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Biomedical subjects

A Yildirim

Publications and source records attributed to A Yildirim.

At least 37 records · Page 2Linked to original sources
PubMed2001

The effects of severe cystocele on urogynecologic symptoms and findings.

BACKGROUND: To evaluate the effects of severe cystocele on lower urinary tract function. METHODS: Urogynecologic evaluation composed of patient questionnaire, urinary diary, pad test, Q-tip test, perineal ultrasonography and cystometry was performed on 60 patients with reducible grade III or IV cystocele before and after reduction of the prolapsed organs. The data were analyzed by Paired-t and Chi-square tests and Pearson's correlation analysis. RESULTS: One-hour pad test revealed that 17 (28.3%) of the 60 patients with reducible severe cystocele had no demonstrable urinary incontinence, while 26 (43.3%) had mild and 17 (28.3%) had moderate or severe incontinence. However, all patients had moderate or severe incontinence after reduction with vaginal packing (p<0.001). The vaginal packing had no significant effect on the maximum bladder capacity, the intravesical pressure at maximum capacity and the frequency of detrusor instability (33.3%). Whereas, urine loss after 1-hour pad test, bladder neck mobility, straining Q-tip angle and PUVA increased significantly after reduction of the cystocele (p<0.01). CONCLUSIONS: As grade III or IV cystocele may mask the presence and severity of urinary stress incontinence, preoperative urogynecological evaluation should be done after reduction of the cystocele.

Adult↗
PubMed2001

[Value of tissue Doppler imaging in the determination of the right ventricular systolic function].

OBJECTIVE: Since there is a difficulty in the assessment of right ventricular systolic function by 2D echocardiography, a noninvasive, practical and, cost effective method is desirable. Tissue Doppler technique enables to visualize systolic and diastolic velocities of the tissue through sample volume replacement. In this study, we aimed to evaluate the relationship between tricuspid annular tissue Doppler velocities and right ventricular systolic functions. METHODS: For this purpose, tricuspid annular systolic (S), early diastolic (E) and, late diastolic (A) velocities were obtained from 38 patients (23 with dilated cardiomyopathy, 15 with mitral stenosis, all of them in sinus rhythm) and 15 healthy control subjects by placing the pulsed wave sample volume at the junction of right ventricular free wall and tricuspid annulus. The time velocity integral (TVI) of S, peak velocity of S and isovolumic contraction time (IVCT) were compared with right ventricular ejection fraction (RVEF) determined by 2D echocardiographic hemi-elliptic shell model, peak velocity of tricuspid regurgitation and dP/dt calculated from the spectral trace of this regurgitation. RESULTS: A significant correlation was determined between RVEF and peak S velocity, S TVI and IVCT (r: 0.76, p < 0.001, r: 0.82, p < 0.0001 and r: -0.85, p < 0.0001 respectively). The peak S velocity < 12 cm/sec, S TVI < 2 cm and IVCT > 75 msec yielded 76%, 84%, 92% sensitivity and 84%, 84%, 80% specificity for predicting the patients with right ventricular ejection fraction < 40%, respectively. A significant and powerful correlation was determined between the peak S velocities and dP/dt in 19 patients whose tricuspid regurgitation could be clearly recorded (r: 0.88, p < 0.0001). CONCLUSIONS: The analysis of tricuspid annular velocities obtained by tissue Doppler technique is a practical method of the assessment of right ventricular systolic functions.

Adult↗
PubMed2001

[The evaluation of the severity of mitral regurgitation using color Doppler echocardiographic methods].

