The Neurochemical Effects of Prazosin Treatment on Fear Circuitry in a Rat Traumatic Stress Model

Sema Ketenci,Nazife Gökçe Acet,Gökçe Elif Sarıdoğan,Banu Aydın,Hülya Cabadak,Mehmet Zafer Gören 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.2

Objective: The timing of administration of pharmacologic agents is crucial in traumatic stress since they can either potentiate the original fear memory or may cause fear extinction depending on the phase of fear conditioning. Brain noradrenergic system has a role in fear conditioning. Data regarding the role of prazosin in traumatic stress are controversial. Methods: In this study, we examined the effects of prazosin and the noradrenergic system in fear conditioning in a predator stress rat model. We evaluated the direct or indirect effects of stress and prazosin on noradrenaline (NA), gamma-aminobuytyric acid (GABA), glutamate, glycine levels and choline esterase activity in the amygdaloid complex, the dorsal hippocampus, the prefrontal cortex and the rostral pons. Results: Our results demonstrated that prazosin might alleviate defensive behaviors and traumatic stress symptoms when given during the traumatic cue presentation in the stressed rats. However prazosin administration resulted in higher anxiety levels in non stressed rats when the neutral cue was presented. Conclusion: Prazosin should be used in PTSD with caution because prazosin might exacerbate anxiety in non-traumatized subjects. However prazosin might as well alleviate stress responses very effectively. Stress induced changes included increased NA and GABA levels in the amygdaloid complex in our study, attributing noradrenaline a possible inhibitory role on fear acquisition. Acetylcholine also has a role in memory modulation in the brain. We also demonstrated increased choline esterase acitivity. Cholinergic modulation might be another target for indirect prazosin action which needs to be further studied.

Paraoxonase Activity and Oxidative Status in Patients with Tinnitus

Sema Koç,Servet Akyüz,Battal Tahsin Somuk,Harun Soyalic,Beyhan Yılmaz,Abdullah Taskin,Hasan Bilinc,Nurten Aksoy 대한청각학회 2016 Journal of Audiology & Otology Vol.20 No.1

Background and Objectives: The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. Subjects and Methods: A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. Results: In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). Conclusions: According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus.

Image Restoration by Lifting-Based Wavelet Domain E-Median Filter

Sema Koç,Ergun Er?lebi 한국전자통신연구원 2006 ETRI Journal Vol.28 No.1

In this paper, we propose a method of applying a liftingbased wavelet domain e-median filter (LBWDEMF) for image restoration. LBWDEMF helps in reducing the number of computations. An e-median filter is a type of modified median filter that processes each pixel of the output of a standard median filter in a binary manner, keeping the output of the median filter unchanged or replacing it with the original pixel value. Binary decisionmaking is controlled by comparing the absolute difference of the median filter output and the original image to a preset threshold. In addition, the advantage of LBWDEMF is that probabilities of encountering root images are spread over sub-band images, and therefore the e-median filter is unlikely to encounter root images at an early stage of iterations and generates a better result as iteration increases. The proposed method transforms an image into the wavelet domain using lifting-based wavelet filters, then applies an e-median filter in the wavelet domain, transforms the result into the spatial domain, and finally goes through one spatial domain e-median filter to produce the final restored image. Moreover, in order to validate the effectiveness of the proposed method we compare the result obtained using the proposed method to those using a spatial domain median filter (SDMF), spatial domain e-median filter (SDEMF), and wavelet thresholding method. Experimental results show that the proposed method is superior to SDMF, SDEMF, and wavelet thresholding in terms of image restoration.

