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ABSTRACT: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated esophageal disease characterized with symptoms related to esophageal dysfunction and eosinophil-predominant inflammation. There has been a dramatic increase in the diagnosis of this disease in recent years. The primary objective of this study was to determine the frequency of EoE in adult patients who were evaluated by gastroenterologists in our clinic with esophageal symptoms. Between November 2010 and May 2011, 311 adult patients who were evaluated in our clinic with esophageal symptoms were enrolled prospectively. All patients underwent endoscopy and had biopsies taken. Gastroesophageal reflux disease was excluded by either proton pump inhibitory treatment or 24-hour ambulatory pH monitorization. The diagnosis was confirmed by one independent pathologist. Frequency of EoE in patients with esophageal symptoms was 2.6% (n = 8; four men and four women). Mean age at diagnosis was 40.2 ± 8 years. Heartburn was the predominant symptom in patients (75% of the patients), and 87.5% (n = 7) of patients had more than one symptom at diagnosis. Nearly 38% of the patients (n = 3) had a history of allergic disease. Endoscopic findings were as follows: transient/fixed esophageal rings (25%), white exudates (25%), and normal appearance (50%). Median number of circulating eosinophils was 208 (93-659)/mm(3) . Median number of intraepithelial eosinophils in proximal-middle 1/3 part and distal 1/3 part of esophagus were 0 (0-50)/hpf and 37 (16-50)/hpf, respectively. In conclusion, EoE is not rare in Turkey, and it should be considered in the differential diagnosis of patients with esophageal symptoms.
Diseases of the Esophagus 08/2012; · 1.81 Impact Factor
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ABSTRACT: Neurologic involvement in Behçet disease, also known as NBD, is one of the most devastating manifestations of the disease. The precise pathologic mechanism of parenchymal NBD lesions has not been established. We evaluated lesion characteristics and probable venous hemorrhage in parenchymal NBD by using SWI, and we compared the imaging results with conventional MR imaging sequences.
We performed cranial MR imaging by using a 1.5T scanner in 23 patients with a definitive diagnosis of parenchymal NBD. We compared the proportion of lesion detection and the performance of hemorrhagic detection with the T2 FSE, T2*GE, and SWI magnitude, and SWI mIP by using the χ(2) test.
The proportion of lesion detection with both SWI magnitude and SWI MinMIP was significantly larger than that with T2*GE. The proportions of lesion detection among all other pairs of methods were not significantly different according to the corresponding P value (χ(2) = 17.4929, df = 3, P = .0006). Proportions of hypointense hemorrhagic lesions with T2 FSE and T2*GE were not significantly different, and likewise for the proportions of hypointense hemorrhagic lesions with SWI magnitude and SWI mIP. In contrast, the proportions of hypointense hemorrhagic lesions with SWI magnitude and SWI mIP were significantly larger than that with T2 FSE and T2*GE (χ(2) = 108.5396, df = 3, P < .0001).
Most of the lesions in parenchymal NBD were found to be hemorrhagic with SWI, supporting the proposed venous theory in pathology. In addition, compared with T2 FSE and T2*GE sequences, SWI was more successful in the determination of widespread involvement of the disease, particularly in nonchronic cases.
American Journal of Neuroradiology 06/2011; 32(6):1050-5. · 2.93 Impact Factor
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ABSTRACT: Recurrence of hepatitis B virus after a liver transplantation (OLT) is a risk factor affecting graft and patient survivals. Short-term hepatitis B virus reactivation rates after OLT range between 3% and 15%. Using combination prophylaxis, the outcomes of OLT among patients with liver disease related to hepatitis B virus have improved to levels comparable to those whose disease is not related to hepatitis B virus.
Since September 2001, we performed 288 OLT in 282 patients including 74 who had liver failure related to hepatitis B virus among whom 58 were followed for >12 months and analyzed retrospectively. Our protocol included lamivudine (100 mg orally per day beginning the day after surgery) and hepatitis B immunoglobulin (10,000 IU IV during the anhepatic phase, 2000 IU/d IV during the first week after surgery, 2000 IU IV/month from postoperative months 1 to 12). Using our protocol, the anti-hepatitis B surface antibodies (HBsAb) serum titer was maintained up to 100 IU/mL. The female:male ratio was 11:47. The mean age of patients was 43±12.8 years.
