Testicular Adrenal Rest Tumor in 11-Beta-Hydroxylase Deficiency Driven Congenital Adrenal Hyperplasia

Mehmet Kaynar,Mehmet Giray Sönmez,Yaşar Ünlü,Tuna Karatağ,Erdem Tekinarslan,Alpay Sümer 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.4

Testicular adrenal rest tumors (TART) occur often as asymptomatic nodules in corticotropin-dependent lesions aberrant adrenal tissue in congenital adrenal hyperplasia(CAH) patients. The present manuscript is about an unusual case of a 16-year-old CAHpatient due to 11β-hydroxylase deficiency. He underwent testicle biopsy because of testicletumor suspicion and diagnosed with TART.

Antithrombotic effect of epigallocatechin gallate on the patency of arterial microvascular anastomoses

Murat İğde,Mehmet Onur Öztürk,Burak Yaşar,Mehmet Hakan Bulam,Hasan Murat Ergani,Ramazan Erkin Ünlü 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.3

Background Microvascular anastomosis patency is adversely affected by local and systemic factors. Impaired intimal recovery and endothelial mechanisms promoting thrombus formation at the anastomotic site are common etiological factors of reduced anastomosis patency. Epigallocatechin gallate (EGCG) is a catechin derivative belonging to the flavonoid subgroup and is present in green tea (Camellia sinensis). This study investigated the effects of EGCG on the structure of vessel tips used in microvascular anastomoses and evaluated its effects on thrombus formation at an anastomotic site. Methods Thirty-six adult male Wistar albino rats were used in the study. The right femoral artery was cut and reanastomosed. The rats were divided into two groups (18 per group) and were systemically administered either EGCG or saline. Each group were then subdivided into three groups, each with six rats. Axial histological sections were taken from segments 1 cm proximal and 1 cm distal to the microvascular anastomosis site on days 5, 10, and 14. Results Thrombus formation was significantly different between the EGCG and control groups on day 5 (P=0.015) but not on days 10 or 14. The mean luminal diameter was significantly greater in the EGCG group on days 5 (P=0.002), 10 (P=0.026), and 14 (P=0.002). Intimal thickening was significantly higher on days 5 (P=0.041) and 10 (P=0.02). Conclusions EGCG showed vasodilatory effects and led to reduced early thrombus formation after microvascular repair. Similar studies on venous anastomoses and random or axial pedunculated skin flaps would also contribute valuable findings relevant to this topic.

Premedication Methods in Nasal Endoscopy: A Prospective, Randomized, Double-Blind Study

Mehmet İlhan Şahin,Kerem Kökoğlu,Şafak Güleç,İbrahim Ketenci,Yaşar Ünlü 대한이비인후과학회 2017 Clinical and Experimental Otorhinolaryngology Vol.10 No.2

Objectives. To identify the optimal pharmacological method of preparing patients for nasal endoscopy. Methods. Twenty healthy volunteers were enrolled in this prospective, randomized, double-blind study. Four types of medications were applied in their nostrils with binary combinations of spray bottles on four different days in a random order: placebo (normal saline [NS]+NS), decongestant (NS+oxymetazoline), anesthetic (NS+lidocaine), and decongestant plus anesthetic (oxymetazoline+lidocaine). Rigid nasal endoscopy was performed 10 minutes after spray application. The volunteers evaluated the discomfort caused by each spray application, and nasal pain scores due to the passage of the endoscope. The physicians quantified nasal decongestion using a visual analogue scale. Endoscopy duration as well as pulse and mean blood pressure (MBP) before spray application, 10 minutes after the application, and immediately after endoscopic examination were also recorded. Results. The discomfort caused by lidocaine was significantly higher than that caused by the other sprays (P<0.001). The lowest pain score related to endoscopy was obtained for oxymetazoline+lidocaine (P<0.001). Nasal decongestion was best achieved with NS+oxymetazoline (P<0.001). Endoscopy duration was the shortest for oxymetazoline+lidocaine (P<0.05). Statistically significant MBP changes were only seen with the application of NS+oxymetazoline (P<0.05). However, neither MBP nor pulse rate change was significant clinically. Conclusion. Application of decongestant and anesthetic sprays together seems to be the best method of pharmacological preparation of patients for nasal endoscopy.

