Search PubMed⌕ Search

Biomedical subjects

G Ozbay

Publications and source records attributed to G Ozbay.

At least 37 records · Page 2Linked to original sources

The prevalence of hereditary thrombophilia in the Trakya region of Turkey.

The prevalences of deficiencies in antithrombin III (AT III), protein C (PC), protein S (PS) and in the activated protein C (APC) resistance in the thrombotic population of the Trakya region, Turkey were investigated. 37 patients with venous thrombosis (VT) and 17 patients with arterial thrombosis (ArT) were included in this study. The mean ages of the patients with VT and ArT were 46 years (range 20-70) and 38 years (range 32-40), respectively. The activity of AT III was measured by commercially available immuno-turbidimetric assay. The activities of PC and PS were determined by coagulometric assay. The APC resistance was measured using a modified APTT-based clotting assay. Among the VT patients, there were 2 cases (5.4%) with AT III, 5 (13.51%) with PC deficiency, 5 (13.51%) with PS deficiency and 2 (5.4%) with APC resistance. In the ArT patient group, there was 1 patient (5.88%) with AT III, 3 (17.64%) with PC deficiency, 1 (5.88%) with PS deficiency and no APC resistant patients, while there was one (2.08%) with PC deficiency and one (2.08%) with APC resistance in the control group (49 persons, mean age 41 years). The relative risk of thrombosis (odds ratio) was 1.7 in the deficiency of PC and 5.6 in the deficiency of PS. The data presented suggests that the prevalences of AT III, PC and PS deficiencies causing thrombophilia in the Trakya region of Turkey are higher than in other reported studies while the APC resistance is lower than in others. Further studies including more patients would be required to clarify these discrepancies.

Activated Protein C Resistance↗

Antianginal and anti-ischemic effects of nisoldipine and ramipril in patients with syndrome X.

BACKGROUND: Syndrome X is defined as typical angina pectoris, positive treadmill exercise test, negative intravenous ergonovine test, and angiographically normal coronary arteries. HYPOTHESIS: In the present study, we investigated the anti-ischemic and antianginal effects of nisoldipine and ramipril in patients with syndrome X. METHODS: After 2 weeks of the first wash-out period, 18 patients (7 men, 11 women, age 46 +/- 10 years) were given nisoldipine (NIS) 5 mg twice daily for 4 weeks, and after 2 weeks of the second wash-out period, the same patients were given ramipril (RAM) 2.5 mg once daily for 4 weeks. A treadmill exercise test with modified Bruce protocol was performed at the end of each period. RESULTS: The time to angina in exercise (607 +/- 115 s-650 +/- 117 s, p = 0.006, vs. 630 +/- 114 s-660 +/- 123 s, p = 0.02), total exercise time (612 +/- 110 s-656 +/- 114 s, p = 0.0008, vs. 630 +/- 114 s-660 +/- 123 s, p = 0.02), and maximum MET value (11.09 +/- 2.08-11.86 +/- 2.04, p = 0.0016, vs. 11.42 +/- 2.09-12.2 +/- 2.26, p = 0.01) were increased significantly with both therapy modalities. The time to 1 mm ST-segment depression (123 +/- 93 s-220 +/- 172 s, p = 0.002) was increased significantly with NIS therapy. The time to ST-segment recovery (434 +/- 268 s-330 +/- 233 s, p = 0.016 vs. 443 +/- 289 s-370 +/- 278 s, p = 0.012), the frequency of anginal attacks per week (1.27 +/- 1.4-0 +/- 0.38, p = 0.005, vs. 1 +/- 1.32-0.33 +/- 0.59, p = 0.028), and the need for sublingual nitroglycerin (1.16 +/- 1.29-0.11 +/- 0.32, p = 0.005, vs. 0.94 +/- 1.16-0.27 +/- 0.57, p = 0.012) were decreased significantly with both drugs. CONCLUSION: We observed that 10 mg daily NIS and 2.5 mg daily RAM have similar anti-ischemic and antianginal effects in patients with syndrome X.

Angiotensin-Converting Enzyme Inhibitors↗

Heart failure during first inferior acute myocardial infarction.

