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Biomedical subjects

Erdal Yilmaz

Publications and source records attributed to Erdal Yilmaz.

At least 19 recordsLinked to original sources
PubMed2007

Myocardial tissue velocities in neonates.

BACKGROUND: Tissue Doppler echocardiography (TDE) has been applied to the children age group; however, myocardial tissue velocities of neonates have been reported by few researchers. METHODS: Myocardial velocities along the longitudinal axis of the left ventricle were measured in two groups: 50 term neonates within 5 days after birth and 54 healthy children by TDE. Sample volumes were placed in mitral lateral annulus (MLA), mitral medial annulus (MMA), and in the basal and middle parts of the left ventricular lateral wall (LVLW) and interventricular septum (IVS). RESULTS: The highest myocardial velocities were obtained from MLA. In all segments, the mean systolic velocity (Sw) was found significantly lower than the mean early diastolic (Ew) and atrial systolic velocities (Aw) (P < 0.0001). The mean Aw was the dominant component in the MMA and were significantly higher than Ew (P < 0.001). The mean Ew/Aw in the MMA and MLA increased significantly while replacing the Doppler beam from base to apex. TDE indexes of neonates, except Aw obtained from MLA and MMA, were significantly lower than that of children group (P < 0.0001 and P < 0.0001, respectively). The mean E/Ew ratio of the left ventricle in neonates was found to be significantly higher than that found in children group (P < 0.0001). CONCLUSION: In neonates, the diastolic and systolic myocardial velocities of the left ventricle were significantly lower than those measured in the children group. Decreased myocardial tissue values of neonates might be reflecting the immaturity of neonatal myocardium.

Adolescent↗
PubMed2007

Visceral artery aneurysms.

OBJECTIVE: Visceral artery aneurysms are rare vascular malformations and the literature lacks satisfactory general information about the pathology. The aim of this study was to review our experiences in the diagnosis and treatment of visceral artery aneurysms. MATERIALS AND METHODS: We retrospectively reviewed data on 10 patients who were diagnosed with visceral artery aneurysms at our institution between June 2002 and September 2005. All available clinical, pathologic, and postoperative data were reviewed and analyzed for postoperative outcome. RESULTS: Four splenic artery aneurysms, 2 hepatic artery aneurysms, 5 renal artery aneurysms, 1 superior mesenteric artery aneurysm, and 1 inferior mesenteric artery aneurysm (13 total visceral artery aneurysms) were diagnosed in 10 patients. All the patients were treated except 1 patient with bilateral renal artery aneurysms. One patient required emergent surgical treatment due to splenic artery aneurysm rupture. Only 1 patient underwent endovascular treatment (ie, coil embolization for a superior mesenteric artery aneurysm); otherwise all the patients were treated surgically on an elective basis. Surgical treatment modalities included ligation with exclusion in 4 patients (2 splenic artery aneurysms, 1 renal artery aneurysm, 1 hepatic artery aneurysm) and resection with revascularization in 4 patients (1 splenic artery aneurysm, 2 renal artery aneurysms, 1 hepatic artery aneurysm, 1 inferior mesenteric artery aneurysm). Histopathologic examination of the vascular materials revealed major atherosclerotic changes except one that showed inflammatory vasculitic changes. One patient required bleeding revision, and mortality did not occur in any of the patients. CONCLUSIONS: Visceral artery aneurysms are rare and potentially life-threatening vascular disorders. The number of cases diagnosed every year increases because of advanced radiologic diagnostic methods and screening programs. Careful consideration and early management of these malformations can be life saving.

Adult↗
PubMed2006

Can prilocaine infiltration alone be the most minimally invasive approach in terms of anesthesia during extracorporeal shock wave lithotripsy?

