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Ibiloglu A.O.,Mersin Tarsus State Hospital | Caykoylu A.,Ankara Ataturk Education and Research Hospital
Journal of Anxiety Disorders | Year: 2011

High rates of anxiety disorders have been reported in bipolar disorders. The study aimed to investigate prevalence of anxiety disorders in remitted bipolar subjects and their influence on the illness severity. Bipolar subjects with anxiety disorders were younger, had earlier age at onset of illness, and were overrepresented by female subjects and those with earlier onset illness compared to those without anxiety disorder. The study demonstrated that (1) anxiety disorders are highly prevalent in bipolar subjects, (2) individual anxiety disorders, particularly SP and PD seem to have an effect on illness severity, (3) bipolar subjects with comorbid anxiety tend to have a poorer course and are less responsive to treatment, and (4) anxiety tends to be associated with an earlier age at onset of bipolar disorder (BPD) and results in a more complicated and severe disease course. © 2011 Elsevier Ltd.

Kurt M.,Erzurum Education and Research Hospital | Tanboga I.H.,Erzurum Education and Research Hospital | Aksakal E.,Ataturk University | Kaya A.,Erzurum Education and Research Hospital | And 3 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2012

Aims: It has been shown that speckle-tracking echocardiography (STE) is a feasible and reproducible method to assess left atrial (LA) function. The relationship between left ventricular end-diastolic pressure (LVEDP) and brain natriuretic peptide (BNP) with LA deformation parameters has not been studied comprehensively. Therefore, we propose to investigate the effects of invasively obtained LVEDP and BNP level on LA deformation parameters assessed by STE and to show the relationship between them. Methods and results: The study population consisted of 62 patients who underwent cardiac catheterization. LVEDP was obtained with a fluid-filled catheter. All patients underwent standard two-dimensional echocardiography. In STE analysis for LA, the peak LA strain at the end of the ventricular systole (LAs-strain) and the LA strain with LA contraction (LAa-strain) were obtained. N-terminal pro-BNP (NT-pro-BNP) levels were measured. The univariate correlation analysis demonstrated that the LAs-strain and LAa-strain had good inverse correlation with LVEDP, and the LAs-strain and LAa-strain only had a moderate correlation with NT-pro-BNP. The area under the receiver-operating characteristic curve of the LAs-strain was 0.96 (0.86-0.99, P < 0.001), and for the LAa-strain, the area was 0.88 (0.74-0.96, P < 0.001) to predict increased LVEDP. A multiple regression analysis demonstrated that the LAs-strain, LAVmax, and LV ejection fraction were independent predictors of increased LVEDP among the covariates examined; however, the LAa-strain and LV mass index were not independent predictors. A borderline statistical significance was found for NT-pro-BNP. Conclusion: LAs-strain more closely related with LVEDP and NT-pro-BNP level than LAa-strain. LAs-strain thus might be used clinically to predict increased LVEDP. © The Author 2011.

Kosemehmetoglu K.,Ankara Ataturk Education and Research Hospital | Guner G.,Hacettepe University | Ates D.,Hacettepe University
Virchows Archiv | Year: 2010

The evaluation of the surgical margins is a major concern in surgical pathology, and marking of surgical margins with substances such as alcian blue, Tipp-ex, artist's pigments, colored gelatin, starch, erythrocyte layers, etc. was recommended for this purpose; Indian ink and tissue marking dyes are widely used. As there is no systematic study comparing tissue marking dyes and Indian ink as the most common substances used for the purpose, this study was conducted to compare the two. Penetration into the tissue, brightness under the microscope, the spreading area of one drop of dye on tissue paper, the intensity of colors, and unit price were compared for each of the five colors of Rotring's Indian ink and Thermo-Shandon's tissue marking dyes, applied on reduction mammoplasty specimens. Rotring's Indian ink is proved to be just as effective as Thermo-Shandon's tissue marking dye and bares the majority of the characteristics of a perfect staining substance, which are easily applied, quickly fixed, durable and cheap, contain no potential contaminants, be work safe, would not smudge/stain surrounding tissues, and look bright under the microscope without obscuring the view. © 2010 Springer-Verlag.

Zan E.,Johns Hopkins Hospital | Zan E.,Ankara Ataturk Education and Research Hospital | Kurt K.N.,Johns Hopkins Hospital | Kurt K.N.,Yeditepe University | And 2 more authors.
American Journal of Roentgenology | Year: 2011

OBJECTIVE. Implantation of a spinal cord stimulator (SCS) is one option for pain control in individuals with chronic lumbosacral radicular or axial lumbar pain. The expected positioning of SCSs based on the location of pain, the types of electrodes (percutaneous vs surgical paddle), and the types of electrode arrays and the potential complications have not been described to date in the radiology literature. MATERIALS AND METHODS. A 5-year retrospective review of the radiology information system at our institution revealed 24 patients with images of 36 SCSs. Those images were reviewed to identify the location and type of electrodes as well as the location of the lead within the spinal canal. Not all implantable pulse generators were within the radiologic field of view. Complications identified by reviewing medical records were correlated with imaging findings. RESULTS. Fourteen different types of electrodes were identified. Most were placed in the thoracic spine only, but six thoracolumbar and two cervical spine electrodes were also present. We measured the position of the electrodes within the spinal canal on 26 CT studies of the 24 patients. On 22 of 26 CT studies, the electrodes were placed in the epidural space in the posterior one third of the spinal canal. Complications included misplaced, retained, and broken leads; puncture of the thecal sac; infection; and hematoma. CONCLUSION. Radiologists should be familiar with the different types of electrodes and typical spinal locations of electrodes, leads, and implantable pulse generators. Improper placement of electrodes may lead to ineffective pain relief or to other complications. © American Roentgen Ray Society.

Dizdar O.,Ankara Ataturk Education and Research Hospital | Yalcin S.,Hacettepe University
Hepato-Gastroenterology | Year: 2011

Background/Aims: This study evaluated the outcomes of the patients with metastatic gastrointestinal stromal tumor who failed imatinib and sunitinib treatment, and were treated with nilotinib within a compassionate use program. Methodology: Patients who had previously received imatinib and sunitinib and had experienced disease progression or drug intolerance with this therapy were included. Demographic and clinical characteristics of the patients, response to nilotinib and duration of response were evaluated along with adverse events. Results: Data of 7 patients (6 males and 1 female) who received nilotinib for at least 30 days were analyzed. Median age of the patients was 68 years (range, 47-70). Complete response was achieved in one patient. One patient experienced partial response, 2 patients stable disease and 3 patients had progressive disease with nilotinib treatment. No life threatening adverse events were observed. Three patients experienced grade 2-3 asthenia. No electrocardiographic changes were observed throughout the treatment period. Conclusions: Nilotinib is active and may represent an alternative treatment choice in patients with gastrointestinal stromal tumor resistant to imatinib and sunitinib. © H.G.E. Update Medical Publishing S.A.

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