OBJECTIVE: This study was planned to assess the vena contracta (VC), flow convergence area (PISA) and jet area (JA) methods in evaluating the severity of mitral regurgitation (MR) and to test the accuracy of a proposed algorithm using these methods. METHODS: Eighty-seven patients with chronic MR were enrolled in the study. VC of < 0.3 cm, maximal MR flow rate calculated by PISA (Qmax) of < 72 cm3/sn and JA of < 4 cm2 were classified as mild MR. VC of > 0.5 cm, Qmax of > 240 cm3/sn and JA of > 8 cm2 were classified as severe MR. Whereas the values between these ranges were called to be moderate MR. The algorithm was planned as follows: In the first step, VC width was measured. If a patient has VC = 0.3-0.5 cm, it was used Qmax in the eccentric jets and JA in the central jets in the second step. The severity of MR were considered as severe, moderate and mild for > 50%, 21-49% and 20% of the regurgitant fraction calculated by the reference method (the quantitative Doppler method depending on aortic and mitral stroke volumes), respectively. RESULTS: The sensitivity of VC was low in differentiating between moderate and severe MR (63%). In eccentric jets, the regurgitant volume calculated by PISA was higher than that of reference method (70 +/- 49 vs. 59 +/- 29 cm3) and the JA was found to be less than that of central jets despite similar regurgitant fraction (6.8 +/- 3.2 vs. 8.5 +/- 3.3 cm2). The algorithm agreed well with the reference method and it was better than those of each tree methods (Cappa coefficients 0.89 vs. 0.65, 0.63 and 0.45 for VC, Qmax and JA; respectively). The accuracies of the algorithm in discriminating between mild and moderate MR or severe and non-severe MR were high (98% and 95%, respectively). CONCLUSIONS: The severity of MR can be determined accurately and simply by using VC, PISA and JA methods together.

Adolescent↗
PubMed2001

[Evaluation of dynamic left ventricular outflow tract obstruction by dobutamine stress echocardiography].

OBJECTIVE: This study was planned to evaluate the dynamic left ventricular outflow tract (LVOT) obstruction by using dobutamine stress echocardiography (DSE) in patients with asymmetric septal hypertrophy and/or septal bulging, who have no signs of LVOT gradient detected by conventional echocardiography, with symptoms mimicking hypertrophic obstructive cardiomyopathy (HOCM). METHODS: In sixty-one consecutive patients referred to our echocardiography laboratory with HOCM pre-diagnosis, exercise dyspnea and limitation of exercise capacity were evaluated. DSE was performed in 31 patients who fulfilled the inclusion criteria. Patients were divided into two groups according to the degree of dynamic gradient increase above baseline values during stress-test (Group 1 < 30 mmHg, Group 2 > 30 mmHg). Left ventricular diameters, septum and posterior wall thicknesses, ejection fraction, LVOT and aortic root diameters, presence of septal bulging and systolic anterior motion (SAM) and degree of septal angulation were sought. RESULTS: There were no significant differences between groups by means of LV diameters, septum and posterior wall thicknesses, EF, LVOT and aortic root diameters, presence of septal bulging (p > 0.05); whereas there were significant differences in SAM and degree of septal angulation (p < 0.05 and p < 0.0001, respectively). Systolic anterior motion (r = 0.61, p < 0.0001) and degree of septal angulation (r = -0.71, p < 0.001) correlated significantly with the dynamic gradient increase. CONCLUSION: Presence of SAM and degree of septal angulation obtained by DSE are reliable parameters to determine dynamic LVOT obstruction in patients who have asymmetric septal hypertrophy and septal bulging with no gradient on LVOT by conventional echocardiography.

Cardiotonic Agents↗
PubMed2000

Antioxidant defence in recurrent abortion.

