Publications by authors named "Hakan Demir"

51 Publications

Effects of boron on the mechanical properties of polymethylmethacrylate denture base material.

Eur Oral Res 2021 Jan;55(1):45-53

Department of Prosthodontics, Faculty of Dentistry,Sakarya University, Sakarya,Turkey.

Purpose: The objective of this study was to determine whether the addition of different types of boron (Borax, Boric Acid and Colemanite) to polymethyl methacrylate denture base resin would improve flexural and impact strengths, and surface hardness of polymethyl methacrylate.

Materials And Methods: Borax, Boric acid, Colemanite were added to heat polymerized polymethyl methacrylate specimens were prepared for flexural strength (65x10x2.5 mm), impact strength (50x6x4 mm), and hardness (20x6x4 mm) tests according to the manufacturers' instructions (n=10). To determine flexural strength of the specimens, they were loaded until failure on a universal testing machine using a three point bending test. Specimens were subjected to the Charpy impact test machine. Hardness of the specimens was measured with an analog shoremeter Shore D. The data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (α=0.05).

Results: The highest mean flexural strength value was seen in 3% Borax group and followed by 1% Colemanite group. In addition, the highest mean impact strength value was recorded in 1% Colemanite group, and differences between 1% Colemanite group and control group were found to be statistically significant (p=0,001). Furthermore, there was significant difference in hardness between control group and all other groups (p<0.001).

Conclusion: The addition of 1% Colemanite to polymethyl methacrylate improved the mechanical properties of PMMA.
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http://dx.doi.org/10.26650/eor.20210132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8055257PMC
January 2021

Urinary Reflux Into the Prostate Gland and Seminal Vesicles: A Potential Pitfall in 18F-FDG and 68Ga-PSMA PET/CT.

Clin Nucl Med 2020 Jul;45(7):536-537

From the Departments of Nuclear Medicine.

A 64-year-old man with lung cancer underwent F-FDG PET/CT for restaging, which demonstrated intense F-FDG uptake in the right lobe of prostate gland and seminal vesicles, indicating a potential prostate cancer. In Ga-PSMA PET/CT, intense uptake in the right lobe of prostate gland and seminal vesicles was also observed but decreased in postmictional delayed images. Magnetic resonance imaging showed high signal intensity of urine in the same areas of uptakes. F-FDG and Ga-PSMA PET/CT findings in the prostate gland and seminal vesicles were considered to be a result of urinary reflux possibly because of the patient's previous transurethral resection.
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http://dx.doi.org/10.1097/RLU.0000000000003069DOI Listing
July 2020

Consensus Report on Diagnosis, Treatment and Prevention of Infective Endocarditis by Turkish Society of Cardiovascular Surgery (TSCVS), Turkish Society of Clinical Microbiology and Infectious Diseases (KLIMIK), Turkish Society of Cardiology (TSC), Turkish Society of Nuclear Medicine (TSNM), Turkish Society of Radiology (TSR), Turkish Dental Association (TDA) and Federation of Turkish Pathology Societies (TURKPATH) Cardiovascular System Study Group.

Turk Gogus Kalp Damar Cerrahisi Derg 2020 Jan 23;28(1):2-42. Epub 2020 Jan 23.

Infective Endocarditis and Other Cardiovascular Infections Study Group.

Infective endocarditis (IE) is rare, but associated with significant morbidity and mortality rates. Estimates of the incidence of IE in Turkey are compromised by the absence of population-based prospective studies. Due to the frequent presence of predisposing cardiac conditions and higher rates of nosocomial bacteremia in highrisk groups, the incidence of IE is expected to be higher in Turkey. Additionally, while IE generally affects older people in developed countries, it still affects young people in Turkey. In order to reduce the mortality and morbidity, it is critical to diagnose the IE to determine the causative agent and to start treatment rapidly. However, most of the patients cannot be diagnosed in their first visits, about half of them can be diagnosed after three months, and the disease often goes unnoticed. In patients diagnosed with IE, the rate of identification of causative organisms is significantly lower in Turkey than in developed countries. Furthermore, most of the centers do not perform some essential microbiological diagnostic tests as a routine practice. Some antimicrobials that are recommended as the first-line of treatment for IE, particularly antistaphylococcal penicillins, are not available in Turkey. These problems necessitate reviewing the epidemiological, laboratory, and clinical characteristics of IE in our country, as well as the current information about its diagnosis, treatment, and prevention together with local data. Physicians can follow patients with IE in many specialties. Diagnosis and treatment processes of IE should be standardized at every stage so that management of IE, a setting in which many physicians are involved, can always be in line with current recommendations. Study Group for Infective Endocarditis and Other Cardiovascular Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases has called for collaboration of the relevant specialist organizations to establish a consensus report on the diagnosis, treatment, and prevention of IE in the light of current information and local data in Turkey.
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http://dx.doi.org/10.5606/tgkdc.dergisi.2020.01954DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067027PMC
January 2020

Diagnosis, treatment and prevention of infective endocarditis: Turkish consensus report-2019.

