Determination Of Serum Cathelicidin (Ll-37) Levels İn Patients With Hashimoto Thyroiditis

Hashimoto tiroiditi (HT) tiroid hücre harabiyeti ile ilerleyen otoimmün tiroid hastalığıdır. İyot alımının yeterli olduğu ülkelerde hipotiroidinin en sık nedenidir. Genel toplumun %10’unda görülür. Kadınlarda daha sıktır. Genellikle artmış TSH düşük serbest T4 (sT4) ve yüksek antikor seviyeleri ile tanı alır. HT patogenezinde hücresel ve humaral immün sistemin iç içe geçmiş etkileri gösterilmiştir. HT diğer otoimmün hastalıklar ile birliktelik gösterebilmektedir. Cathelicidinler antimikrobial ve immunstimulator peptit ailesinin önemli üyeleridir. LL-37; hCAMP 18 adında proprotein şeklinde sentezlenen insan cathelicidinidir. LL-37’nin farklı yolaklar üzerinden antimikrobiyal ve immün modülatör etkileri mevcuttur. LL-37’nin otoimmün hastalıklar, vaskülitler ve diğer inflamatuar hastalıklardaki immün modülatör rolü incelenmektedir. Literatürde Hashimoto tiroiditinde LL-37’nin rolü üzerine yapılan çalışma bulunmamaktadır. Bu çalışma Gazi Üniversitesi Tıp Fakültesi Hastanesi Endokrinoloji ve Metobolizma Hastalıkları Bölümünde 2018 yılı Ocak –Nisan ayları arasında Hashimoto Tiroiditli hastalar üzerinde yapıldı. Hashimoto tiroiditli hastalarda serum LL-37 düzeyinin belirlenmesi amaçlandı. Çalışmaya alınan hastaların ve sağlıklı kontrol grubu bireylerinin yaş, BMI, TSH, T3, T4, Anti TPO, Anti Tg, 25(OH)D3 düzeyleri kaydedildi. Olgulardan kan örnekleri toplandı ve ELİSA yöntemi ile serum cathelicidin (LL-37) düzeyleri ölçüldü. Çalışmaya alınan 40 sağlıklı kontrol, 48 Hashimoto tiroiditli hasta grupları arasında yaş, cinsiyet, BMI açısından fark saptanmadı. LL-37; kontrol grubuna X göre Hashimoto Tiroiditinde anlamlı yüksek bulundu (p<0,001). HT’li olgularda cinsiyet, yaş, hastalık yaşı, TSH, serbest T3, serbest T4 düzeyi, tedavi alan hastalarda kullanılan levotiroksin sodyum dozu, Anti Tg varlığı, Anti Tg titresi, Anti TPO titresi, 25OH D3 düzeyi ile serum LL-37 düzeyi arasında anlamlı koreleasyon ilişkisi saptanmadı. LL37’nin HT ’yi öngörmede tanısal değeri olduğu görüldü. (p<0,001). LL-37 için % 71 sensitivite ,%70 spesifite ile belirlenen 714pg/ml sınır değerine göre Hashimoto Tiroditi tanısı koymadaki pozitif prediktif değer %73,9, negatif prediktif değer %66,7 olarak belirlendi. LL-37’nin anti TG negatif olgularda da HT’yi öngörmede tanısal değeri olduğu görüldü (p=0,001) ve % 68 sensitivite, %70 spesifite ile belirlenen 714pg/ml sınır değerine göre tanı koymadaki pozitif prediktif değeri %67,9 negatif prediktif değeri %70 olarak belirlendi. LL-37 değeri 714 pg/ml ve üzerinde olanlarda HT görülme sıklığı %73,9 olup, LL-37 değeri 714 pg/ml olan bir olgunun Hashimoto Tiroiditi olma riski yaklaşık 5,6 kat fazla saptandı.(OR=5,66; p<0,001). LL-37 nin HT için tanısal marker olarak kullanılmasında enfeksiyöz veya otoiimmun inflamatuvar süreçlerin büyük bölümünde artış göstermesi sınırlayıcı olmaktadır. Bu sebeple LL-37 nin tek başına kullanılmasındansa HT için yüksek spesifite gösteren Anti TPO ile birlikte kullanılması uygundur. Bunun yanında hastalık yaşı, otoantikor düzeyleri ve diğer parametrelerden etkilenmemesi nedeniyle otoantikor negatif otoimmün tiroid hastalıkları gruplarında tanısal bir marker olabileceği düşünülmüş olup daha büyük ve farklı otoimmün tiroid hastalıklarını da kapsayan gruplarda yapılacak başka çalışmalara ihtiyaç vardır.Hashimoto thyroiditis (HT) is autoimmune thyroid disease progressing with thyroid cell damage. The most common cause of hypothyroidism in developed countries having sufficient iodine intake is HT. It occurs in 10% of the general population. It's more common in females. The disease is usually diagnosed with elevated TSH low free T4 and high antibody levels. Although the genetic and environmental factors influence the pathogenesis of the disease, the mechanism is not fully understood. HT may be associated with other autoimmune diseases. The human cathelicidin (LL-37) is one of the most important members of the antimicrobial and immunostimulator family of peptides. It is synthesized as a proprotein called hCAMP 18 from the gene domain on the chromosome. LL-37 has antimicrobial and immunomodulatory effects on different pathways. The role of LL-37 in the immunomodulator role in autoimmune diseases, vasculitis and other inflammatory diseases has been researched. There is no literature on the role of LL-37 in HT The study was carried out between January- April 2018 in the Department of Endocrinology and Metabolism Diseases of Gazi University Medical Faculty Hospital on HT patients. In this study, it was aimed to determine serum LL-37 level in patients with HT. Age, BMI, TSH, T3, T4, Anti TPO, Anti Tg, 25 (OH)D3 levels were recorded in HT and healthy controls. Blood samples were collected from the cases and serum LL-37 levels were measured by ELISA method. Forty healthy controls and 48 patients with HT were included in the study. There is no difference between the groups in terms of age, sex, and BMI LL-37 was found to be significantly higher in HT with autoimmune thyroid disease (p< 0,001). In patients with HT, no significant correlation was found between serum LL-37 level and sex, age, disease age, TSH, free T3, free T4 level, levothyroxine sodium doxia, anti TG titre, anti TPO titre, 25(OH)D3 level. LL-37 was found to be diagnostic value for prediction of HT (p <0.001). The positive predictive value was 73.9% and the negative predictive value was 66.7% in HT according to the 714pg / ml limit value determined by 71% sensitivity and 70% specificity for LL-37 , respectively. It was also found that LL-37 was diagnostic value in anti TG negative cases (p = 0.001) ( Positive Predictive Value 67%, Negative Predictive Value 70%, when diagnosed according to 714pg / ml limit value determined by 68% sensitivity and 70% specificity ). The incidence of HT was 73.9% in cases with a LL-37 value greater than 714 pg / mL. In a patient with a LL-37 value greater than 714 pg / ml, HT is thought to be about 5.6 times more likely. (OR = 5.66, p< 0.001) The use of LL-37 as a diagnostic marker for HT is limited by the increased incidence of infectious or autoimmune inflammatory processes. Therefore, when LL-37 alone is used, it is appropriate to use it in combination with anti-TPO which has high specificity for HT. In addition, since it is not affected by disease age, autoantibody levels and other parameters, autoantibody is thought to be a diagnostic marker in autoimmune thyroid diseases group and there is a need for further studies in groups including bigger and different autoimmune thyroid diseases

