozdemir, Nuriye,Inal, Ali,Urakci, Zuhat,Buyukberber, Suleyman Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.8

Background: The aim of this study was to evaluate the efficacy and toxicity of long-term, low-dose oral etoposide as an advanced treatment option in patients with platinum resistant epithelial ovarian cancer. Materials and Methods: For the purposes of this study, 51 patients with histologically-confirmed, recurrent or metastatic platinum-resistant epithelial ovarian cancer (EOC) treated at six different centers between January 2006 and January 2011 were retrospectively evaluated. Patients were treated with oral etoposide (50 mg/day for a cycle of 14 days, repeated every 21 days). Results: Among the 51 platinum-resistant patients, 17.6% demonstrated a partial response and 25.5% a stable response. The median progression-free survival (PFS) was 3.9 months (95% CI, 2.1-5.7), while the median overall survival was 16.4 months (11.8.20.9). No significant relationship was observed between the pre-treatment CA 125 levels, post-treatment CA-125 levels and the treatment response rates (p=0.21). Among the 51 patients who were evaluated in terms of toxicity, grade 1 or 4 hematologic toxicity was observed in 19 (37.3%); and grade 1-4 gastrointestinal toxicity occurred in 15 patients (29.4%). Conclusions: Chronic low-dose oral etoposide treatment is generally effective and well-tolerated in platinum-resistant ovarian cancer patients.

Evaluation of Renal Function Using the Level of Neutrophil Gelatinase-Associated Lipocalin is Not Predictive of Nephrotoxicity Associated with Cisplatin-Based Chemotherapy

Kos, F. Tugba,Sendur, Mehmet Ali Nahit,Aksoy, Sercan,Celik, Huseyin Tugrul,Sezer, Sevilay,Civelek, Burak,Yaman, Sebnem,Zengin, Nurullah Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2

Background: For early detection of renal damage during the usage of cisplatin based chemotherapy, changes in renal function should be monitored carefully. In recent years, neutrophil gelatinase-associated lipocalin, a small polypeptide molecule, has shown promise as a marker of acute renal failure. The aim of this present study was to assess possible risk prediction of cisplatin-induced nephrotoxicity using serum NGAL. Materials and Methods: A total of 34 consecutive patients with documented serum creatinine at least 24 hours before every cycle of cisplatin-based chemotherapy were included in the study. Demographic and medical data including age, performance status, tumor characteristics and comorbid diseases were collected from medical charts. Renal function was evaluated at least 48 hours before the treatment and at the end of the treatment based on the Modification of Diet in Renal Disease (MDRD) formula. Before and after cisplatin infusion serum NGAL levels were measured for the first and 3rd cycles of chemotherapy. Results: The median age of the study population was 54 (32-70) years. Fifteen patients (41.1%) were treated on an adjuvant basis, whereas 19 patients (58.9%) were treated for metastatic disease. There was no correlation of serum NGAL levels with serum creatinine (r=0.20, p=0.26) and MDRD (r=-0.12, p=0.50) and creatinine clearance-Cockcroft-Gault (r=-0.22, p=0.22) after cisplatin infusion at the end of the 3rd cycle of chemotherapy. Conclusions: In our study, serum NGAL levels were not correlated with the cisplatin induced nephrotoxicity. Further prospective studies are needed to conclude that serum NGAL level is not a good surrogate marker to predict early cisplatin induced nephrotoxicity.

Serum 25-hydroxy Vitamin D Status is Not Related to Osteopenia/Osteoporosis Risk in Colorectal Cancer Survivors

Akinci, Muhammed Bulent,Sendur, Mehmet Ali Nahit,Aksoy, Sercan,Yazici, Ozan,Ozdemir, Nuriye Yildirim,Kos, Tugba,Yaman, Sebnem,Altundag, Kadri,Zengin, Nurullah Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.8

Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recently published studies. In addition, prospective investigations have indicated that low vitamin D levels may be associated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exact incidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis is still not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors of osteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancer survivors treated with surgery and/or chemotherapy ${\pm}$ radiotherapy were recruited from medical oncology outpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed, and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients was divided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: The median age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male. The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); mild deficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency (<10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17 (15.0%). Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma, chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis. Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). In female patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients (p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5% and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopenia and osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first to evaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.

Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Salman Sharif,Yousuf Shaikh,Onur Yaman,Mehmet Zileli 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

The effects of high-fat diet on implant osseointegration: an experimental study

Serkan Dü,ndar,Ferhan Yaman,Muhammed Fatih Ozupek,Arif Saybak,Mehmet Gul,Fatih Asutay,Mustafa Kirtay,Ibrahim Hanifi Ozercan 대한구강악안면외과학회 2016 대한구강악안면외과학회지 Vol.42 No.4

Objectives: In this study, we investigated whether a high-fat diet (HFD) affected the bone implant connection (BIC) in peri-implant bone. Materials and Methods: Four male rabbits were used in this study. Dental implant surgery was introduced into each tibia, and four implants were integrated into each animal. In both the normal diet (ND) group (n=2) and HFD group (n=2), 8 implants were integrated, for a total of 16 integrated implants. The animals continued with their respective diets for 12 weeks post-surgery. Afterward, the rabbits were sacrificed, and the BIC was assessed histomorphometrically. Results: Histologic and histomorphometric analyses demonstrated that BIC was not impaired in the HFD group compared to the ND group. Conclusion: Within the limitations of this study, we found that HFD did not decrease the BIC in rabbit tibias.

Effects of general and spinal anesthetic techniques on endothelial adhesion molecules in cesarean section

Mehtap Honca,Tarık Purtuloglu,Emin Ozgur Akgul,Muzaffer Oztosun,Tevfik Honca,Ali Sizlan,Mehmet Agilli,İbrahim Aydin,Memduh Yetim,Fevzi Nuri Aydin,Halil Yaman 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.66 No.5

Background: The aim of this study was to investigate the effects of anesthetic techniques used during general anesthesia (GA) and spinal anesthesia (SA) on endothelial adhesion molecules in the fetal circulation of healthy parturients undergoing elective cesarean section. Methods: Patients were randomly assigned to either the general anesthesia (n = 20) or spinal anesthesia (n = 20) group. Maternal and cord blood neopterin, sE-selectin, and sL-selectin levels were measured in both groups. Results: Cord blood neopterin concentrations in the SA group were not different from those in the GA group, but maternal neopterin levels in the SA group were different from those in the GA group. Maternal blood levels of sE-selectin and sL-selectin were not different between the two groups. Similarly, the cord blood levels of sE-selectin and sL-selectin were not different between the two groups. We found an increased inflammatory process in the fetal circulation depending on the anesthetic method used. Conclusions: These results indicate the effects of general and spinal anesthetic techniques on serum sL-selectin, sE-selectin, and neopterin levels in neonates and parturients undergoing elective cesarean section. sE-selectin and neopterin concentrations and leukocyte counts were higher in the fetal circulation than in the maternal circulation during both GA and SA.

A novel echocardiographic method for assessing arterial stiffness in obstructive sleep apnea syndrome

Serkan Akdag,Aytac Akyol,Huseyin Altug Cakmak,Hulya Gunbatar,Muntecep Asker,Naci Babat,Aydin Rodi Tosu,Mehmet Yaman,Hasan Ali Gumrukcuoglu 대한심장학회 2015 Korean Circulation Journal Vol.45 No.6

Background and Objectives: Obstructive sleep apnea syndrome (OSAS) is associated with increased arterial stiffness and cardiovascularcomplications. The objective of this study was to assess whether the color M-mode-derived propagation velocity of the descendingthoracic aorta (aortic velocity propagation, AVP) was an echocardiographic marker for arterial stiffness in OSAS. Subjects and Methods: : The study population included 116 patients with OSAS and 90 age and gender-matched control subjects. Thepatients with OSAS were categorized according to their apnea hypopnea index (AHI) as follows: mild to moderate degree (AHI 5-30) andsevere degree (AHI≥30). Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), brachial artery flow-mediateddilatation (FMD), and AVP were measured to assess arterial stiffness. Results: AVP and FMD were significantly decreased in patients with OSAS compared to controls (p<0.001). PWV and CIMT were increasedin the OSAS group compared to controls (p<0.001). Moreover, AVP and FMD were significantly decreased in the severe OSAS groupcompared to the mild to moderate OSAS group (p<0.001). PWV and CIMT were significantly increased in the severe group compared tothe mild to moderate group (p<0.001). AVP was significantly positively correlated with FMD (r=0.564, p<0.001). However, it was found tobe significantly inversely related to PWV (r=-0.580, p<0.001) and CIMT (r=-0.251, p<0.001). Conclusion: The measurement of AVP is a novel and practical echocardiographic method, which may be used to identify arterial stiffnessin OSAS