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( Ergenekon Karagoz ),( Alpaslan Tanoglu ),( Asim Ulcay ),( Veysel Ozalper ),( Vedat Turhan ),( Muammer Kara ),( Levent Gorenek ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The neutrophil to lymphocyte ratio (NLR), an infi ammation index, has been suggested to predict prognosis of various infi ammatory and neoplastic diseases. However, there are only a few studies examining the relationship between NLR and liver fi brosis score in HBV infected cases in literature. In this study, we aimed to determine the relationship between neutrophil to lymphocyte ratio (NLR) and fi brosis level. Methods: 144 biopsy proven naive chronic hepatitis B cases and 42 healthy subjects were included in the study. Previously treated patients by antiviral therapy and patients with anti-Delta positive were excluded from the study. Hepatitis B patients were divided into two groups with fi brosis scores of 0-1 and 2-6 according to ISHAC score. Results: Of the 144 cases, 125 (86.9 %) were male, 19 (13.1%) were female. fibrosis scores of 84 cases (58.3 %) were = 2 while 60 cases had fi brosis scores < 2 (41.7 %). There was a significant difference between Naive chronic hepatitis B group and healthy subjects in terms of NLR.The mean serum NLR was 1.822±0.853 in chronic hepatitis B patient group while it was found to be 2.29±1.408 in healthy subjects (p<0,05).There was not a signifi cant correlation existed between fi brosis score and NLR. NLR level was 1,906±1.027 in patients with fi brosis score 0-1 while this level was 1.762±0.702 in patients with fi brosis score 2-6 (p=0,576). Conclusions: In comparisons of healthy subjects with Hepatitis B infected patients, NLR was found to be lower in patients with Hepatitis B. Further studies are needed to determine the relationship between NLR and Hepatitis B.
( Veysel Ozalper ),( Ibrahim Cetindagli ),( Ergenekon Karagoz ),( Emrullah Solmazgul ),( Cihan Top ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Hyperkalemia is a common and serious clinical problem that occurs often due to impaired urinary potassium excretion because of acute or chronic kidney disease or drugs that effect renin-angiotensin-aldosterone axis. We report a hyperkalemic patient with 9.0mEq/L without any ECG changes. Case Report: A 86-year-old-woman suffering fatigue within two days had admitted emergency service because of sudden bilateral lower extremity paralysis. She had esential hypertension, ischemic heart disease and chronic kidney disease and was using Spironolactone, silazopril, asetilsalisilik, isosorbid-5-mononitrat ve karvedilol. Initial neurological examination of extremities was; 2/5 of lower extremity, 4/5 of upper extremity. Initial laboratory fi ndings potassium:9,1mmol/L, sodium:141mmol/L, creatinine: 1,9mg/dl. In his arterial blood gas analyse, pH:7.27, HCO3:16mEq/L, pCO2:30mm- Hg, potassium:9,1mmol/L. Spironolactone and silazopril treatment had stopped. With an intensive electrolyte-follow-up, She was commenced on intravenous fl uid, injection calcium gluconate and glucose/insulin infusion. Within two hours of treatment her potassium level decreased by 1.5 mmol/L. After eight hours of intensive treatment, potassium level reached below 6,5mEq/L. Five Days later, after three days of close follow-up with normal potassium level, the patient had discharged. Conclusion: ECG differancies like fl attening in U wawe, expansion in QRS, taper in T wawe, arrhytmias, asystoles can be seen in hypercalemia. Especially in the circumstances that serum potassium level is above 8 mEq/L ECG differancy is expected to be seen. So that, it is suggested that biochemical elevation in hypercalemic cases is verifi ed with ECG. Although it is rarely seen like in our cases, it shouldn`t be forgotten that severe hypercalemia can be seen without ECG differancy.