Effects of Dexmedetomidine Infusion During Sevoflurane Anesthesia on Otoacoustic Emissions

Mehmet İlhan Şahin,Alperen Vural,Aynur Akın,İbrahim Ketenci,Yaşar Ünlü 대한청각학회 2019 Journal of Audiology & Otology Vol.23 No.2

Background and Objectives: Knowing the ototoxic potential of the agents used in medical treatments is important for the protection of hearing. Although we have knowledge regarding some effects of dexmedetomidine, which is an anesthetic-sparing drug, its influence over the hearing system has never been studied and is obscure yet. The aim of this study is to determine the effects of intravenous dexmedetomidine application during sevoflurane anesthesia on otoacoustic emissions (OAEs). Subjects and Methods: This prospective randomized study was performed on 60 patients (34 male, 26 female, mean age: 30.6±9.2 years) who were scheduled for an elective surgery under general anesthesia and the patients were enrolled and randomly divided into 2 groups. They received dexmedetomidine (Group D) or Saline (Group S) infusion during a standardized Sevoflurane anesthesia. Transient and distortion product OAEs were measured preoperatively and postoperatively (24th hour). OAE results were compared within and between groups. Results: In group D postoperative OAEs were lower than preoperative OAEs and postoperative levels of group S, especially at low frequencies (p<0.05). Conclusions: Dexmedetomidine infusion affects the micromechanical function of cochlea especially in the low-frequency region. Dexmedetomidine should be carefully used during general anesthesia to avoid its probable harmful effects on cochlear micromechanics.

Evaluating the effect of donor anxiety levels and lifestyle characteristics on the activation of platelet concentrates

Soner Yılmaz,İbrahim Eker,Elif Elçi,Aysel Pekel,Rıza Aytaç Çetinkaya,Aytekin Ünlü,Cengizhan Açıkel,İsmail Yaşar Avcı 대한혈액학회 2019 Blood Research Vol.54 No.4

BackgroundSmoking, alcohol use, performing regular physical exercise, dietary habits, and anxiety level may cause platelet activation. We aimed to evaluate the anxiety levels, smoking sta-tus, alcohol intake, and sportive habits of donors, and determine their impact on the qual-ity of apheresis-platelets.MethodsState and Transient Anxiety Inventory (STAI) was used to determine the level of donors’anxiety. STAI has two subscales: S-anxiety scale (STAI-I) and T-anxiety scale (STAI-II), each comprising 20 questions rated on a 4-point Likert scale. Data on smoking, alcohol con-sumption, and performing regular physical exercise were obtained from a questionnaire filled out before donation. Flow cytometric analysis was used to quantify activated platelets.ResultsThe STAI-I level of 86 participants was normal, while that of 12 was higher. No significant difference was found in the active platelet absolute count [1.8×1011 (2.7) and 1.4×1011 (1.3), respectively; P=0.665] between donors with normal STAI-I levels and those with higher STAI-I levels. Of 98 donors, 42 had normal STAI-II levels, while 56 had higher STAI-II levels. No significant difference was found in the active platelet absolute count [2.3×1011 (3.1) and 1.5×1011 (2.3), respectively; P=0.224] between donors with normal STAI-II levels and those with higher STAI-II levels. Platelet counts of individuals who perform regular physical exercise were significantly higher than those of individuals who did not perform regular physical exercise (6.3±1.4×1011 vs. 5.5±1.4×1011).ConclusionThe quality of apheresis platelets is not affected by anxiety levels and lifestyle character-istics of blood donors. There is no need to organize apheresis blood donor pool consider-ing with these subjects.