Biomedical subjects
Publications and source records attributed to E Yildirim.
Trabeculectomy was performed in 24 eyes affected by primary open angle glaucoma. Visual fields were measured using automated perimetry preoperatively and in the first, third, sixth and twelfth months after surgery. Significant improvement in visual field occurred in 96% of cases.
Six patients with severe metabolic alkalosis were treated with intravenous hydrochloric acid (HCl) infusion. HCl was given through a central venous catheter, at a concentration of 0.1 mEq per ml. At least two of the following criteria were considered for initiation of the therapy: An arterial pH of greater than 7.45, a base excess (BE) of greater than +7 mmol/L, a PaCO2 of greater than 50 mmHg. The HCl amount was calculated using the BE formula, however, two thirds was infused for avoiding excessive acid loading. Patients were monitored by the blood gases, serum electrolytes, hemoglobin, hematocrit, bilirubin determinations and blood smear findings. While a significant decrease was noticed in pH and BE values, moderate changes were detected in PaCO2 due to different ventilatory status of the cases. All laboratory test results remained within normal limits and no complication was encountered. The advantage of the therapy is that less volume is needed for the correction of alkalosis, particularly in the cases requiring fluid restriction. HCl therapy, moreover, is a safe and time-saving method because of having rapid response to the treatment in the critically ill surgical patients.
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Fifteen new (2/4-substituted)benzaldehyde (2-oxobenzothiazolin-3-yl)acetohydrazones were synthesized and their structures were elucidated by NMR and elemental analysis. Their anticonvulsant activity was tested by a pentylenetetrazole induced seizure test. Compounds 4e and 4h were found to be the most promising among the others.
BACKGROUND: Surgical flap necrosis is one of the most common problems after procedures such as mastectomies and regional lymph node dissections. In this prospective randomized study, the effect of topical dimethylsulfoxide (DMSO) on skin flap viability was analyzed. MATERIAL AND METHODS: Sixty-six consecutive patients with breast cancer who had skin flaps created during mastectomy were randomized into two groups. Topical DMSO was applied on surgical flaps of the patients in Group-1, topical saline was applied for those in Group-2. Necrotic flap edges were recorded during the follow-up period for each patient, then excised and weighted in a blind manner. RESULTS: The mean weight of flap edge necrosis was 23.48 +/- 9.5 (mean +/- sem) microg in DMSO group and 126.27 +/- 44.8 microg in control group (p = 0.03). The hospitalization period was 9.6 +/- 0.5 days and 11.8 +/- 0.8 days in DMSO group and control group respectively (p = 0.02). There were no side effects due to DMSO. CONCLUSION: The application of DMSO reduced skin flap necrosis and improved outcome of surgical flaps.
It has been shown that serum levels of tumor necrosis factor alpha (TNF-alpha) are increased in breast cancer patients. There are few data available on the reduction of serum levels of this cytokine following chemotherapy. The aim of this study was to determine the effect of neoadjuvant chemotherapy on serum concentrations of TNF-alpha and the relation to response rates in locally advanced breast cancer. Twenty consecutive patients with non-inflammatory stage III-B breast cancer achieving a partial or complete clinical response to three courses of neoadjuvant chemotherapy followed by modified radical mastectomy were prospectively included in the study and evaluated. Sera were collected before the start and after the termination of chemotherapy. Serum concentrations of TNF-alpha were measured by an ELISA method. The pathological response rates were also evaluated and recorded. The control group consisted of 12 healthy age-matched women. The mean pre-treatment TNF-alpha value of breast cancer patients was 15.9 +/- 0.9 pg/mL while it was 5.8 +/- 1.7 pg/mL in the control group; the difference was statistically significant (p < 0.0001). The serum levels of TNF-alpha were markedly decreased in patients with partial and complete responses compared to pre-treatment values (p < 0.0001). There was also a difference in TNF-alpha levels in patients with partial vs complete responses (p < 0.0001). The relative change between pre- and post-treatment values correlated significantly with the type of response (p = 0.004). These results suggest that the serum concentration of TNF-alpha can be an indicator of response and could be used in clinical decision-making for patients with locally advanced breast cancer.
Subclavian vein catheterization, a timesaving, convenient and easy method of central venous access is not free of complications. In this report 150 consecutive infraclavicular subclavian vein catheterization attempts were evaluated with regard to noninfectious complications. 95.3% of the patients were successfully catheterized. While the overall complication rate was 29.3%, major complications occurred in 2.6%. The complication rate in right-sided attempts (35.5%) was significantly higher than in left-sided attempts (12.5%) (p less than 0.01). All of the major complications occurred in right-sided attempts. Left sided attempts seem to be safer unless specific contraindications exist. Malpositionings were the most common complications (16%) and were easily identified and managed by routine postprocedure chest X-rays. The mortality rate was 0%. As a result we think that this procedure will still remain as a valuable central venous catheterization method in experienced hands with proper indications and prompt treatment in the case of complications.
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