Increased free radical activity has been implicated in the pathogenesis of recurrent abortion. This investigation was conducted to determine if changes in some parameters of the antioxidant system contribute to this condition. Plasma ascorbic acid, alpha-tocopherol, total thiols, ceruloplasmin, uric acid, albumin, and erythrocyte glutathione (GSH) were assayed in 25 nonpregnant (NP) healthy women, 25 normotensive pregnants (NTP), and 120 women with recurrent abortion. Recurrent aborters were divided into four subgroups according to the etiology: autoimmune (AUTO, n=25), luteal phase defect (LPD, n=25), anatomical defect (AD, n=20) and unexplained (UNEx, n=50). Plasma levels of ascorbic acid, alpha-tocopherol, and erythrocyte GSH were significantly decreased in AUTO, UNEx and LPD subgroups than those in two control groups and the AD group (ANOVA). Plasma thiols of UNEx and AUTO aborters were diminished according to controls and other abortion subgroups (ANOVA). Ceruloplasmin levels showed a decline in AUTO and UNEx subgroups when compared to controls, AD and LPD aborters (ANOVA). When UNEx, AUTO and LPD recurrent abortion subgroups were compared with each other (Student's t-test) total thiols and erythrocyte GSH of UNEx and AUTO subgroups were diminished in comparison with LPD. We suggest that decreased concentrations of plasma ascorbic acid, alpha-tocopherol, total thiols and erythrocyte GSH in UNEx, AUTO and LPD reflect the increased oxidative stress, expressing a progress of the condition. Also, the imbalance between antioxidant defence and free radical activity is more evident in the AUTO subgroup. As a conclusion, although impaired antioxidant defence may be responsible for recurrent abortions, the recurrent abortions may also result in oxidative stress and depletion and weakness of antioxidant defence.

Abortion, Habitual↗
PubMed2000

Comparison of antioxidant and antimicrobial activities of tilia (Tilia argentea Desf ex DC), sage (Salvia triloba l.), and black tea (Camellia sinensis) extracts.

The antioxidant activity of the water extract of Tilia argentea Desf ex DC was determined by the thiocyanate method. The antioxidant activity of the water extract increased with the increasing amount of lyophilized extract (50-400 microg) added into the linoleic acid emulsion. Statistically significant effect was determined in 100 microg and higher amounts. Antioxidant activities of water extracts of tilia (Tilia argentea Desf ex DC), sage (Salvia triloba L.), and two Turkish black teas commercially called Rize tea and young shoot tea (Camellia sinensis) were compared. For comparison studies, 100 microg portions of extracts were added into test samples. All samples were able to show statistically significant antioxidant effect. Both of the tea extracts showed highest antioxidant activities, nevertheless, differences between tilia and sage and tilia and tea were not statistically significant (for both cases p > 0.05). Like antioxidant activity, the reducing power of water extract of Tilia argentea Desf ex DC was also concentration dependent. Even in the presence of 50 microg of extract, the reducing power was significantly higher than that of the control (p < 0.05) in which there was no extract. Unlike antioxidant activity, the highest reducing power activity was shown by sage extract. Among the tea extracts, young shoot extract was the most effective one, however, it had significantly lower activity than sage (p < 0.05). Although tea flower had the lowest reducing power activity, it was higher than that of tilia. But this difference was not statistically significant (p > 0.05). From these results, we could suggest that although the reducing power of a substance may be an indicator of its potential antioxidant activity, there may not always be a linear correlation between these two activities. In addition, antimicrobial activities of each of the above extracts were studied by disk diffusion methods on different test microorganisms. None of the extracts showed antibacterial activity on the studied microorganisms.

Anti-Bacterial Agents↗
PubMed2000

A malformed fetus in a rudimentary uterine horn pregnancy.

We present a case of a 13-week pregnancy with a malformed fetus in a ruptured, non-communicating rudimentary horn. The patient, a 21-year-old woman with pelvic and right-sided abdominal pain, was admitted to the gynecology clinic of our institution. A ruptured rudimentary horn pregnancy was diagnosed by ultrasonography. The fetus in the gestation sac showed evisceration of the liver and intestines and an absent left femur. There was an amniotic band extending across the body of the fetus. The ruptured horn was excised by laparotomy. The factors associated with rudimentary horn pregnancy and related fetal abnormalities are discussed.

Abnormalities, Multiple↗
PubMed2000

A 22-week cervical pregnancy.

We report on a cervical pregnancy at advanced gestational age. Misdiagnosis allowed pregnancy to proceed until the 22nd week of gestation and made its management more complicated. An abdominal hysterectomy with preservation of the adnexa was performed.

Adult↗
PubMed1999

Second-look laparotomy; factors affecting the results and the prognosis.