Turk Kardiyol Dern Ars 2020 03;48(2):187-226

Turkish Society of Clinical Microbiology and Infectious Diseases, Infective Endocarditis and Other Cardiovascular Infections Study Grup (Istanbul University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Resarch Hospital, Başkent University, İstanbul Medeniyet University, Ankara University, Kartal Koşuyolu High Speciality Training and Research Hospital, Kırşehir Ahi Evran University, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Bezmiâlem Vakıf University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Resarch Hospital, Ankara City Hospital, Marmara University, Uludağ University, Yozgat Bozok University, Göztepe Training and Research Hospital), İstanbul, Turkey.

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http://dx.doi.org/10.5543/tkda.2020.89689DOI Listing
March 2020

The Karaman score: A new diagnostic score for acute appendicitis.

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):545-551

Department of General Surgery, Sakarya University Training and Research Hospital, Sakarya, Turkey.

Background: The Karaman score is a novel diagnostic scoring system consisting of 6 parameters. The aim of the present study was to assess the diagnostic performance of the Karaman score in comparison with the Alvarado score.

Methods: A total of 200 patients who underwent an appendectomy were enrolled in the study (research registry number: 2290).

Results: The cutoff threshold of the Karaman score in distinguishing acute appendicitis from negative appendectomy was ≥9 with 84.3% sensitivity, 64.7% specificity, 92.1% positive predictive value (PPV), and 45.8% negative predictive value (NPV). The cutoff threshold of the Alvarado score in distinguishing acute appendicitis from negative appendectomy was ≥8 with 72.9% sensitivity, 70.6% specificity, 92.4% PPV, and 34.8% NPV. In multivariate logistic regression analysis, an Alvarado ≥8 score (Odds ratio [OR]:6.644, 95% confidence interval [CI]: 2.854-15.466; p<0.001) and a Karaman ≥9 score (OR:10.374, 95% CI: 4.383-24.558; p<0.001) were each individually predictive in distinguishing acute appendicitis from negative appendectomy when correction was made according to age and gender. However, when both scores were evaluated together, the Alvarado score ≥8 lost its efficacy (OR:1.838, 95% CI: 0.517-6.530; p=0.347), whereas the Karaman score ≥9 retained its predictive power (OR:6.586, 95% CI: 1.893-22.917; p=0.003).

Conclusion: The Karaman score was more predictive than the Alvarado score in distinguishing acute appendicitis from a negative appendectomy.
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http://dx.doi.org/10.5505/tjtes.2018.62436DOI Listing
November 2018

Pyogenic liver abscess after laparoscopic sleeve gastrectomy.

Pak J Med Sci 2018 May-Jun;34(3):767-769

Dr. Kerem Karaman, Associate Professor, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.

An infected material in the gastrosplenic area after laparoscopic sleeve gastrectomy (LSG) due to hematoma or staple line leak has the potential to spread of the bacterial content to the liver which can result in pyogenic liver abscess. Presently described is a thirty-seven-year-old female patient with unilocular pyogenic liver abscess two weeks after LSG. The abscess resolved by Ultrasound guided percutaneous drainage plus intravenous antibiotic treatment. Review of the literature regarding 3 other cases with liver abscess after LSG is also presented.
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http://dx.doi.org/10.12669/pjms.343.14409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041545PMC
July 2018

Cation-Eutectic Transition via Sublattice Melting in CuInPS/InPS van der Waals Layered Crystals.

ACS Nano 2017 07 14;11(7):7060-7073. Epub 2017 Jul 14.

School of Chemical & Biomolecular Engineering, Georgia Institute of Engineering , 311 Ferst Drive NW, Atlanta, Georgia 30332, United States.

Single crystals of the van der Waals layered ferrielectric material CuInPS spontaneously phase separate when synthesized with Cu deficiency. Here we identify a route to form and tune intralayer heterostructures between the corresponding ferrielectric (CuInPS) and paraelectric (InPS) phases through control of chemical phase separation. We conclusively demonstrate that Cu-deficient CuInPS forms a single phase at high temperature. We also identify the mechanism by which the phase separation proceeds upon cooling. Above 500 K both Cu and In become mobile, while PS anions maintain their structure. We therefore propose that this transition can be understood as eutectic melting on the cation sublattice. Such a model suggests that the transition temperature for the melting process is relatively low because it requires only a partial reorganization of the crystal lattice. As a result, varying the cooling rate through the phase transition controls the lateral extent of chemical domains over several decades in size. At the fastest cooling rate, the dimensional confinement of the ferrielectric CuInPS phase to nanoscale dimensions suppresses ferrielectric ordering due to the intrinsic ferroelectric size effect. Intralayer heterostructures can be formed, destroyed, and re-formed by thermal cycling, thus enabling the possibility of finely tuned ferroic structures that can potentially be optimized for specific device architectures.
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http://dx.doi.org/10.1021/acsnano.7b02695DOI Listing
July 2017

Tuning the properties of metal-organic framework nodes as supports of single-site iridium catalysts: node modification by atomic layer deposition of aluminium.

Faraday Discuss 2017 09;201:195-206

Department of Chemical Engineering, University of California, Davis, California 95616, USA.

