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Biomedical subjects

C Akarsu

Publications and source records attributed to C Akarsu.

8 recordsLinked to original sources

Cerebral haemodynamics in patients with pseudoexfoliation glaucoma.

PURPOSE: To evaluate the cerebral haemodynamics in patients with pseudoexfoliation glaucoma. METHODS: A total of 19 consecutive patients with pseudoexfoliation glaucoma and 19 age- and sex-matched healthy volunteers were recruited in a prospective comparative study. The affected eye in patients with unilateral glaucoma and the eye with more advanced lesions in patients with bilateral glaucoma were included in the study, and the ipsilateral middle cerebral arteries (MCA) were evaluated. While in the controls, the study eye and the ipsilateral MCA were chosen randomly. Measurements included systemic arterial pressure, heart rate, intraocular pressure (IOP), and transcranial colour Doppler parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistivity index (RI), and pulsatility index (PI). RESULTS: The mean PSV, EDV, and TAMAX were significantly lower in the patients with pseudoexfoliation glaucoma than in healthy controls (P<0.001, <0.001 and <0.001, respectively). Additionally, patients with pseudoexfoliation glaucoma had significantly higher PI and RI than healthy controls (P=0.001 and 0.04, respectively). Systolic and diastolic blood pressures (P=0.19 and 0.91, respectively) and heart rate (P=0.06) were not different between the groups. The mean IOP were significantly higher in the glaucoma patients compared with the controls (P<0.001). CONCLUSION: This study suggests that pseudoexfoliation glaucoma is associated with a reduction in the blood flow velocity and elevation in the resistance of the MCA.

Aged↗

Retinal nerve fiber layer thickness is unaffected in migraine patients.

OBJECTIVES: To search for possible structural effects of migraine on the retina. MATERIALS AND METHODS: The study group included 39 consecutive migraine patients, 15 with visual aura and 24 without aura, and 25 healthy subjects as the control group. Scanning laser polarimetry was used to measure and compare retinal nerve fiber layer (RNFL) thickness between migraine and control groups. RESULTS: The mean age of the patients and the control group were 35.64 +/- 8.3 and 35.96 +/- 9.14 years, respectively (P = 0.92) and the mean duration of migraine in patients with aura and without aura as 4.4 +/- 2.9 and 5.3 +/- 4.3 years, respectively (P = 0.68). Parameters related to RNFL thickness were found to be similar (P > 0.001) in migraine and control subjects. After examining the whole patient group migraine patients with and without aura were compared to each other and the control group individually for RNFL thickness parameters. Briefly no statistical difference was found for any of the test parameters between migraine patients with aura, without aura and controls (P > 0.001). CONCLUSION: Retinal nerve fiber layer thickness was found to be unaffected in migraine patients.

Adolescent↗

Fertility of ejaculated and testicular megalohead spermatozoa with intracytoplasmic sperm injection.

In this study the fertility and outcome of intracytoplasmic sperm injection (ICSI) using megalohead spermatozoa from the ejaculates and testicles was evaluated. Seventeen males with megalohead and pinhead sperm forms in their ejaculate were studied in 22 cycles. A high number of sperm heads without tails and abundant round spermatid forms were commonly observed. Round-headed spermatozoa were seldom accompanied by these severely abnormal spermatozoa. The majority of megalohead spermatozoa were observed to have multiple tails, were predominant in the sample, and were used for ICSI. Ejaculated megalohead spermatozoa were used for ICSI in 15 cycles, while testicular spermatozoa were used in seven cycles where there were no vital spermatozoa or spermatozoa of low vitality in the ejaculate. The same abnormal morphology was observed in the testicles as in the ejaculated spermatozoa in the same males. Mean (+/- SD) low motility 4.7 +/- 5.6% and sperm count (3.8 +/- 4.19 x 10(6)) were common findings in these severely teratozoospermic patients. A low fertilization rate (43.2%) was achieved by using megalohead sperm forms (group I, n = 17) in comparison with the control group (60.2%) which had zero normal sperm morphology according to strict criteria (group II, n = 30) (P <0.01). Furthermore, a low pregnancy rate (9.1%) was obtained in the megalohead sperm group in comparison with the control group (40%) (P <0.05). Low fertilization and pregnancy rates may be due to a high incidence of chromosomal abnormalities from severely defective spermatozoa in the ejaculate. Couples should be counselled and warned about possible low fertilization and pregnancy rates with ICSI when only pinhead and megalohead forms with a high number of sperm heads without tails are present in the ejaculate.

Adult↗

Evaluation of intrauterine abnormalities in infertile patients by sonohysterography.

