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Clinical and hemodynamic profiles of elderly patients with pulmonary arterial hypertension： a single center, prospective study

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Journal of Geriatric Cardiology 2017年第1期14卷 20-27页

作者： Ebru Ozpelit Bahri Akdeniz Dilek Sezgin can sevinc Kemal can Tertemiz Mehmet Emre Ozpelit Mustafa Baris Nezihi Baris Department of Cardiology School of Medicine Dokuz Eylul University Izmir Turkey Department of lnternal Medicine Faculty of Nursing Dokuz Eylul University Izmir Turkey Department of Chest Disease School of Medicine Dokuz Eylul University Izmir Turkey Department of Cardiology Medicalpark Hospital Izmir Turkey Department of Radiology School of Medicine Dokuz Eylul University Izmir Turkey

Backgrounds Pulmonary arterial hypertension （PAH） was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. Methods In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger （18-65 years） and elderly （〉 65 years） patients with definitive diagnosis of precapillary PAIl were compared. Results A total of 119 patients were analyzed in this study; 43 were elderly （mean age： 71.5 ± 5.5 years）, while 76 were non-elderly （mean age 44.5 ±15.2 years）. During the mean follow-up duration of 26.8 ±25.0 months, 43 deaths occurred, 17 of which were among the elderly group, with 28 among non-elderly group. Comparison of baseline parameters showed that 6 min walking distance, hemoglobin levels, pulmonary artery pressures and pulmonary vascular resistance were significantly lower; and estimated glomerular filtration rate, body mass index, E/e＇ and pulmonary capillary wedge pressure were significantly higher in the elderly group than in the younger group. Survival analysis demonstrated that the independent predictors of death were tricuspid plane annular systolic excursion （TAPSE; HR： 1.272, 95% CI： 1.079-1.499, P = 0.004） and uric acid （HR： 1.291, 95% CI： 1.042-1.600, P = 0.019） in the elderly group. In contrast, in the non-elderly group, higher brain natriuretic peptide （HR： 1.002, 95% CI： 1.001-1.004, P 〈 0.001） and higher right atrial pressure （HR： 1.128, 95% CI： 1.026-1.241, P = 0.013） values were the only parameters associated with mortality. Conclusions Our data suggest that elderly PAH patients have a unique clinical and hemodynamic profile, with totally different prognostic markers compared to younger PAH patients.

关键词： Clinical characteristics Prognosis Pulmonary hypertension The elderly

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Outcome of penile prosthesis implantation： are malleable prostheses an appropriate treatment option in patients with erectile dysfunction caused by prior radical surgery？

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Asian Journal of Andrology 2017年第4期19卷 477-481页

作者： Cuneyd sevinc Orkunt Ozkaptan Muhsin Balaban Ugur Yucetas Tahir Karadeniz Department of Urology Medicana International Hospital Istanbu134521 Turkey Department of Urology Kolan International Hospital Istanbu134384 Turkey Department of Urology Istanbul Training and Research Hospital Istanbu 134098 Turkey

The aim of our study was to evaluate the outcome of penile prosthesis implantation in patients with various comorbidities as a cause of erectile dysfunction （ED）. The data of 181 patients who underwent surgery between 1998 and 2012 in two centers were evaluated. The mean age of the patients was 52.2 years （range： 31-71 years）. The study group contained 162 patients （89.5%） with malleable prostheses and 19 （10.5%） with inflatable implants. All patients were re-evaluated 1 month later to assess prosthesis function and complications, and further re-examinations were performed if needed. Satisfaction was defined as having satisfactory intercourse and happiness with the device in general. The follow-up period was at least 12 months for each patient. The postoperative complication rate was 32% （n = 58）. The number of complications with inflatable and malleable prostheses was 7 （3.9%） and 51 （28.1%）, respectively. Overall, 21 prostheses （11.6%） had to be removed because of various complications and patient dissatisfaction. Patients with prior radical surgery had higher extraction rates （n = 14.606, P 〈 0.05, Chi-square test）. The main reasons for removal were erosion （n = 11; 6.1%） and infection （n = 3; 2.1%）. With respect to satisfaction during intercourse, we found that 104 （57.5%） patients described themselves as very satisfied with the prosthesis, while 21 （11.6%） were unsatisfied. The high explantation rate in patients with prior surgery was remarkable in our study. Our results revealed that a malleable prosthesis should not be the preferred type of implant for patients with prior surgery.