The metal-organic framework NU-1000, with Zr-oxo, hydroxo, and aqua nodes, was modified by incorporation of hydroxylated Al(iii) ions by ALD-like chemistry with [Al(CH)(iso-propoxide)] followed by steam (ALD = atomic layer deposition). Al ions were installed to the extent of approximately 7 per node. Single-site iridium diethylene complexes were anchored to the nodes of the modified and unmodified MOFs by reaction with Ir(CH)(acac) (acac = acetylacetonate) and converted to Ir(CO) complexes by treatment with CO. Infrared spectra of these supported complexes show that incorporation of Al weakened the electron donor tendency of the MOF. Correspondingly, the catalytic activity of the initial supported iridium complexes for ethylene hydrogenation increased, as did the selectivity for ethylene dimerization. The results of density functional theory calculations with a simplified model of the nodes incorporating Al(iii) ions are in qualitative agreement with some catalyst performance data.
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http://dx.doi.org/10.1039/c7fd00031fDOI Listing
September 2017

Uptake of an Acrochordon Incidentally Detected on 68Ga Prostate-Specific Membrane Antigen PET/CT.

Clin Nucl Med 2017 Jun;42(6):461-462

From the Departments of *Nuclear Medicine, and †Dermatology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Ga prostate-specific membrane antigen (PSMA) PET/CT is a promising tool for imaging of prostate cancer. Ga-PSMA PET/CT uptake of prostate cancer and its metastases are reflective of significant overexpression of PSMA. However, PSMA expression of benign neoplasms and nonprostate epithelial malignancies is not very well defined. We report a moderate Ga-PSMA uptake of an acrochordon (skin tag), which was incidentally found in a patient referred for staging prostate cancer. Acrochordon is a frequent, small, soft, skin-colored or hyperpigmented, benign, and usually pedunculated neoplasm of the skin. Nuclear medicine physicians should be aware of it while reporting a Ga-PSMA PET/CT.
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http://dx.doi.org/10.1097/RLU.0000000000001650DOI Listing
June 2017

Comparison of two procedures for symptomatic hemorrhoidal disease: Ligation under Vision and Ferguson Hemorrhoidectomy - a retrospective cohort study.

Pak J Med Sci 2017 Jan-Feb;33(1):90-95

Prof. Fehmi Celebi, Department of General Surgery, Sakarya University Teaching and Research Hospital, Sakarya, Turkey.

Objective: To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes.

Methods: Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position.

Results: In a mean postoperative follow-up period of 51.76+/-22.3 months; ectropion, anal fissure, and anal incontinence were the most frequent complications. The overall complication rate was significantly less after LUV than FH, (6.7% . 14.2%, =0.047). The complication rate and need for a second or third surgery did not significantly differ between the two procedures with the increase in affected quadrants (>0.05). The visual analog scale (VAS) at 24 hours was similar in both groups (=0.267).

Conclusions: LUV is a safe, and practical procedure with similar outcomes compared to FH. LUV may be a better choice than excisional hemorrhoidectomies when three or four quadrants of the anal canal are involved with hemorrhoids as this reduces mucosal defect related possible complications such as ectropion and anal stenosis.
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http://dx.doi.org/10.12669/pjms.331.11266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368337PMC
April 2017

The Association of Oral Vitamin D and Calcium Supplementation With Bone Mineral Density in Pediatric Acute Lymphoblastic Leukemia Patients.

J Pediatr Hematol Oncol 2017 05;39(4):287-292

Departments of *Pediatric Hematology †Biochemistry ‡Nuclear Medicine, Kocaeli University, Kocaeli, Turkey.

Aim: To investigate the association of calcium (Ca) and vitamin D (vit D) supplementation with bone mineral density (BMD) in pediatric acute lymphoblastic leukemia (ALL).

Materials And Methods: Group I (n=11): de novo ALL patients aged 1 to 18 years. Group II (n=46): pediatric ALL survivors in first complete remission and ALL patients on maintenance chemotherapy. We stratified group II into 3 subgroups according to the postdiagnosis period (group IIa: 8 to 24 mo, group IIb: 24 to 48 mo, group IIc: >48 mo). Group III (n=22): healthy siblings of group II. Daily oral vit D3 and Ca carbonate was given only to group I. In group I, BMD was measured at diagnosis and after completion of intensive chemotherapy (TP1 and TP2).

Results: A significant increase in Ca (P=0.024) and 25-OH vit D (P=0.01), and a decrease in magnesium (P=0.023) were detected at TP2 compared with TP1 in group I. Mean plasma levels of 25-OH vit D were <20 ng/mL in all the groups. Total body (P=0.005), total body less head (P=0.005), and L1 to L4 BMD Z scores (P=0.025) decreased significantly at TP2 compared with TP1. The lowest BMD scores were found at 8 to 24 months after diagnosis in unsupplemented patients. A gradual increase in BMD Z scores was shown, with the highest scores in group IIc.

Conclusion: Vit D and Ca supplementation in pediatric ALL patients during intensive chemotherapy may not prevent bone mineral loss. BMD scores of pediatric ALL patients described by other studies, as a major decrease in the first 2 years and gradual increase afterward, was also observed in our patients.
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http://dx.doi.org/10.1097/MPH.0000000000000797DOI Listing
May 2017

Prognostic factors and treatment results of pediatric Hodgkin's lymphoma: A single center experience.

Turk J Pediatr 2015 Jul-Aug;57(4):359-66

Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey.

