Browsing by Author "Demir, T."

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Angiocentric Glioma Manifesting as Psychotic Symptoms in an Adolescent: a Case Report
(2013) Kadak, M.T.; Demirel, A.; Demir, T.
Cerebral cortical malformations can be associated with psychotic symptoms, and frontal, temporal, and limbic lesions may lead to psychosis-like symptoms. Therefore, these regions have a role in the pathogenesis of psychosis and related symptoms. Here, we report a 13-year-old adolescent who presented with auditory and visual hallucinations, persecutory delusions, and aggression. The patient's symptoms remitted after the resection of the left temporal lobe, fusiform gyrus, uncus, amygdala, and hippocampus. Histological examination revealed angiocentric glioama. We discuss the relationship between psychotic symptoms and the neural network that links the frontal lobe with limbic structures and how it can be disturbed by developmental abnormalities. © 2013 Elsevier GmbH.
Increased Oxidative Stress in Living Kidney Donors: Correlation of Renal Functions With Antioxidant Capacity
(Elsevier Science inc, 2017) Yildirim, M.; Karahan, M.; Kucuk, H. F.; Demir, T.; Demir, H.; Turan, H.; Ari, E.
Background. Substantial attention has recently been paid to the possibility of an increased risk of chronic kidney disease (CKD) in living kidney donors. It has been demonstrated that CKD patients suffer from increased oxidative stress, which have been reported to show a strong association with several clinical problems such as accelerated atherosclerosis. The purpose of the current cross-sectional, single-center study was to evaluate the relationship between renal functions of living kidney donors and systemic oxidative stress. Methods. A total of 55 living kidney donors operated at least 1 year ago and 40 age and sex-matched healthy individuals were enrolled in this study. Plasma malondialdehyde (MDA) levels were determined as oxidative stress marker. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. Renal function parameters and proteinuria were also assessed. Results. Mean serum creatinine levels were higher (P = .022) and 24-hour creatinine clearance was lower (P = .016) in living kidney donors compared with healthy controls. Serum MDA levels were higher (P = .034), and SOD and GPx activities were lower (P = .023 and P < .001, respectively). There was a significant positive correlation between serum GPx activity and 24-hour creatinine clearance levels (r = 0.524, P < .01). A linear regression analysis showed that serum GPx activity was still significantly and positively correlated with creatinine clearance (regression coefficient = 0.416, P < .001). Conclusion. Our data demonstrated that living kidney donors exhibit slightly reduced kidney function, increased oxidative stress, and decreased antioxidant activity. We propose that 24-hour creatinine clearance is positively correlated with antioxidant enzyme GPx. To our knowledge, this is the first study to demonstrate the association between renal functions and antioxidant activity in kidney donors.
Is Lymph Node Dissection Necessary for Staging While Undergoing Nephrectomy in Patients With Renal Cell Carcinoma
(Mosby Inc., 2021) Demir, T.; Aliyev, A.; Beşiroğlu, M.; Araz, M.; Köstek, O.; Sakin, A.; Türk, H.M.
Objective: The essential treatment for patients with renal cell carcinoma is nephrectomy. As no lymph node dissection (LND) could be performed in the majority of these patients, healthy staging could not be carried out. In this study, we investigated the impact of LND during nephrectomy on patient survival. Methods: A total of 181 patients—58 (32%) were female and 123 (68%) were male—were included in the study. Median follow-up period was 48 months. The patients were separated into 4 groups according to their stage during diagnosis; group 1 (T1–3N0M0), group 2 (T1–3NXM0), group 3 (T1–3N1M0), and group 4 (T1–4N0/XM1). The disease-free survival of nonmetastatic patients and the overall survival of all groups were calculated. Results: Mean age was 58.4 ± 12.0 years. Median survival for Group 1 could not be reached. Median survival was 89 months in Group 2, 50 months in Group 3, and 39 months in Group 4 (P <0.001). There was no statistically significant difference between the N1 and M1 groups (P = 0.297). For the NX patient group without LND, median survival was 89 months, which is worse than the N0 group and better than the N1 group (P = 0.002). Conclusions: Our study presumes that the patients without LND are not staged sufficiently, NX patients have worse survival rates when compared with N0 patients, node-positive patients have poor survival rates as do the metastatic patients, and it should be defined as TNM stage4. © 2020
Natural History of Congenital Generalized Lipodystrophy: a Nationwide Study From Turkey
(Endocrine Society, 2016) Akinci, B.; Onay, H.; Demir, T.; Ozen, S.; Kayserili, H.; Akinci, G.; Garg, A.
Context: Congenital generalized lipodystrophy (CGL) is a rare autosomal recessive disorder characterized by near-total lack of body fat. Objective: We aimed to study natural history and disease burden of various subtypes of CGL. Design: We attempted to ascertain nearly all patients with CGL in Turkey. Setting: This was a nationwide study. Patients or Other Participants: Participants included 33 patients (22 families) with CGL and 30 healthy controls. Main Outcome Measure(s): We wanted to ascertain genotypes by sequencing of the known genes. Whole-body magnetic resonance imaging was used to investigate the extent of fat loss. Metabolic abnormalities and end-organ complications were measured on prospective follow-up. Results: Analysis of the AGPAT2 gene revealed four previously reported and four novel mutations (CGL1; c.144C-A, c.667-705delinsCTGCG, c.268delC, and c.316<1G-T). Analysis of the BSCL2 gene revealed four different homozygous and one compound heterozygous possible disease-causing mutations (CGL2), including four novel mutations (c.280C-T, c.631delG, c.62A-T, and c.465-468delGACT).Twohomozygous PTRFmutations(c.481-482insGTGAandc.259C-T)wereidentified (CGL4). Patients with CGL1 had preservation of adipose tissue in the palms, soles, scalp, and orbital region, and had relatively lower serum adiponectin levels as compared to CGL2 patients. CGL4 patients had myopathy and other distinct clinical features. All patients developed various metabolic abnormalities associated with insulin resistance. Hepatic involvement was more severe in CGL2. End-organ complications were observed at young ages. Two patients died at age 62 years from cardiovascular events. Conclusions: CGL patients from Turkey had both previously reported and novel mutations of the AGPAT2, BSCL2, and PTRF genes. Our study highlights the early onset of severe metabolic abnormalities and increased risk of end-organ complications in patients with CGL. © 2016 by the Endocrine Society.