Assesment of Myocardial Ischemia by Combination of Tissue Synchronisation Imaging and Dobutamine Stress Echocardiography

Muhammed Hakan Tas,Enbiya Aksakal,Yekta Gurlertop,Ziya Simsek,Fuat Gundogdu,Serdar Sevimli,Eftal Murat Bakirci,Sule Karakelleoglu 대한심장학회 2013 Korean Circulation Journal Vol.43 No.6

Background and Objectives: Dobutamine stress echocardiography (DSE) is an important non-invasive imaging method for evaluating ischemia. However, wall motion interpretation can be impaired by the experience level of the interpreter and the subjectivity of the visual assessment. In our study we aimed to combine DSE and tissue syncronisation imaging to increase sensitivity for detecting ischemia. Subjects and Methods: 50 patients with indications for DSE were included in the study. In 25 patients we found DSE positive for isch-emia and in the other 25 patients we found it to be negative. The negative group was accepted as the control group. There was no signifi-cant difference in terms of risk factors and echocardiographic parameters between the two groups, except for wall motion scores. In both groups, left ventricular dyssychrony was accepted as the difference between time to peak systolic velocity (Ts) in the reciprocal four cou-ple of non-apical segments at rest and during peak stress. Timings were corrected for heart rate. We compared the differences of the dys-synchronisation value at rest and during peak stress to determine the distinctions within the groups and between the groups of DSE pos-itive and negative patients. Results: We found that stress and ischemia did not create any significant difference over the left intraventricular dyssynchrony with DSE,although at the segmenter level it prolonged the time to peak systolic velocity (p<0.05). These alterations did not show any significant difference between positive and negative DSE groups. Conclusion: As a result, this segmenter dyssynchrony and the time to peak systolic velocity, which is corrected for heart rate, did not en-hance any new value over DSE for detecting ischemia.

Effects of powder particle size on mechanostructure and cell viability of the synthesised bioceramic bone grafts

Mehtap Demirel,Bunyamin Aksakal 한양대학교 세라믹연구소 2018 Journal of Ceramic Processing Research Vol.19 No.1

Hydroxyapatite (HA) based biografts were syntesized at 0.68, 1.2 and 2.4 μm powder particle size by sol gel method. The effectof powder particle sizes on morphology, mechanical properties and in vitro cell viability of the biografts were analysed. Eachcomposition at different particle sizes (0.68, 1.2 and 2.4 μm) were sintered at 1180 oC and quantitative phase analysis wascharacterized by FTIR, XRD and SEM-EDX. Mechanical properties were determined by axial compression and Vickershardness tests. The highest compresion strengths and hardness values were obtained in samples having the particle size of 0.68μm and such values were increased with decreased particle sizes. Furthermore, from in vitro Cell viability tests it wasdetermined that no toxicity was detected at 0,1 and 0,3 μM concentrations at lower powder particle sizes. However, cellviability was significantly reduced in the syntesized samples having 2.4 μm particle size at 0,3 μM concentration.

Laser hemorrhoidoplasty in the treatment of symptomatic hemorrhoids: a pilot Australian study

Jain Anshini,Lew Chen,Aksakal Gamze,Hiscock Richard,Mirbagheri Naseem 대한대장항문학회 2024 Annals of Coloproctolgy Vol.40 No.1

Purpose: Traditional therapeutic approaches to the surgical management of hemorrhoid disease such as hemorrhoidectomies are plagued with severe postoperative pain and protracted recovery. Our pilot study aims to the laser hemorrhoidoplasty (LH) patients with symptomatic hemorrhoid disease that have failed conservative management for the first time in an Australian population. Methods: Thirty patients were prospectively enrolled to undergo LH. Postoperative pain, time to return to function, and quality of life (QoL) were determined through the Hemorrhoid Disease Symptom Score and Short Health Scale adapted for hemorrhoidal disease and compared to a historical group of 43 patients who underwent a Milligan-Morgan hemorrhoidectomy by the same surgeon at 3, 6, and 12 months. Results: The LH group had significantly lower mean predicted pain scores on days 1 and 2 and lower defecation pain scores and lower opioid analgesia use on days 1, 2, 3, and 4. The median time to return to normal function was significantly lower in the LH group (2 days vs. 9 days, P<0.001). Similarly, the median days to return to the workplace was significantly lower in the LH group (6 days vs. 13 days, P=0.007). During long-term follow-up (12 months), hemorrhoid symptoms and all QoL measures were significantly improved, especially among those with grade II to III disease. Conclusion: This pilot study demonstrates low pain scores with this revivified procedure in an Australian population, indicating possible expansion of the therapeutic options available for this common condition. Further head-to-head studies comparing LH to other hemorrhoid therapies are required to further determine the most efficacious therapeutic approach.