OBJECTIVES: To evaluate the analgesic effect and utility of prilocaine infiltration alone for minimal morbidity during extracorporeal shock wave lithotripsy. METHODS: A total of 114 patients with kidney stones, aged 18 to 69 years, were randomly separated into two groups. The 58 patients in group 1 received intramuscular diclophenac 30 minutes before extracorporeal shock wave lithotripsy, and the 56 patients in group 2 received prilocaine infiltration into the 30 cm2 area below the 12th rib right before the session. A visual analog scale (0 to 100 mm) was used to evaluate pain. RESULTS: The visual analog scale scores for group 2 were statistically lower at 1, 10, and 20 minutes compared with the scores for group 1 (P = 0.006, P = 0.005, and P = 0.006, respectively). However, no difference was detected at the end of the procedure. The requirement for additional analgesic was less in group 2 (P = 0.007). CONCLUSIONS: Prilocaine infiltration alone can be used for analgesic purposes efficiently and safely during extracorporeal shock wave lithotripsy with minimal morbidity.

Adolescent↗
PubMed2006

Window technique on circumcision.

OBJECTIVE: To remove the preputium by using a simple, quick and safe method without damaging glans, frenulum and urethra as well as with a good cosmetic result. PATIENTS AND METHODS: The procedure, remind the guillotine technique at first, but completely different from it. Basically, a long haemostat is applied onto preputium and skin and subdermal tissue were incised; a small window is opened at dorsal of preputial mucosa and it is excised, while observing glans and frenulum. RESULTS: The circumcisions were performed in a quick, safe and pretty bloodless way. There was no case with glans amputation, frenulum short cut or urethral damage, even if a clamp includes the foreskin with a part of glans or excess frenulum unnoticedly. CONCLUSION: This technique is simple, quick, relatively bloodless operation with cosmetically good result. Morever it is quite safe against to amputation of glans, frenular short cut or urethral fistula formation.

Circumcision, Male↗
PubMed2006

Magnetic resonance imaging (MRI) in penile metastases of extragenitourinary cancers.

BACKGROUND: The aim of present study is to evaluate the efficacy of magnetic resonance imaging (MRI) in different types of penile metastases. MATERIALS AND METHODS: In this report, we present three cases of penile metastases that have been developed secondary to extragenitourinary malignancies. Two of them did not have any primary malignancy history. RESULTS: Penile biopsies were performed in all patients and metastatic penile tumours were found due to extragenitourinary malignancies. Penile MRI was performed before biopsies. The findings of MRI were correlated with histopathologic diagnosis. Moreover, penile MRI was found to be more sensitive in the evaluation of the lesions than ultrasonography. CONCLUSION: MRI can be accepted as a reliable non-invasive method for the evaluation of the extent of penile metastases and involvement of tunica albuginea or urethral.

Adenocarcinoma↗
PubMed2006

Relationship between nocturnal penile tumescence parameters, International Index of Erectile Function symptom scores and sildenafil responses1This paper was presented at the 6th Congress of the International Society of Sexual and Impotence Research, Buenos Aires, Argentina, 17-21 October 2004.

OBJECTIVE: To evaluate the correlation between International Index of Erectile Function (IIEF) questionnaire scores, nocturnal penile tumescence parameters and sildenafil response in patients with erectile dysfunction using a minimal investigations approach. MATERIAL AND METHODS: A total of 97 patients without any risk factors for erectile dysfunction were included. After completing the IIEF questionnaire, nocturnal penile tumescence monitoring was performed in all patients for 1 or 2 nights. Subsequently, sildenafil was given at a dosage of 50 or 100 mg according to the response. The relationship between nocturnal penile tumescence results, the severity of erectile dysfunction according to the IIEF questionnaire and sildenafil response was evaluated using Pearson's chi2 test. RESULTS: Based on the questionnaire scores, 25 patients (25.8%) had mild, 44 (45.4%) had moderate and 28 (28.8%) had severe erectile dysfunction. Forty-four patients (45.4%) had normal and 53 (54.6%) had abnormal parameters after nocturnal penile tumescence recording. The sildenafil response was positive in 63 patients (64.9%) who were given 50 mg and in 26 (26.8%) who were given 100 mg. However, eight patients (8.2%) did not respond to sildenafil. While the severity of erectile dysfunction according to IIEF scores and the sildenafil response did not show any correlations with nocturnal penile tumescence results, there was a statistically significant relationship between sildenafil response and the severity of erectile dysfunction. CONCLUSION: Changing concepts in the evaluation of ED have resulted in the use of effective therapeutic applications consistent with the degree of symptoms of patients without the waste of time caused by performing expensive, invasive, ineffective and time-consuming diagnostic tests.