OBJECTIVE: To define the factors which might effect the results of second-look laparotomy (SLL) and the prognosis of patients with negative SLL. METHODS: Fourteen (42.4%) of the 33 patients who underwent SLL for primary epithelial ovarian cancer had residual disease (positive SLL), while 19 (57.6%) of them had no evidence of disease (negative SLL); 13 (68.4%) of the 19 patients who were followed without any intervention, still had no evidence of disease, while 6 (31.6%) of them had clinical recurrences. The age of the patients, histopathological type, stage and grade of the cancers, type of chemotherapy and the effectiveness of the cytoreductive surgery were presumed as prognosticators and were compared in each group of patients. RESULTS: The age of the patients, histopathological type of the carcinomas and the type of combined chemotherapy were similar in patients with negative or positive SLL and those with recurrences or no evidence of disease during the follow-up after negative SLL (p>0.05). However, the groups of patients with negative SLL and those with no evidence of disease during the follow-up period had lower grade or stage of cancers and less frequent sub-optimal cytoreduction than the groups of patients with positive SLL and those with recurrences during the follow-up, respectively (p<0.05). CONCLUSION: SLL could be selectively performed in patients with high grade or high stage ovarian carcinoma or in those patients treated by sub-optimal cytoreduction.

Adenocarcinoma↗
PubMed1999

Sources of self-identity among Turkish adolescents.

As part of the International Self-Identity Research Project, this study explored sources of identity among Turkish adolescents. The interview sample consisted of three male and three female high school students in Ankara, Turkey. The results indicated that social, familial, personal, physical, and moral-ethical dimensions contributed to adolescents' definitions of self, but to different degrees. Social and familial dimensions were very influential and were used as reference points for defining self in other areas. Physical and personal aspects of identity were also apparent, but were not as salient as social and familial dimensions. Patriotism and religion played a role in moral-ethical identity. Overall, self-identity influenced emotional state, cognitive and behavioral functioning, and social relations to a significant degree.

Adolescent↗
PubMed1998

Hormone replacement therapy and urinary prostaglandins in postmenopausal women.

The objective of the study was to observe the effects of hormone replacement therapy upon urinary prostaglandin E2 and prostaglandin F2 alpha levels in postmenopausal patients. A total number of 55 women were enrolled in this study and 15 premenopausal (PreM) healthy subjects constitute the control group. A total of 40 patients at least 12 months after their natural menopause were divided into two groups: 15 of them was not medicated hormone replacement therapy (which composed NRHRT group) while 25 of the rest, received conjugated estrogen (Premarin) 0.625 mg/day orally plus medroxyprogesterone acetate (Farlutal) 10 mg/day orally built up the RHRT group. PGE2 and PGF2 alpha levels were measured with PGE2 [125I] and PGF2 alpha [3H] RIA kits. Statistical significance was analyzed by Student's t-test for impaired data. NRHRT and RHRT patients had had increased urinary PGE2 levels when compared with PreM (P < 0.001). HRT caused a significant decrease in PGE2 levels in menopausal women (P < 0.001). Urinary PGF2 alpha values of NRHRT and RHRT were significantly lower (P < 0.001) in comparison with PreM group. There was no difference in PGF2 alpha values between two postmenopausal groups. HRT given to postmenopausal patients might have a positive impact on prostaglandins and therefore on bone turnover in a series of various mechanisms.

Adult↗
PubMed1998

Results of the anti-incontinence operations and Kegel exercises in patients with type II anatomic stress incontinence.

BACKGROUND: To evaluate the results of anti-incontinence operations and Kegel exercises in patients with pure type II anatomic stress incontinence. METHODS: After evaluation by physical, genitourinary and urologically oriented neurological examinations, urogynecologic tests, perineal ultrasonography and cystometry, pure type II anatomic stress incontinence was diagnosed in 98 patients. Modified Pereyra and Burch operations were performed in 27 and 24 of the 51 (52.0%) patients, who had surgical treatments, respectively, while the remaining 47 (48.0%) patients were advised to perform Kegel exercise. The results of the treatment methods were evaluated subjectively by patient questionnaire and 24-hour urinary diary and objectively by one-hour pad test and stress test. RESULTS: Fifty-one patients treated by anti-incontinence operations had 90.2% objective and 94.1% subjective complete successes (cure) with a mean follow-up of 13.7 months. These data were 8.5% and 14.9% respectively, for 47 patients treated by Kegel exercises with a mean follow-up of 12.8 months. Both the subjective and objective cure rates of surgical treatments were found to be significantly higher than those of Kegel exercises in patients with type II anatomic stress incontinence (p<0.01). Patients with good compliance to Kegel exercises had 20.7% subjective and 13.8% objective cures, however those with low compliance had only 5.6% subjective and no objective cures. CONCLUSIONS: These data suggested that anti-incontinence operations were more effective than Kegel exercises for the treatment of patients with type II anatomic stress incontinence.

