Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

Emrah Ipek,Emrah Ermis,Selami Demirelli,Erkan Yıldırım,Mustafa Yolcu,Bingül Dilekci Sahin 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.4

We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

Methylene Tetrahydrofolate Reductase C677T Mutation and Left Ventricular Hypertrophy in Turkish Patients with Type 2 Diabetes Mellitus

( Hulya Yilmaz ),( Bedia Agachan ),( Arzu Ergen ),( Zeynep Ermis Karaalib ),( Turgay Isbir ) 생화학분자생물학회 2004 BMB Reports Vol.37 No.2

This study was designed to investigate, in the Turkish population, the association of methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and left ventricular hypertrophy (LVH) in patients with type II diabetes mellitus. Our study included 249 patients with type II diabetes mellitus (102 men, 147 women) and 214 healthy volunteers as controls (91 men, 123 women). MTHFR C677T genotypes were determined by polymerase chain reaction, restriction fragment length polymorphism techniques. No differences were observed in the distribution of MTHFR genotypes or allele frequencies in the cases versus the controls. The frequency of the MTHFR-mutated allele (T) was 31.7% in the type II diabetes mellitus versus 31.1% of the controls. The homozygous mutation (T/T) in the MTHFR gene was identified in 12% of the type II diabetes mellitus versus 9.3% of the controls. Patients with the TT genotype showed a higher prevalence of LVH when compared to patients with the CC and CT genotypes (p = 0.01). The MTHFR gene C677T mutation may be a possible risk factor for the development of LVH in the type II diabetic patients

Combination of imatinib mesylate with lithium chloride and medroxyprogesterone acetate is highly active in Ishikawa endometrial carcinoma in vitro

Ayhan Bilir,Mine Erguven,Ezgi Ermis,Mine Sencan,Nuray Yazihan 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.4

Objective: The aim of the study was to investigate whether lithium chloride and medroxyprogesterone acetate can potentiate the cytotoxicity of imatinib mesylate in human endometrial cancer in vitro and the effect of midkine in these therapies. Methods: Imatinib mesylate (50 μM), lithium chloride (100 μM), medroxyprogesterone acetate (200 μM) and their combination were applied to monolayer and three dimensional cultures of human Ishikawa endometrial cancer for 72 hours. The cell proliferation index, apoptotic index, caspase-3 and midkine levels, cell cycle distributions in monolayer cultures and cell ultrastructure in spheroid cultures were evaluated. Results were statistically analyzed using the Student’s t-test. Results: All drug applications inhibited cell proliferation (p<0.05), however the combination were the effective groups for 72 hours (p<0.05). Interestingly, although the loss of efficiency was seen higly seen every 24 hours at single applications, the inhibition rates of the combination groups were almost same for 72 hours. In concordance with these results, the apoptotic index, caspase-3 levels (p<0.05), cell morphology and ultrastructure damages were much higher in the combination groups. Imatinib mesylate induced S-phase arrest, however other groups induced G0+G1-phase arrest at 24 hours and all groups induced G0+G1 arrest at 72 hours (p<0.05). Imatinib mesylate and imatinib mesylate with medroxyprogesterone acetate induced highest decrease in midkine levels, respectively (p<0.05). Conclusion: The present study showed that the combination of imatinib mesylate with lithium chloride and medroxyprogesterone acetate is highly active in Ishikawa endometrial carcinoma in vitro and the inhibition of midkine involved in their mechanism of action against endometrium defense. Objective: The aim of the study was to investigate whether lithium chloride and medroxyprogesterone acetate can potentiate the cytotoxicity of imatinib mesylate in human endometrial cancer in vitro and the effect of midkine in these therapies. Methods: Imatinib mesylate (50 μM), lithium chloride (100 μM), medroxyprogesterone acetate (200 μM) and their combination were applied to monolayer and three dimensional cultures of human Ishikawa endometrial cancer for 72 hours. The cell proliferation index, apoptotic index, caspase-3 and midkine levels, cell cycle distributions in monolayer cultures and cell ultrastructure in spheroid cultures were evaluated. Results were statistically analyzed using the Student’s t-test. Results: All drug applications inhibited cell proliferation (p<0.05), however the combination were the effective groups for 72 hours (p<0.05). Interestingly, although the loss of efficiency was seen higly seen every 24 hours at single applications, the inhibition rates of the combination groups were almost same for 72 hours. In concordance with these results, the apoptotic index, caspase-3 levels (p<0.05), cell morphology and ultrastructure damages were much higher in the combination groups. Imatinib mesylate induced S-phase arrest, however other groups induced G0+G1-phase arrest at 24 hours and all groups induced G0+G1 arrest at 72 hours (p<0.05). Imatinib mesylate and imatinib mesylate with medroxyprogesterone acetate induced highest decrease in midkine levels, respectively (p<0.05). Conclusion: The present study showed that the combination of imatinib mesylate with lithium chloride and medroxyprogesterone acetate is highly active in Ishikawa endometrial carcinoma in vitro and the inhibition of midkine involved in their mechanism of action against endometrium defense.