The purpose of this study was to assess the usefulness of sonohysterography in the detection of abnormalities of the uterine cavity in infertile patients, compared with other diagnostic methods. Transvaginal ultrasonography, sonohysterography, hysterosalpingography and finally hysteroscopy were performed in 37 patients with primary and 25 patients with secondary infertility. Suspected uterine anomalies were also confirmed by laparoscopy. Transvaginal ultrasonography and hysterosalpingography were able to detect 36.3 and 72.7% of uterine pathologies respectively. Sonohysterography was able to detect all the anomalies except for a single endometrial polyp (90.3%). However, there was no significant difference between the diagnostic capabilities of these methods. We recommend the use of sonohysterography as an easy, cheap and noninvasive method for the diagnosis of intrauterine pathologies in infertile patients.

Adult↗

The effect of uterine volume on uterine artery Doppler velocimetry in the myomatous state.

This study aimed at testing the hypothesis that lower uterine arterial (UA) Doppler indices are caused by increased uterine volume rather than the presence of myoma. Uterine volumes were calculated and uterine and/or myomal arterial pulsatility index (PI) and resistance index (RI) were obtained by transvaginal color Doppler ultrasonography. The mean uterine volume in the myomatous group (276.2 cm3; range 65-928 cm3, n = 100) was significantly greater than that of the control group (101.4 cm3; range 36-171 cm3; n = 60; p = 0.00). The mean UA PI and RI values in the study group were significantly lower than their corresponding values in the control group (0.77 +/- 0.08 and 1.69 +/- 0.47 vs. 0.82 +/- 0.06 and 1.97 +/- 0.49, respectively, p = 0.01). When the myomatous uterine volumes of the study group were categorized into two subgroups (< 200 and > or = 200 cm2) the UA PI and RI values were lower in the latter group (p = 0.006 and p = 0.015, respectively). However, after analysis of receiver-operator-characteristic curves, none of the UA Doppler indices could differentiate the myomatous uterus from the normal uterus.

Adult↗

Prediction of perinatal outcome by middle cerebral artery Doppler velocimetry.

The relationship between pulsatility index (PI) in the middle cerebral artery (MCA) and adverse perinatal outcome was studied in 162 normal and 75 high-risk pregnancies. The intrapartum cardiotocographic (CTG) findings, the mode of delivery, 1 and 5-minute Apgar scores, the pH level of the umbilical artery, admission to the neonatal intensive care unit (NICU) and the incidence of intrauterine fetal growth retardation were recorded. In the low risk group, the PI values in the MCA were only affected in growth retarded fetuses (P = 0.0084). In the high-risk group, there was an association between the MCA PI values and 5-minute Apgar scores (P = 0.0397), umbilical artery pH values (P = 0.0068) and development of IUGR (P = 0.0376). In both groups, an abnormal intrapartum CTG, the 1-minute Apgar score, cesarean section for fetal distress and admission to the NICU were not related to PI values in the MCA. Our present study suggests that Doppler flow measurement of MCA provides useful information about perinatal outcome, especially in the high-risk pregnancies.

Adolescent↗

Hemodynamic assessment in pelvic inflammatory disease by transvaginal color Doppler ultrasonography.

One of the major signs of inflammation is a change in vascular flow and caliber. It is possible to detect these changes with the help of transvaginal color Doppler velocitometry. The purpose of this study was to evaluate the changes in pelvic circulation in cases with pelvic infection and to correlate these findings with other infectious parameters. The study group consisted of 20 cases who had the diagnosis of pelvic inflammatory disease (PID). Resistance index (RI) and pulsatility index (PI) were measured with transvaginal color Doppler ultrasonography in the uterine and ovarian arteries as well as at the tubouterine junction three times in a one-month period. At the same time the body temperature, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and leukocyte counts were recorded. Infectious parameters declined to normal values, following a pattern parallel to clinical improvement from the first until day 30. Infectious parameters revealed significant differences between days 1-7, 1-30 and 7-30. On the other hand, low resistance in all three measurement points exhibited a rapid increase on the day 7 day and plateaued until the day 30 day. Color Doppler velocitometry measurements revealed significant differences between days 1-7 and 1-30 but not between days 7-30. These findings demonstrate that as the infection subsides, the changes in vascular flow return to normal before infectious parameters do. In conclusion, it is possible to detect decreased vascular resistance in acute infection with the help of transvaginal color Doppler ultrasonography. Furthermore, color Doppler ultrasonography can accurately detect regression of the infectious process before body temperature and acute phase reactants do.

Adult↗