Plasma visfatin levels in young male patients with uncomplicated and newly diagnosed hypertension.
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Biomedical subjects
Publications and source records attributed to G Erdem.
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Brucellosis is an endemic disease seen in many countries. It may affect different organ systems. Brucellar breast abscess is a rare entity. We report the radiological findings of breast abscess due to brucella. A 63-year-old female was investigated with mammography, ultrasonography, magnetic resonance imaging (MRI), and magnetic resonance spectroscopy (MRS). A mass measuring 25 x 20 x 15 mm was detected in the left breast on mammography and ultrasonography. The mass was homogenously hyperintense on T1- and T2-weighted MRI images. On contrast-enhanced T1-weighted images, peripheral capsular enhancement was found. MR spectroscopic analysis of the mass revealed elevated lipid and acetate peaks. The diagnosis was provided by fine needle aspiration biopsy and specimen culture. The lesion had diminished in size after 12 months' treatment with combined tetracycline and rifampicine.
Prediabetes has been associated with an increased risk of cardiovascular disease and mortality. Soluble P-selectin (sP-selectin) is an index of platelet activation and also a risk factor for future vascular events. sP-selectin levels were investigated in prediabetic subjects who had no confounding factors such as hypertension, obesity or dyslipidaemia. sP-selectin, hsCRP levels and HOMA-IR indexes were measured in 40 prediabetic subjects (n = 24 for IFG and n = 16 for IGT) and age-, sex- and BMI-matched 40 healthy controls. sP-selectin levels in prediabetic subjects were not significantly different compared with those in controls (p = 0.12). Prediabetic group had similar hsCRP (p = 0.29), higher HOMA-IR indexes (p < 0.001) and lower HDL cholesterol levels (p = 0.001) when compared with healthy controls. The power of the study was 0.93 for sP-selectin, 0.7 for hsCRP and 1.0 for HOMA. Our data suggest that sP-selectin may not contribute to the prothrombotic state as well as the accelerated atherogenesis associated with prediabetes.
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Records of 381 neonates who underwent exchange transfusion (ET) due to ABO haemolytic disease at the Division of Neonatology of Hacettepe University, Ankara, Turkey, between January 1977 and December 2003 were reviewed. Records were kept for the type of blood used in ET, the number of ETs for each infant, adverse event attributable to ET and bilirubin levels before, and 4 and 8 h after each ET. Of 381 infants, 300 were transfused with whole blood, whereas 81 infants were transfused with O red cells suspended in A or B plasma. The re-exchange rate was higher in the whole blood group, compared with the erythrocyte and plasma group. Use of erythrocyte and plasma provided 30% reduction in the number of ETs per patient. Eight hours after the first ET, mean bilirubin levels were 84% of the pre-exchange values in the whole blood group and 73% of the pre-exchange values in the erythrocyte and plasma group (P = 0.001). As the use of O group red cells re-suspended in AB plasma decreased the re-exchange risk compared with O group whole blood, we suggest the use of O red cells re-suspended in AB plasma for the ET in cases of ABO haemolytic disease.
We present five new cases of van der Knaap's leukoencephalopathy, which is a rare abnormality characterized by infantile-onset white matter disease with swelling and mild clinical course. Based on the very rare histopathological data, this disease is considered a vacuolating myelinopathy with peripherally located intralamellar vacuoli. Although approximately 70 cases have so far been published, there are very limited data in the literature regarding diffusion-weighted imaging (DWI) findings of this recently discovered entity. In this paper, in addition to MRI, MRS and DWI findings in three patients are shown, apparent diffusion coefficient (ADC) maps are calculated, and ADC measurements made from various regions of interest are documented. MRI showed diffuse swelling and areas of T2 high signal in supratentorial white matter, sparing the cortex and central gray matter structures. MRS findings indicated some degree of neuronal loss. DWI and ADC maps showed increased diffusion rates, suggesting a different type of tissue damage than that would be expected in vacuolating myelinopathies. We believe that DWI and ADC mapping would be of help in providing a baseline for monitoring the progression of the disease.
BACKGROUND AND METHODS: measles is a common cause of morbidity and mortality in developing countries. Although the measles-mumps-rubella vaccine (MMR) is currently in use in developed countries, monovalent measles vaccine (MV) is routinely recommended by World Health Organization (WHO) at 9 months of age in Turkey, as in many other developing countries. In this study, 442 Turkish children received MV at 9 months of age and were revaccinated with MMR vaccine at 15 months of age. In the second group 495 children received MMR at 12 months of age with no earlier measles vaccination. Antibodies were measured before the first vaccination and 6 weeks after the MMR. All children had been followed for occurrence of measles infection for 60 months. Two vaccination schedules were compared for immunogenicity and protection rates. CONCLUSIONS: seroconversion and clinical protection rates were significantly higher in children who received only MMR at 12 months of age than in children revaccinated at 15 months of age. Seroconversion rate for measles was 69.9% in children who received MMR at 12 months of age and 90.3% in children revaccinated at 15 months of age (P=0.0003). While there was no measles case in children who were revaccinated, 12 (2.7%) children in the first group acquired measles during the follow-up period. Vaccination at 12 months of age appeared to be better than the current national standard. The late elimination of maternal antibodies and the inhibitory effect of a weak antibody response after the first dose of vaccine at 9 months may explain the better immunogenicity and efficacy of the MMR vaccine given at 12 months of age.
