Successful treatment of thymoma-associated erythroid hypoplasia and thrombocytopenia with paclitaxel.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
E Kurt
Publications and source records attributed to E Kurt.
Craniocerebral gunshot wounds: results of less aggressive surgery and complications.
Four hundreds patients who suffered from cranial gunshot wounds injuries were analyzed. Surgical therapy, primary and secondary debridement, including repair of dural defects and removal of retained intracranial bone and metal fragments were applied. Central nervous system infections were mostly observed in cases with cerebrospinal fluid (CSF) fistulas. In 130 of 400 patients, bone and metal fragments were determined on control CT scans. Most of the deaths in this group of patients were attributed to the influence of brain injury and occurred within the first month after injury. Fragments retained after first debridement were followed periodically by CT scans. Surgery was not performed until the infection developed. Retained fragments did not increase the infection risk but high rates of infection did occur in cases with CSF fistulas. The presence of diffuse brain damage, brainstem injury, CNS infection, or ventricular injury was associated with a poor outcome. The prognostic importance of complications such as intracranial haemorrhage, epileptic seizures, hydrocephalus, was also investigated.
Adolescent↗
Therapy, outcome and analysis of c-kit expression in patients with extrapulmonary small cell carcinoma.
In this study, we aimed to investigate the clinicopathological characteristics with special emphasis on c-kit expression and the treatment results of patients with extrapulmonary small cell carcinoma (EPSCC). The medical records of the patients with EPSCC were reviewed, and the data regarding patient and tumour characteristics, treatment and clinical outcome were retrieved and analysed. A total of 28 patients with the diagnosis of EPSCC were identified. There were 19 males and 9 females, with a mean age of 56.5 years. Patients with limited disease (LD) (n = 13) were treated with surgery, chemotherapy (CT) and radiotherapy with different sequences. Patients with extensive disease (ED) (n = 15) were mainly treated with combination CT. The median overall survival was 14.5 months in patients with LD compared to 11 months in those with ED (p = 0.029). Ten patients (36%) showed c-kit overexpression. There was no significant difference between the survival of c-kit-positive and c-kit-negative patients (p = 0.367). In conclusion, our study demonstrates that the prognosis of EPSCC is poor despite currently available treatments. C-kit may be considered as a potential target for novel therapeutical approaches.
Adult↗
Comparison of the serum erythropoietin levels in chemotherapy-naive and cisplatin-treated cancer patients.
There are conflicting data about the effects of cisplatin on erythropoietin (EPO) response to anemia. Aim of our study was to investigate whether endogenous EPO response to anemia in cisplatin treated patients was insufficient in comparison to the anemic chemotherapy-naive cancer patients and non cancer patients with iron deficiency anemia. Patients who had hemoglobin (Hb) levels of less than 110 g/l were included in the study. Fifteen chemotherapy- naive cancer patients were enrolled in Group A. Group B consisted of 15 patients who had been treated with three cycles of cisplatin chemotherapy and then became anemic and in Group C were included 15 patients who had iron deficiency anemia, without any malignancy. The mean Hb values were not different between all groups (102.8+/-39.8 g/l, 103.1+/-2.5 g/l and 99.3+/-3.6 g/l in Group A, Group B and Group C, respectively). However, EPO levels were found to be significantly lower in Group A and Group B than Group C (29.63+/-9.09 mU/ml, 20.87+/-2.43 mU/ml and 85.38+/-25.72 mU/ml, respectively; p=0.017 Group A vs. Group C, p=0.005 Group B vs. Group C). No significant difference was found between Group A and B (p=0.917). Opposite the iron deficiency anemia, cancer anemia is associated with an inadequate EPO response to anemia and administration of cisplatin does not lead to it further deterioration.
Anemia↗
Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake: survivors vs non-survivors.