Adult↗
PubMed2006

Testicular nitric oxide and thiobarbituric acid reactive substances levels in obstructive azoospermia: a possible role in pathophysiology of infertility.

OBJECTIVE: The aim of the study is to evaluate the levels of nitrite/nitrate and thiobarbituric acid reactive substances (TBARS) and their relationship with seminal parameters in experimental obstructive azoospermic rats to explain the possible mechanism of impaired sperm quality in obstructive azoospermia. METHODS: A total of 10 male Spraque-Dawley rats underwent bilateral vas resection and ligation (Group-1 = vasectomy group). The findings were compared with control group (Group-2 = sham group, n = 10). Animals were sacrificed 8 weeks after surgery. Testes were removed and used for the evaluation of nitrate/nitrite and TBARS levels and for histology. Epididymal-aspirated seminal plasma was used for semen count and morphological analysis according to the Kruger criteria. RESULTS: Testicular tissue nitrate/nitrite and TBARS levels were 35.7 +/- 3.1 micromol/g protein and 3.7 +/- 0.1 nmol/g protein in Group-1, and 19.3 +/- 0.7 micromol/g protein and 3.1 +/- 0.1 nmol/g protein in Group-2, respectively. Both parameters showed statistical differences between the two groups. Testicular tissue nitrate/nitrite and TBARS levels showed negative and statistically significant correlations with sperm motility and morphology. CONCLUSIONS: The present study showed that testicular nitrate/nitrite and TBARS levels were increased in obstructive azoospermia. For that reason, we concluded that antioxidant treatment can be recommended to patients before sperm extraction for artificial reproduction due to obstructive infertility after vasectomy reversal.

Animals↗
PubMed2006

Serum IL-1beta, IL-2, and IL-6 in insulin-dependent diabetic children.

Insulin-dependent diabetes mellitus (IDDM) is a chronic disease characterized by T-cell-dependent autoimmune destruction of the insulin-producing beta cells in the pancreatic islets of Langerhans, resulting in an absolute lack of insulin. T cells are activated in response to islet-dominant autoantigens, the result being the development of IDDM. Insulin is one of the islet autoantigens responsible for the activation of T-lymphocyte functions, inflammatory cytokine production, and development of IDDM. The aim of this study was to investigate serum concentrations of interleukin (IL)-1beta, IL-2, IL-6, and tumor necrosis factor (TNF)-alpha in children IDDM. The study population consisted of 27 children with IDDM and 25 healthy controls. Children with IDDM were divided into three subgroups: (1) previously diagnosed patients (long standing IDDM) (n : 15), (2) newly diagnosed patients with diabetic ketoacidosis (before treatment) (n : 12), and (3) newly diagnosed patients with diabetic ketoacidosis (after treatment for two weeks) (n : 12). In all stages of diabetes higher levels of IL-1beta and TNF-alpha and lower levels of IL-2 and IL-6 were detected. Our data about elevated serum IL-1beta, TNF-alpha and decreased IL-2, IL-6 levels in newly diagnosed IDDM patients in comparison with longer standing cases supports an activation of systemic inflammatory process during early phases of IDDM which may be indicative of an ongoing beta-cell destruction. Persistence of significant difference between the cases with IDDM monitored for a long time and controls in terms of IL-1beta, IL-2, IL-6, and TNF-alpha supports continuous activation during the late stages of diabetes.

Adolescent↗
PubMed2006

Spinal intradural-intramedullary cavernous malformation. Case report and literature review.

Cavernous angiomas or cavernomas are uncommon vascular malformations of the central nervous system and spinal involvement is much rarer especially in pediatric patients. We report a case of spinal intradural-intramedullary cavernous angioma in a 14-year-old male child. The cavernoma was located at the level of C6-C7 at the dorsal part of the spinal cord. The diagnosis was made with MRI and the patient underwent surgical treatment. The cavernoma was totally removed with laminotomy and microsurgical techniques. Somatosensory evoked potential monitoring was also used peroperatively. The clinical, radiological and surgical features of this rare case were presented and discussed with reference to the literature.

Adolescent↗
PubMed2006

Frequency of hypoferritinemia, iron deficiency and iron deficiency anemia in outpatients.

