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Biomedical subjects

E Yilmaz

Publications and source records attributed to E Yilmaz.

At least 73 records · Page 4Linked to original sources

The relation between human leukocyte antigen (HLA) distribution and intestinal obstruction and adhesions in childhood: preliminary report.

To investigate the association between the human leukocyte antigen (HLA) system and adhesions causing intestinal obstruction in childhood in order to determine whether HLA profiles can be used to identify and screen individuals at risk for intestinal adhesions, clinical and laboratory evaluations were done in a total of 42 (F:M = 27:15) patients. The mean age was 6.11 +/- 3.2 years (0.6-13 years). The patients were tested for HLA phenotype in two groups; the HLA phenotype distribution and relative risk (RR) for adhesions were determined. The study patients were children operated upon due to acute abdominal emergencies. Group 1 included patients who needed readmission after the surgery due to intestinal obstruction (n = 19), group 2 patients had no readmission for any reason following surgery (n = 23). Of the 19 patients in group 1, 9 were treated only medically and 10 needed surgical intervention. Among the patients in whom medical treatment was initiated (n = 14), 5 needed surgery during follow-up. There was an increased RR for certain HLA subtypes (A24 [9], HLA11, DR11 [5], B22) in patients presenting with intestinal obstruction due to adhesions. Among these, A24 (9) and DR11 (5) were statistically significant (P < 0.05) compared with the control group. Several possible mechanisms could link the HLA system with disease, especially those in which the immune response is suspected to be involved, but the questions of how the inflammatory response is initiated and the role of proinflammatory cytokines remain unclear. Future research developments are likely to focus on increased understanding of the molecular biology of the major histocompatibility complex and its biological function in the immune response and adhesion formation and intestinal obstruction. It is possible that HLA profiles can be used to identify individuals at risk for intestinal adhesions in the future.

Abdomen, Acute↗

Multiple coarctation of the pulmonary artery.

Pulmonary artery coarctation is a rare congenital anomaly characterized by single or multiple stenoses of the pulmonary arteries and their branches. There are only a few reports describing the radiological film of this entity. In this paper we report the case of a 68 year-old woman who presented with dyspnea. The scintigraphic, examination of the lungs gave the misleading impression of pulmonary embolism, and only angiography and magnetic resonance imaging established the correct diagnosis of multiple coarctations of the pulmonary artery.

Aged↗

Mal de Meleda: a review of Turkish reports.

Keratoderma Palmoplantare Transgrediens or mal de Meleda (MDM) is a very rare, inherited disorder. Its name derives from the island of Meleda. Although, MDM has been reported from many different countries, only two Turkish patients with MDM have been reported in the international literature. Our six cases of MDM are reported, and retrospective analysis of published Turkish patients with MDM is included. We review the clinical characteristics, associated findings, consanguinity, and family history of the cases. In total, 26 Turkish cases of MDM including ours have been documented. Ten cases showed various nail abnormalities, the most common associated feature. We add 24 new cases from Turkey to the list in the literature. Our findings suggest that the MDM gene may also have originated elsewhere than in Mljet.

Adolescent↗

Quantitative analysis of collagens and fibronectin expression in human right ventricular hypertrophy.

One of the main features in human tetralogy of Fallot (TF) is right ventricular hypertrophy (RVH) due to pressure (sub-pulmonary stenosis) and volume overload (ventricular septal defect). Currently, primary correction at a young age is the treatment of choice. To unravel the role of extracellular matrix in RVH, we examined myocardial expression of collagens and fibronectin in TF patients with primary correction (TF1, age 0.7 +/- 0.2 yr.), secondary surgery (TF2, age 36.9 +/- 4.6 yr), and in age-matched control patients. Sirius red staining quantified by video imaging showed significantly increased interstitial staining for collagens in both TF1 and TF2 groups as compared to respective controls. Fibronectin was expressed in extracellular spaces, perivascular regions, and in some cardiomyocytes. Quantitative analysis of fibronectin revealed increased expression in only TF1 group as compared to respective control. Our results indicate an increased amount of myocardial extracellular matrix deposition as a sign of fibrosis during RVH in patients with TF.

Adult↗

The use of sucralfate suspension in the treatment of oral and genital ulceration of Behçet disease: a randomized, placebo-controlled, double-blind study.

