Performance of F-18 Fluorocholine PET/CT for Detection of Hyperfunctioning Parathyroid Tissue in Patients with Elevated Parathyroid Hormone Levels and Negative or Discrepant Results in Conventional Imaging

Lebriz Uslu-Bes¸li,Kerim Sonmezoglu,Serkan Teksoz,Elife Akgun,Emre Karayel,Huseyin Pehlivanoglu,Baresh Razavi Khosroshahi,Meltem Ocak,Levent Kabasakal,Sait Sager,Yusuf Bukey 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.2

Objective: Our aim was to assess the diagnostic performance of F-18 fluorocholine (FCH) positron emission tomography/ computed tomography (PET/CT) in detecting hyperfunctioning parathyroid tissue (HPT) in patients with elevated parathyroid hormone levels with negative or inconclusive conventional imaging results and to compare the findings with those obtained using technetium-99m sestamibi (MIBI) scintigraphy and neck ultrasonography (US). Materials and Methods: Images of 105 patients with hyperparathyroidism who underwent FCH PET/CT, dual-phase MIBI parathyroid scintigraphy (median interval: 42 days), and neck US were retrospectively analyzed. The gold standard was histopathological findings for 81 patients who underwent parathyroidectomy and clinical follow-up findings in the remaining 24 patients. Sensitivities, positive predictive values (PPVs), and accuracies were calculated for all imaging modalities. Results: Among the 81 patients who underwent parathyroidectomy, either parathyroid adenoma (n = 64), hyperplasia (n = 9), neoplasia (n = 4), or both parathyroid adenoma and hyperplasia (n = 1) were detected, except 3 patients who did not show HPT. Of the 24 (23%) patients who were followed-up without operation, 22 (92%) showed persistent hyperparathyroidism. FCH PET/CT showed significantly higher sensitivity than MIBI scintigraphy and US in detection of HPT (p < 0.01). Sensitivity, PPV, and accuracy of FCH PET/CT were 94.1% (95/101), 97.9% (95/97), and 92.4% (97/105), respectively. The corresponding values for MIBI scintigraphy and US were 45.1% (46/102), 97.9% (46/47), and 45.7% (48/105) and 44.1% (45/102), 93.8% (45/48), and 42.9% (45/105), respectively. Among the 35 patients showing negative MIBI scintigraphy and neck US findings, 30 (86%) showed positive results on FCH PET/CT. FCH PET/CT could demonstrate ectopic locations of HPT in 11 patients whereas MIBI and US showed positive findings in only 6 and 3 patients, respectively. Conclusion: FCH PET/CT is an effective imaging modality for detection of HPT with the highest sensitivity among the available imaging techniques. Therefore, FCH PET/CT can be recommended especially for patients who show negative or inconclusive results on conventional imaging.

A Rare Cause of Recurrent Acute Pancreatitis in a Child: Isovaleric Acidemia with Novel Mutation

Elif Sag,Alper Han Cebi,Gulay Kaya,Gulay Karaguzel,Murat Cakir 대한소아소화기영양학회 2017 Pediatric gastroenterology, hepatology & nutrition Vol.20 No.1

Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or heredi-tary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, “the odor of sweaty feet,” abdominal pain, vomit-ing, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.

Recent Advances in Autism Spectrum Disorders: Applications of Whole Exome Sequencing Technology

Elif Funda Sener,Halit Canatan,Yusuf Ozkul 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.3

Autism spectrum disorders (ASD) is characterized by three core symptoms with impaired reciprocal social interaction and communication, a pattern of repetitive behavior and/or restricted interests in early childhood. The prevalence is higher in male children than in female children. As a complex neurodevelopmental disorder, the phenotype and severity of autism are extremely heterogeneous with differences from one patient to another. Genetics has a key role in the etiology of autism. Environmental factors are also interacting with the genetic profile and cause abnormal changes in neuronal development, brain growth, and functional connectivity. The term of exome represents less than 1% of the human genome, but contains 85% of known disease-causing variants. Whole-exome sequencing (WES) is an application of the next generation sequencing technology to determine the variations of all coding regions, or exons of known genes. For this reason, WES has been extensively used for clinical studies in the recent years. WES has achieved great success in the past years for identifying Mendelian disease genes. This review evaluates the potential of current findings in ASD for application in next generation sequencing technology, particularly WES. WES and whole-genome sequencing (WGS) approaches may lead to the discovery of underlying genetic factors for ASD and may thereby identify novel therapeutic targets for this disorder.