Five patients died of causes unrelated to hepatitis B virus. At the time of death, their hepatitis B surface antigens were negative, and serum titers of anti-HBsAb were 45, 35.3, 56.4, 79.6, and 123 IU/mL. Mean follow-up was 46.5±18.9 months (range, 12-79). The hepatitis B surface antigen became positive in 4 patients; the remaining 49 had no evidence of hepatitis B surface antigen. In 18 patients, serum titer of anti-hepatitis B surface antigen was 0; in the remaining 31 patients, it was 69.2±133 IU/mL.
Our combination protocol with hepatitis B immunoglobulin and lamivudine is a safe, cost-saving, and effective treatment for hepatitis B virus prophylaxis after liver transplantation.
Transplantation Proceedings 03/2011; 43(2):598-600. · 1.00 Impact Factor
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Endoscopy 01/2011; 43 Suppl 2 UCTN:E33. · 5.21 Impact Factor
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ABSTRACT: SWI is a new technique for evaluating diffuse axonal injury associated with punctate hemorrhages. The aim of our study was to determine the prevalence of cerebral microhemorrhages in amateur boxers compared with nonboxers by using SWI and to evaluate the sensitivity of SWI compared with T2 FSE and T2*GE sequences.
We performed cranial MR imaging with a 1.5T scanner in 21 amateur boxers and 21 control subjects. The study protocol included conventional MR images, T2 FSE, T2*GE, and SWI sequences. The proportions of boxers and controls having CSP, DPVS, cerebral atrophy, cerebellar atrophy, ventricular dilation, PSWMD, and microhemorrhages were computed and were compared by using the χ(2) test of proportions. The relationship between microhemorrhages and boxing-related covariates was assessed by using the Wilcoxon rank sum test. The association between the categories was tested by using the Fisher exact test.
Using SWI, microhemorrhages were found in 2 (9.52%) of 21 boxers. The microhemorrhages were not visible on T2 FSE or T2*GE images. The proportion of subjects with microhemorrhages did not differ significantly between the boxers and control subjects (χ(2) = 0.525, df = 1, P = .4688). The prevalence of CSP and DPVS was significantly higher in the boxers than in the control subjects.
More microhemorrhages were detected in amateur boxers than in controls, but this difference was not statistically significant.
American Journal of Neuroradiology 10/2010; 32(1):99-102. · 2.93 Impact Factor
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ABSTRACT: Radiologic identification of the location of the CSF leakage is important for proper surgical planning and increases the chance of dural repair. This article describes our experience in analyzing clinically suspected cranial CSF fistulas by using MR imaging combined with the intrathecal administration of a gadolinium-based contrast agent.
A total of 85 consecutive patients with suspected CSF fistulas who presented with persistent or intermittent rhinorrhea or otorrhea lasting for more than 1 month between 2003 and 2007 were included in this study.
We observed objective CSF leakage in 64 of 85 patients (75%). The CSF leak was located in the ethmoidal region in 37 patients (58%), in the superior wall of the sphenoid sinus in 8 patients (13%), in the posterior wall of the frontal sinus in 10 patients (15%), in the superior wall of the mastoid air cells in 6 patients (9%), and from the skull base into the infratemporal fossa in 1 patient (2%). Two patients (3%) showed leakage into >1 paranasal sinus.
MR cisternography after the intrathecal administration of gadopentate dimeglumine represents an effective and minimally invasive method for evaluating suspected CSF fistulas along the skull base. It provides multiplanar capabilities without risk of radiation exposure and is an excellent approach to depict the anatomy of CSF spaces and CSF fistulas.