BACKGROUND: We reviewed medical records of dialyzed patients admitted to our hospital after the Marmara earthquake and evaluated the factors affecting mortality in survivors and non-survivors according to the survival times. PATIENTS AND METHODS: Crush syndrome (CS) was diagnosed in 110 patients. Dialysis treatment was initiated in 60 patients; 21 of all died. The patients were divided into 2 groups which consisted of 39 survivors (Group A, 25 male, 14 female, mean age: 31 +/- 2.2 years) and 21 non-survivors (Group B, 9 male, 12 female, mean age: 27 +/- 3.0 years). Victims treated by any form of renal replacement therapy, including daily or intermittant hemodialysis and/or continuous venovenous hemodiafiltration. Clinical and laboratory findings were recorded regularly. Statistical analysis was performed with Kaplan-Meier method, log rank test and Cox regression analysis for the survival functions. RESULTS: APACHE II scores were 13.5 +/- 0.5 for Group A and 13 +/- 0.9 for Group B. Dialysis support was started to patients in Group A in a mean period of 2.8 +/- 0.2 days and in Group B in a mean period of 3.7 +/- 0.6 days after the earthquake (p > 0.05). The most frequent site of trauma was lower extremity (61.5%) and upper + lower extremities (23%) in Group A, and lower extremity (38.1%) and trunk + lower extremity (23.8%) in Group B. The frequencies of abdominal trauma, pelvic fracture and thoracic trauma in Group B were 23.8%, 19% and 14.2%, respectively. Multiple trauma was more frequent in Group B than in Group A (42.8% vs 2.5%). The rates of fasciotomy, amputation and surgery were similar in both groups. The frequency of sepsis was higher in non-survivors. In our center, the overall mortality rate was 8%, mortality rate in CS was 21% and in dialyzed patients it was 35%. Mortality was mainly associated with sepsis. Survival periods (52.3 +/- 4.0 days) in Group A were longer than in Group B (17.3 +/- 2.5 days). With Cox regression analysis, the parameters such as systolic hypotension on admission, female gender, high serum peak creatine kinase (> 20,000 U/l) and multiple trauma including thoracic and abdominal regions, were factors increasing risk of mortality. CONCLUSION: As a result, sepsis, multiple trauma and severe crush injury were the main factors increasing mortality risk in dialyzed injuries after the earthquake.
Acute Kidney Injury↗
Two in one: patient-controlled epidural analgesia (PCEA) to prevent erection and control pain in adult hypospadias-surgery patients.
Following penile surgery, erections are painful and may prejudice the result, because the sutures may not withstand a rigid erection. Therefore, prevention of erection and management of pain are extremely important following hypospadias repair, especially in adult patients. In this prospective study, we aimed to achieve these goals by using an epidural block with patient-controlled analgesia. We allocated 20 adult patients scheduled for hypospadias repair randomly either to receive or not to receive epidural analgesia. Postoperative pain was scored according to a standardised scoring system, based on a 10 point visual analogue scale. In group I (n = 10), analgesia was provided by a 3 ml h(-1) continuous infusion of fentanyl (2 microg) and bupivacaine solution (0.125%) in 1 ml saline via an epidural catheter for the first 3 days. Patient-controlled epidural analgesia was administered with an additional 5 ml of the same solution when the pain score was high (> 4). After 3 days, fentanyl was excluded from the treatment protocol, and analgesia was maintained with bupivacaine (0.125%). In group II (n = 10, control group), an epidural catheter was not inserted, and analgesia was maintained with pethidine (1 mg kg(-1)). Pain management was found to be more effective in group I. No erections occurred in group I, but the erection rate in group II was mean +/- s.d. = 1.7 +/- 0.2. The differences were found to be statistically significant (P<0.05). We highly recommend the technique described here, which offers efficient analgesia and control of erection in adult hypospadias patients.
Adolescent↗
Prevention of posterior capsule opacification by intraoperative single-dose pharmacologic agents.
