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Biomedical subjects

E Kaya

Publications and source records attributed to E Kaya.

At least 37 records · Page 2Linked to original sources

Fetal cord blood as an alternative source of hematopoietic progenitor cells: immunophenotype, maternal cell contamination, and ex vivo expansion.

The present study was performed to investigate the character of hematopoietic progenitor cells in fetal cord blood (CB). Thirty blood samples from fetuses at a median of 24 weeks of gestation (range 19-29) and 30 neonatal CB samples were analyzed for their immunophenotype by three-color flow cytometry and examined for the presence of female cells by fluorescence in situ hybridization (FISH). We tested the effects of different cytokine combinations (rhIL-1beta, rhIL-3, rhIL-6, rh erythropoietin [rhEPO], rhGM-CSF plus rhSCF, and rhSCF plus rhflt3-ligand) on the differentiation of 100 CD34+-enriched neonatal CB cells for up to 21 days. Ex vivo expansion of 32 unselected fetal blood samples cells was performed in the presence of rhSCF and rhflt3-ligand. The percentage of CD34+ cells in fetal blood was significantly higher compared with neonatal CB (1.24%+/-0.82% versus 0.33%+/-0.18%, p = 0.0001) and inversely correlated with the age of gestation. The contamination of fetal and neonatal CB with maternal cells was low (1.72%+/-0.89%, range 1.0%-4.0%). By using rhflt3-ligand we were able to expand committed progenitor cells while maintaining cells with stem cell function. The use of expanded fetal immature progenitors might have implications for in utero transplantation and autologous gene therapy.

Cell Culture Techniques↗

Financial burden of trauma care on a university hospital in a developing country.

BACKGROUND: Trauma care is expensive and more so for the hospitals not subsidized by the government, as is the case in developing countries. In this study, the burden of trauma care on a typical Level I trauma center in Turkey was investigated. METHODS: Medical, demographic, and financial records of trauma patients who were hospitalized in the calendar year of 1996 were analyzed. RESULTS: A total of 347 patients had complete data available for analysis. The mean Injury Severity Score was 13.3+/-0.5. Total hospital charges and charges per patient were $547,391 and $1,577, respectively. There was a positive correlation between the Injury Severity Score and the hospital charges. Although 54.2% of the patients were self-payer and the rest (45.8%) had some form of a health insurance, 5.5% ($30,496) of total hospital charges of these 347 trauma patients could not be collected by the hospital. CONCLUSION: Trauma care is expensive and reimbursement is not always possible, but the hospital's nonreimbursed money was within tolerable limits, and the overall financial balance of the hospital from the trauma care was on the positive side, even in the absence of government subsidy.

Adult↗

Correlation between maternal thyroid function tests and endothelin in preeclampsia-eclampsia.

OBJECTIVE: To investigate the relationship between results of maternal thyroid function tests and endothelin levels in preeclamptic or eclamptic women. METHODS: Thyroid hormones, TSH, and endothelin were measured in plasma or serum from 37 proteinuric, preeclamptic or eclamptic women and 20 normotensive, nonlaboring, pregnant women. Subjects were subdivided into four groups according to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and birth weights of infants with respect to gestational age. RESULTS: A significant decrease in concentrations of total thyroxine (T4) (13.76+/-1.84 microg/dL versus 10.00+/-1.48 microg/dL, P < .05), total triiodothyronine (T3) (180.58+/-30.84 ng/dL versus 141.16+/-27.31 ng/dL, P < .01), free T4 (1.45+/-0.27 ng/dL versus 1.10+/-0.21 ng/dL, P < .01) and free T3 (3.32+/-0.56 pg/mL versus 2.41+/-0.60 pg/mL, P < .01) and a significant increase in TSH (1.55+/-0.89 microIU/mL versus 2.96 +/-1.07 microIU/mL, P < .05) and endothelin (2.31+/-0.61 pg/mL versus 6.11+/-1.41 pg/mL, P < .001) levels were observed in the preeclamptic-eclamptic group compared with the normotensive group. Also, women without HELLP syndrome and without small-for-gestational-age infants had elevated levels of thyroid hormones and decreased levels of TSH and endothelin compared with other subgroups, but stastical significance was reached only in total T4 (P < .05), TSH (P < .05), and endothelin (P < .001). Birth weights of infants born to preeclamptic or eclamptic women correlated positively with total T4 (P < .01) and total T3 (P < .01) and negatively with TSH (P < .01) levels. A more significant negative correlation was found in preeclamptic-eclamptics (P < .001) between birth weight and endothelin levels than in control subjects (P < .05). Endothelin levels in preeclamptic or eclamptic women correlated negatively with total T4 (P < .01), total T3 (P < .05), free T4 (P < .05), and free T3 (P < .05) and positively with TSH levels (P < .01) compared with control subjects. CONCLUSION: Moderate decreases in thyroid hormones with concomitant increases in TSH levels in maternal serum correlated with severity of preeclampsia or eclampsia and high levels of endothelin. Changes in results of thyroid function tests induced by preeclampsia or eclampsia might be consequences of the dysfunction in the hypothalamic-pituitary-thyroid axis, secondary to the disease itself.