American Journal of Neuroradiology 09/2009; 31(1):71-5. · 2.93 Impact Factor
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ABSTRACT: The control of natural organic matter (NOM) in drinking water treatment plants is required in order to control (i) the formation of potentially harmful disinfection byproducts (DBPs), (ii) the regrowth of bacteria and (iii) pipe corrosion in the distribution system. Photocatalysis is a promising advanced oxidation technology due to its ability to mineralise chlorinated byproduct precursors such as humic acids (HAs) to carbon dioxide and water. In this study, the efficiency of HAs and NOM removal in terms of UV absorbance at 254 nm (UV254) was tested by means of a new photocatalytic reactor made of stacked polymethylmethacrylate (PMMA) rings coated by TiO2 nanofilm. Three different sets of rings were coated with TiO2 gel one, two and three times respectively to optimise the coating thickness according to UV254 removal efficiency. The titania sol was immobilised on the substrate by a low temperature procedure and after 8 months the reactors were reactivated by means of UV radiation before the experiments. The photocatalytic removal efficiency of humic acid in terms of UV254 was significantly higher after 1 hour for the reactor employed with high thickness TiO2 nanofilm (around 20%) compared to middle and low thickness reactors (6 and 1.4%, respectively). However, during the same reaction time only 10% of UV254 was removed with high thickness TiO2 nanofilm using raw surface water, probably owing to ionic species naturally occurring in the raw water sample. Finally, the activation of the TiO2 nanofilm may be effectively accomplished by means of UV radiation where calcination cannot be applied (e.g. thermally sensitive substrates).
Water Science & Technology 02/2007; 55(12):113-8. · 1.12 Impact Factor
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ABSTRACT: Cytomegalovirus (CMV)-associated diseases remain a major problem in transplant recipients. Early diagnosis is critical. Presentation of early CMV colitis can be mild and nonspecific in transplant recipients. Although serology is helpful in the diagnosis, sometimes it is inadequate. Because the endoscopic features of CMV colitis are specific, colonoscopy facilitates the histopathologic examination. We present the clinical properties and advantages of early colonoscopy in transplant recipients with CMV colitis. The study group included seven patients (six men, one woman of mean age, 36.7 years (range, 22 to 64 years) whose mean transplant duration was 12.3 months (range, 1 to 72 months). Six of the seven patients experienced an acute graft rejection treated with high doses of steroids; one patient had a herpes simplex virus infection. All patients were on steroid treatment with a various combinations of immunosuppressive agents, including cyclosporine, mycophenolate mofetil, and tacrolimus. All patients presented with mild diarrhea without any blood or mucous discharge. Four patients had fever exceeding 38 degrees C; two had abdominal pain. Stool examinations revealed normal findings in six patients, while one patient had white blood cells and amoebic cysts. Serum CMV IgM and CMV pp65 antigenemia were negative in five of seven patients and two had positive results. All patients showed typical colonoscopic and histopathologic findings compatible with CMV colitis. Standard ganciclovir treatment was successful in all patients. Early and rapid colonoscopy is beneficial for the early diagnosis and management of CMV colitis in transplant recipients.
Transplantation Proceedings 10/2005; 37(7):3059-60. · 1.00 Impact Factor
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ABSTRACT: In the present study, the decomposition of two biocides used in the textile finishing process with Advanced Oxidation Processes (AOPs) has been studied. Different AOPs, i.e O3/OH-, TiO2/UV-A and Fe2+/H2O2 have been used representing mutually combined components of the chemically and photochemically driven advanced oxidation systems. The course of reaction was examined by changes in chemical oxygen demand (COD), total organic carbon (TOC) and acute toxicity towards the water flea Daphnia magna (assessed in terms of the effective dilution ratio LD50). Particular attention has been paid to determine the inhibitory effect of raw and ozonated biocides on biological activated sludge consortium at concentrations typically encountered in textile finishing effluents. Significant oxidation and mineralization of both biocides could be achieved employing ozonation at pH = 11.5 and heterogeneous photocatalysis (TiO2/UV-A) at pH = 5.0, whereas Fenton's reagent appeared to be less effective in COD and acute toxicity abatement.
Water Science & Technology 02/2005; 52(10-11):309-16. · 1.12 Impact Factor
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ABSTRACT: The occurrence of THMs and HAAs, and other volatile organics in Istanbul (Turkey) and Salerno (Italy) surface water resources was investigated by the previous and present data obtained on raw, coagulated, pre-chlorinated, pre-ozonated water samples. The present drinking water directives/regulations in developed countries set maximum contaminant level (MCL) for THMs at different levels. In Italy, where the 80-85% of water demand is supplied by groundwater, a relatively low THMs value of 30 µg l -1 was set, however there are no HAAs and bromate limits. On the other hand, there is still no regulation for the THMs in Turkey. The characterization of chlorinated by-products, particularly THMs, is detailed according to raw water origin and treatment technologies currently applied in both cities.