PURPOSE: To determine whether an intraoperative single dose of dexamethasone, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDTA and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Celal Bayar University, School of Medicine, Manisa, and Department of Pathology, Dokur Eylül University, School of Medicine, Izmir, Turkey. METHODS: Fifty-four rabbits were randomly divided into 6 groups. Dexamethasone (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDTA and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hydrodissection and 0.9 cc into the capsular bag after phacoemulsification. The sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evaluated histologically. RESULTS: The drugs were significantly effective in preventing PCO compared with the control (P <.005). Dexamethasone had a weaker effect than the other drugs. In histological analysis, although monolayer LECs in the dexamethasone and diclofenac groups were observed, there was no proliferative activity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in contrast to the multilayer cells in the control. CONCLUSIONS: Intraoperative single-dose application of EDTA, EDTA+RGD peptide combination, and MMC significantly prevented the development of PCO in rabbit eyes. Diclofenac was less effective but also reduced PCO. Although dexamethasone did not prevent the proliferation of LECs, it decreased PCO clinically.
Animals↗
Manipulating the fatty acid composition of muscle and adipose tissue in beef cattle.
Enhancing the n-3 polyunsaturated fatty acid (PUFA) content of beef is important in view of the generally saturated nature of fatty acids in ruminant meats and the negative effect this can have on human health. This study examined the effects of different sources of dietary n-3 PUFA on the performance of steers and the fatty acid composition of m. longissimus thoracis muscle and associated subcutaneous adipose tissue. Animals were fed ad libitum on grass silage plus one of four concentrates (60:40 forage:concentrate on a DM basis) containing differing sources of lipid: Megalac (16:0), lightly bruised whole linseed (18:3n-3), fish oil (20:5n-3 and 22:6n-3) and a mixture of linseed and fish oil (1:1, on an oil basis). Diets were formulated so that total dietary oil intake was 6 %, approximately half of which was from the experimental test oil. Linseed feeding not only increased the levels of 18:3n-3 in muscle phospholipid from 9.5 to 19 mg/100 g muscle but also enhanced the synthesis of 20:5n-3, the level of which increased from 10 to 15 mg/100 g muscle. Linseed also increased the proportion of 18:3n-3 in muscle neutral lipid and in adipose tissue lipids by a factor of 1.64 and 1.75 respectively. Fish oil feeding doubled the proportion of 20:5n-3 and 22:6n-3 in muscle phospholipids. The proportion of 18:1 trans in muscle neutral lipid was higher on the n-3 PUFA diets than the control diet, 0.04 and 0.02 respectively. Despite the implied modification to rumen metabolism, lipid source did not affect feed intake, growth rate, cold carcass weight or carcass fatness, but carcass conformation score was higher on fish oil treatments (P < 0.05). However, total muscle fatty acid content was not different between treatments and ranged from 3.5-4.3 % of tissue weight. The increase in n-3 PUFA in the meat produced by feeding linseed or fish oil lowered the n-6:n-3 ratio but had little effect on the P:S ratio.
Adipose Tissue↗
Relationships between behavioral and meat quality characteristics of pigs raised under barren and enriched housing conditions.
In this study the effects of barren vs enriched housing conditions of pigs on their behavior during the lairage period (2-h holding period before slaughter), carcass characteristics, postmortem muscle metabolism, and meat quality were studied. The barren housing system was defined by common intensive housing conditions (i.e., with slatted floors and recommended space allowances), whereas the enriched environment incorporated extra space and straw for manipulation. Salivary cortisol concentrations were measured before transport and at the end of the lairage period. During the lairage period the percentage of time spent walking and fighting by the pigs was registered. Carcass characteristics such as weight, meat percentage, and backfat thickness were determined. At 5 min, 45 min, 4 h, and 24 h postmortem, pH, temperature, and lactate concentrations were determined in the longissimus lumborum (LL) and biceps femoris (BF) muscles. Capillarization of the muscle, mean muscle fiber area, and color and drip loss after 2 and 5 d of storage were determined for both muscle types. Pigs from the barren environment had a significantly higher increase in cortisol from farm to slaughter, but no differences in behavior were observed during the lairage period. Carcass characteristics did not differ between pigs from barren and those from enriched housing conditions. Postmortem lactate formation was significantly lower in LL muscles of enriched pigs at 4 and 24 h postmortem. Capillary density and mean muscle fiber area did not differ between the groups of pigs. The percentage of drip loss at 2 and 5 d after storage of LL muscle samples from enriched-housed pigs was significantly lower than that of the barren-housed pigs. Similar tendencies were found for the BF muscle from pigs kept in an enriched environment, but these were not statistically significant. The housing system did not affect meat color. It is concluded that on-farm improvement of animal welfare by environmental enrichment can also lead to beneficial economic effects after slaughter by improving the water-holding capacity of pork.