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The tegument phosphoproteins of human cytomegalovirus (HCMV) elicit cytotoxic T-lymphocyte (CTL) responses and are hence candidates for subunit vaccine development. Little is known, however, about the tegument proteins of nonhuman cytomegaloviruses, such as guinea pig CMV (GPCMV). DNA sequence analysis of the Eco R I "C" fragment of the GPCMV genome identified an open reading frame (ORF) which is colinear with that of the HCMV tegument phosphoprotein, UL83 (pp65). This ORF was found to have identity to HCMV UL83 and was predicted to encode a 565-amino-acid (aa) protein with a molecular mass of 62.3 kDa. Transcriptional analyses revealed that a GPCMV UL83 probe hybridized with both 2.2 kb and 4.2 kb mRNA species at 48 h post-infection (p.i.); synthesis of these messages was blocked by phosphonoacetic acid (PAA), defining these as "late" gene transcripts. In vitro translation of the UL83 ORF in reticulocyte lysate resulted in synthesis of a 65 kDa protein. Immunofluorescence experiments revealed that the putative GPCMV UL83 homolog exhibited a predominantly nuclear localization pattern. Polyclonal antisera were raised against a UL83/glutathione-S-transferase (GST) fusion protein. This antibody identified a 70-kDa virion-associated protein, the putative GPCMV UL83 homolog, in immunoblot and radioimmunoprecipitation experiments. Labeling experiments with 32P-orthophosphate indicated that the GPCMV UL83 protein is phosphorylated. Western blot analysis of glycerol tartrate gradient-purified virions and dense bodies confirmed that the putative GPCMV UL83 homolog was a constituent of both fractions.
A controlled study was conducted to assess the role of high-dose i.v. immunoglobulin (HDIVIG) therapy in neonatal immune haemolytic jaundice. Patients with ABO and/or Rh incompatibilities proved by significant hyperbilirubinaemia (>204 mmol l(-1)), positive direct antiglobulin test and high reticulocyte count (> or =10%) were randomly assigned to receive either conventional phototherapy alone or phototherapy with high-dose i.v. immunoglobulin (1 g kg(-1), over 4 h) as soon as the diagnosis was established. Exchange transfusions were performed if serum bilirubin concentrations exceeded 290 mmol l(-1) and increased by more than 17 mmol l(-1) per h despite both treatment manoeuvres. Eight of 58 patients in the HDIVIG group required exchange transfusions, whereas it became necessary in 22 of 58 patients in the control group (p<0.001). The durations of phototherapy and hospitalization in terms of hours were significantly shorter in the HDIVIG group (p<0.05). No side effects of HDIVIG therapy were observed. In conclusion, HDIVIG therapy in newborns with ABO or Rh haemolytic diseases reduces haemolysis, serum bilirubin levels and the need for blood exchange transfusion, a procedure which has potential complications and carries a risk of mortality.
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AIM: To determine lipid peroxide concentrations in the first 10 days of life. METHODS: Malondialdehyde concentrations were investigated in neonates with or without hyperbilirubinaemia during the first 10 days of life. RESULTS: Serum malondialdehyde concentrations were higher in infants with hyperbilirubinaemia than in controls. A positive correlation was found between malondialdehyde and bilirubin concentrations in the study group. When the study group was categorised according to the presence of haemolysis, a significant correlation was found between malondialdehyde and bilirubin concentrations in those infants with hyperbilirubinaemia due to haemolysis. There was no such correlation in those without haemolysis. CONCLUSION: Exchange transfusion rapidly produces variable changes in pro-oxidant and antioxidant plasma concentrations in neonates, which may be responsible for free radical metabolism. The fall in malondialdehyde concentration is probably directly related to its exogenous removal by exchange transfusion.
BACKGROUND: Streptococcus pneumoniae is an important pathogen for both children and adults. Although there is an effective vaccine, it is not protective under 2 years of age and common serotypes differ from one location to another. METHODS: A total of 44 Streptococcus pneumoniae isolates were recovered from clinical specimens of children in various hospitals in Ankara, Turkey. All isolates were serotyped and evaluated for vaccine coverage and tested for antibacterial susceptibility. RESULTS: There were 23 different serotypes with a predominance of serotypes 6A, 14, 19F and 23F. The nine-valent conjugate vaccine, which has been proposed for use in young children, covers 90.4% of isolations in children < 2 years of age. This coverage decreases to 43.4% after 2 years of age. The coverage of 23-valent vaccine is better than that of the conjugate vaccine (60.8% vs 43.4%, P < 0.05). Two relatively common and resistant types in our isolates (10A and 21) are not included in either vaccines and adding these serotypes into the 23-valent vaccine was suggested. Although the rate of intermediately penicillin resistant strains was 31.8%, highly penicillin resistant strains were not found in the present study. CONCLUSIONS: The usefulness of conjugate vaccine before 2 years of age and appropriate choice of vaccine strains to include all resistant serotypes for older children in our region, is discussed. It is shown that conjugated vaccine is protective in children less than 2 years of age, but a booster with 23-valent vaccine will be needed once they are older than 2.
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The factor V Leiden mutation in 12-children with thrombosis and in 20 controls was investigated. Five heterozygous individuals and 1 homozygous individual among the cases with thrombosis and 1 heterozygous individual among controls were found. Central nervous system thromboses were increased in children with the factor V mutation, associated with protein S deficiency.
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