The prevalence rates of hypoferritinemia (IDec/one abnormal indicator), iron deficiency (IDef/two abnormal indicators) and iron deficiency anemia (IDA) in children who were referred to the outpatient clinics of the Department of Pediatrics for the first time within 1 month were investigated. Exclusion criteria were iron therapy before and during the study period and a history of chronic illness. Acute-phase reactants, such as erythrocyte sedimentation rate and C-reactive protein levels, were measured in all cases indicative of infectious diseases. Blood samples were obtained from each study patient admitted to the outpatient clinics during the study period. The hospital charts were later further evaluated, and samples of patients with any current illness known to interact with the iron status of the patient were discarded, and patients were contacted to supply new samples about 1 month after treatment of the infection. Thus, in patients with indications of an infection, samples obtained 1 month after treatment were assessed. The children (n = 557) were divided into four age groups: those aged 4 months to 2 years (group I), 2-6 years (group II), 7-12 years (group III) and 12-18 years (group IV). Children with a decrease in serum ferritin levels without anemia (IDec), and those with lower ferritin, transferrin saturation (TS) and serum iron (SI) concentration (IDef) were evaluated. IDA was diagnosed if hemoglobin (Hb) concentrations were lower than those adjusted for age, ferritin <12 ng/ml and TS <or=16% and if SI was decreased. IDec, IDef and IDA were detected in 26, 11.1 and 12.7% of the patients, respectively. Only 50.1% of the patients visiting the outpatient clinics were found to be normal. The rates of IDec (28.9%), IDef (21.9%) and IDA (26.2%) were highest in group I. IDec had the highest percentages in all groups. In group I, the rates of IDec, IDef, and IDA were 37.2, 66.1 and 69%, respectively. SI concentration was abnormal in 77.1% of the cases in group I (4 months to 2 years of age). Half of the patients referred to the outpatient clinics were suffering from abnormalities related to lower SI concentrations. Close monitoring and treatment of iron deficiency is advised especially in early childhood.

Adolescent↗
PubMed2006

Treatment of iron deficiency anemia with intravenous iron preparations.

OBJECTIVE: We aimed to determine the effects of intravenous iron therapy on blood parameters in pediatric patients who do not tolerate oral iron therapy for any reason. PATIENTS AND METHODS: The patient group consisted of candidates for elective operations requiring blood transfusions in order to raise hemoglobin (Hb) concentrations rapidly and for whom oral iron administration is useless and compliance with long-term treatment is definitely impossible due to sociocultural factors. Sixty-two children were included in the study. Venous blood samples were taken at diagnosis, and after 1 week and 1, 2 and 3 months. Hb, hematocrit, erythrocyte indices (mean erythrocyte volume, mean erythrocyte Hb and mean erythrocyte Hb concentration), serum iron (SI) levels, iron binding capacity, transferrin receptor (CD71) and serum ferritin levels were measured. Iron sucrose was used as an intravenous iron preparation. RESULTS: All children showed improvements in iron deficiency anemia. A statistically significant elevation occurred between the time of diagnosis and week 1 (p<0.05) in nearly all parameters. SI was raised until at least 1 month of therapy. There was no significant difference between transferrin receptors measured before and after the intravenous iron therapy. Ferritin did not exceed the values achieved in the 1st month. Mild side effects were encountered in only 8 (12.9%) patients. Treatment was not discontinued because of side effects in any case. The patients in the control group were given an oral form containing ferroglycine sulfate. CONCLUSION: Intravenous iron therapy can replace oral therapy in patients whose blood parameters must be raised rapidly and in situations where oral iron administration would not be appropriate for any reason. However, reinforcement with oral iron therapy or additional intravenous doses would be appropriate.

Adolescent↗
PubMed2006

Effects of extracorporeal shock wave lithotripsy treatment on transient evoked otoacoustic emissions in patients with urinary lithiasis.