Abattoirs↗
Analysis of hearing loss after shunt placement in patients with normal-pressure hydrocephalus.
OBJECT: Following shunt placement for treatment of normal-pressure hydrocephalus (NPH), several patients suffered hearing loss. The authors undertook a study to analyze this outcome. METHODS: Sixteen patients in whom NPH was diagnosed were treated by placement of a ventriculoperitoneal shunt. Their hearing was assessed pre- and postoperatively by using pure tone audiometry. Two thirds of the ears tested showed a postoperative hearing loss of more than 10 dB. Recovery of the hearing loss occurred 6 to 12 weeks after shunt placement in 75% of the ears examined. CONCLUSIONS: Although shunt insertion for treatment of NPH results in a decrease in hearing, most of the loss can be recovered.
Aged↗
Penetration of topical and oral ofloxacin into the aqueous and vitreous humor of inflamed rabbit eyes.
PURPOSE: This study aimed to investigate the penetration of topical and oral ofloxacin into aqueous humor and vitreous humor in post-traumatic endophthalmitis model in rabbits. METHODS: A standardized intraocular infection after penetrating injury was made in the right eyes of 16 rabbits. Intraocular infection was induced by intravitreal injection of a suspension of Staphylococcus aureus. The intact left eyes were maintained as controls. The animals were divided randomly into two groups. (1) In the topical group, two drops of ofloxacin 0.3% eyedrops were instilled to both eyes every 30 min for 4 h. (2) In the topical-oral group, two doses of 25 mg/kg of ofloxacin at 12-h intervals were given orally, then the protocol of the first group was applied. Aqueous and vitreous humor samples were taken 30 min after the last drop. Ofloxacin concentrations were measured by using HPLC. RESULTS: Mean aqueous levels of ofloxacin in control eyes were: 3.25 +/- 2.55 microg/ml in topical group. 4.58 +/- 5.39 microg/ml in topical-oral group. Mean aqueous levels in inflamed eyes were: 5.21 +/- 4.55 microg/ml in topical group, 10.34 +/- 8.88 microg/ml in topical-oral group. Mean vitreous levels of ofloxacin in control eyes were: 0.17 +/- 0.07 microg/ml in topical group, 1.30 +/- 1.23 microg/ml in topical-oral group. Mean vitreous levels in inflamed eyes were: 0.35 +/- 0.22 microg/ml in topical group, 3.48 +/- 2.69 microg/ml in topical-oral group. There was no significant difference among the groups (P > 0.05), however. CONCLUSIONS: The result of this study suggests that oral supplementation of ofloxacin to topical instillation increased the ocular levels of ofloxacin in the post-traumatic endophthalmitis model. Mean drug concentrations in aqueous and vitreous humors were above the 90% minimum inhibitory concentrations (MIC90) for most of the common microorganisms causing endophthalmitis in all eyes, except in the vitreous humors of the intact eyes instilled topically.
Administration, Topical↗
The effects of prolonged acute use and inflammation on the ocular penetration of topical ciprofloxacin.