Adult↗
PubMed1997

Gender role influences on Turkish adolescents' self-identity.

This study investigated gender role influences on Turkish adolescents' self-identity process as part of the International Self-Identity Research Project. A total of 154 male and 119 female adolescents ages 14 through 17 from urban and rural areas of Turkey were surveyed through a questionnaire. The results indicated that "family" was the dominant source of belongingness for both males and females, followed by "friendships" and "school." Friendships and education were valued more by females than by males. Symbolic items (e.g., relationships, happiness) influenced females' self-identity more than they did males, while males tended to place greater importance on material items (e.g., home, TV, sports equipment). Athletic activities were highly important in males' self-validation process while females were oriented more toward the artistic and creative. General affective attributes (e.g., honesty, respect, thoughtfulness) were similarly valued by males and females as important criteria for self-evaluation. Finally, males were more religious, patriotic, and felt stronger ties to ancestors while females appeared to be more altruistic and placed high importance on social relations.

Adolescent↗
PubMed1997

The effect of tamoxifen on the neonatal development of rat glans penis.

From the first day of birth to the fifth day, daily subcutaneous 100 micrograms tamoxifen (Tx) was injected into new-born male rats. The penises that were taken totally were fixated in 10% formaline, and then they were put in paraffin inclusion. The paraffin sections were stained with Hematoxylen-Eosin, Verhoeff and Triple on days 7, 14, 21, 28, 35 and 60. The alterations in the development of glans penis construction were examined. We found that in the glans penis of animals which were given Tx, from the 21st day, the epidermal projections were erased slowly and on the 60th day the epidermal projections and keratinisation completely ceased altogether. As a result, the development of epidermal projections in rats which were given tamoxifen in the neonatal period were hindered.

Animals↗
PubMed1996

Doppler and B-mode ultrasonography in biophysical profile scoring.

OBJECTIVE: Biophysical profile scoring (BPS) is a valuable antepartum test for establishing fetal well-being, although the time constraint in some clinics limits its extensive use. In this study we attempted to shorten the total test time without excluding any of the test components. METHOD: The non-stress test (NST) part of the BPS was performed using simultaneous pulsed wave Doppler and B-mode ultrasonography (duplex NST). It was possible to observe all the components of the BPS during the same period (duplex BPS). RESULTS: Fifty-four tests were performed on 40 pregnant patients. The mean test time was 14.3 min. A discrepancy was shown between the ultrasonographic observation and the women's perception of the fetal movements in 46% of the tests. CONCLUSION: Duplex NST is considered a more reliable test than the classical cardiotocographic NST. Duplex BPS is proposed as an easy-to-perform, compact and time-saving modification to the classical BPS.

Embryonic and Fetal Development↗
PubMed1995

Tracheoinnominate artery fistula following tracheostomy.

Tracheoinnominate artery fistula is a relatively rare but highly lethal complication occurring in patients with long-standing tracheostomies. Early evaluation of this problem and prompt aggressive therapy are necessary. When massive haemorrhage begins, immediate arterial compression, control of the airway and subsequent treatment of the injured artery may be lifesaving. Immediate surgical exploration through a median sternotomy is necessary to control the proximal and distal innominate artery. After the damaged artery has been excised, vascular reconstruction can be performed to preserve the connection between the proximal and distal ends of the innominate artery. A pedicled pericardial patch was successfully used for the tracheal reconstruction.

Adult↗