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        Genetic Variations in Attention Deficit Hyperactivity Disorder Subtypes and Treatment Resistant Cases

        Dilek Unal,Mehmet Fatih Unal,Mehmet Alikasifoglu,Arda Cetinkaya 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.4

        ObjectiveaaWe evaluated the distribution of alpha-2A adrenergic receptor (ADRA2A) and catechol-o-methyltransferase (COMT) single nucleotide polymorphisms (SNPs) among ADHD subtypes and other homogeneous patient populations including treatment-resistant cases and patients with high symptom severity. Methodsaa121 ADHD patients aged 6–18 years were included in the study. Diagnosis and subtypes designation were confirmed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and symptoms were evaluated using the Conners’ Parent (CPRS) and Teacher Rating Scales (CTRS). The response to methylphenidate was assessed objectively using the Clinical Global Impression-Severity Scale (CGI-S) and Global Assessment of Functioning Scale (GAS) as well as the Continuous Performance (CPT) and Trail Making tests (TMT-A, B). Patients were genotyped for ADRA2A (rs1800544) and COMT (rs4680) SNPs by PCR/RFLP and compared to a gender-matched control group. ResultsaaAlthough there was no association of COMT (rs4680) SNP with symptoms or diagnosis, the ADRA2A polymorphism, low socioeconomic status (SES), and comorbid psychiatric diagnosis were all associated with poor response to methylphenidate in logistic regression analysis. ConclusionaaClinicians may consider adjuvant strategies when these negative factors are present to increase the success of tailored ADHD treatments in the future.

      • KCI등재후보

        Intraparenchymal Methylene Blue Injection for Sentinel Lymph Node Biopsy in Breast Cancer Patients does not Interfere with the Pulse Oximetry Readings

        Fatih Aydogan,Ziya Salihoglu,Cihan Uras,Ilhan Karabicak,Varol Celik,Ali Cercel,Semih Baghaki,Ufuk Topuz,Deniz Atasoy,Rovnat Babazade,Hilal Unal 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

        Purpose: Alteration in oxygen saturation is a side effect of the dye used in sentinel lymph node biopsy. The object of this study was to determine the possible effects of methylene blue on the oxygen saturation in patients undergoing sentinel lymph node biopsy. Methods: The complete peroperative records of 148 patients who underwent sentinel lymph node biopsy with intraparenchymal injection of methylene blue were reviewed. The data reviewed included the preinjection pulse oximeter saturation readings and the postinjection values until the readings returned to the preoperative levels in the postanesthesia care unit. Results: The pulse oximetry values were recorded preoperatively, after intubation and, at 15, 30, 45, and 60 minutes of the operation. The results showed that methylene blue did not cause any significant changes in oxygen saturation levels. Conclusion: We suggest that methylene blue might be preferable for the patients with concomitant disease, and for whom close monitoring of their oxygen saturation is required.

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        Evaluation of Oxidative Metabolism in Child and Adolescent Patients with Attention Deficit Hyperactivity Disorder

        Muslum Kul,Fatih Unal,Hasan Kandemir,Bahram Sarkarati,Kamer Kilinc,Sultan Basmacı Kandemir 대한신경정신의학회 2015 PSYCHIATRY INVESTIGATION Vol.12 No.3

        ObjectiveaaOxidative metabolism is impaired in several medical conditions including psychiatric disorders, and this imbalance may be involved in the etiology of these diseases. The present study evaluated oxidative balance in pediatric and adolescent patients with attention deficit hyperactivity disorder (ADHD). MethodsaaThe study included 48 children and adolescents (34 male, 14 female) with ADHD who had no neurological, systemic, or comorbid psychiatric disorders, with the exception of oppositional defiant disorder (ODD), and 24 sex- and age-matched healthy controls (17 male and seven female). ResultsaaTAS was significantly lower, and TOS and OSI were significantly higher in patients with ADHD than in healthy controls. Total antioxidant levels were lower in patients with comorbid ODD than in those with no comorbidity. No difference was found in TOS or OSI among the ADHD subtypes; however, TAS was higher in the attention-deficient subtype. ConclusionaaOur findings demonstrated that oxidative balance is impaired and oxidative stress is increased in children and adolescents with ADHD. This results are consistent with those of previous studies.

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