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Biomedical subjects

M Arslan

Publications and source records attributed to M Arslan.

143 records · Page 8Linked to original sources
PubMedDate not supplied

Noncurative total gastrectomy and oesophagogastrectomy in the treatment of advanced gastric carcinoma in a country with high incidence.

The role of extensive resectional surgery, including total gastrectomy for the palliation of advanced gastric cancer is controversial. This study shows operative results with complications and mortality occurring after total gastrectomy in patients with advanced stage gastric carcinoma. The study included 83 (48 males and 35 females, median age was 54.6 +/- 11.4 years) patients who underwent palliative total gastrectomy or oesophagogastrectomy (distal oesophagectomy in continuity with total gastrectomy). The reason for nonradical treatment was a too locally advanced disease. There was no case of carcinoma without serosal extension. Only five patients were free of histological lymph node metastases. A total of 72 (86.7%) early postoperative complications, including 17 self-limited wound complications, and 21 pulmonary complications were noted. Dehiscence of the oesophagojejunal anastomosis was noted in 7 patients, 3 of whom subsequently died. A total of 8 (9.6%) patients died in the postoperative period. The mean survival period was 12.8 +/- 0.8 months for all patients. It was 18.16 +/- 2.04 months in stage IIIA patients, 13.37 +/- 0.79 months in stage IIIB, and 7.51 +/- 0.97 months in stage IV patients. Total gastrectomy is a relatively safe procedure even when performing as a palliative procedure, with acceptable mortality and low lethal complication rate, and should be considered an alternative option in palliative treatment of advanced gastric cancer.

Adult↗
PubMedDate not supplied

CYP17 genetic polymorphism in patients with endometrial hyperplasia and cancer.

We investigated the association of CYP17 gene polymorphism with the risk of having endometrial cancer and a well-known precursor of it, endometrial hyperplasia. Group A (control group) consisted of 35 patients who had histologically proven normal endometrium. Group B and C consisted of 18 and 30 patients who had endometrial hyperplasia with and without atypia, respectively. Group D consisted of 57 patients who had endometrial cancer. Venous blood samples were collected from patients in groups, and polymerase chain reaction was performed to determine the CYP17 gene polymorphism. Significant increase of A1/A1 and a decrease of A1/A2 genotype frequencies have been determined in patients with endometrial cancer and with atypical endometrial hyperplasia. No significant differences were found between groups in the frequency of A2/A2 genotype. There was no significant difference between the groups in the meaning of allele distributions. CYP17 polymorphism had correlation with endometrial atypia and cancer. Related effects of different types of CYP17 gene variants on the progression of hyperplastic endometrial cells into carcinoma should be evaluated in further studies. Progress in this area would help us modulate preventive treatments used in those actual high-risk group patients.

Adult↗
PubMedDate not supplied

Long-term prevention of atrial fibrillation after coronary artery bypass surgery: comparison of quinidine, verapamil, and amiodarone in maintaining sinus rhythm.

AIM OF STUDY: To evaluate the necessity and efficacy of quinidine fumarate, verapimil, or amiodarone prophylaxis for sinus rhythm maintenance in patients who experienced atrial fibrillation after coronary artery bypass surgery. METHODS: Between 1992 and 1995, this prospective, randomized, placebo-controlled study examined 120 patients in whom atrial fibrillation occurred and was restored to sinus rhythm by pharmacological therapy or direct current cardioversion in the immediately postoperative period after coronary artery by-pass surgery. There were no significant differences in perioperative characteristics among the patients, who were randomly separated into four groups in the course of discharge. In group 1 (n = 30), patients did not receive antiarrhythmic drugs. Quinidine fumarate was given in group 2 (n = 30), verapimil in group 3 (n = 30), and amiodarone in group 4 (n = 30). Patients were monitored six times over a 90-day postoperative period by 24-hour Holter monitoring and routine examination. RESULTS: The recurrent atrial fibrillation usually developed within 15 days of discharge. Atrial fibrillation occurred in one patient (3.33%) in group 1, and two each (6.66%) in groups 2, 3, and 4. Atrial fibrillation was asymptomatic and occurred with slow ventricular response in groups 3 and 4. Side effects occurred in 5 patients (16.6%) given quinidine, 1 patient given amiodarone, but in no patient given verapimil. CONCLUSIONS: There were no significant differences in the maintenance of sinus rhythm among the four groups, so we suggest that long-term prevention of atrial fibrillation in patients with coronary artery bypass grafting was not necessary at the postdischarge period.

Aged↗
PubMedDate not supplied

Repair of the left AV valve in atrioventricular septal defect in adults.