Does Cholecystectomy Increase the Esophageal Alkaline Reflux? Evaluation by Impedance-pH Technique

( Ahmet Uyanikoglu ),( Filiz Akyuz ),( Fatih Ermis ),( Serpil Arici ),( Gurhan Bas ),( Mustafa Cakirca ),( Bulent Baran ),( Zeynel Mungan ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2012 Journal of Neurogastroenterology and Motility (JNM Vol.18 No.2

Background/Aims The aim of this study is to investigate the reflux patterns in patients with galbladder stone and the change of reflux patterns after cholecystectomy in such patients. Methods Fourteen patients with cholecystolithiasis and a control group including 10 healthy control subjects were enrolled in this prospective study. Demographical findings, reflux symptom score scale and 24-hour impedance pH values of the 14 cholecystolithiasis cases and the control group were evaluated. The impedance pH study was repeated 3 months after cholecystectomy. Results Age, gender, and BMI were not different between the two groups. Total and supine weakly alkaline reflux time (%) (1.0 vs 22.5, P = 0.028; 201.85 vs 9.65, P = 0.012), the longest episodes of total, upright and supine weakly alkaline reflux mediums (11 vs 2, P = 0.025; 8.5 vs 1.0, P = 0.035; 3 vs 0, P = 0.027), total and supine weakly alkaline reflux time in minutes (287.35 vs 75.10, P = 0.022; 62.5 vs 1.4, P = 0.017), the number of alkaline reflux episodes (162.5 vs 72.5, P = 0.022) were decreased with statistical significance. No statistically significant difference was found in the comparison of symptoms between the subjects in the control group and the patients with cholecystolithiasis, in preoperative, postoperative and postcholecystectomy status. Conclusions Significant reflux symptoms did not occur after cholecystectomy. Post cholecystectomy weakly alkaline reflux was decreased, but it was determined that acid reflux increased after cholecystectomy by impedance pH-metry in the study group.

Methylene Tetrahydrofolate Reductase C677T Mutation and Left Ventricular Hypertrophy in Turkish Patients with Type II Diabetes Mellitus

Yilmaz, Hulya,Agachan, Bedia,Ergen, Arzu,Karaalib, Zeynep Ermis,Isbir, Turgay Korean Society for Biochemistry and Molecular Biol 2004 Journal of biochemistry and molecular biology Vol.37 No.2

This study was designed to investigate, in the Turkish population, the association of methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and left ventricular hypertrophy (LVH) in patients with type II diabetes mellitus. Our study included 249 patients with type II diabetes mellitus (102 men, 147 women) and 214 healthy volunteers as controls (91 men, 123 women). MTHFR C677T genotypes were determined by polymerase chain reaction, restriction fragment length polymorphism techniques. No differences were observed in the distribution of MTHFR genotypes or allele frequencies in the cases versus the controls. The frequency of the MTHFR-mutated allele (T) was 31.7% in the type II diabetes mellitus versus 31.1% of the controls. The homozygous mutation (T/T) in the MTHFR gene was identified in 12% of the type II diabetes mellitus versus 9.3% of the controls. Patients with the TT genotype showed a higher prevalence of LVH when compared to patients with the CC and CT genotypes (p = 0.01). The MTHFR gene C677T mutation may be a possible risk factor for the development of LVH in the type II diabetic patients.