PURPOSE: To study the aqueous and vitreous penetration of ciprofloxacin after prolonged acute topical administration and to investigate the effects of inflammation on drug penetration. METHODS: A standardized model of intraocular infection after penetrating injury was made in the right eyes of eight rabbits. The intact left eyes were maintained as the control. Two drops of ciprofloxacin 0.3% eyedrops were instilled topically every 1 h for 7 h to all eyes of the rabbits. Aqueous and vitreous samples (100 microl) were obtained half an hour after the last drop. Instillation was continued for 7 h more and samples were obtained as before. Drug concentrations were measured using HPLC. RESULTS: The mean aqueous humor levels of ciprofloxacin were: in control eyes 1.31 +/- 0.78 microg/ml after 7 h and 1.85 +/- 1.69 microg/ml after 14 h of instillation: in inflamed eyes 2.18 +/- 1.02 microg/ml after 7 h and 2.91 +/- 2.12 microg/ml after 14 h. The mean vitreous humor levels were: in control eyes 0.65 +/- 0.44 microg/ml after 7 h and 0.72 +/- 0.8 microg/ml after 14 h of instillation; in inflamed eyes 0.67 +/- 0.77 microg/ml after 7 h and 1.01 +/- 0.43 microg/ml after 14 h. However, the differences among the groups were not significant (P > 0.05). CONCLUSIONS: Ciprofloxacin penetration into aqueous humor was higher in 14-h topical application than that for 7 h. Inflammation increased the penetration of topical ciprofloxacin into aqueous while administered for 7 h and into both aqueous and vitreous humor while administered for 14 h. c
Administration, Topical↗
Intramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature.
The authors report the case of a 70-year-old woman who developed a Brown-Sequard-syndrome within 6 weeks caused by an intramedullary spinal cord metastasis of an occult renal cell carcinoma. Intramedullary metastases are rare and represent only 4-8.5% of central nervous system metastases. An important feature of intramedullary metastases is the rapid progression of neurological deficits which necessitates rapid treatment. There are only eight earlier reports of intramedullary metastasis due to renal cell carcinoma (Schiff D, O'Neill BP. Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology 1996;47:906-12; Belz P. Ein Fall von intramedullaerer Grawitz-Metastase im Lumbalmark. Frankfurt Z Pathol 1912;10:431-44; Gaylor JB, Howie JW. Brown-Sequard-syndrome. A case of unusual aetiology. J Neurol Neurosurg Psychiatry 1938;1:301-5; Kawakami Y, Mair WGP. Haematomyelia due to secondary renal carcinoma. Acta Neuro Pathol 1973;26:85-92; Strang RR. Metastatic tumor of the cervical spinal cord. Med J Aust 1962;1:205-6; Von Pfungen. Uber einige Fälle von Haematomyelie nichttraumatischen Ursprungs. Wien Klin Rdsch 1906;20:44-50; Weitzner S. Coexistent intramedullary metastasis and syringomyelia of cervical spinal cord. Report of a case. Neurology 1960;674-8). To the best of our knowledge this is the first report on a patient in whom symptoms from the metastasis of a renal cell carcinoma preceded the detection of the primary tumor. This report presents the clinical, neuroradiological and histopathological findings of an intramedullary metastasis of a renal cell carcinoma and provides an overview of the literature on intramedullary spinal cord metastases.
Aged↗
Interscalene brachial plexus block and pulmonary function.
Explore the source record for details and available documents.
Brachial Plexus↗
Methylprednisolone and vitamin E therapy in perinatal hypoxic-ischemic brain damage in rats.
To study the efficacy of methylprednisolone/vitamin E in reducing cerebral edema and improving the ultimate neuropathological outcome in perinatal cerebral hypoxia-ischemia, 40 seven-day postnatal rats were subjected to right common carotid artery ligation followed by exposure to 8% oxygen at 37 degrees C for 3 h. The animals were divided into groups. Twenty rat pups received an intraperitoneal injection of 30 mg/kg body weight methylprednisolone and vitamin E (100 U/kg) immediately following cerebral hypoxia-ischemia. Control animals received either no therapy (n = 10) or an equivalent volume of normal saline (n = 10). After 72 h of recovery from hypoxia-ischemia, the animals were killed and their brains were examined to measure the water contents in the right and left hemispheres (29 rat pups), whereas the others were killed at 21 days for neuropathological examination. Methylprednisolone/vitamin E-treated rats had significantly less water content in the right hemisphere (87.08 +/- 0.28%, mean +/- S.E.M.) than saline-treated animals (89.07 +/- 0.37%, mean +/- S.E.M., P < 0.0001). Methylprednisolone/vitamin E significantly reduced water content in the right hemisphere of the brain. Neuropathological study was performed on nine rat pups. The brains of four methylprednisolone/vitamin E- and five saline-treated pups were examined at the end of the 21-day recovery period. Two groups of the right cerebral cortex included thinning of the cortex. Significantly less damage was seen in the methylprednisolone/vitamin E-treated pups. Our study suggests that trials of methylprednisolone/vitamin E might be effective if they are given to the mother at risk of fetal hypoxia during labor or to the hypoxic infant right after delivery in preventing hypoxic brain damage.