Epidural anesthesia for laparoscopic cholecystectomy in a patient with sickle cell anemia, beta thalassemia, and Crohn’s disease -A case report-

Sema Şanal Baş,Onur Özlü 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.4

A 37-year-old woman diagnosed with sickle cell anemia (SCA), beta (+) thalassemia, Crohn’s disease, and liver dysfunction was scheduled for laparoscopic cholecystectomy (LC) due to acute cholecystitis with gall bladder. Regional anesthesia was performed. An epidural catheter was inserted into the 9-10 thoracal epidural space and then 15 ml of 0.5% bupivacaine was injected through the catheter. The level of sensorial analgesia tested with pinprick test reached up to T4. Here we describe the first case of the combination of sickle cell anemia (SCA), beta (+) thalassemia, and Crohn’s disease successful anesthetic management with attention to hemodynamics, particularly with regards to liver dysfunction.

Visual and Auditory Reaction Times of Patients with Opioid Use Disorder

Sema Baykara,Kübra Alban 대한신경정신의학회 2019 PSYCHIATRY INVESTIGATION Vol.16 No.8

Objective Reaction time is defined as the time from the start of a stimulus to the start of the voluntary movement. Time plays an important role in undertaking daily living activities. Reaction time is an important factor in respect of both quality of life and of capabilities demonstrated in the work environment. Alcohol and some addictive substances have effect on RT. The aim of this study was to compare the visual and auditory reaction times of patients with opioid use disorder with healthy control subjects. Methods The study was applied to two groups as the opioid use disorder group and the control group. A Sociodemographic and Clinical Data Form was prepared for each patient including age, gender, marital status and education level. Using a computer program the response to visual screen color change (red/blue) and to an auditory ‘beep’ sound of the computer system were recorded. The Student’s ttest was applied as a statistical method. Results The results showed longer reaction times in the patients with opioid use disorder. Conclusion To add improving reaction time approaches in opioid use disorder treatment may contribute to treatment by increasing quality of life and work performance.

Neuropathic Pain and its Relationship With Fibromyalgia, Vitamin D Status and Medication Use in Patients With Ankylosing Spondylitis

( Sema Mızrak ),( Mehmet Kırnap ),( İsa Cüce ) 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.3

Objective. To determine the frequency of neuropathic pain (NeP) and potentially related new factors including fibromyalgia, vitamin D and medication use in ankylosing spondylitis (AS) patients. Methods. In total, 102 patients with AS were prospectively enrolled in this study and evaluated for pain severity (visual analog scale, VAS), disease activity (the Bath Ankylosing Spondylitis Disease Activity Index, BASDAI), fibromyalgia and current medication use. The presence of NeP was also assessed using the painDETECT questionnaire. Blood samples were taken from all patients to analyze serum 25-hydroxyvitamin D and inflammatory marker levels. Results. NeP component 32 (21 [20.6%]; clearly NeP and 11 [10.8%]; mixed NeP) was present in patients with AS. Compared to those without NeP, they had significantly higher VAS and BASDAI scores (p=0.022 and 0.003, respectively). In addition, there was a highly significant difference of frequency of fibromyalgia between patients with and without NeP (50.0% vs. 5.7%, p<0.001). Vitamin D status and medication use were comparable for patients with and without NeP. Logistic regression analysis revealed that only fibromyalgia was a significant predictor of NeP. Conclusion. This study confirmed that about one-third of AS patients have the NeP component. In addition, NeP was found to be associated with the frequency of fibromyalgia. However, no relation was found between NeP and vitamin D status and medication use in AS. (J Rheum Dis 2021;28:126-132)

SASAKIAN STATISTICAL MANIFOLDS WITH QSM-CONNECTION AND THEIR SUBMANIFOLDS

( Sema Kazan ) 호남수학회 2023 호남수학학술지 Vol.45 No.3

In this present paper, we study QSM-connection (quartersymmetric metric connection) on Sasakian statistical manifolds. Firstly, we express the relation between the QSM-connection □ and the torsionfree connection ∇ and obtain the relation between the curvature tensors ~R of □ and R of ∇. After then we obtain these relations for □ and the dual connection ∇* of ∇. Also, we give the relations between the curvature tensor ~R of QSM-connection □ and the curvature tensors R and R* of the connections ∇ and ∇* on Sasakian statistical manifolds. We obtain the relations between the Ricci tensor of QSM-connection □ and the Ricci tensors of the connections ∇ and ∇*. After these, we construct an example of a 3-dimensional Sasakian manifold admitting the QSM-connection in order to verify our results. Finally, we study the submanifolds with the induced connection with respect to QSM-connection of statistical manifolds.