Durability of Sustained Virologic Response in Chronic Hepatitis C

( Ahmet Uyanikoglu ),( Sabahattin Kaymakoglu ),( Ahmet Danalioglu ),( Filiz Akyuz ),( Fatih Ermis ),( Binnur Pinarbasi ),( Kadir Demir ),( Fatih Besisik ),( Yilmaz Cakaloglu ) 대한소화기학회 2013 Gut and Liver Vol.7 No.4

Background/Aims: The aim of this study is to investigate the rate of sustained virologic response (SVR) in chronic hepatitis C patients receiving antiviral treatment. Methods: The files of patients with chronic hepatitis C treated with interferon±ribavirin between 1995 and 2009 were reviewed retrospectively. Six months after the end of treatment, patients with negative hepatitis C virus (HCV)-RNA (<50 IU/mL, as determined by the polymerase chain reaction method) were enrolled in the study. Results: The mean age of 196 patients (89 males) was 46.13±11.10 years (range, 17 to 73 years). In biopsies, the mean stage was 1.50±0.94; histological activity index was 7.18±2.43. In total, 139 patients received pegylated interferon (IFN) +ribavirin, 21 patients received classical IFN+ribavirin, and 36 patients received IFN alone. The HCV genotypes of 138 patients were checked: 77.5% were genotype 1b, and 22.5% were other genotypes. After achievement of SVR, the median follow-up period was 33.5 months (range, 6 to 112 months), and in this period relapse was only detected in two patients (1.02%) at 18 and 48 months after treatment. Conclusions: In total, 98.9% of patients with SVR in chronic hepatitis C demonstrated truly durable responses over the long-term follow-up period of 3 years; relapsed patients had intermittent or low-grade viremia. (Gut Liver 2013; 7:458-461)

The Relationship between P & QT Dispersions and Presence & Severity of Stable Coronary Artery Disease

Bingül Dilekci Şahin,Erkan Yıldırım, M.D.,Emrah Ipek,Mahir Cengiz,Kursat Aslan,Esra Poyraz,Selami Demirelli,Murat Bayantemur,Emrah Ermis,Cavlan Ciftci 대한심장학회 2016 Korean Circulation Journal Vol.46 No.4

Background and Objectives: The study aimed to evaluate the correlation between electrocardiographic (ECG) parameters and presence and extent of coronary artery disease (CAD) to indicate the usefulness of these parameters as predictors of severity in patients with stable CAD. Subjects and Methods: Two hundred fifty patients, without a history of any cardiovascular event were included in the study. The ECG parameters were measured manually by a cardiologist before coronary angiography. The patients were allocated into five groups: those with normal coronary arteries (Group 1), non-critical coronary lesions (Group 2), one, two and three vessel disease (Group 3, Group 4 and Group 5, respectively. . Results: Group 1 had the lowest P wave dispersion (PWD) and P wave (Pmax), QT interval (QTmax), QT dispersion (QTd), corrected QT dispersion (QTcd) and QT dispersion ratio (QTdR), while the patients in group 5 had the highest values of these parameters. Gensini score and QTmax, QTd, QTcmax, QTcd, QTdR, Pmax, and PWD were positively correlated. QTdR was the best ECG parameter to differentiate group 1 and 2 from groups with significant stenosis (groups 3, 4, and 5) (area under curve [AUC] 0.846). QTdR was the best ECG parameter to detect coronary arterial narrowing lesser than 50% and greater than 50%, respectively (AUC 0.858). Conclusion: Presence and severity of CAD can be determined by using ECG in patients with stable CAD and normal left ventricular function.