Global NEST Journal Copyright©. 01/2005; 7:95-105.
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ABSTRACT: Water samples of different origins (Buyukcekmece and Omerli, Istanbul, Turkey, and Alento, Salerno, Italy) were treated by coagulation, ozonation, and coagulation followed by ozonation and photocatalysis. Disinfection by-products (DBPs) formation potential of raw and treated water samples was compared in relation to removal efficiencies by the respective treatment methods. The major DBPs, namely trihalomethanes (THMs) and haloacetic acids (HAAs), and other DBPs were identified and quantified. Besides major THMs and HAAs, the presence of bromoform in high amounts was also detected due to the high levels of bromide ions in raw Buyukcekmece and Omerli water samples. Depending on the natural organic matter (NOM) removal efficiencies of each treatment process, the distribution of individual THMs and HAAs was found to be NOM-site specific. Other DBPs were also detected and chloral hydrate (C 2 H 3 Cl 3 O 2) was found in significant amounts. The responsible precursor sites could only be reduced by photocatalytic treatment of NOM.
Desalination. 01/2005; 176:155-166.
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ABSTRACT: The degradation of formic acid (HCOOH), FA (a surrogate contaminant) using titanium dioxide (TiO2) and 1% Pt doped TiO2 electrodes, prepared by sol—gel methods, was investigated in a photoelectrocatalytic (PEC) system in order to determine the effect of Pt doping on the oxidation potential of TiO2. Pt doping shifts the position of band edge and therefore the direct and indirect oxidation potentials of TiO2 in PEC systems. As a result, the degradation of formic acid via the generation of hydrogen peroxide production on 1%Pt—TiO2 electrodes was much better than that on non-doped electrodes. The degradation of HCOOH was also examined with respect to the faradaic efficiency of this process. It was found that the 1%Pt—TiO2 photoanode had a 30% higher efficiency than that of non-doped TiO2 photoanodes.
Journal of Applied Electrochemistry 05/2004; 34(6):653-658. · 1.75 Impact Factor
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ABSTRACT: This study addresses the application of a photoelectrocatalytic (PEC) system with separated hole and electron reactions to treat humic acid (HA) from river water. A TiO2 electrode, coated by the sol-gel method, is used for that purpose. The degradation of humic acid in the river water was followed with respect to time using parameters of UV254, color and total organic carbon (TOC). For comparison purposes the photocatalytic (PC) removal of HA was also studied on the same photoanode. The obtained results showed that the PEC system was much more effective than the PC method. The effect of other important reaction variables, such as external potential, oxygen and UV intensity on HA degradation were also investigated. For all the external applied potential conditions and UV intensity range over 90% removal of UV254 and color were obtained with the PEC system while TOC removal was between 58-80%.
Water Science & Technology 02/2004; 49(4):153-8. · 1.12 Impact Factor
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ABSTRACT: A systematic approach was followed to optimise pH, temperature and the doses of FeSO4 and H2O2 for Feton's reagent (FR) to decolourize and detoxify the solutions containing of Remazol Red 120 (RR) dye and its mixture with Remazol Brillant Blue (RB) and Remazol Yellow 84 (RY) reactive dyes. The acute toxicity of each dye composition was measured using D. magna. Optimum pH for RR singly used and for the dye mixture was found 3.5 while optimum temperature was determined 50°C, 40°C and 30°C for 100 mg/l of RR, 200 mg/l of RR and the dye mixture, respectively. More than 98% of colour and 92% of COD removal were obtained for the dye solutions. For obtaining high colour and COD removal H2O2 concentration had to be increased 3 times when RR concentration was doubled whereas FeSO4 was to be increased 2.5 times for the dye mixture. The results obtained indicate that FR can be assurely used for complete toxicity removal and obtaining high colour and COD efficiency with no toxic effluent on D. magna for the dye solutions studied. Acute toxicity test with H2O2 was useful to evaluate the complete oxidation resulting in practically no residual H2O2 (<3 mg/l) in the solution.
Desalination. 173(3):239-248.