İnternetten lüks tüketim ürünleri satın alımının tüketici karar verme envanteri açısından incelenmesi

Küresel dünya ile yaşamın her alanı değişime ve dönüşüme uğrarken, günümüzde küresel pazardaki mal hizmetlere tüm coğrafi bölgelerde aynı koşul ve standartlarla ulaşılmaktadır. Gelişmiş olan ekonomiklerde olduğu gibi gelişmekte olan ülke ekonomileri de bu küresel pazarlara entegre olmakta ve kapitalin tüketim odaklı nüfusu lüks tüketim pazarının büyümesinde paydaş olmaktadır. Lüks tüketim ürünleri sunan firmalar, müşteri potansiyelini arttırmak amacıyla, lüksün daha kolay ulaşılabilir olmasını sağlayan pazarlama stratejileri üretme çabasındadır. Firmaların bu çabalarında ve bu pazarın büyümesinde dijital teknolojilerdeki hızlı gelişmeler en büyük yardımcı araç konumundadır. Sistemdeki değişimler tüketicilerdeki lüks algısı davranışlarında da değişimi getirmekte, lüks olarak gruplandırılan ürün ve hizmetler yalnızca ekonomik refah seviyesi yüksek tüketici grubu ile sınırlı kalmayıp, orta seviye gelir grubuna dahil tüketiciler için de ulaşabilir konuma yerleşmektedir. Bu çalışmanın konusu “İnternetten Lüks Tüketim Ürünleri Satın Alımının Tüketici Karar Verme Envanteri açısından İncelenmesi”’dir. Çalışmanın ilk iki bölümünde pazarlama yazınında yer alan tüketim, tüketici, tüketici davranışları, internet üzerinden alışveriş ve lüks tüketim ile ilgili kavramlara açıklık getirilirken son bölümde 683 katılımcı ile yapılan anket sonuçları analiz edilmiştir. -------------------- While all areas of life and global world are undergoing change and a transformation, today the goods and services in the global market are reached with the same conditions and standards in all geographical regions. As in developed economies, the economies of developing countries integrate into these global markets and the consumption-oriented population of the capital becomes a stakeholder in the growth of the luxury consumption market. Firms that offer luxury consumer products endeavor to produce marketing strategies that make luxury more accessible in order to increase customer potential. The rapid development of digital Technologies is the most important tool in the efforts of the companies and the growth of this market. The changes in the system also bring about changes in the perception of luxury behaviours of consumers, and products and services grouped as luxury are not limited to the consumer group with a high level of ecoconomic welfare, but are also accessible to consumers in the middle income group. The title of the study is “Examining Online Luxury Product Shopping In Terms of Consumer Decision Making Inventory.” In the first three chapters of the study, the consepts related to consumption, consumer, luxury consumption and online shopping in the marketing literatue are clarified, in the last section, the results of the survey with 683 participants are analyzed