Adult↗

Hyaluronic acid plus heparin for improved efficacy in prevention of adhesion formation in rat uterine horn model.

OBJECTIVE: To determine the effectiveness of hyaluronic acid (HA) and heparin [unfractioned heparin (UH) or low molecular weight heparin (LMWH)] combination in reducing adhesion formation in a rat uterine horn model. STUDY DESIGN: Prospective, randomized, comparative study in a rat model was done in Surgical Research Laboratory, Erciyes University. A standard lesion was created by unipolar electrocautery in 120 uterine horns of total 60 female Wistar-Albino rats. Animals were then randomly assigned into four groups, each consisting of 15 animals: (1) control, no adjuvant given; (2) HA, 1 ml of 0.4% solution given onto each horn preoperatively; (3) HA, 1 ml of 0.4% solution given preoperatively plus 1 ml of UH given postoperatively; (4) HA, 1 ml of 0.4% solution given before injury plus 1 ml of LMWH given after injury. A second-look laparotomy was performed two weeks after surgery. The number of horns with adhesion was determined and a scoring system applied. RESULT(S): The number of horns without adhesion formation was significantly higher in HA plus UH (P<0.05) and HA plus LMWH (P<0.01) groups compared to control group. The extent, severity and total scores of adhesion formation were also found to be significantly reduced in other groups when compared to control group. Combination of HA plus UH and HA plus LMWH significantly reduced all adhesion scores compared to HA alone. But a direct comparison of the ability of HA plus UH versus HA plus LMWH in reducing adhesion scores in the rat uterine horn yielded an insignificant difference. CONCLUSION: Administration of HA before injury followed by UH or LMWH given after injury has been documented to improve the efficacy of HA alone in reducing adhesion formation.

Animals↗

The effects of different doses of medroxyprogesterone acetate on serum lipids, lipoprotein levels and atherogenic index in the menopausal period.

The purpose of our study was to make a contribution to research in determining the least harmful progestogen dose for women who have not had their uterus removed. The study was an open comparative trial. The patients were consecutively assigned to two groups. The first group (n = 19) were given 0.625-mg conjugated equine estrogen plus 5-mg medroxyprogesterone acetate (MPA), and the second (n = 18) 0.625-mg conjugated equine estrogen plus 2.5-mg MPA. Serum total cholesterol (T-cholesterol), triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels plus LDL-C/HDL-C values (atherogenic index) were measured before the study and again after 6 and 12 months. These values were compared with ANOVA and postANOVA tests (Scheffe) within the groups and with unpaired t-test between the two groups. The triglyceride serum levels in the first group were decreased in the 12th month compared to baseline levels. In addition, LDL-C/HDL-C values were significantly decreased in the 6th month, but these values slightly increased in the following 6 months. In the second group, T-cholesterol, triglyceride, LDL-C and atherogenic index were decreased in the 12th month when compared to baseline levels within the groups. This decrease was statistically significant (p < 0.05). There was no significant difference between the two groups (p > 0.05). Hormone replacement therapy with continuous 0.625-mg conjugated equine estrogen and 2.5-mg MPA had a better effect on lipid profiles than 0.625-mg conjugated equine estrogens and 5-mg MPA after 12 months of treatment.

Arteriosclerosis↗

TrkA immunoreactive neurones in the rat spinal cord.

We report the presence in rat spinal cord of a novel neuronal system expressing tyrosine kinase receptor (trkA), the high affinity receptor for nerve growth factor (NGF). TrkA immunoreactive cell bodies were observed in the intermediate grey matter of the spinal cord and were classified into three main groups: central canal cells located dorsolateral to the aqueduct, partition cells located between lamina X, and the lateral border of the intermediate grey, and a morphologically heterogeneous group which included large cells located near the lateral border. In situ hybridization confirmed that cells in all these areas express trkA mRNA. Combined immunofluorescence and retrograde Fluoro-Gold labelling was used to further characterise the projections and neurotransmitter profile of the trkA cells. Although often located in the vicinity of preganglionic cell groups, trkA immunoreactive cells are not themselves preganglionic. Rather, the central canal and partition cells belong to a neurochemically complex cholinergic propriospinal system. Many partition cells coexpress trkA, choline acetyltransferase (ChAT), the low affinity neurotrophin receptor, p75, and nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d). In contrast, trkA immunoreactive central canal cells express ChAT, but do not express p75 and only a subpopulation express NADPH-d. The large trkA immunoreactive cells located on the lateral border do not express ChAT. TrkA immunoreactive fibres were also present and were located in the dorsal horn, in the dorsal columns, and in a bundle ventral to the aqueduct. However, double labelling revealed that the trkA immunoreactive fibres are not intrinsic but are primary afferent in origin and coexpress p75. The location of this novel trkA neuronal system is consistent with it having a role in the segmental integration of autonomic outflow. NGF could affect this system by modulating neuronal phenotype and/or synaptic efficacy.