Prevalence and Comparing of Some Microbiological Properties, Somatic Cell Count and Antibiotic Residue of Organic and Conventional Raw Milk Produced in Turkey

Bayram Urkek,Mustafa Sengul,Tuba Erkaya,Vecihi Aksakal 한국축산식품학회 2017 한국축산식품학회지 Vol.37 No.2

The aim of this study was to investigate the effects of production systems and milk collection periods on the somatic cell count (SCC), some microbiological properties, total aerobic mesophilic bacteria (TAMB), coliform, Staphylococcus aureus (S. aureus), yeast and mould) and antibiotic residue of milk; in Turkey. Milk samples were collected from 9 conventional farms and 9 organic farms during one year time, at six different months (December 2013 to October 2014), and all farms were selected from the same geographical locations. All organically managed farms had organic production certificates given by the Republic of Turkey Ministry of Food, Agriculture and Livestock. The count of TAMB, coliform, and coagulase positive S. aureus were affected by production systems at the level of p<0.01; yeast and mold, and somatic cell count (SCC) were affected at the level of p<0.05. But, differences according to months were statistically significant only on TAMB (p<0.01) and coliform (p<0.05) counts. The general means of TAMB, coliform and yeast and mould counts of the organic milk (OM) were significantly lower (p<0.05), while the general means of SCC and coagulase positive S. aureus count of the OM was significantly higher (p<0.05) compared to conventional milk (CM). Antibiotic residue was determined in one of the CM sample and in two of the OM samples. Our study is the first research that compared conventional and organic milk in Turkey. This study indicated that the microbiological quality of OM was the higher in terms of TAMB, coliform and yeast and mould, whereas was the lower in relation to SCC and coagulase positive S. aureus counts. But, the quality of both milk types should be improved.

Causal Attributions, Social Support and Psychological Morbidity in Patients Undergoing Thyroid Surgery

Nazmiye Kocaman Yıldırım,Beyza Özçınar,Selim Doğan,Nihat Aksakal,Nuri Alper Sahbaz,Fırat Tutal,Bahar Canday Torun,Mine Özkan,Yeşim Erbil 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.4

Purpose: The primary objective of the present study was to investigate the course of anxiety and depression in thyroidectomy. The second objective was to investigate the association between somatic symptoms and psychological symptoms, and the final objective was to identify the sociodemographic, clinical, and psychosocial factors that affect psychiatric morbidity. Methods: This prospective study, 101 patients who were admitted to the Endocrine Surgery Clinic of the Department of General Surgery, Istanbul Faculty of Medicine, University of Istanbul, with thyroid pathology were included in the study. Data were collected before surgery, and in the early, and late periods after surgery. Data were collected using a semi-structured interview form, a visual analogue scale, and the Hospital Anxiety and Depression Scale. Results: The average scores of anxiety and depression before surgery were statistically significantly higher compared with the early and late periods after surgery (P<0.001). Psychological morbidity was identified about 10% of patients before surgery and remained after thyroidectomy. A poor positive correlation founded between somatic symptoms and psychological condition in period surgery (P<0.05). Various sociodemographic features and psychosocial parameters affected anxiety and depression level (P<0.05). Conclusion: Anxiety and depression level in thyroid diseases decreased after thyroidectomy. These patients may express psychologic distress through somatic symptoms. Screening of psychological morbidity is suggested in patients planned thyroid surgery, especially in women, low-educated, inadequate social support, attributed to psychological causes.

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.

Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer

Mustafa Haksal,Nuri Okkabaz,Ali Emre Atici,Osman Civil,Yasar Ozdenkaya,Ayhan Erdemir,Nihat Aksakal,Mustafa Oncel 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.1

Purpose: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. Methods: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. Results: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). Conclusion: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.

Preventive Effects of a Major Component of Green Tea, Epigallocathechin-3-Gallate, on Hepatitis-B Virus DNA Replication

Karamese, Murat,Aydogdu, Sabiha,Karamese, Selina Aksak,Altoparlak, Ulku,Gundogdu, Cemal Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.10

Background: Hepatitis B virus infection is one of the major world health problems. Epigallocatechin-3 gallate is the major component of the polyphenolic fraction of green tea and it has an anti-viral, anti-mutagenic, anti-tumorigenic, anti-angiogenic, anti-proliferative, and/or pro-apoptotic effects on mammalian cells. In this study, our aim was to investigate the inhibition of HBV replication by epigallocatechin-3 gallate in the Hep3B2.1-7 hepatocellular carcinoma cell line. Materials and Methods: HBV-replicating Hep3B2.1-7 cells were used to investigate the preventive effects of epigallocatechin-3 gallate on HBV DNA replication. The expression levels of HBsAg and HBeAg were determined using ELISA. Quantitative real-time-PCR was applied for the determination of the expression level of HBV DNA. Results: Cytotoxicity of epigallocathechin-3-gallate was not observed in the hepatic carcinoma cell line when the dose was lower than $100{\mu}M$. The ELISA method demonstrated that epigallocatechin-3 gallate have strong effects on HBsAg and HBeAg levels. Also it was detected by real-time PCR that epigallocatechin-3 gallate could prevent HBV DNA replication. Conclusions: The obtained data pointed out that although the exact mechanism of HBV DNA replication and related diseases remains unclear, epigallocatechin-3 gallate has a potential as an effective anti-HBV agent with low toxicity.

Familial gigantiform cementoma with Ehlers - Danlos syndrome: A report of 2 cases

Sakar, Olcay,Aren, Gamze,Mumcu, Zeynep,Unalan, Fatma,Aksakalli, Nihan,Tolgay, Ceren Guney The Korean Academy of Prosthodonitics 2015 The Journal of Advanced Prosthodontics Vol.7 No.2

Ehlers-Danlos syndrome is an autosomal dominant hereditary disorder of connective tissue, while familial gigantiform cementoma is a condition that usually manifests as multiple radiopaque cementum-like masses throughout the jaws. This case report discusses the oral management and prosthetic rehabilitation of two patients presenting familial gigantiform cementoma with Ehlers-Danlos Syndrome.