关键词： erectile dysfunction erosion impotence penile prosthesis radical surgery satisfaction

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Early detection of response to imatinib therapy for gastrointestinal stromal tumor by using 18F-FDG-positron emission tomography and computed tomography imaging

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World Journal of Gastroenterology 2007年第15期13卷 2261-2262页

作者： Sabri Zincirkeser Alper sevinc M Emin Kalender Celalettin Camci Department of Nuclear Medicine Gaziantep University School of MedicineSahinbey Medical CenterGaziantep TR-27310Turkey Department of Medical Oncology Gaziantep University School of MedicineGaziantep Oncology HospitalGaziantep TR-27310Turkey

A 41-year old female with metastatic gastrointestinal stromal tumor was referred to 18F-FDG-positron emission tomography and computed tomography （PET/CT） scan before and after one-month treatment with imatinib （Glivec, Gleevec, Novartis, Basel, Switzerland）, a tyrosine kinase inhibitor （400 mg/d）. Metabolic response was evaluated before and after one month of therapy. The decrease of the maximum standardised uptake value （SUV） was 79% （from 9.8 to 2.1）. Positron emission tomography demonstrated complete metabolic response after one-month of imatinib treatment. Additionally, the previous lesion was compared with the coronal computerized tomographic image. There was no difference in the size of the tumor before and after therapy according to CT images. However, metabolic activity was inhibited. 18F-FDG-PEr is a valuable method for the detection of response to one-month imatinib treatment in patients with gastrointestinal stromal tumors.

关键词： 18F-fluorodeoxyglucose Positron emission tomography Computerized tomography Gastrointestinal stromal tumor Imatinib

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Effect of sunitinib on metastatic gastrointestinal stromal tumor in patients with neurofibromatosis type 1: A case report

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World Journal of Gastroenterology 2007年第18期13卷 2629-2632页

作者： M Emin Kalender Alper sevinc Ediz Tutar Akif Sirikci Celalettin Camci Department of Medical Oncology Gaziantep University School of Medicine Gaziantep Oncology Hospital Gaziantep TR-27310 Turkey Department of Pathology Gaziantep University School of Medicine Sahinbey Medical Center Gaziantep TR-27310 Turkey Department of Radiology Gaziantep University School of Medicine Sahinbey Medical Center Gaziantep TR-27310 Turkey

Gastrointestinal stromal tumor （GIST） represents the most common mesenchymal malignancy of the gastrointestinal （GI） tract. In neurofibromatosis （NF）, the increased incidence of tumor needs to be considered even in non-symptomatic individuals. Patients with neurofibromatosis NF type 1 have an increased risk of developing GI tumors including rare types such as GIST. We report a case of GIST in a 53-year-old male patient with neurofibromatosis. The patient was diagnosed with NF four years ago and his medical history revealed that he was hospitalized 5 times with a provisional diagnosis of massive lower gastrointestinal bleeding. GIST was diagnosed at explorative laparotomy and the tumor was 21 cm × 13 cm × 7 cm in size. Immunohistochemical examination showed that vimentin, actin and CDl17 were positive. Computerized tomography showed peritoneal implants three months later. Imatinib mesylate （600 mg/d） was initiated. However, control computerized tomography revealed liver and omental metastasis. The dosage was elevated to 800 mg/d. Despite high dosage, the progression of the metastatic lesions continued in the liver and omentum. The patient started oral sunitinib malate （Sutent~ Pfizer Inc, New York, NY, USA） 50 mg per day for 4 consecutive weeks, followed by 2 wk off per treatment cycle. The metastatic lesions in the liver and omentum were decreased in size after four courses, suggesting that sunitinib is also an effective treatment modality for metastatic GIST in NF patients.

关键词： Neurofibromatosis Gastrointestinal stromal tumors Imatinib Sunitinib

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Intraoperative acidosis is a new predictor for postoperative pancreatic fistula after pancreaticoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2016年第3期15卷 302-309页

作者： Erdem Kinaci Mert Mahsuni sevinc Abdulkerim Ozakay Savas Bayrak Ekrem Cakar Serkan Sari Istanbul Training and Research Hospital Department of General Surgery

BACKGROUND： Early diagnosis of postoperative pancreatic fistula （POPF） is important for proper interventions. The pre- operative, intraoperative and early postoperative biochemical markers have predictive value of ... 详细信息

关键词： acidosis fistula intraoperative predictor pancreaticoduodenectomy

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Effect of growth hormone on small intestinal homeostasis relation to cellular mediators IGF-I and IGFBP-3

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World Journal of Gastroenterology 2009年第43期15卷 5418-5424页