Gendered jobs and occupational prestige in Turkey: Women in the hierarchy elevator

Aslı Ermiş-Mert 이화여자대학교 아시아여성학센터 2017 Asian Journal of Women's Studies(AJWS) Vol.23 No.4

The success of women in traditionally male disciplines of higher education is not correspondingly reflected in their employment in high-prestige male-dominated jobs in Turkey and this paper seeks to understand the individual level factors that have influenced women’s limited presence in these, particularly in relation to their household- and family-related responsibilities from the 1980s to the 2000s and with reference to current patterns. The term “hierarchy elevator” is introduced to describe and elaborate how horizontal gender segregation intersects with vertical gender segregation as both create disadvantages for women in the job market, considering that their representation is limited in traditionally male jobs and prestigious jobs. Using ordered logistic regressions, this paper demonstrates that being highly educated reinforces women’s career trajectories in high-prestige male-dominated jobs in Turkey, while married women are largely excluded from these. Those who have one child compared to none are more likely to attain these jobs, while having two or more children impedes their labor market outcomes in these positions. This finding can be associated with the expanded financial resources of the few women who work in high-prestige male-dominated jobs for being able to afford childcare, and who may also prefer to have just one child each in order to maintain their status in these demanding jobs.

A case of immune-mediated type 1 diabetes mellitus due to congenital rubella ınfection

Hüseyin Anıl Korkmaz,Çağatay Ermiş 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.1

Congenital rubella infection is a transplacental infection that can cause intrauterine growth retardation, cataracts, patent ductus arteriosus, hearing loss, microcephaly, thrombocytopenia, and severe fetal injury. It has been shown that type 1 diabetes mellitus develops in 12%–20% of patients with congenital rubella infection, and disorders in the oral glucose tolerance test is observed in 40% of patients. No biochemical or serological markers exist which could indicate that type 1 diabetes was caused by a congenital rubella infection. We report a 13-year-old male patient who was admitted to our hospital with complaints of new-onset polyuria, polydipsia, urination, and weight loss. In addition, he was found to have neurosensory hearing loss, patent ductus arteriosus, and microcephaly. Immunemediated type 1 diabetes mellitus was considered due to the fact that the autoantibodies of diabetes mellitus were positive.

Epidemiologic features of ınflammatory bowel disease in Western Blacksea region of Turkey for the last 10 years: retrospective cohort study

Güray Can,Emrah Poşul,Bülent Yılmaz,Hatice Can,Uğur Korkmaz,Fatih Ermiş,Mevlüt Kurt,Ülkü Dağlı 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.3

Background/Aims: There are only a few epidemiological study about inflammatory bowel disease in the last 10 years in Turkey, especially in Western Blacksea region. In our study, we aimed to identify the changes in the incidence and the prevalence of inflammatory bowel disease in Western Blacksea region at the last 10 years. Methods: Totally 223 patients with inf lammatory bowel disease (160 ulcerative colitis, 63 Crohn’s disease) were enrolled in the study followed up between 2004 to 2013 years. The epidemiological characteristics of patients were recorded. Results: The prevalences were 12.53/105 and 31.83/105 for Crohn’s disease and ulcerative colitis respectively. Mean annual incidences increased from 0.99/105 and 0.45/105 for ulcerative colitis and Crohn’s disease (2004 to 2005 years) to 4.87/105 and 2.09/105 for ulcerative colitis and Crohn’s disease respectively (2011 to 2013 years). While the prevalence was higher in urban areas in Crohn’s disease (12.60/105), it was higher in rural areas in ulcerative colitis (36.17/105). In ulcerative colitis, mean annual incidences were 2.91/105 and 2.86/105 for urban and rural areas respectively. In Crohn’s disease, they were 1.37/105 and 1.08/105 for urban and rural areas respectively. Conclusions: The incidence of inflammatory bowel disease seems to increase in Western Blacksea region at the last 10 years. This increment is more prevalent in rural areas.