Application of a multiple criteria analysis for the selection of appropriate radical based processes in treatment of car wash wastewater

Elif DURNA,Nevim GENC 대한환경공학회 2021 Environmental Engineering Research Vol.26 No.2

In this study, the treatment of car wash wastewater was investigated by radical based hybrid/combined processes. Proposed processes, (Microwave (MW) + persulfate (PS) + Electrocoagulation (EC)), (ozone (O₃) + PS + EC) and (MW + PS + O₃), were optimized with Taguchi orthogonal array technique for maximum COD removal. The COD removal under optimum conditions was obtained to be 84%, 64.9% and 61.4%, for (MW + PS+ EC), (O₃ + PS+ EC) and (MW + PS+ O₃) processes, respectively. Operating costs for (MW + PS + EC), (O₃ + PS + EC) and (MW + PS + O₃) processes have been calculated as 0.2614, 0.1335 and 0.2653 €/L wastewater under optimum operating conditions. Pareto analysis showed that MW time and PS dose are very effective parameters but especially ozone related parameters have no significant effect on COD removal. Processes were evaluated with the PROMETHEE approach in terms of treatment efficiency, operating cost, sludge formation, and preferability criteria to determine the most suitable among the three alternative processes. As a result, the preference order of the processes for the treatment of car wash wastewater with radical based treatment processes was found as (MW + EC + PS) > (MW + O₃ + PS) > (O₃ + EC + PS).

Endoscopic Findings of Children with Familial Mediterranean Fever

Elif Sağ,Ferhat Demir,İsmail Saygın,Mukaddes Kalyoncu,Murat Çakır 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4

Purpose: Familial Mediterranean fever (FMF) is an auto inflammatory disease characterized by periodic fever, synovitis and serositis. Patients may be admitted to gastroenterology units due to gastrointestinal symptoms. In this study; we aimed to analyze endoscopic findings and diagnostic utility of endoscopic procedure in children with FMF. Methods: Patient with FMF that was performed endoscopy for the gastrointestinal symptoms were included to the study (39 of 164 patients, 53 procedure). A control group was randomly designed as age and gender matched four endoscopic procedures per one endoscopic procedure of patients with FMF (n=212). Results: No different was found between the patients and control group in esophagogastroscopy findings. However, the diagnosis of gastrointestinal pathology was made by esophagogastroscopy in 46.2% patients. Colonoscopic examination revealed that the frequency of inflammatory bowel disease (IBD) was higher in undiagnosed patients compared to both the control group (50.0% vs. 6.9%, p<0.05, odds ratio [OR]:13.4 and 95% confidence inteval [95% CI]: 2.1-84.3) and the patients under colchicine treatment (50.0% vs. 8.3%, p<0.05, OR: 11 and 95% CI: 0.8-147.8). Colonoscopic procedure that was made after the diagnosis was found to provide contribution by 16.7% in determining the etiology of the additional symptoms. Conclusion: Patients with FMF may be admitted to pediatric gastroenterology outpatient clinic prior to diagnosis or during the follow-up period. The frequency of IBD is high in undiagnosed patients with FMF. Endoscopic procedures may be helpful in these patients for the diagnosis accompanying mucosal lesions.

Examining the relationship between socioeconomic structure and urban transport network efficiency: a circuity and spatial statistics based approach

Elif Su Karaaslan,K. Mert Cubukcu 대한공간정보학회 2023 Spatial Information Research Vol.31 No.5