The aim of this study was to assess the demographic, clinic data, prognostic factors and treatment/follow-up results of children who were diagnosed with Hodgkin lymphoma and followed in our center of Pediatric Oncology, Kocaeli University Medical Faculty, Kocaeli, Turkey, for 10 years. This retrospective study evaluated 41 patients with Hodgkin lymphoma who were younger than 18 years-old. All patients were treated with risked adapted ABVD (Adriamycin, Bleomycin, Vincristine, Dacarbazine) chemotherapy and also received involved field radiotherapy. Thirty-two patients (78%) were males and 9 (22%) were females, with a mean age of 10.7±4.0 years. The histopathological diagnosis was mixed cellular type in 51.2% of the patients. B symptoms (unexplained fever, unexplained weight loss, drenching night sweats) were present in 53.7% of the patients and 36.6% of the patients were at advanced stage at the time of the diagnosis. The 3-year overall and event-free survival rates were 88% and 5-year overall and event-free survival rates were 88%, 78%. Age, stage, treatment risk groups, presence of B symptoms and hematological parameters had no significant effect on overall and event-free survival in univariate analysis while bulky disease was the only significant factor on overall survival. Our treatment policy was succesful regarding the similar survival rates in the treatment risk groups, however novel treatment strategies adopting the early response with the reduction of adverse effects are planned in the near future.
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February 2017

High-Tc Layered Ferrielectric Crystals by Coherent Spinodal Decomposition.

ACS Nano 2015 Dec 20;9(12):12365-73. Epub 2015 Nov 20.

School of Chemical & Biomolecular Engineering, Georgia Institute of Technology , 311 Ferst Drive NW, Atlanta, Georgia 30332, United States.

Research in the rapidly developing field of 2D electronic materials has thus far been focused on metallic and semiconducting materials. However, complementary dielectric materials such as nonlinear dielectrics are needed to enable realistic device architectures. Candidate materials require tunable dielectric properties and pathways for heterostructure assembly. Here we report on a family of cation-deficient transition metal thiophosphates whose unique chemistry makes them a viable prospect for these applications. In these materials, naturally occurring ferrielectric heterostructures composed of centrosymmetric In4/3P2S6 and ferrielectrically active CuInP2S6 are realized by controllable chemical phase separation in van der Waals bonded single crystals. CuInP2S6 by itself is a layered ferrielectric with a ferrielectric transition temperature (Tc) just over room temperature, which rapidly decreases with homogeneous doping. Surprisingly, in our composite materials, the ferrielectric Tc of the polar CuInP2S6 phase increases. This effect is enabled by unique spinodal decomposition that retains the overall van der Waals layered morphology of the crystal, but chemically separates CuInP2S6 and In4/3P2S6 within each layer. The average spatial periodicity of the distinct chemical phases can be finely controlled by altering the composition and/or synthesis conditions. One intriguing prospect for such layered spinodal alloys is large volume synthesis of 2D in-plane heterostructures with periodically alternating polar and nonpolar phases.
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http://dx.doi.org/10.1021/acsnano.5b05682DOI Listing
December 2015

Inappropriate combination of warfarin and aspirin.

Anatol J Cardiol 2016 Mar 24;16(3):189-96. Epub 2015 Apr 24.

Department of Cardiology, Kocaeli Derince Training and Research Hospital; Kocaeli-Turkey.

Objective: A combination of warfarin and aspirin is associated with increased bleeding compared with warfarin monotherapy. The aim of the study was to investigate the incidence and appropriateness of the combination of warfarin and aspirin in patients with atrial fibrillation (AF) or mechanical heart valve (MHV).

Methods: This cross-sectional study included consecutive patients with AF or MHV on chronic warfarin therapy (>3 months) without acute coronary syndrome or have not undergone a revascularization procedure in the preceding year. Medical history, concomitant diseases, and treatment data were acquired through patient interviews and from hospital records.

Results: Three hundred and sixty patients (213 with AF, 147 with MHV) were included. In those with AF, a significantly higher warfarin-aspirin combination was observed with concomitant vascular disease (38.8% vs. 14.6%), diabetes (36.6% vs. 16.3%), statin therapy (40% vs. 16.9%), left ventricular systolic dysfunction (33.3% vs. 17.5%) (p<0.05 for all). The use of combination therapy was similar between different CHADS-VASc scores. In patients with MHV, higher combination therapy was observed in males (41% vs. 26.7% in females; p=0.070), concomitant vascular disease (47.8% vs. 29.8%; p=0.091), and AF (56.3% vs. 29.8%; p=0.033). Independent predictors of warfarin-aspirin combination were concomitant vascular disease, diabetes, and (younger) age in patients with AF and were concomitant AF and male sex in patients with MHV. Interestingly, the incidence of combination therapy was found to increase with a higher HAS-BLED score in both patients with AF and MHV (p<0.001).

Conclusion: The combination of warfarin and aspirin was found to be prescribed to patients with AF mainly for the prevention of cardiovascular events, for which warfarin monotherapy usually suffices. On the other hand, co-treatment with aspirin appeared to be underused in patients with MHV.
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http://dx.doi.org/10.5152/akd.2015.6050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336805PMC
March 2016

Transomental prolapse of Meckel's diverticulum.

Am Surg 2015 Jan;81(1):E14-5

Department of General Surgery, Sakarya University, Faculty of Medicine, Sakarya, Turkey.

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January 2015

Retroanastomotic hernia after Moynihan's gastroenterostomy.

World J Gastrointest Surg 2014 Sep;6(9):187-9

Kerem Karaman, Metin Ercan, Fatih Altintoprak, Department of General Surgery, Faculty of Medicine, Sakarya University, Serdivan 54130, Sakarya, Turkey.