Neutrophil to Lymphocyte Ratio - Not an Independent Prognostic Factor in Patients with the Myelodysplastic Syndrome

Akinci, Sema,Silay, Kamile,Ulas, Arife,Guney, Tekin,Hacibekiroglu, Tuba,Basturk, Abdulkadir,Akinci, Muhammed Bulent,Alkan, Afra,Dilek, Imdat Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Purpose: Neutrophil-to-lymphocyte ratio (NLR) was evaluated as a potential prognostic factor in patients with myelodysplastic syndrome (MDS). Materials and Methods: Between December 2009 and April 2014, 14 female (35%) and 26 male (65%) MDS patients who were followed up in our hematology clinic were included in the study for NLR during diagnosis. Division was into two groups according to the NLR, and the correlation with mortality was evaluated. The prognostic significance of NLR regarding treatment outcome was also evaluated with adjustment for known confounding risk factors. Results: The mortality rate of the patient group was 55%, and median survival was 18 months. There was no significant correlation between mortality and NLR at a median value of 1.8 (p=0.75). Thrombocytopenia was observed to increase mortality (p=0.027), and there was a significant correlation between mortality and pancytopenia (p=0.017). Conclusions: This first study of NLR and mortality did not show any significant correlation. In centres with limited access to genetic evaluation for the presence of pancytopenia and/or thrombocytopenia at the time of diagnosis, a platelet level less than $50{\times}10^9/l$ may be poor prognostic markers in MDS patients.

Determinants of Opioid Efficiency in Cancer Pain: a Comprehensive Multivariate Analysis from a Tertiary Cancer Centre

Goksu, Sema Sezgin,Bozcuk, Hakan,Uysal, Mukremin,Ulukal, Ece,Ay, Seren,Karasu, Gaye,Soydas, Turker,Coskun, Hasan Senol,Ozdogan, Mustafa,Savas, Burhan Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.21

Background: Pain is one of the most terrifying symptoms for cancer patients. Although most patients with cancer pain need opioids, complete relief of pain is hard to achieve. This study investigated the factors influencing persistent pain-free survival (PPFS) and opioid efficiency. Materials and Methods: A prospective study was conducted on 100 patients with cancer pain, hospitalized at the medical oncology clinic of Akdeniz University. Patient records were collected including patient demographics, the disease, treatment characteristics, and details of opioid usage. Pain intensity was measured using a patient self-reported visual analogue scale (VAS). The area under the curve (AUC) reflecting the pain load was calculated from daily VAS tables. PPFS, the primary measure of opioid efficacy, was described as the duration for which a patient reported a greater than or equal to two-point decline in their VAS for pain. Predictors of opioid efficacy were analysed using a multivariate analysis. Results: In the multivariate analysis, PPFS was associated with the AUC for pain (Exp (B)=0.39 (0.23-0.67), P=0.001), the cumulative opioid dosage used during hospitalisation (Exp (B)=1.00(0.99-1.00), P=0.003) and changes in the opioid dosage (Exp (B)=1.01 (1.00-1.01), P=0.016). The change in VAS score over the standard dosage of opioids was strongly associated with current cancer treatment (chemotherapy vs. others) (${\beta}=-0.31$, T=-2.81, P=0.007) and the VAS for pain at the time of hospitalisation (${\beta}=-0.34$, T=-3.07, P= 0.003). Conclusions: The pain load, opioid dosage, concurrent usage of chemotherapy and initial pain intensity correlate with the benefit received from opioids in cancer patients.

Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients?

Goksu, Sema Sezgin,Gunduz, Seyda,Unal, Dilek,Uysal, Mukremin,Arslan, Deniz,Tatli, Ali Murat,Bozcuk, Hakan,Ozdogan, Mustafa,Coskun, Hasan Senol Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.10

Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.