OBJECTIVE: To determine the efficacy of topically applied sucralfate suspension in the treatment of oral and genital ulceration of Behçet disease. DESIGN AND SETTING: A randomized, placebo-controlled, double-blind study at a university referral center. PATIENTS: Forty patients with Behcet disease were included in the study. INTERVENTION: Patients were given topical sucralfate or placebo 4 times a day for 3 months and examined clinically at biweekly intervals. MAIN OUTCOMES MEASURES: For each lesion, the mean frequency, healing time, and pain were evaluated during the pretreatment, treatment, and follow-up periods. No patients were given any concurrent disease-specific or immunosuppressive topical and systemic drugs during the 9-month study period. RESULTS: Of the 40 patients included in the study, the results in 30 patients (16 patients treated with sucralfate and 14 patients treated with placebo, ranging in age from 16 to 52 years [mean+/-SD age, 34.3+/-8.1 years]) were evaluable for efficacy. Treatment with sucralfate decreased significantly the mean frequency, healing time, and pain of oral ulceration and healing time and pain of genital ulceration compared with the pretreatment period. The effectiveness of sucralfate on the frequency and healing time of oral ulceration continued during the post-treatment period. In the placebo group, no significant difference was found in measured parameters of oral and genital ulceration except the pain of the oral ulceration between the pretreatment and treatment periods. CONCLUSION: Our results showed that topical sucralfate suspension is an easy, safe, inexpensive, and effective treatment for oral and genital ulceration in patients with Behçet disease.

Adolescent↗

Analysis of the peripheral blood lymphocyte subsets in patients with bladder carcinoma.

OBJECTIVES: To evaluate the immune system of patients with bladder transitional cell carcinoma (TCC) by using peripheral blood lymphocyte subsets and to further compare the relationship between these subsets with respect to tumor stage and grade (superficial versus invasive and low versus high grade). METHODS: Thirty patients with superficial TCC of the bladder, 30 patients with invasive TCC of the bladder, and 30 age- and sex-matched control subjects without any malignancy or immunologic abnormality were included in this study. The peripheral blood lymphocyte subset analysis was performed in all patients before any treatment was performed. RESULTS: All lymphocyte subset values of patients with invasive bladder cancer, except B cell value, were significantly lower (P < 0.01) than the values of the control group. There were no significant differences between the lymphocyte subset values of patients with superficial bladder cancer and those of control subjects. The comparison of the lymphocyte subset values of the patients with superficial versus invasive bladder carcinoma revealed that in patients with invasive bladder carcinoma, the numbers of T and natural killer (NK) cells were significantly lower (P < 0.05) than those of patients with superficial bladder carcinoma. Patients with high-grade tumors had significantly fewer (P < 0.05) T and NK cells than patients with low-grade tumors. CONCLUSIONS: Our results indicate that analysis of mean NK and T cell values and the mean ratio of CD4+/CD8+ cells in peripheral blood might be a useful adjunct for the clinical evaluation of patients with bladder cancer.

Adult↗

Evaluation of serum arginase activity in benign prostatic hypertrophy and prostatic cancer.

Activities of arginase, prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) were determined in sera of healthy male controls, benign prostatic hypertrophy (BPH) and prostatic cancer patients. Serum arginase activity in the cancer group (22.8+/-11.6 U/l) was significantly lower than in both the control (33.64+/-16.19 U/l) and the BPH group (58.8+/-11.6 U/l) (p<0.001, respectively), while the BPH group had significantly higher levels compared to the controls (p<0.05). However, serum arginase levels in all groups had no statistically significant correlation with PAP and PSA. Serum arginase activity correlated inversely with the Gleason grades. These results suggest that serum arginase assay may be used for the pretreatment evaluation of patients with prostatic diseases.

Acid Phosphatase↗

The significance of testicular reactive oxygen species on testicular histology in infertile patients.

This study was designed to investigate the relationship between the effects of testicular reactive oxygen species (ROS) levels and testicular histology on infertile patients with the aid of xanthine oxidase system and testicular tissue malondialdehyde levels. Forty patients with idiopathic infertility constituted our study group. Bilateral testicular biopsies were performed and spermatogenesis was assessed histopathologically. Patients were divided into 4 groups according to spermatogenic pattern (normal spermatogenesis; hypospermatogenesis; maturation arrest; Sertoli cell only syndrome). Testicular tissue xanthine oxidase and malondialdehyde (MDA) concentrations were analyzed in each sample by spectrophotometric assay and thiobarbituric acid reaction assay, respectively. Testicular tissue MDA and xanthine oxidase concentrations were not statistically different in patients having normal spermatogenesis, with respect to Sertoli cell only syndrome, maturation arrest and hypospermatogenesis, respectively. As a result of our study we think that there are still some factors other than ROS which may be important contributors to spermatogenetic injury that need to be examined.