Retroanastomotic hernias after gastroenterostomies-either antecolic or retrocolic-are extremely rare but are associated with high mortality rates due to delayed identification which precludes immediate surgical reduction. In this report, we present a 77-year-old man with retroanastomotic herniation of the efferent loop segments that occurred 14 years after a Moynihan's gastroenterostomy.
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http://dx.doi.org/10.4240/wjgs.v6.i9.187DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176780PMC
September 2014

Pulmonary 18F-FDG microembolism detected on only delayed image in a PET/CT study.

Clin Nucl Med 2015 Mar;40(3):253-5

From the Department of Nuclear Medicine, Kocaeli University School of Medicine, Kocaeli, Turkey.

Focal 18F-FDG pulmonary uptake on PET without corresponding abnormality on CT is an incidental and rare finding. This artifact is associated with iatrogenic FDG microembolus as a result of vascular endothelium damage during injection. We present a pulmonary FDG microembolus in a patient evaluated for suspicion of gallbladder cancer not in early (standard 1-hour imaging after FDG injection) but in delayed image. To our knowledge, this is the first case that describes the possibility of FDG microembolism on only delayed image in a PET/CT study.
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http://dx.doi.org/10.1097/RLU.0000000000000585DOI Listing
March 2015

Bone and lymph node metastases from neuroblastoma detected by (18)F-DOPA-PET/CT and confirmed by posttherapy (131)I-MIBG but negative on diagnostic (123)I-MIBG scan.

Clin Nucl Med 2014 Jul;39(7):673

Department of Pediatric Hematology/Oncology, Kocaeli University School of Medicine, Kocaeli, Turkey, E-mail: Department of Nuclear Medicine, Kocaeli University School of Medicine, Kocaeli, Turkey Department of Pediatric Hematology/Oncology, Kocaeli University School of Medicine, Kocaeli, Turkey.

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http://dx.doi.org/10.1097/RLU.0000000000000475DOI Listing
July 2014

Indirect inguinal hernia sac containing testis and spermatic cord in an adult patient with cryptorchidism.

J Surg Case Rep 2014 Mar 7;2014(3). Epub 2014 Mar 7.

Department of General Surgery, Sakarya Teaching and Research Hospital, Sakarya, Turkey.

Sliding hernias are those in which part of the sac wall is formed by a retroperitoneal organ and/or its mesentery protruding outside the abdominal wall cavity. The hernia sac may contain jejunum, ileum, vermiform appendix, Meckel's diverticulum, stomach, ovary, fallopian tube or urinary bladder. Our report features an adult case with cryptorchidism in which testis and spermatic cord constitute a component of the indirect inguinal hernia sac.
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http://dx.doi.org/10.1093/jscr/rju017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197921PMC
March 2014

Correlation of Cystatin-C and radionuclidic measurement method of glomerular filtration rate in patients with lung cancer receiving cisplatin treatment.

Ren Fail 2014 Aug 21;36(7):1043-50. Epub 2014 May 21.

Department of Nuclear Medicine and.

Objective: Cisplatin is a chemotherapeutic agent which affects renal functions adversely. The best indicator of renal functions is glomerular filtration rate (GFR) measurement. Cystatin-C appears to be a good alternative to existing methods of measuring GFR. However, it is controversial whether Cystatin-C demonstrates GFR correctly for patients receiving chemotherapy. This study aimed to investigate the correlation between GFR values calculated by Cystatin-C based formulas, radionuclidic method (multiple blood sampling) and blood Cystatin-C values in patients with lung cancer, receiving cisplatin treatment in both pre-treatment and post-treatment periods.

Materials And Methods: Thirty-six patients with lung cancer who were going to receive cisplatin treatment were included in this study. However, the evaluation was performed with 20 patients since 16 of them could not complete the treatment. Blood Cystatin-C values, GFR values calculated via Cystatin-C based formulas, and radionuclidic method were investigated before and after the cisplatin treatment.

Results: After treatment significant decreases were detected in GFR values, obtained via radionuclidic measuring method. However, there was no significant difference in Cystatin-C values between pre-treatment and post-treatment periods. Also GFR values obtained by Cystatin-C based formulas were not significantly different in pre-treatment and post-treatment periods. There were meaningful correlations between radionuclidic method and Cystatin-C values and Cystatin-C based formulas before treatment. However, all correlations disappeared after the treatment.

Conclusion: GFR values, calculated by Cystatin-C may not be reliable in following renal functions in patients receiving chemotherapy. When reliable monitoring of the renal functions is necessary radionuclidic method may be preferred in these patients.
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http://dx.doi.org/10.3109/0886022X.2014.918813DOI Listing
August 2014

Low radioiodine uptake in congestive heart failure.

Nucl Med Commun 2014 Jun;35(6):643-8

Departments of aNuclear Medicine bCardiology, Kocaeli University School of Medicine, Kocaeli, Turkey cDepartment of Radiology, Oregon Health and Science University, Portland, Oregon, USA.

Objectives: Our aim was to compare the radioiodine uptake (RAIU) of congestive heart failure (CHF) patients with that of a control group and investigate the prognostic value. We also assessed correlations of RAIU with other clinical parameters.

