Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature

Tolunay, Orkun,Celik, Tamer,Celik, Umit,Komur, Mustafa,Tanyeli, Zeynep,Sonmezler, Abdurrahman The Korean Pediatric Society 2016 Clinical and Experimental Pediatrics (CEP) Vol.59 No.no.sup1

Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

Awareness and Attitude Relating to the Human Papilloma Virus and its Vaccines Among Pediatrics, Obstetrics and Gynecology Specialists in Turkey

Tolunay, Orkun,Celik, Umit,Karaman, Seyfettin Senih,Celik, Tamer,Resitoglu, Salim,Donmezer, Cigdem,Aydin, Fahri,Baspinar, Huseyin,Mert, Mustafa Kurthan,Samsa, Hasan,Arli, Sefa Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Background: To determine the level of knowledge on human papillomavirus (HPV) infection and vaccination, and the attitude towards HPV vaccination in pediatricians, obstetricians and gynecologists (OBG). Materials and Methods: Participants were administered a 40-question survey, investigating the demographic properties, the knowledge on the HPV infection-vaccination and attitudes towards vaccination. Results: The study enrolled a total of 228 participants (131 pediatricians and 97 OBGs). At a rate of 99.6%, the participants agreed with the fact that the HPV infection was the most common sexually transmitted disease and 33.8% of the participants had the opinion that the HPV vaccination should be administered only in women. The lowest level of HPV vaccine recommendation was among the pediatrics specialists (59.4%, p=0.012). When asked whether they would have their daughters receive HPV vaccination, 79.5% of the participants answered favorably; this rate was 36.7% for the sons. At a rate of 59.5% of the participants thought that the HPV vaccine needed to be included in the national vaccine schedule. Most of the participants (91.6%) had the idea that reduction of the vaccine costs would increase the vaccination frequency. Conclusions: We observed that the consideration of the costs and the prejudices relating to the inefficacy of vaccination as well as the inadequate level of knowledge were involved in the physicians' resistance to HPV vaccination. We believe that the healthcare professionals should be informed adequately to overcome false beliefs, thereby ensuring success of the HPV vaccine upon inclusion in the national vaccine schedule in the future.

Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and re- view of literature

Orkun Tolunay,Tamer Çelik,Ümit Çelik,Mustafa Kömür,Zeynep Tanyeli,Abdurrahman Sönmezler 대한소아청소년과학회 2016 Clinical and Experimental Pediatrics (CEP) Vol.59 No.no.sup1

Guillain-Barré syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-Barré syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-Barré syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-Barré syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

Estimating the age-dependent changes in carbon stocks of Scots pine (Pinus sylvestris L.) stands in Turkey

Lee, J.,Tolunay, D. a.,Makineci, E.,Ç,ö,mez, A. n.,Son, Y. M.,Kim, R.,Son, Y. EDP Sciences 2016 Annals of forest science Vol.73 No.2

<P>Key message Simulated and observed carbon stocks in Scots pine forests varied considerably with stand age. The contribution of biomass to the total forest carbon stocks increased and that of dead organic matter decreased with increasing stand age. Context Understanding changes in forest carbon stocks over time is important to estimate carbon inventory. Although Scots pine (Pinus sylvestris L.) is a main species in Turkey, studies on such changes are still lacking. Aims We aimed to estimate the changes in carbon stocks, with stand age, of Scots pine stands in Turkey using field work data and a forest carbon model (FBDC model). Methods Biomass and dead organic matter carbon stocks were investigated to adjust the forest carbon model and to verify the model estimates. Forest carbon stocks with regards to stand age were simulated. Results The simulated carbon stocks were generally in clear agreement with the observed values on a stand scale. Changes in simulated and observed carbon stocks of biomass and dead organic matter varied with stand age. The contribution of biomass to total forest carbon stocks increased, and that of dead organic matter decreased, with increasing stand age. Conclusion We found that the carbon stocks in each pool and their contribution to the total forest carbon stocks varied with stand age. Our results are expected to contribute to the understanding of annual changes in the carbon stocks of Turkish forests.</P>

Estimating the effect of abandoning coppice management on carbon sequestration by oak forests in Turkey with a modeling approach

Lee, Jongyeol,Makineci, Ender,Tolunay, Doğ,anay,Son, Yowhan Elsevier 2018 The Science of the total environment Vol.640 No.-