Animals↗
Cervical spine involvement in metastatic colorectal carcinomas: should we think about an alternative route of metastasis other than Batson's plexus?
Explore the source record for details and available documents.
Adenocarcinoma↗
The effect of long-term use and inflammation on the ocular penetration of topical ofloxacin.
PURPOSE: To study the penetration of ofloxacin into the aqueous and vitreous humors after long-term topical administration and to investigate the effects of inflammation on drug penetration in rabbits. METHODS: A standardized model of intraocular infection after penetrating injury was achieved in the right eyes of 16 rabbits. The animals were randomly and equally divided into two groups. The intact left eyes of the groups were maintained as the control. Ofloxacin eyedrops (0.3%) were instilled into all eyes at a frequency of 2 drops every hour for 7 hours in the first group and for 14 hours in the second group. Half an hour after the last drop, samples of the aqueous and vitreous humors were taken and ofloxacin concentrations were measured by using HPLC. RESULTS: The mean aqueous humor concentrations of ofloxacin in control eyes after 7 and 14 hours of instillation were: 1.45 +/- 0.93 microg/ml and 2.48 +/- 0.33 microg/ml, respectively; those in infected eyes 2.35 +/- 1. 84 microg/ml and 3.49 +/- 1.47 microg/ml, respectively. However the differences among the groups were not significant (p > 0.05). The vitreous ofloxacin concentrations in the control eyes were similar after 7 and 14 hours of instillation (0.23 +/- 0.14 microg/ml, 0.27 +/- 0.10 microg/ml, respectively). In infected eyes, the mean vitreous ofloxacin concentration after 14 hour of instillation was significantly higher than that in control eyes (p < 0.05; 0.4 +/- 0. 09 microg/ml, 0.29 +/- 0.11 microg/ml, respectively). The mean vitreous ofloxacin concentration in infected eyes after 14 hours instillation was not significantly higher than that after 7 hours instillation. CONCLUSIONS: Topical ofloxacin instillation for 7 or 14 hours yields aqueous concentrations above the MIC(90) for common ocular pathogens. Prolonged application and the presence of inflammation increased the penetration of ofloxacin into the vitreous humor.
Administration, Topical↗
The effects of acetylcholine and propolis extract on corneal epithelial wound healing in rats.
PURPOSE: To investigate the effects of topical acetylcholine and topical administration of propolis, a natural beehive product, on corneal epithelial wound healing. METHODS: The whole corneal epithelium was debrided in 42 eyes of 21 rats by mechanical scraping with a dulled scalpel blade. Animals were divided into three groups. Group 1 received topical 1% water extract of propolis (WEP), group 2 received topical acetylcholine (ACh), and group 3 (control group) received topical phosphate-buffered saline, 6 times a day for 3 days, starting immediately after debridement. The area of the corneal epithelial defect was stained with fluorescein, photographed, and then measured every 12 h. The mean epithelial defect area and the mean percentage of epithelial defect remaining at each follow-up were compared between the groups. RESULTS: The mean epithelial defect area and the mean percentage of epithelial defect remaining at each time were significantly smaller (p < 0.001, p < 0.05, respectively) in the ACh and propolis groups as compared with control groups. There was no statistically significant difference between the propolis or ACh groups at any time (p > 0.05). At 72 h, the mean percentage of defect remaining was 2.58% in the ACh group, 1.3% in the propolis-treated group, and 8.68% in the control group. CONCLUSIONS: This study demonstrated that ACh and propolis facilitated corneal epithelial wound healing of rats. Although the mechanisms of the effect of propolis on wound healing and its clinical use still remain to be determined, ACh may have a place in the treatment of corneal epithelial injuries.
Acetylcholine↗