Methods: A total of 32 CHF patients and 14 controls were included in this study. RAIU was measured at the fourth and 24th hour using an uptake probe. The patients were followed up for a mean period of 32.09±8 months.

Results: The mean fourth-hour RAIU was 6.28±5.51 and the mean 24th-hour RAIU was 14.43±9.49 in the patient group. The mean fourth and 24th hour RAIUs of the control group were 9.93±1.92 and 22.90±5.89, respectively, which were statistically higher than that of the patient group (P=0.0001 and 0.001, respectively).Cardiac death occurred in nine patients during follow-up. The fourth and 24th hour uptake ratios were statistically significantly lower in the cardiac death group compared with the no-death group (3±2.01 vs. 7.57±5.93 and 7.39±7.34 vs. 17.18±8.9, respectively; P=0.003 and 0.007). On stepwise multivariate Cox regression analyses, only urea proved to be a significant independent predictor of cardiac death (hazard ratio 1.021; 95% confidence interval 1.005-1.037; P<0.008). Significant negative correlations were found between the fourth and 24th hour RAIUs and high-sensitivity C-reactive protein, urea, and creatinine levels, but no correlation was found between RAIUs and estimated glomerular filtration rate.

Conclusion: CHF patients have lower RAIU values probably because of an expanded iodine pool and prolonged Wolff-Chaikoff effect. Also, patients who died during follow-up had lower RAIU values, but RAIU did not emerge as an independent predictor of death. However, studies with larger patient groups are definitely needed.
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http://dx.doi.org/10.1097/MNM.0000000000000099DOI Listing
June 2014

Long-term results of endoscopic resection for type I gastric neuroendocrine tumors.

J Surg Oncol 2014 Feb 25;109(2):71-4. Epub 2013 Oct 25.

Division of Gastroenterology, Gulhane Military Medical Academy, Ankara, Turkey.

Background: A number of different therapies, including endoscopic resection, have been suggested for the treatment of Type 1 gastric neuroendocrine tumors (NETs). The current study aimed to determine the long-term efficacy of endoscopic resection for Type 1 gastric NETs.

Methods: Twenty-two patients (from 1999 to 2012) with Type 1 gastric NETs were included in the study. All patients were treated with endoscopic resection and received regular followed-up appointments at a tertiary referral center.

Results: All patients were initially diagnosed with hypergastrinemia, atrophic gastritis and intestinal metaplasia. Polyps' diameters were >1 cm in 4 patients, and between 0.5 and 1 cm in 18 patients. All detectable lesions were successfully resected. One patient required surgery due to gastric perforation during endoscopic mucosal resection. Recurrence was detected in four patients (18%) and endoscopic resection was performed again. Local or distant metastasis was not observed in any patient during follow-up. Median follow-up time was 7 years, with a maximum of 14 years. Seventeen patients (78%) completed a 5-year follow-up period, and overall disease-free survival rate was 100%.

Conclusions: Long-term follow-ups with 22 patients suggest that endoscopic resection of Type 1 gastric NETs is a safe and effective treatment option with a relatively low recurrence rate.
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http://dx.doi.org/10.1002/jso.23477DOI Listing
February 2014

Reduced heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT.

Ann Nucl Med 2012 Oct 20;26(8):609-15. Epub 2012 Jun 20.

Department of Nuclear Medicine, Kocaeli University School of Medicine, Umuttepe, Kocaeli, 41380, Turkey.

Objective: A mild decrease in blood pressure and increase in heart rate (HR) are considered normal hemodynamic responses to dipyridamole. In this study, we tried to investigate HR response to dipyridamole and its predictors in patients undergoing gated myocardial perfusion single photon emission computed tomography (SPECT).

Methods: 201 consecutive patients undergoing dipyridamole stress Tc99m-MIBI or Tl-201 gated myocardial perfusion SPECT were prospectively enrolled. Dipyridamole was infused over 4 min and radiopharmaceutical was injected 3 min after the end of infusion. A reduced heart rate response to dipyridamole considered if the HR ratio (peak HR/rest HR) was 1.20 or less. Stress (sLVEF), rest (rLVEF) left ventricular ejection fractions, stress and rest motion (SMS, RMS) and thickening scores (STS, RTS) were derived automatically by QGS. Summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) for myocardial perfusion were calculated. Patients were grouped according to HR response and groups were compared. A logistic regression analysis was used to determine independent predictors of reduced HR response.

Results: Reduced HR response was found in 78 % of patients. Patients with abnormal HR response were more frequently had a history of diabetes mellitus, chronic renal failure, and had lower high-density lipoprotein (HDL) levels. Peak HR, SSS, SRS, sLVEF and rLVEF were lower; rest HR, RTS, and the number of patients with ≤ 45 % sLVEF and rLVEF were higher in reduced HR response group (all p < 0.05). There was no difference between groups by means of gender, rest and peak systolic or diastolic tension, SDS, SMS, STS, RMS, history of hypertension, peripheral arterial disease, metabolic syndrome, coronary interventions, digoxin, calcium channel blocker or beta blocker usage. Multivariable logistic regression analysis demonstrated that the independent predictors of reduced HR response were HDL, rest HR and SSS. When HDL was removed from the model, chronic renal failure also emerged as an independent predictor.