BACKGROUND: Inferior acute myocardial infarctions (AMI) have better in-hospital prognosis than do anterior AMI. Authors of several studies reported that patients with inferior AMI complicated by atrioventricular block, concomitant precordial ST-segment depression and involvement of right ventricle have larger infarctions and a worse prognoses than do patients without these features. OBJECTIVE: To analyse the incidence, clinical course and in-hospital prognosis of patients with heart failure and first inferior AMI. METHODS: We analysed in 257 consecutive patients with first inferior AMI who had been admitted to the coronary care unit during January 1991 and March 1995. The clinical and electrocardiographic characteristics, as well as the morbidities and in-hospital mortalities, of groups of patients with and without heart failure during inferior AMI were compared. RESULTS: Symptoms and signs of heart failure were noted for 49 patients (19%). We found that patients who had suffered heart failure during inferior AMI were older (62.1 +/- 9.86 versus 58.78 +/- 10.58 years, P < 0.05) than those who had not suffered heart failure. There was no significant difference between patients' sex, history of diabetes mellitus, hypertension, smoking status, thrombolytic therapy, involvement of right ventricle and QRS score for these two groups. We found a greater prevalence of ST-segment depression (ST-segment depression > or = 1 mV in more than one precordial lead with maximal ST-segment depression in leads V4-V6) of V4-V6 precordial leads (57 versus 26%, P = 0.00002) and a lesser prevalence of no ST-segment depression (ST-segment depression < 0.1 mV in each precordial lead; 14 versus 38%, P = 0.001) among patients who had suffered heart failure. We found greater incidences of serious ventricular arrhythmias (53 versus 26, P = 0.0002) and ventricular tachycardiafibrillation (16 versus 7%, P = 0.03) among patients who had suffered heart failure than we did among those who had not. Third-degree atrioventricular block was more often found in patients who had suffered heart failure (23 versus 12%, P = 0.07) but this difference was not statistically significant. We found that the in-hospital mortality among patients who had suffered heart failure was much higher than that among those who had not (24.5 versus 3.8%, P = 0.000001). CONCLUSION: We found that heart failure occurs primarily in old patients, and in those with precordial ST-segment depression, especially in leads V4-V6. The patients who suffer heart failure have worse in-hospital prognosis due to serious ventricular arrhythmias and cardiogenic shock.

Acute Disease↗

Effect of aminophylline in patients with atropine-resistant late advanced atrioventricular block during acute inferior myocardial infarction.

BACKGROUND: Advanced atrioventricular (AV) block is a frequent complication in patients with acute inferior myocardial infarction (AIMI). This conduction abnormality is associated with narrow QRS complex in conducted or junctional escape beats, suggesting that the site of block is the AV node; however, its pathophysiology has not been properly established. HYPOTHESIS: This study investigated the effect of aminophylline in eight patients (5 men, 3 women, age range 51 to 78 years, mean 67.5 +/- 8.8 years) with atropine-resistant late advanced AV block during AIMI. METHODS: Advanced AV block was late in appearance in all patients, starting 2 to 5 days after AIMI, and consisted of second-degree Mobitz II type in two patients and of complete AV block in six patients; all patients had narrow QRS complexes. Before aminophylline administration, all patients had a temporary pacemaker installed which was switched off throughout the study. They were given intravenous atropine (1 mg) that was found to be ineffective. One-half h after atropine, the first aminophylline injection (240 mg) was given intravenously over 10 min. One h following the first injection, a second aminophylline dose (240 mg) was administered. Electrocardiographic rhythm strips were obtained before and after drug administration, and the type of AV block and atrial and ventricular rate were noted. RESULTS: Aminophylline restored 1:1 conduction with first-degree AV block in six patients, Mobitz I AV block in one patient, and normal sinus rhythm in one patient. Mean atrial and ventricular rates before aminophylline were 104 +/- 16 beats/min and 57 +/- 9 beats/min, respectively, and after drug administration 95 +/- 25 beats/min and 89 +/- 17 beats/min, respectively, (p = 0.012). CONCLUSION: These results indicate that aminophylline improves AV conduction in atropine-resistant late advanced AV block complicating AIMI.

Aged↗

Multilocular cystic nephroma: an unusual localization.

We present a case of multilocular cystic nephroma with an unusual localization treated by a nephron-sparing procedure. A 21-year-old white woman presented with a history of hematuria and right lumbar pain. Imaging techniques revealed a multilocular cystic mass originating from the renal parenchyma but mainly involving the renal pelvis. The lesion was localized almost entirely within the renal pelvis at surgery and was treated by excision. Pathologic analysis was consistent with multilocular cystic nephroma. The patient remains free of recurrence with 10 years of follow-up. We conclude that multilocular cystic nephroma may present as a cystic lesion localized within the renal pelvis, and we advocate simple excision of these lesions.

Adult↗

Early and late advanced atrioventricular block in acute inferior myocardial infarction.