作者： Betul Ersoy Kemal Ozbilgin Erhun Kasirga sevinc Inan Senol Coskun Ibrahim Tuglu Division of Pediatric Endocrinology Department of PediatricsFaculty of MedicineCelal Bayar University Manisa 45010Turkey Department of Histology and Embryology Faculty of MedicineCelal Bayar UniversityManisa 45010 Turkey Division of Pediatric Gastroenterology De- partment of PediatricsFaculty of MedicineCelal Bayar UniversityManisa 45010Turkey Department of Histology and Embryology Faculty of MedicineCelal Bayar University Manisa 45010Turkey Department of Pediatrics Faculty of Medicine Celal Bayar UniversityManisa 45010Turkey

AIM:To evaluate the effects of growth hormone(GH) on the histology of small intestines which might be related to the role of insulin like growth factor(IGF)-I, IGF-binding protein 3(IGFBP-3)and its receptors. METHODS:Twelve week-old adult male Wistar albino rats were divided into two *** study group(n =10),received recombinant human growth hormone (rGH)at a dose of 2 mg/kg per day subcutaneously for 14 d and the control group(n=10)received physiologic *** sections of jejunum were stained with periodic acid shift(PAS)and hematoxylin and eosin(HE) for light *** were also examined for IGF-I, IGFBP-3 and IGF-receptor *** intensity was graded semi-quantitatively using the HS- CORE. RESULTS:Goblet cells and the cells in crypt epitheliawere significantly increased in the study group compared to that of the control *** have demonstrated an increase of IGF-I and IGFBP-3 immunoreactivities in surface epithelium of the small intestine by GH ***-I receptor immunoreactivities of crypt,villous columnar cells,enteroendocrine cells and muscularis mucosae were also more strongly positive in the study group compared to those of in the control group. CONCLUSION:These findings confirm the important trophic and protective role of GH in the homeostasis of the small *** trophic effect is mediated by an increase in IGF-I synthesis in the small intestine, but the protective effect is not related to IGF-I.

关键词： Growth hormone Small intestine Like growth factor-I Insulin like growth factor binding protein 3

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Etiology and portal vein thrombosis in Budd-Chiari syndrome

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World Journal of Gastroenterology 2008年第18期14卷 2858-2862页

作者： Oguz Uskudar Meral Akdogan Nurgul Sasmaz sevinc Yilmaz Muharrem Tola Burhan Sahin Turkiye Yuksek htisas Hospital clinics of gastroenterology Ankara 06010 Turkey Turkiye Yuksek htisas Hospital hematology unit Ankara 06010 Turkey Turkiye Yuksek htisas Hospital clinics of radiology Ankara 06010 Turkey

AIM: To research the etiology, portal vein thrombosis and other features of Budd-Chiari syndrome (BCS) patients prospectively. METHODS: A total of 75 patients (40 female, 35 male) who were diagnosed between January 2002 and July 2004 as having BCS were studied prospectively. Findings from on physical examination, ultrasonography, duplex ultrasonography and venography were analyzed. Hemogram and blood chemistry were studied at the time of diagnosis and on each hospital visit. Bone marrow examination and immune phenotyping were performed by a hematologist when necessary. Protein C, S, antithrombin Ⅲ, activated protein C resistance, and anticardiolipin antibodies, antinuclear antibodies, and anti ds-DNA were studied twice. The presence of ascite, esophageal varices, and portal thrombosis were evaluated at admission and on every visit. RESULTS: At least one etiological factor was determined in 54 (72%) of the patients. The etiology could not be defined in 21 (28%) patients. One etiological factor was found in 39, 2 factors in 14 and 3 factors in 1 patient. The most common cause was the web (16%), the second was Hydatid disease (11%), the third was Behcet’s disease (9%). Portal vein thrombosis was present in 11 patients and at least one etiology was identified in 9 of them (82%). CONCLUSION: Behcet’s disease and hydatid disease are more prominent etiological factors in Turkey than in other countries. Patients with web have an excellent response to treatment without signs of portal veinthrombosis while patients having thrombofilic factors more than one are prone to develop portal vein thrombosis with worse clinical outcome.