Access to urban public transportation services is crucial for all city residents. Undoubtedly, more efficient public transportation services should be provided for the needy ones. The study aims to develop a simple yet efficient analytical approach to spatially determine the urban areas that receive inefficient public transportation services. In this study, the spatial distribution of the efficiency of public transportation and its relation to socioeconomic variables (per capita income level and population density) are examined at the neighborhood in Izmir, Turkey, level using circuity. The results from univariate and bivariate Global and Local Moran’s I analyses reveal that the high-efficiency levels are spatially clustered, Higher-income neighborhoods have better public transportation systems compared to lower-income ones. According to Bivariate Local Moran’s I analyses, among the 348 neighborhoods at least 31 and at most 81 neighborhoods are either in a High-High or Low-Low cluster for the four time periods considered. As for the relationship between circuity and density, at least 21 and at most 75 neighborhoods are a part of a cluster. The fact that there is a significant relationship between the efficiency of public transportation and socioeconomic variables calls for alteration in the planning policies regarding urban public transportation supply. Although the variation in public transport efficiency levels across the neighborhoods can partly be attributed to physical conditions, the city should provide equal accessibility and efficiency regardless of the socio-economic status of the neighborhoods. The findings can well be generalized for cities of similar sizes in developing countries.

An Investigation on Process Capability Analysis for Fused Filament Fabrication

Elif Elçin Günay,Anusha Velineni,Kijung Park,Gül E. Okudan Kremer 한국정밀공학회 2020 International Journal of Precision Engineering and Vol.21 No.4

Additive manufacturing (AM) has become a popular manufacturing technology today. Many companies have been investingin AM technologies and skill development to carefully integrate them into their capabilities. Despite its benefi ts, AM hasseveral disadvantages that require in-depth analysis and process engineering. This research focuses on the reproducibilityissue of fused fi lament fabrication (FFF) for polylactic acid printing to reveal whether the AM technology can produce partscomparable to those by traditional or subtractive manufacturing. For this purpose, identifi cation of optimal process parametersand process capability analysis are integrated to achieve repeatable minimum deviation from target dimensions. First,a design of experiments is planned and performed to determine the optimal combination of signifi cant factors to ensuredimensional accuracy. Then, process capability analysis under optimal factor settings is performed to examine whether theprinted part dimensions satisfy the target performance levels. Findings from this study show the FFF process can match thereproducibility of manufacturing parts produced by traditional manufacturing technologies.

Does transcutaneous electrical nerve stimulation affect pain, neuropathic pain, and sympathetic skin responses in the treatment of chronic low back pain? A randomized, placebo-controlled study

( Elif Yakşi ),( Ayşegül Ketenci ),( Mehmet Barış Baslo ),( Elif Kocasoy Orhan ) 대한통증학회 2021 The Korean Journal of Pain Vol.34 No.2

Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients’ visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

Common Fixed Points of w-Compatible Maps in Modular A-metric Spaces

Elif Kaplan,Servet Kutukcu 한국수학교육학회 2021 純粹 및 應用數學 Vol.28 No.2

The aim of this paper is to prove a common fixed point theorem for two w-compatible maps in modular A-metric spaces. The main result is also illustrated by an example to demonstrate the degree of validity of our hypothesis.

Novel Compound Heterozygous Mutations of TGM1 Gene Identified in a Turkish Collodion Baby Diagnosed with Non-Bullous Congenital Ichthyosiform Erythroderma

( Elif Keleş Gülnerman ),( Nurcan Hanedan ),( Merve Akillioglu ),( Gülsüm Kayhan ),( Esra Adişen ),( Özlem Erdem ),( İbrahim Murat Hirfanoğlu ),( Ebru Ergenekon ),( Eray Esra Önal ),( Canan Türkyilmaz 대한피부과학회 2023 Annals of Dermatology Vol.35 No.7

Autosomal recessive congenital ichthyosis (ARCI) is a group of diseases presenting as collodion baby at birth. ARCI is categorized as Harlequin ichthyosis, lamellar ichthyosis, and non-bullous congenital ichthyosiform erythroderma (NBCIE), bathing suit icthyosis (BSI) and others. We describe the case of a male newborn with NBCIE whose whole exome sequencing revealed two variants of TGM1 gene (NM_000359.3) in a compound heterozygous state: c.790C>T (p.Arg264Trp) in exon 5 and c.2060G>A (p.Arg687His) in exon 13. In the literature, the Arg264Trp variant has been reported as homozygous or compound heterozygous with other variants in patients with BSI. In contrast, the Arg687His variant has been reported only as homozygous in patients with BSI. To the best of our knowledge, this is the first case whose two compound heterozygous variants, exhibiting the NBCIE phenotype, instead of the BSI.