BACKGROUND: Advanced atrioventricular block is a frequent complication in patients with inferior acute myocardial infarction (AMI); in patients in hospital, it often occurs concurrently with other complications and is associated with high mortality. Very little information is available about early and late advanced atrioventricular block in inferior AMI. We hypothesized that the time of appearance of advanced atrioventricular block characterized by poor response to atropine requiring temporary pacemaker therapy may affect the prognosis of patients with inferior AMI. METHODS: We studied 51 patients with inferior AMI and advanced atrioventricular block characterized by poor response to atropine requiring temporary pacemaker therapy. According to pre-established electrocardiographic criteria and the time of appearance of the advanced atrioventricular block, patients were divided into two groups: an early block group consisting of 30 patients who developed advanced atrioventricular block during the first 24 h of inferior AMI, and a late block group consisting of 21 patients who developed advanced atrioventricular block after the first 24 h of chest pain. RESULTS: The groups were similar regarding age, coronary risk factors, frequency of right ventricular infarction, QRS score, atrial and ventricular rates, the time of return to first-degree atrioventricular block, cardiac arrhythmias, heart failure and mortality. The early advanced atrioventricular block group included a greater number of men than did the late group (P = 0.017). CONCLUSION: These data suggest that the time of appearance of advanced atrioventricular block does not affect the prognosis of hospital patients with inferior AMI.

Anti-Arrhythmia Agents↗

Long-term efficacy of interferon-alpha and ursodeoxycholic acid in treatment of chronic type C hepatitis.

Interferon-alpha (IFN) and ursodeoxycholic acid (UDCA) combined have a controversial role in the treatment of chronic type C hepatitis. We studied the long-term efficacy of both drugs alone or in combination. In a three-year period, 108 patients were randomized into three treatment arms: (1) IFN alone 3 MU three times a week (N = 49), (2) IFN 3 MU three times a week + UDCA 250 mg twice a day (N = 45), and (3) UDCA alone 250 mg twice a day (N = 14). Response was defined as complete normalization of serum ALT. For the responders at the end of six months, the treatment was run to 12 months. Nonresponders (NRs) of the first group were crossed over to combination and NRs of the combination received 6 MU three times a week IFN+UDCA for the next six months. The enrollment to the UDCA alone arm was stopped early, since only 1/14 normalized serum ALT at the end of third month. However, 12/14 completed six months and 11 NRs received IFN 3 MU three times a week alone for the next six months. Twelve discontinued treatment due to side effects. Responders were followed-up untreated for 18 months. Sustained response (SR) was defined as persistence of normal serum ALT levels in this period. At the end of six months, 22/45 (48%) from the IFN-alone and 23/39 (58%) from the combination group responded. Twenty NRs from former and 15 of latter group were crossed over. While none of the 20 from the IFN-alone group responded to the combination, 1/15 NRs of the combination group responded to dose escalation. SR was achieved in 9/45 (20%) of the IFN alone and 7/39 (18%) of the combination group. The mean time form the end of the treatment to the relapse was not different between the groups. Five of 11 UDCA NRs responded to IFN with SR in 2. It was concluded that UDCA as a single agent is ineffective in achieving response in the treatment of chronic type C hepatitis. Combined with IFN, it increases response rate insignificantly although this is not sustained.

Alanine Transaminase↗

Oxygen free radicals impair wound healing in ischemic rat skin.

Oxygen free radicals are produced and play an important role in ischemic injury. We therefore wished to investigate the role of free radicals on ischemic skin wound healing. For this purpose, H-shaped flaps, where the test ischemic wound is the horizontal line in the H, were created on the dorsum of the rat. To inhibit the probable hazards of free radicals, allopurinol and superoxide dismutase (SOD) were given to the animals. Most of the studied wound-healing parameters were impaired in the ischemic group. In the allopurinol-treated group, breaking strength was increased by 52% by day 7 and by 109% by day 14 (p < 0.0002 and p < 0.001), and in the SOD-treated group the increase was 69% both by days 7 and 14 of healing when compared with the ischemic control group (p < 0.003 and p < 0.002). Hydroxyproline content was increased 75% with allopurinol and 113% with SOD in the wound by day 7 (p < 0.03 and p < 0.001 respectively). SOD treatment caused a significant decrease in wound edema by day 7 of healing (p < 0.05). Histopathological evaluation revealed that in the SOD- and allopurinol-treated groups, the amount of collagen and its organization were more prominent when compared with the ischemic controls. These results show that oxygen free radicals play an important role in the failure of ischemic wound healing, and antioxidants partly improve the healing in ischemic skin wounds.

Allopurinol↗

Calciphylaxis: a condition mimicking necrotizing vasculitis.

A patient with end stage renal disease developed ischaemic skin necrosis and digital gangrene. He had diffuse arterial calcification associated with hyperparathyroidism secondary to renal failure. The patient received inappropriate cyclophosphamide therapy as he had been misdiagnosed as having an inflammatory vasculitis. This clinical picture, previously named "calciphylaxis" should come into the differential diagnosis of systemic vasculitis in a uraemic patient with hyperparathyroidism.