Adult↗

Effect of transurethral electrovaporization of the prostate on serum prostate specific antigen concentration.

OBJECTIVE: To assess the effect of transurethral electrovaporization of the prostate (TUVP) on serum prostate specific antigen (PSA) concentration. PATIENTS AND METHODS: Twenty-five men (mean age 61.7 years) with symptoms of prostatism underwent TUVP. Serum PSA levels were determined before any prostatic manipulation, and again at 1 and 24 h after TUVP. In the first 6 weeks after TUVP, serum PSA was measured every week. Prostatic size was measured by transrectal ultrasonography before and again at 6 weeks after TUVP. RESULTS: The mean serum PSA concentration was significantly higher at 1 and 24 h after TUVP (P<0.001) than before. The PSA level returned to less than the value before TUVP at 2, 3 and 4 weeks afterwards in eight (32%), 13 (52%) and 20 (80%) patients, respectively; five (20%) patients reached the baseline value 6 weeks after TUVP. The mean reduction in prostatic volume 6 weeks after TUVP was 42% and the reduction in tissue volume was significantly correlated with the decrease in serum PSA concentration at 6 weeks (P<0.05). CONCLUSION: TUVP increases serum PSA levels, the transient elevation persisting for up to 6 weeks but then declining to a stable, low PSA concentration. Therefore, it is important to wait at least 6 weeks to obtain an accurate and meaningful serum PSA level after TUVP.

Biomarkers↗

Combined transurethal resection and vaporization of the prostate using newly designed electrode: a promising treatment alternative for benign prostatic hyperplasia.

BACKGROUND AND OBJECTIVE: Postoperative irritative symptoms and lack of tissue samples for histologic examination are the two main disadvantages of transurethral electrovaporization of the prostate. To decrease the postoperative irritative symptoms while minimizing intraoperative and postoperative bleeding and also to obtain tissue samples, we have combined the techniques of transurethral resection and vaporization, a procedure we have termed Vapor-cut, by using the Wolf Wing gold-plated electrode. PATIENTS AND METHODS: Forty-eight patients with symptomatic benign prostatic hyperplasia (BPH) were enrolled in the study. Adverse events during the procedure, including serial changes in both serum hematocrit and sodium, and postoperative irritative symptoms were recorded after removal of the urethral catheter. Preoperative and postoperative symptom scores and maximum flow rates (Qmax) were obtained in each patient. The volume of the prostate was measured preoperatively and postoperatively using transrectal ultrasonography. RESULTS: During the procedure, there was minimal bleeding, and serum sodium and hematocrit levels were not changed significantly. The mean operative time was 49.3 minutes. The catheterization time and hospital stay were 48 and 60 hours, respectively. Only five patients (10%) reported transient and intermittent postoperative hematuria lasting for 1 week. After removal of the urethral catheter, four patients (8%) had irritative voiding symptoms. No patients experienced postoperative urinary retention or required subsequent catheterization. At 3-month follow-up, the improvement in the mean Qmax was 114%, and the decrease in the symptom score was 72%. The average reduction in the weight of the prostate was 55%. CONCLUSION: Vapor-cut of the prostate appears to be a safe, effective alternative to the standard loop resection and vaporization. It has the advantages of minimal blood loss, excellent operative visibility, decreased postoperative irritative symptoms, and availability of tissue samples with short catheterization and hospitalization times.

Electrodes↗

Pityriasis rosea in a patient with Behçet's disease treated with interferon alpha 2A.

Interferons have been used for the treatment of many diseases because of their immunomodulatory, antiviral, antitumoral, and antiproliferative effects. Systemic interferon alpha 2a (IFN-alpha 2a) is also efficacious in the management of Behçet's disease (BD). Many adverse cutaneous reactions related to IFN-alpha have been reported. In the light of the current literature, we report here the first case of Pityriasis rosea (PR) that developed while receiving IFN-alpha 2a for BD. However, since this is the first report on this association, further observations are needed to determine their clinical relevance.

Adult↗

Predominant tricuspid stenosis secondary to bacterial endocarditis in a patient with permanent pacemaker and balloon dilatation of the stenosis.

In a 49-year-old woman with sick sinus syndrome and a permanent VVI pacemaker, severe tricuspid stenosis and its clinical consequences developed 4 years after the attack of endocarditis. Besides the quite unusual occurrence of lead related tricuspid stenosis, successful treatment with balloon dilatation is the unique feature of this case.

Catheterization↗

Is the efficacy of topical corticosteroid therapy for psoriasis vulgaris enhanced by concurrent moclobemide therapy? A double-blind, placebo-controlled study.