关键词： Budd-Chiari syndrome Etiology Web Behcet's disease Portal thrombosis

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Determination of ^(210)Po and ^(210)Pb depositions in lichen and soil samples collected from K?prüba??-Manisa,Turkey

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Nuclear Science and Techniques 2018年第6期29卷 92-100页

作者： Sermin Cam Kaynar Umit H. Kaynar Umran Hicsonmez Omer S. sevinc Department of Physics Faculty of Sciences and Arts Manisa Celal Bayar University 45140 Manisa Turkey Science Education Faculty of Education Manisa Celal Bayar University 45900 Manisa Turkey Department of Chemistry Faculty of Sciences and ArtsManisa Celal Bayar University 45140 Manisa Turkey Primary School Science Teaching Duzce University81620 Manisa Turkey

üIn this study, we aimed to determine the accumulations of ^(210) Po and ^(210) Pb in soil and lichen samples in K? prü bas??. The K? prü bas?? district is home to the largest uranium deposits in Turkey. To date, there has been no study recorded in the literature related to ^(210) Po and ^(210) Pb depositions in lichens in K? prü bas??. Six different lichen species(Cladonia convoluta, Parmelina tiliacea, Physcia stellaris, Pleurosticta acetabulum, Xanthoparmelia conspersa, and Xanthoria parietina) as well as soil samples were collected from seven sampling locations around K? prü bas??. Lichens were used as biomonitors for ^(210) Po and ^(210) Pb deposition. The ^(210) Po and ^(210) Pb activity concentrations were measured in all the samples by alpha spectrometry. The activity concentrations in the lichen samples ranged from 64 to 577 Bq kg^(-1) with an average of 266 Bq kg^(-1) for ^(210) Po and from 78 to 565 Bq kg^(-1) with an average of 333 Bq kg^(-1) for ^(210) Pb. The activity ratios of ^(210) Po/ ^(210) Pb ranged from 0.80 to 1.99. In the lichen species,the mean ^(210) Po activity values varied from 154 Bq kg^(-1) in Pleurosticta acetabulum to 390 Bq kg^(-1) in Xanthoparmelia conspersa. The range of the mean ^(210) Pb activity was between 153 Bq kg^(-1) in Cladonia convoluta and 378 Bq kg^(-1) in Parmelina tiliacea. In the soil samples, ^(210) Po and ^(210) Pb activity concentrations were ranged from14 to 1268 Bq kg^(-1) and from 19 to 1113 Bq kg^(-1),respectively. While the values of ^(210) Po and ^(210) Pb measured in the lichen samples are comparable with those of the literature, the results of ^(210) Po and ^(210) Pb in the soil taken from the uranium mine are higher than the results of the literature studies.

关键词：土壤样品地衣种土耳其收集样品测量 alpha 平均数 Po

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An unusual cause ofileal perforation:Report of a case and literature review

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World Journal of Gastroenterology 2009年第21期15卷 2672-2674页

作者： Sami Akbulut Bahri Cakabay Cihan Akgul Ozmen Arsenal Sezgin Mahsuni Mert sevinc Department of Surgery Diyarbakir Education and Research Hospital Department of Radiology Dicle University Faculty of Medicine Department of Pathology Diyarbakir Education and Research Hospital

An ileal perforation resulting from a migrated biliary stent is a rare complication of endoscopic stent placement for benign or malignant biliary tract *** describe the case of a 59-year-old woman with a history of abdominal surgery in which a migrated biliary stent resulted in an ileal *** with comorbid abdominal pathologies,including colonic diverticuli,parastomal hernia,or abdominal hernia,may be at increased risk of perforation from migrated stents.

关键词： Adhesion Biliary stent Ileal perforation Migration Choledocholithiasis

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An interesting cause of esophageal ulcer etiology: Multiple myeloma of IgG kappa subtype

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World Journal of Gastroenterology 2006年第14期12卷 2305-2307页

作者： Yavuz Pehlivan Alper sevinc Ibrahim Sari Murat T Gulsen Mehmet Buyukberber Mehmet E Kalender Celalettin Camci Gaziantep University School of Medicine Departments of Internal MedicineMedical OncologyPathologyand GastroenterologySahinbey Medical CenterGaziantepTR-27310Turkey

Multiple myeloma is a neoplasm of mature and immature plasma cells. A 50-year-old woman with lumbago, dysphagia, and left arm pain was presented. Upper endoscopical examination was performed. There was an exudate-covered ulcer in the distal esophagus, located at 30-32 cm from the incisors, covering the whole mucosa. Histopathological examination of the specimens obtained from the lesion showed the involvement of plasma cells consistent with multiple myeloma of IgG kappa subtype. Esophageal involvement of multiple myeloma should be kept in mind in patients presenting with dysphagia.

关键词： Multiple myeloma Esophageal ulcer Dysphagia Endoscopy

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