Exploration of carbon additives to the synthesis of Cu2Mo6S8 structures and their electrocatalytic activity in oxygen reduction reaction

WOS:000746612900013Catalytic processes are contemplated as break point in generating alternative and sustainable energy platforms. The cathodic oxygen reduction reaction (ORR) is an important catalytic system, mainly finding practice in fuel cell and metal-air battery technologies. This work presents the synthesis, structural characterization and electrocatalytic properties of three different Cu2Mo6S8 structures as alternative ORR electrocatalysts. The effect of different carbon additives during synthesis was studied and no positive influence of the carbon addition was indicated. Our findings show that only the bare Cu2Mo6S8 enhances the ORR electro-performance to class with the state-of-the-art ORR catalysts. Excellent stability of 10,000 consecutive ORR cycles, a superior onset potential of 0.894 V and half-wave (E1/2) potential of 0.641 V vs. reversible hydrogen electrode (RHE) increase the noteworthiness of the Cu2Mo6S8 electrodes. Aside from experimental investigations, density functional theory calculations deliver profound knowledge on the structural and electronic properties (electronic band structure, partial density of states and electron density) of Cu2Mo6S8

Efficacy of Octyl-2-Cyanoacrylate in Type I Tympanoplasty

11th International Congress on Cleft Lip and Palate and Related Craniofacial Anomalies -- SEP 10-13, 2009 -- Fortaleza, BRAZIL --Objective: To evaluate the safety and efficacy of octyl-2-cyanoacrylate for type I tympanoplasty. Methods: This study involved 23 patients (14 females and 9 males) with chronic otitis media who underwent type I tympanoplasty. During surgery, the temporal fascia is placed underlying the eardrum remnant, and octyl-2-cyanoacrylate was dropped over the temporal fascia. The mean air-bone gap (ABG) at the 4 frequencies (500, 1000, 2000, and 4000) was calculated for each patient before and after surgery. These data were compared by Student t test. Results: The mean follow-up was 10 months (range, 6-12 mo). Successful tympanic membrane grafting occurred in 21 patients (91.3%). Graft failure was seen in 2 patients. The mean preoperative ABG of the 23 patients was 19.3 (SD, 5.7) dB, and the postoperative ABG improved to a mean value of 8.2 (SD, 5.9) dB (P <= 0.0001). Conclusions: Octyl-2-cyanoacrylate is effective and safe in using as a compound on temporalis muscle fascia in type I tympanoplasty and can be used more widely in tympanoplasty.WOS:0002907321000652-s2.0-79957971932PubMed: 2155889

Evaluation of chronic inflammation in the aetiology of venous insufficiency by investigating cytomegalovirus DNA

Introduction: Lower extremity venous insufficiency is a significant health problem with economic and sociological consequences, lowering the quality of life, and sometimes leading to serious complications. The aim of this study is to evaluate the cytomegalovirus (CMV) effect on chronic inflammation in the aetiology of chronic venous insufficiency. Material and methods: Between November 2017 and August 2018, 468 patients who underwent radio-frequency ablation therapy and phlebectomy were included in the study. PCR analyses for CMV DNA were performed on the venous tissue samples. Patients with post-thrombotic syndrome were excluded from the study. After ethical approval, the relationship between the presence of CMV DNA, gender, body mass index, and bilaterality of chronic venous insufficiency were investigated. Results: When the relationship between CMV DNA and gender or body mass index was examined, a significant relationship was not detected. But when the patients with bilateral chronic venous insufficiency and patients with unilateral chronic venous insufficiency were compared regarding CMV DNA positivity, the patients with bilateral chronic venous insufficiency had significantly higher CMV DNA positivity (p = 0.002). Also, the incidence of venous ulcers in the CMV DNA exposed group was significantly higher. Conclusions: In the literature there are many studies showing that CMV triggers atherosclerosis, but there is no study in which CMV directly produces chronic venous insufficiency. The high rates of positivity suggest that CMV, which is the basis of chronic inflammation, may be a significant factor in the aetiology of chronic venous insufficiency