BACKGROUND: Psychosocial factors have been implicated in the onset and exacerbation of psoriasis. OBJECTIVE: We conducted a randomized, placebo-controlled, double-blind study to investigate the effect of an antidepressant agent, moclobemide, on the course of psoriasis vulgaris. METHODS: Sixty subjects were enrolled in the study. Patients were randomly assigned to treatment groups. Patients received moclobemide 450 mg/day or placebo and a topical corticosteroid ointment (diflucortolone valerate) for 6 weeks. Patients were examined at the beginning of the study and at 2-week intervals. At each visit, the severity of psoriasis and psychologic status were evaluated with the Psoriasis Area Severity Index (PASI), Beck Depression Inventory (BDI), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HRS-D-17) and State-Trait Anxiety Inventory including state (STAI-1) and trait anxiety (STAI-2). RESULTS: Treatment efficacy was able to be evaluated in 22 patients in the moclobemide-treated group and in 20 in the placebo-treated group. The improvement rates in PASI, BDI, STAI-1, and HAM-A scores were significantly higher in the moclobemide treatment group. The level of state anxiety was diminished in the moclobemide group. Correlation was positive between improvement rates of the psoriatic lesions and state anxiety in all patients. CONCLUSION: Our results suggest that an antidepressant drug is useful in the treatment of psoriasis.

Administration, Topical↗

Left ventricular geometric patterns and QT dispersion in untreated essential hypertension.

The spectrum of left ventricular adaptation to hypertension, different types of hypertrophy patterns, and QT dispersion in different types of hypertrophy was investigated in 107 patients with untreated essential hypertension and 30 age- and gender-matched normal adults studied by 12-derivation electrocardiogram (ECG), two-dimensional, and M-mode echocardiography. Left ventricular mass (LVM), body mass index, total peripheral resistance (TPR), relative wall thickness (RWT), and QT dispersion were found to be statistically significantly higher in the hypertension group (P < .001 for all). Among hypertensive patients, 41.1% had both normal LVM and RWT, here called normal left ventricle in hypertension; 10.3% had concentric hypertrophy with increased LVM and RWT; 14.95% had eccentric hypertrophy with increased LVM and normal RWT; and 32.7% had concentric remodeling with normal LVM and increased RWT. Echocardiographically derived cardiac index was higher in the concentric hypertrophy and eccentric hypertrophy patterns (P = .002 and P < .0001, respectively), whereas TPR was higher in the concentric hypertrophy and concentric remodeling patterns (P = .017 and .02, respectively). QT dispersion values were found to be increased in the hypertensive group (P = .001), whereas similar values were calculated for different types of hypertrophy patterns. We conclude that the more common types of ventricular adaptation to essential hypertension are eccentric hypertrophy and concentric remodeling. Concentric hypertrophy is found to be associated with both volume and pressure overload, whereas eccentric hypertrophy is associated with volume overload only and concentric remodeling is associated with pressure overload. But different left ventricular geometric patterns seem to have similar effects on QT dispersion.

Echocardiography↗

A randomized, controlled and blinded study of papulopustular lesions in Turkish Behçet's patients.

BACKGROUND: Papulopustular lesions (PPL), the commonest presentation of skin lesions in Behcet's disease (BD) are cutaneous, sterile folliculitis or acne-like lesions on erythematous base. Our purpose was to determine the true frequency and anatomic location of the PPL and compare this with controls. We also sought to determine whether or not there was any relationship between PPL and either disease activity or other manifestations of BD. METHODS: Fifty patients with BD, diagnosed according to the criteria of the International Study Group for Behcet's Disease, were enrolled in the study. The control group consisted of 100 patients with other dermatologic diseases (21 acne and 79 non-acne patients), selected randomly. A dermatologist counted the lesions, in a blind protocol, on seven anatomic locations: scalp, face, neck, trunk, upper and lower extremities and genitalia. RESULTS: The frequency of PPL in patients with BD was 96% and the most common location was the trunk, whereas in the control group the frequency was 89% and the most common location was the face. In acne and non-acne patients, the frequency was 100% and 86.1% respectively. The total mean number, and mean numbers of PPL on the location of trunk, upper and lower extremities, and genitalia were higher in patients with BD than in controls. When the PPL in BD patients with a positive pathergy test was compared with that in patients with a negative pathergy test, the difference was significantly higher. CONCLUSIONS: Our results indicate that PPL appear to be non-specific. In the diagnosis of BD the mean number and anatomic location of the lesions are of more importance than the frequency.

Acne Vulgaris↗