Animals↗

Effects of vitamin E and cimetidine on peritonitis-induced lipid peroxidation.

To investigate the effects of acute fecal peritonitis on plasma and tissue lipid peroxidation and possible protective effects of vitamin E (Vit E) and cimetidine at 4 h in a rat peritonitis model, four groups were designated as: controls, peritonitis, Vit E and cimetidine. Plasma, liver, lung and kidney thiobarbituric acid reactive substances (TBARS) and conjugated diene (CD) levels were measured to monitor oxidative injury. The present fecal peritonitis model caused a significant elevation in liver TBARS; however, neither Vit E nor cimetidine was effective in preventing TBARS formation. Administration of Vit E and cimetidine caused significant decrements from the peritonitis value in liver and lung CD levels.

Animals↗

Recurrent molar pregnancy after ovulation induction and repeat ovulation induction. A case report.

BACKGROUND: Although hydatidiform mole is not commonly encountered following ovulation induction, patients who have already had molar pregnancies are at increased risk of developing further molar diseases with worsening histologic characteristics. That fact underlies the ethical dilemma of repeat ovulation induction. CASE: A 38-year-old woman, gravida 3, para 0, had three consecutive episodes of hydatidiform subsequent to clomiphene citrate and gonadotropin ovulation induction. She seems to be the first in the literature to develop three consecutive molar pregnancies without a normal intrauterine pregnancy. CONCLUSION: Although ovulation induction commenced again in this patient after she gave informed consent, the risks underlying the ethical dilemma persist.

Adult↗

A strange condition: postmenopausal pregnancy.

Climacterium is characterized by symptoms that occur as a result of the differentiation of hormonal equilibrium. It begins around the age of 40 and continues up to the age of 60. In this period cycles are usually anovulatory. This paper presents a case which may be diagnosed as abortus incompletus despite the patient being in menopause for five years previously.

Abortion, Incomplete↗

Failure of artificial insemination of husband's semen in the treatment of male infertility.

In the management of infertility, in case semen quality is found insufficient and could not be improved by medical means, handling the available spermatozoa in the most beneficial way has been aimed. Thus, artificial insemination with low quality semen has become a therapeutic alternative. In this study homologous artificial insemination has been used to treat infertility caused by oligoasthenospermia. Eighteen couples have been treated for 58 cycles by intrauterine or paracervical insemination using cervical cups. During the same period 42 cycles with timed vaginal intercourse have been assessed. Though no pregnancies could be obtained following artificial insemination, one pregnancy occurred during no-treatment cycles.

Adult↗

Effect of CO2 pneumoperitoneum on bacteremia in experimental peritonitis.

Bacteria transfer to the blood from the peritoneum is thought to be augmented when the diaphragmatic stomata are activated by an increased intra-abdominal pressure. Therefore, it may be expected that the increase in intra-abdominal pressure during laparoscopic surgery can augment the absorption of bacteria from the peritoneum to the blood. The present study examines the effect of pneumoperitoneum on bacteremia in experimental Escherichia coli peritonitis in rabbits. Twenty-four rabbits were divided into three groups. 10(9) colony forming units of E. coli were inoculated intraperitoneally into group 1 (n = 8). Group 2 (n = 8) received an identical bacterial inoculum and underwent a midline laparotomy at the 2nd hour. Group 3 (n = 8) also had an identical bacterial inoculum which was followed by 15 mm Hg CO2 pneumoperitoneum for 1 h at the 2nd hour. In all groups, the growth value (GV) was measured in the 3rd- and 6th-hour blood cultures using the Bactec NR 730 system. There was no difference in the 3rd- and 6th-hour GVs (p > 0.05) among the three groups. In conclusion, pneumoperitoneum with 15 mm Hg CO2 in experimental E. coli peritonitis did not increase the bacteremia when compared with the control and laparotomy groups.

Animals↗

Colonic actinomycosis: report of a case and review of the literature.