Radiation Exposure to Premature Infants in a Neonatal Intensive Care Unit in Turkey
Turan Olgar,Esra Onal,Dogan Bor,Nurullah Okumus,Yildiz Atalay,Canan Turkyilmaz,Ebru Ergenekon,Esin Koc 대한영상의학회 2008 Korean Journal of Radiology Vol.9 No.5
Objective: The aim of this work was to determine the radiation dose received by infants from radiographic exposure and the contribution from scatter radiation due to radiographic exposure of other infants in the same room. Materials and Methods: We retrospectively evaluated the entrance skin doses (ESDs) and effective doses of 23 infants with a gestational age as low as 28 weeks. ESDs were determined from tube output measurements (ESDTO) (n = 23) and from the use of thermoluminescent dosimetry (ESDTLD) (n = 16). Scattered radiation was evaluated using a 5 cm Perspex phantom. Effective doses were estimated from ESDTO by Monte Carlo computed software and radiation risks were estimated from the effective dose. ESDTO and ESDTLD were correlated using linear regression analysis. Results: The mean ESDTO for the chest and abdomen were 67 μGy and 65 μGy per procedure, respectively. The mean ESDTLD per radiograph was 70 μGy. The measured scattered radiation range at a 2 m distance from the neonatal intensive care unit (NICU) was (11-17 μGy) per radiograph. Mean effective doses were 16 and 27 μSv per procedure for the chest and abdomen, respectively. ESDTLD was well correlated with ESDTO obtained from the total chest and abdomen radiographs for each infant (R2 = 0.86). The radiation risks for childhood cancer estimated from the effective dose were 0.4 × 10-6 to 2 × 10-6 and 0.6 × 10-6 to 2.9 × 10-6 for chest and abdomen radiographs, respectively. Conclusion: The results of our study show that neonates received acceptable doses from common radiological examinations. Although the contribution of scatter radiation to the neonatal dose is low, considering the sensitivity of the neonates to radiation, further protective action was performed by increasing the distance of the infants from each other. Objective: The aim of this work was to determine the radiation dose received by infants from radiographic exposure and the contribution from scatter radiation due to radiographic exposure of other infants in the same room. Materials and Methods: We retrospectively evaluated the entrance skin doses (ESDs) and effective doses of 23 infants with a gestational age as low as 28 weeks. ESDs were determined from tube output measurements (ESDTO) (n = 23) and from the use of thermoluminescent dosimetry (ESDTLD) (n = 16). Scattered radiation was evaluated using a 5 cm Perspex phantom. Effective doses were estimated from ESDTO by Monte Carlo computed software and radiation risks were estimated from the effective dose. ESDTO and ESDTLD were correlated using linear regression analysis. Results: The mean ESDTO for the chest and abdomen were 67 μGy and 65 μGy per procedure, respectively. The mean ESDTLD per radiograph was 70 μGy. The measured scattered radiation range at a 2 m distance from the neonatal intensive care unit (NICU) was (11-17 μGy) per radiograph. Mean effective doses were 16 and 27 μSv per procedure for the chest and abdomen, respectively. ESDTLD was well correlated with ESDTO obtained from the total chest and abdomen radiographs for each infant (R2 = 0.86). The radiation risks for childhood cancer estimated from the effective dose were 0.4 × 10-6 to 2 × 10-6 and 0.6 × 10-6 to 2.9 × 10-6 for chest and abdomen radiographs, respectively. Conclusion: The results of our study show that neonates received acceptable doses from common radiological examinations. Although the contribution of scatter radiation to the neonatal dose is low, considering the sensitivity of the neonates to radiation, further protective action was performed by increasing the distance of the infants from each other.
( 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.
Elif Keleş Gülnerman,Nurcan Hanedan,Merve Akillioglu,Gülsüm Kayhan,Esra Adişen,Özlem Erdem,İbrahim Murat Hirfanoğlu,Ebru Ergenekon,Eray Esra Önal,Canan Türkyilmaz,Esin Koç 대한피부과학회 2023 Annals of Dermatology Vol.35 No.-
Autosomal recessive congenital ichthyosis (ARCI) is a group of diseases presenting as col- lodion 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 se- quencing 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 heterozy- gous 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.