OBJECTIVE: The aim of this prospective study was to investigate the effects of electrohydraulic extracorporeal shock wave lithotripsy (ESWL) on the transient evoked otoacoustic emissions (TEOAEs) of the patients on whom ESWL was applied for urinary stones. METHODS: The study group consisted of 10 patients (7 male, 3 female) with unilateral urinary lithiasis on whom ESWL was applied in one course and 20 of their ears. The control group was chosen from patients who attended the Otolaryngology and Urology departments. Ten patients (7 male, 3 female) without urinary stones and ear problems and 20 of their ears constituted the control group. Only patients with normal hearing levels were included in the study. TEOAEs were recorded before the ESWL application (B-ESWL), on the first day (A-ESWL-1), and on day 15 (A-ESWL-15). RESULTS: At B-ESWL, the mean stimulus for the control group was significantly higher than that of the study group. Three kilohertz percentage values were significantly decreased on A-ESWL-1. The difference between A-ESWL-1 and A-ESWL-15 and between B-ESWL and A-ESWL-15 of the study group at 3.0 kHz% was not significant. CONCLUSION: It was thought that the reason for only temporary damage at 3.0 kHz was a result of the resonance effect of the external auditory canal. It was concluded that no damage on the other frequencies was due to protective earheadings and short exposure time to the noise. Since all of our patients had protective earheadings on both ears during the ESWL procedure, they may have been protected from any permanent damage of the inner ear and hairy cells of the cochlea.

Adult↗
PubMed2005

Levels of cytokines (IL-1beta, IL-2, IL-6, IL-8, TNF-alpha) and trace elements (Zn, Cu) in breast milk from mothers of preterm and term infants.

It has been well documented that human milk contains several immunomodulator components which are important during infant period when the newborn's immune system is still under development. In this study, we aim at examining levels of cytokines, zinc (Zn), and copper (Cu) in milk from mothers of premature and mature infants, and comparing changes during lactation periods consequently. Milk was collected from total of 40 mothers (group M: mothers of mature infants, n = 20; group PM: mothers of premature infants, n = 20) from four lactation stages: colostrum (0-7 days), transitional (7-14 days), mature milk (21 days), and mature milk (2nd month). Levels of cytokines (interleukin [IL]-lbeta, IL-2, IL-6, IL-8, tumor necrosis factor-alpha [TNF-alpha]) were determined by chemiluminesence method, whereas atomic absorption spectrophotometer was used for the determination of Zn and Cu levels. Cytokine levels were determined to be high in colostrum and transient milk from mothers of full-term infants, whereas their levels were reduced drastically in the 21st day and the 2nd month milk (P < .01, P < .001). Similar trends were observed in milk from mothers of premature infants, but cytokine levels were significantly lower in colostrum compared to colostrum from mothers of mature infants (P < .01). The differences in cytokine levels were continuous in transient milk (P < .05) and mature milk (21 days) (P < .05), whereas there was no statistically significant differences between milk from both groups of mothers in the 2nd month (P > .05). Zn levels in milk from mothers of premature infants were significantly lower compared to the ones from mothers of mature infants (P < .01) and these differences continued through the 2nd month. Although Cu levels were lower in milk from mothers of premature infants, there was no statistically significant difference except colostrum (P > .05). Our results clearly demonstrate that the level of immunomodulating agents such as cytokines and trace elements in milk from mothers of premature infants is less than the level of the same agents in milk from mothers of full-term infants. Although there are commercially available products for infant feeding, human milk is still the best natural nutrient for newborns. Therefore, when premature infants are breastfed, necessary precautions such as supplemantary diets must be considered for possible infections and risks related with immune system deficiency.

Copper↗
PubMed2005

Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis.

This prospective study, performed in 76 children with a urinary tract infection (UTI), evaluates the diagnostic value of procalcitonin (PCT) and proinflammatory cytokines (IL-1beta, IL-6 and TNF-alpha) in children with acute pyelonephritis documented by dimercaptosuccinic acid scintigraphy (DMSA). Renal parenchymal involvement was assessed by (99m )Tc-DMSA scintigraphy within 7 days of admission. The diagnosis of acute pyelonephritis was confirmed only in patients with reversible lesions on scintigraphy. According to DMSA scan results, patients were divided into two groups, lower UTI or acute pyelonephritis. In acute pyelonephritis, serum PCT level was found to be significantly higher than it is in the lower UTI (p <0.001). Also, significantly higher serum proinflammatory cytokines (IL-1beta, IL-6 and TNF-alpha) levels were detected in those with acute pyelonephritis than those with lower UTI (p <0.001). We conclude that both serum PCT and proinflammatory cytokine levels may be used as accurate markers for diagnosis of acute pyelonephritis.