Conclusion: Reduced HR response to dipyridamole is associated with ventricular dysfunction, cardiac autonomic neuropathy. Low HDL levels also seem to be related with reduced HR response.
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http://dx.doi.org/10.1007/s12149-012-0618-zDOI Listing
October 2012

Radioiodine therapy in Graves' disease: is it possible to predict outcome before therapy?

Nucl Med Commun 2012 Aug;33(8):859-63

Department of Nuclear Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.

Objective: To assess the predictability of outcome and evaluate the factors that may lead to treatment failure in patients with Graves' disease who are treated with a single dose of radioiodine.

Materials And Methods: This is a retrospective study of 123 patients (M: 42; F: 81) with Graves' disease who received radioiodine therapy with a single fixed (10 mCi) dose for hyperthyroidism. Pretreatment age, sex, BMI, type of anti-thyroid drug used, propylthiouracil doses, iodine uptake, uptake ratio (4/24 h radioiodine uptake), and thyroid volume of the patients in whom radioiodine therapy succeeded or failed were compared.

Results: Post-therapy follow-up revealed that therapy failed in 22% of the patients. Iodine uptakes and uptake ratios and volumes were found to be significantly higher in patients in whom therapy failed. It was observed that uptake ratio was at least 1 in 25 patients (20%), and therapy failed in 20 (80%) of these patients. Of the 98 patients (80%) in whom uptake ratio was less than 1, therapy was unsuccessful in only seven (7%).

Conclusion: Uptake ratio is a simple index that may be used to predict the patients in whom therapy may fail or succeed. In patients with Graves' disease who have an uptake ratio of less than 1, radioiodine appears to be an effective dose with high success rates. In contrast, because of the high rates of failure in patients with an uptake ratio of at least 1, use of radioiodine therapy at a dose of 10 mCi does not seem to be appropriate.
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http://dx.doi.org/10.1097/MNM.0b013e3283559ba1DOI Listing
August 2012

Graves' disease in a patient with ectopic mediastinal thyroid.

Clin Nucl Med 2011 Nov;36(11):1039-40

Department of Nuclear Medicine, Kocaeli University School of Medicine, Kocaeli, Turkey.

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http://dx.doi.org/10.1097/RLU.0b013e3182291c15DOI Listing
November 2011

Sentinel lymph node biopsy with a gamma probe in patients with high-risk cutaneous squamous cell carcinoma: follow-up results of sentinel lymph node-negative patients.

Nucl Med Commun 2011 Dec;32(12):1216-22

Departments of Nuclear Medicine, Kocaeli University School of Medicine, Umuttepe, Turkey.

Objective: Lymphoscintigraphy (LS) and sentinel lymph node biopsy have become the standard of care for melanoma and breast cancer. However, the data on patients with cutaneous squamous cell carcinoma (SCC) are limited. We aimed to evaluate and identify the role of LS and sentinel lymph node biopsy in patients with high-risk cutaneous SCC.

Methods: Nineteen patients (13 men, six women; 47-87 years of age, mean age 67.5 ± 12.3) with SCC were included in the study. LS was performed on all patients after intracutaneous injection of Tc-99m nanocolloid. Primary lesions and sentinel lymph nodes (SLNs) were excised with the help of a gamma probe.

Results: A total of 26 SLNs and 32 secondary lymph nodes were imaged on LS and were marked. During surgery, 29 SLNs, 21 secondary lymph nodes and three nonactive lymph nodes were excised. In total, 53 lymph nodes were removed surgically. A histopathological study revealed that all lymph nodes were negative for metastasis. Patients were followed up for an average of 41.1 ± 22.2 months (7-80 months). Until the time of data collection, 14 patients were alive and had no regional lymph node or distant metastasis. Local recurrence was seen in only one patient. He was reoperated upon 38 months ago.

Conclusion: The feasibility of determining SLNs using LS and an intraoperative gamma probe in patients with cutaneous SCC was shown. Unnecessary elective lymph node dissection and possible complications could be avoided in 19 patients.
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http://dx.doi.org/10.1097/MNM.0b013e32834b76cfDOI Listing
December 2011

Peel bond strength of two silicone soft liners to a heat-cured denture base resin.

J Adhes Dent 2011 Dec;13(6):579-84

Department of Prosthodontics, Cumhuriyet University, Sivas, Turkey.

Purpose: This study investigated the peel strength of two different soft liners to a polymethylmethacrylate (PMMA) denture base resin before and after thermocycling.

Materials And Methods: The silicone-based soft liner materials tested were Molloplast B and Permaflex; the denture base material was a heat-cured acrylic resin, Meliodent. A total of 40 specimens was prepared using rectangular molds with dimensions of 100 x 10 x 2 mm for PMMA and 150 x 10 x 2 mm for soft liners, as described in ASTM-D903-93. For each of the liner materials, 10 specimens were packed against a cured PMMA denture base surface as recommended by the manufacturers. The other 10 specimens were packed against PMMA denture base dough and processed together. In each group, 5 of the specimens were tested directly, while the other 5 were thermocycled in a water bath (5°C to 55°C; 3000 cycles) before testing. Peel testing was performed using an Instron testing machine.

Results: The results revealed that peel strength values of the Permaflex specimens prepared according to the manufacturer's recommendations were significantly higher than those of Molloplast B (p < 0.05). However, when packing was done against uncured PMMA dough, the difference between the specimens of two liners was not significant. Thermocycling led to significant decreases in the peel strength of both Permaflex liner specimens packed against cured/uncured PMMA resin surfaces (p < 0.05), whereas this process did not affect the strength of Molloplast B specimens.