Abdominal actinomycosis is a rare entity which presents some difficulty in establishing a correct preoperative diagnosis. We report herein the case of a 41-year-old woman who developed abdominal actinomycosis involving the left colon and the surrounding retroperitoneum. The patient, who had an intrauterine contraceptive device (IUCD) in situ, presented with left flank pain and the signs and symptoms of an intraabdominal mass, which was initially diagnosed as a neoplasm originating from the left colon or the retroperitoneal space. Thus, a left colectomy was performed, but the histopathological pathological diagnosis revealed abdominal actinomycosis. We evaluated the diagnosis and treatment of this disease in light of the knowledge acquired from the available literature on this rare entity.

Actinomycosis↗

Urodynamic evaluation in spinal cord injuries.

Spinal cord injury, regardless of its level, causes flaccid paralysis during the shock phase affecting the detrusor and rectal musculature. Then, depending on the level and severity of the lesion, the bladder gains spasticity or remains flaccid. Monitoring the reflex behaviour of detrusor and sphincter activities helps to select the treatment modalities. Thirty patients with cord injuries of various levels have been urodynamically tested at 3-month intervals. The shock phase of the acutely tested patients lasted about 8-9 weeks. Eventually, 23 of the cases were hyperreflexic, while 7 cases remained areflexic: 2 had detrusor-sphincter dyssynergia. The response to treatment has been investigated by cystometrographical and electromyographical methods.

Adolescent↗

Relation between birth weight and thyroid function in preeclampsia-eclampsia.

Maternal thyroid function was investigated in 37 preeclamptic and 8 eclamptic patients and 45 normal pregnant women in the third trimester as controls. There were significant correlations between maternal values of total thyroxine (TT4), total triiodothyronine (TT3), thyroxine-binding globulin, free thyroxine index and birth weight of newborns in the patients with preeclampsia-eclampsia, but there was no correlation in the controls. Also, the maternal free thyroxine, free triiodothyronine, triiodothyronine uptake and thyroid stimulating hormone values showed no correlation with the birth weights of babies in both groups. The reduced serum concentrations of TT4 and TT3 may reflect the severity of preeclampsia.

Adult↗

Isolated ovarian polyarteritis nodosa.

Polyarteritis nodosa is a rare disorder and a form of systemic vasculitis. A 48 year-old female was admitted to the hospital because menorrhagia and pelvic pain in February 1993. The patient underwent exploratory laparotomy resulting in a total hysterectomy and bilateral salpingo-oophorectomy for myoma of uterus and a right adnexal cystic mass. Histopathologic examination revealed left ovarian periarteritis nodosa. Further investigation and 9 months follow-up failed to show any systemic involvement. To our knowledge the isolated ovarian polyarteritis nodosa is the first case in the literature.

Arteries↗

Ultrastructural and surface-area changes of acute and traditionally expanded full thickness skin grafts.

The purpose of this study was to determine the effect of expansion on the survival of full thickness skin grafts. In eight pigs 300 ml rectangular tissue expanders were placed into subcutaneous pockets. In four pigs (group I), the expanders were inflated rapidly with a mean 200 ml saline. In the other four pigs (group II), a mean total of 300 ml saline was injected in weekly increments over eight weeks. At the completion of expansion, full thickness skin grafts were taken from the expanded area and sutured back to the donor defects. In both groups surviving graft areas were similar to controls (p greater than 0.06). This study showed that acute and traditional expansion does not lead to increased loss of full thickness skin grafts of the expanded skin.

Animals↗

Efficacy of tenoxicam on intra-abdominal adhesion prevention in a rat model.

The aim of this study was to investigate the effect of tenoxicam as a non-steroidal anti-inflammatory drug (NSAID) on intra-abdominal adhesion prevention in a rat model. Altogether 50 Wistar-Albino rats weighing 220-280 g were assigned to five groups, each of which was made up of 10 rats. All the rats were anaesthetized and prepared for sterile surgery. After a mid-line laparotomy was performed, a 1 cm area of the caecum was rubbed with gauze until subserosal haemorrhage developed, and then a 5 mm-diameter part of the peritoneum on the right side of the abdominal wall was removed. Prior to complete closure, 3 ml of the test material was placed into the abdominal cavity. On the eighth day the rats were killed and the adhesion score was determined. The groups and their mean adhesion scores were as follows: control group (normal saline), 2.5; group of dilution buffer, 1.8; tenoxicam (0.125 mg/kg), 1.3; tenoxicam (0.25 mg/kg), 1.3; and tenoxicam (0.5 mg/kg), 0.9. The differences between the adhesion scores among all the groups (P < 0.05, Kruskal-Wallis test), and those between the tenoxicam groups and control group (P < 0.05, Mann-Whitney U-test), were significant. Thus a single instillation of tenoxicam into the peritoneal cavity at the time of surgery reduced adhesion formation effectively in this model, irrespective of dosage.

Abdomen↗