Acute Disease↗
PubMed2005

The differential diagnostic values of cytokine levels in pleural effusions.

The aim is to examine whether the changes in pleural fluid interleukin (IL)-1beta, IL-2, IL-6, and IL-8 levels were significant in differential diagnosis of childhood pleural effusions. IL-1beta, IL-2, IL-6, and IL-8 levels in pleural fluids of all 36 patients were measured. The levels of IL-1beta, IL-2, IL-6, and IL-8 in pleural fluids were statistically significantly higher in the transudate group compared with those of the exudate group. The levels of IL-1 beta, IL-6, and IL-8 were also found to be statistically significantly higher in the empyema group compared with both the parapneumonic and the tuberculous pleural effusion groups. The levels of IL-2 and IL-6 were detected to be statistically significantly higher in the tuberculous pleural effusion group in comparison with those of the parapneumonic effusion group. The results showed that pleural fluids IL-1beta, IL-2, IL-6, and IL-8 could be used in pleural fluids exudate and transudate distinction.

Adolescent↗
PubMed2005

Changes in neuropeptide y tissue concentration in the wall of the rat urinary bladder after acute distension.

Neuropeptide Y (NPY) is known to be associated with the adrenergic system. The relationship among the late micturition disorders following acute urinary distension, the adrenergic system and NPY was investigated. A total of 90 rats were included in the study of which 30 acted as the control group. Acute urinary distension was created in 60 rats. The NPY concentration within their bladders was assessed by the use of radioimmunoassay (RIA) at 3 h after distension and subsequently on days 2, 7 and 21, then the third and sixth months. The NPY concentrations assessed in the third and sixth months were compared with the control group in the same age group. By means of the RIA method, a substantial decline of NPY concentration was observed at 2 days after distension, while the concentration started to increase after day 7 (P = 0.003). This increase continued until the twenty first day (P = 0.004). However, a significant decline was maintained when compared to the concentration before distension. In the third and sixth months, a significant decline were observed in the NPY concentration in comparison to the control group (P = 0.004 and P = 0.005, respectively). Early and late micturition disorders experienced after acute urinary distension may be the result of adrenergic denervation which may be related to NPY.

Animals↗
PubMed2005

Terazosin in the treatment of premature ejaculation: a short-term follow-up.

AIM: The aim of the present study was to evaluate the efficacy of terazosine in patients with premature ejaculation and lower urinary tract symptoms (LUTS), after excluding other sexual disorders and chronic prostatitis. METHODS: A total of 90 patients with premature ejaculation and LUTS were enrolled to the study after excluding sexual disorders, prostatitis and benign prostatic hyperplasia. The patients were divided into two groups. Sixty patients in group 1 were treated with terazosine 5 mg daily for a month. Patients were followed monthly and questioned for their ejaculation problem. The results were classified as cure, improvement and ineffective. If patients showed improvement and ineffectiveness, the treatment was continued with 10 mg daily for the following month. Group 2 was included 30 patients, and placebo was applied for a month. At the end of this period, in patients who did not show any improvement, terazosine 10 mg was started. RESULTS: In the treatment group, at the 1st month follow-up, 21 patients (35%) were cured, 20 (33.3%) showed improvement. In 19 (31.7%) patients, the treatment was ineffective. In group 2, 9 (30%) patients showed improvement and the rest had no-changes after one-month follow up. There was statistically significant difference between two groups (Pearson chi2 test = 0.000). Later, terazosine 10 mg was given to the patients in group 2 and to the patients who showed improvement or unsuccessful result with terazosine 5 mg. With terazosine 10 mg, 10 (14.5%) patients were cured, 29 (42.2%) patients were improved. Finally, terazosine treatment in patients with premature ejaculation was found to be effective in 60 patients (66.7%). CONCLUSION: Alpha blockers seem to be physiological medical agents in the treatment of premature ejaculation since ejaculation is under sympathetic control. Moreover, these agents are effective in lower urinary tract and they should be used in patients with premature ejaculation and lower urinary tract symptoms.

Adrenergic alpha-Antagonists↗