Conclusion: Results indicated that the material Molloplast B was superior to the material Permaflex in terms of peel strength when the specimens were simultaneously polymerized with PMMA and thermocycled.
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http://dx.doi.org/10.3290/j.jad.a21851DOI Listing
December 2011

The bond strength of a highly cross-linked denture tooth to denture base polymers: a comparative study.

J Adhes Dent 2011 Feb;13(1):85-92

Department of Prosthodontics, Faculty oF Dentistry, Gazi University, Ankara, Turkey.

Purpose: This study compared shear bond strength and type of bond failure between a highly cross-linked tooth and different denture base polymers.

Materials And Methods: Cross-linked denture teeth were bonded to either a heat-, an auto-, a microwave-polymerized denture base resin or a relatively new injection-molded, microwave-polymerizable polyurethane-based resin. Six experimental groups were established for each of the shear and peel tests. In four of the groups, teeth were used as received and bonded to each of the denture base resins; in the remaining two groups, they were treated with dichloromethane to determine its effect on the bonding with heat or auto-polymerized denture base resins. Bond strength was determined by compressive load applied at 45 degrees on the palatal surface of each tooth until fracture; the type of bond failure was assessed by the peel test.

Results: The results showed that heat-cured PMMA groups failed cohesively and demonstrated significantly higher bond strengths than the other resins used. The application of dichloromethane on the ridge lap areas of teeth resulted in a significant improvement of bond strengths in heat- and auto-cured resins.

Conclusion: Within the limitations of this experimental study, the results suggest that type of denture base material and processing methods may have an influence upon the bond strength between interpenetrating polymer network (IPN) denture teeth and base materials. Treatment of denture teeth with dichloromethane could provide substantial improvement in the bond strength of teeth with heat and auto-cured denture base resins; however, this finding should be validated in further investigations on the long-term effect of such treatment on the bond strength.
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http://dx.doi.org/10.3290/j.jad.a18241DOI Listing
February 2011

Effect of maleic anhydride pretreatment on tensile bond strength of a silicone soft liner to a denture base polymer.

J Adhes Dent 2011 Oct;13(5):481-7

Department of Prosthodontics, Cum huriyet University, Sivas, Turkey.

Purpose: To determine the effect of resin surface treatment with dissolved maleic anhydride in butanone added into primer on the tensile bond strength between an acrylic denture base resin and a silicone soft liner.

Materials And Methods: To test tensile bond strength, standard dumbbell-shaped acrylic specimens were prepared. Five experimental groups, including the control, were tested (n = 5). Maleic anhydride solutions prepared in butanone at concentrations of 1%, 5%, 10% or 20% were then mixed with 1 ml of Primo adhesive and the mixtures were applied onto the resin bonding surfaces. Silicone liner material was applied to resin surfaces in the conventional manner. Tensile bond strength of the specimens was measured in a universal testing machine. Fractured surfaces were observed under the scanning electron microscope, and resulting chemical changes with the solutions used were analyzed spectroscopically.

Results: The highest bond strength value was obtained for the group treated with 5% maleic anhydride (2.53 ± 0.48 MPa); the lowest value was for the group treated with 20% maleic anhydride (1.59 ± 0.29 MPa). Mixed failure was the dominant type seen in the experimental groups. Spectroscopic analysis showed the interaction of the anhydride carbonyl groups with the Primo primer.

Conclusion: The treatment of resin surfaces with maleic anhydride added to Primo adhesive effectively increased bond strength between silicone soft liner and denture base resin.
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http://dx.doi.org/10.3290/j.jad.a19817DOI Listing
October 2011

Obesity control and low protein diet preserve or even improve renal functions in Bardet-Biedl syndrome: a report of two cases.

Med Sci Monit 2011 Jan;17(1):CS12-14

Department of Nephrology, School of Medicine, Kocaeli University, Kocaeli, Turkey.

Background: Bardet-Biedl syndrome (BBS) is a rare autosomal-recessive disorder characterized by abdominal obesity, mental retardation, dysmorphic extremities, retinal dystrophy, hypogonadism, and kidney structural abnormalities or functional impairment. It is now considered a significant cause of chronic and end-stage renal disease in children. To the best of our knowledge there have been no previous studies on the role of diet in the management of renal functions in patients with BBS.

Case Reports: Two siblings, aged 32 and 27 years, with BBS are presented. On admission both patients were obese, with body mass indexes (BMI) of 40 and 39 kg/m2. Their creatinine clearances (CrCl) were 41 and 24 mL/min. After 2 years of follow-up with a diet consisting of 0.6 g/kg/day protein and 1400 kcal/day energy, their BMI's were decreased to 29 and 27 kg/m2, whereas their CrCl's were increased to 44 and 32 mL/min, respectively. 99mTc-MAG3 scintigraphy also revealed improved renal function.

Conclusions: Since this syndrome most likely results in end-stage renal disease, follow-up of renal dysfunction is essential. Low protein diet and/or obesity control may slow the progression of renal failure in patients with BBS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3524693PMC
http://dx.doi.org/10.12659/msm.881320DOI Listing
January 2011