<P><B>Abstract</B></P> <P>A significant area of the oak forests in Turkey has been historically managed by short-rotation coppicing for wood production. Coppice management was almost abandoned in Turkey in 2006 and so investigating its impact on forest carbon (C) sequestration has become an important issue. Therefore, we investigated the net effect of this change in management on C sequestration by oak forests in Turkey using field measurement data and a forest C model (Forest Biomass and Dead organic matter Carbon (FBDC) model). The FBDC model estimated the annual forest C dynamics and considered the effect of the substitution of wood for fossil fuels under two management scenarios over a 100-year period: (1) abandoning coppice (no management) and (2) continuing coppice (20-year-interval harvest). The field measurement data were used to parameterize the FBDC model to the study sites and to verify the simulated C stocks. Continuing coppice management constrained an increase in the C stocks (116.0–140.3 Mg C ha<SUP>−1</SUP>) and showed a mean annual C sequestration of 0.6 Mg C ha<SUP>−1</SUP> yr<SUP>−1</SUP> if wood was substituted for fossil fuels. In contrast, abandoning coppicing practices increased the level of forest C stocks (128.1–236.2 Mg C ha<SUP>−1</SUP>), enhancing the mean annual C sequestration to 1.1 Mg C ha<SUP>−1</SUP> yr<SUP>−1</SUP>. Accordingly, the abandonment of coppice management increased the mean annual C sequestration by 0.5 Mg C ha<SUP>−1</SUP> yr<SUP>−1</SUP> in the long-term. However, sensitivity analysis showed a possibility of a larger difference in C sequestration between the two scenarios due to a decrease in the stand productivity by repeated coppices and a high likelihood of a lower substitution effect. The verification supported the scientific reliability of the simulation results. Our study can provide a scientific basis for enhancing C sequestration in coppice forests.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Abandoning coppice in Turkey is expected to affect carbon (C) sequestration. </LI> <LI> C sequestration was estimated under abandoning and continuing coppice scenarios. </LI> <LI> Forest carbon model and field measurement data were combined. </LI> <LI> Abandoning and continuing coppice sequestered 1.1 and 0.6 Mg C ha<SUP>−1</SUP> yr<SUP>−1</SUP>. </LI> <LI> The abandonment of coppice would enhance the C sequestration in the long-term. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

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.

Effect of A One-Week Balanced Diet on Expression of Genes Related to Zinc Metabolism and Inflammation in Type 2 Diabetic Patients

( Lucia Leite Lais ),( Sancha Helena De Lima Vale ),( Camila Alves Xavier ),( Alfredo De Araujo Silva ),( Tolunay Beker Aydemir ),( Robert J Cousins ) 한국임상영양학회 2016 Clinical Nutrition Research Vol.5 No.1

To evaluate the effect of diet on metabolic control and zinc metabolism in patients with type 2 diabetes mellitus (T2DM). One-week balanced diet was provided to 10 Brazilians patients with T2DM. Nutritional assessment, laboratorial parameters and expression of zinc transporter and inflammatory genes in peripheral blood mononuclear cells (PBMC) were performed. Healthy non-diabetic subjects of the same demographic were recruited to provide baseline data. Diabetic patients had higher body mass index and greater fasting plasma glucose, plasma tumor necrosis factor α (TNFα) and plasma interleukin 6 (IL6) levels compared with healthy subjects. In addition, the expression of transporters 4 (ZnT4) mRNA was lower and IL6 mRNA was higher in PBMC of these diabetic patients than in healthy subject. One week after a balanced diet was provided, fasting plasma glucose decreased significantly as did TNFα, IL6 and Metallothionein 1 (MT1) mRNAs. No change was observed in zinc transporter expression in PBMC after the dietary intervention. A healthy eating pattern maintained for one week was able to improve metabolic control of diabetic patients by lowering fasting plasma glucose. This metabolic control may be related to down-regulation of zinc-related transcripts from PBMCs, as TNFα, IL6 and MT1 mRNA.

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.

Circulating miR-195 as a Therapeutic Biomarker in Turkish Breast Cancer Patients

Cecener, Gulsah,Ak, Secil,Eskiler, Gamze Guney,Demirdogen, Elif,Erturk, Elif,Gokgoz, Sehsuvar,Polatkan, Volkan,Egeli, Unal,Tunca, Berrin,Tezcan, Gulcin,Topal, Ugur,Tolunay, Sahsine,Tasdelen, Ismet Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.9

Background: Dysregulation of miRNA expression may be used as a biomarker for specific tumours because it may contribute to development of cancer. Circulating miRNA profiles have been highlighted for their potential as predictive markers in heterogeneous diseases such as breast cancer. In the literature, there is evidence that miR-195 levels are differentially expressed pre- and post-operative periods in breast cancer patients. At the same time, miRNA expression levels may vary because of ethnic origins. This study aimed to determine expression levels and potential roles of miR-195 in Turkish breast cancer patients. Materials and Methods: The expression patterns of miR-195 were initially examined in breast cancer tissues (luminal A and B type) (n=96). Subsequently, blood samples were prospectively collected from preoperative and postoperative Turkish breast cancer patients and disease free controls. Total RNA was isolated, and the expression level of miR-195 was quantified by real-time PCR. Results: We found that miR-195 level was altered in Turkish breast cancer patients, with down-regulation evident in breast cancer tissues compared to normal adjacent specimens. Furthermore, circulating levels of miR-195 was significantly decreased in post-operative blood samples compared with pre-operative levels (p=0.01 and <0.05). However, miR-195 was significantly increased in pre-operative blood samples of the luminal B type (p=0.04 and <0.05). Conclusions: This study represents the first report of a miR-195 expression profile in Turkish breast cancer patients. Our data suggests that miR-195 levels might be a clinically useful biomarker in the earliest stage of Turkish breast cancer patients.