Arterioles↗

Urinary N-acetyl-beta-D-glucosaminidase and beta 2-microglobulin excretion in primary nephrotic children.

Enzymuria and low molecular weight proteinuria reflect tubular damage and dysfunction, respectively. We examined urinary N-acetyl-beta-D-glucosaminidase (U-NAG) and beta 2-microglobulin (U-beta 2M) excretion in 17 steroid-resistant and 39 steroid-sensitive children with nephrotic syndrome whose glomerular filtration rates were within the normal range. Fourteen healthy children were taken as controls. U-NAG and U-beta 2M levels did not show a difference between the steroid-resistant and steroid-sensitive groups but were significantly higher in the nephrotic groups compared to the controls (p < 0.0001 and p < 0.01, respectively). In the steroid-sensitive group, U-NAG levels were significantly higher in patients in the relapse phase than in those in remission (p < 0.0001). This finding was also valid for U-beta 2M excretion, but reached significance only for patients in remission who did not receive steroids (p < 0.01). There was a positive correlation between proteinuria and U-NAG and U-beta 2M excretion in all patients (rs = 0.69, p < 0.001 and rs = 0.39, p < 0.001, respectively). In conclusion, massive glomerular proteinuria may cause a marked U-NAG excretion and a moderate urinary U-beta 2M elevation independent of primary renal disease.

Acetylglucosaminidase↗

Primary fibrosarcoma of the heart.

A case of primary fibrosarcoma of the heart, which was diagnosed in a 17 year old man, is presented. Extensive tumour resection and postoperative radiation therapy was carried out. The patient is alive after 18 months after the operation. Although these tumours are associated with very poor survival, early diagnosis and combined therapy may prolong life expectancy.

Adolescent↗

[Treatment of chronic viral hepatitis B in children with moderate doses of alpha interferon].

AIM: The alpha interferon treatment criteria have not been established in children with chronic hepatitis B. We report the results of a prospective study. METHODS: Between 1988-1992 14 children (2 girls and 12 boys) with chronic hepatitis B received 3 million U/m2 of interferon alpha three times a week for 6 months. All patients underwent a liver biopsy that showed a pattern of chronic active hepatitis. One patient had cirrhosis. Hepatitis B surface antigen, hepatitis Be antigen and hepatitis B virus DNA had been positive in the serum in all for at least 6 months and anti-delta antibodies were negative in all. Pretreatment aminotransferase levels were at least 1.5 times the upper limit of normal. RESULTS: After treatment patients were followed up for at least one year (mean: 21.5 +/- 8.3 months). At the end of treatment HBV DNA was negative in 13 out of 14 patients and reappeared in one; HBeAg seroconversion was observed in 11 patients with the appearance of anti-HBe antibodies. Six patients lost the HBs antigen within 1 to 14 months after treatment. Anti-HBs antibodies did not appear in any patients and aminotransferase level normalized in 13 patients. Thirteen patients underwent liver biopsy after treatment which showed improvement in 12. CONCLUSIONS: Treatment with alpha interferon at doses of 3 MU/m2 is effective in children with active hepatitis B. Long-term follow up is needed to evaluate the effectiveness of this therapy.

Adolescent↗

Lipoma of the liver.

A case of lipoma of the liver with dimensions of 21 x 15 x 18 cm in a 65 year old male patient is presented. The tumour was visualized in ultrasonography as a homogenous lesion with a hyperechogenic image whereas it presented as a lesion having a density between -23 to -60 HU in CT. Angiographical examination showed increased vascularity and pathological accumulation of contrast medium. Histopathological examination revealed a lipoma of liver entirely consisting of mature lipocytes.

Aged↗

An endodermal sinus tumor of the head and neck region.

A 2-year-old patient with a recurrent endodermal sinus tumor of the nasopharynx is presented. After the first attempt to surgically excise the tumor it recurred, causing upper airway obstruction within 2 months. Combined treatment with surgery, radiotherapy and chemotherapy resulted in a disease-free survival of four years.

Child, Preschool↗

Immature teratoma of the ovary.

The clinicopathologic experience of 10 patients with immature ovarian teratoma is presented. The mean age of the patients was 22.1. Abdominopelvic mass was the presenting symptom in the majority of cases. Immature ovarian teratomas accounted for 4.0% of germ cell tumors and 2.1% of all ovarian neoplasms diagnosed in our institution. Of the patients, 6 had Stage I disease and 7 had grade I tumor. Unilateral tumor was encountered in the majority of patients. Adequate primary surgical-pathologic staging and multiagent chemotherapy seem to be the treatment of choice.

Adolescent↗