BACKGROUND: This study examined the septal cleft and septal commissure of the left atrioventricular (AV) valve, which are two different anatomical structures. METHODS: We presented 36 cases of adult partial atrioventricular septal defect. A distinction was made between patients based on the anatomy of the anterior leaflet of the left AV valve. The left AV valve appeared to be normal or to have minimal radial openings from the free edge of the anterior leaflet of the left AV valve in 10 patients (28%). There was a septal commissure structure in 8 (22%), and a septal cleft structure in 18 (50%) patients. In the commissure type anatomy, leaflet coaptation was usually adequate and no or mild degree of left AV regurgitation existed preoperatively. Cleft type structure usually was associated with some degree of left AV regurgitation. Attempts were made to close the septal clefts and leave the septal commissures unsutured during the repair of the partial AV septal defects. RESULTS: We have not found any increase of left AV regurgitation in patients with commissures during the follow-up period. Closure of the cleft successfully eliminated regurgitation. Long-term results for septal cleft and septal commissure after repair of partial AV septal defect were excellent with survival of 100% and freedom from reoperation of 100% at mean 6.5 years. CONCLUSIONS: Septal cleft and septal commissure should be considered two different structures. Repairing procedures for left AV valve abnormalities associated with partial AV septal defect should only be done in patients who have cleft type of leaflet structure.

Adolescent↗
PubMedDate not supplied

Four cases with chronic intestinal pseudo-obstruction due to hollow visceral myopathy.

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction is a rare clinical syndrome characterized by symptoms and signs of intestinal obstruction without any organic lesion obstructing the intestine. Visceral myopathy is one of the etiological causes and full thickness intestinal biopsy is essential for reaching a diagnosis. In this article we describe 4 cases of hollow visceral myopathy; our aim is to stress the importance of full thickness biopsy. METHODOLOGY: Four cases of hollow visceral myopathy are studied herein. All the patients had recurrent abdominal pain and constipation. The onset of symptoms was early in life or in the second to third decade. A diagnosis was established in all cases by full thickness intestinal biopsy obtained during laparotomy. Associated disorders were noted in 2 cases. One patient had Axenfelt syndrome, non-descended testicles and primary hypogonadism, and another had a diagnosis of Kleinfelter syndrome. RESULTS: All of the 4 cases were diagnosed to be suffering from hollow visceral myopathy by full thickness intestinal biopsy and 2 had additional disorders as well. CONCLUSIONS: Patients with chronic intestinal pseudo-obstruction should be carefully evaluated as to whether there is an associated disorder and the diagnosis may be delayed unless full thickness intestinal biopsy is obtained.

Abdominal Pain↗
PubMedDate not supplied

Effect of omeprazole on gallbladder contraction in humans.

BACKGROUND/AIMS: Omeprazole causes hypergastrinemia because of the effects of prolonged complete suppression of acid secretion and also gastrin has an excitatory effect on gallbladder contraction. Therefore, we investigated the meal-induced gallbladder emptying in healthy subjects receiving omeprazole and compared them to controls. METHODOLOGY: Twenty healthy volunteers participated in this study. Gallbladder volume was measured by ultrasonography. After basal measurement, the volunteers received saline intravenously (i.v.) 2 cc (no:10) or omeprazole 20 mg i.v. (no:10). After 15 min the gallbladder volume was scanned at 15 min intervals for 60 min for each of the subjects. At the end of the period, all the subjects received a standard test meal (ensure 250 cal/250 mL), after 1 hour the gallbladder volumes were rescanned at 15 min periods for 60 min. RESULTS: Mean gallbladder volume in the omeprazole group was not significantly different during a 45 min period as compared to the baseline value. The residual gallbladder volume at the end of the 15th minute (43.9 +/- 5.6 mL), 30th minute (45.4 +/- 5.9 mL), 45th minute (40.5 +/- 6.1 mL) and 60th minute (40.5 +/- 6.1 mL) showed no significant differences in both the omeprazole group and the controls. Mean gallbladder volumes of both groups after meal intake were significantly lower during the 1-hour period as compared to the baseline value (P < 0.05). The mean volumes did not show any significant differences between the omeprazole group and the control subjects. CONCLUSIONS: Omeprazole did not change the gallbladder volume during fasting and the postprandial period as compared to the control group.

Adult↗
PubMedDate not supplied

Ligation in adult persistent ductus arteriosus.

Seventy one patients with a persistent ductus arteriosus were operated upon at the Cardiovascular Unit in Gülhane Military Medical Academy. The mean age of these cases was 24 years. Twenty five patients (35%) were asymptomatic. The average pulmonary artery systolic pressure was 50 +/- 22 mmHg. In the majority of the cases the ductus was ligated (91.5%), but 6 of the cases were treated by division (8.5%). Early and late complications or mortality were not encountered. In this study 71 cases are reviewed: the preoperative cardiac catheterization and the operative findings are studied in relation to the surgical procedures used. Ligation is a simple, quick and effective surgical treatment for persistent ductus arteriosus in adults.

Adult↗
PubMedDate not supplied

Appearance of alpha-smooth muscle actin in peritubular cells of monkey testes is induced by androgens, modulated by follicle-stimulating hormone, and maintained after hormonal withdrawal.

This study analyzed the hormonal requirements necessary for the development of primate testicular peritubular cells. Alpha-smooth muscle actin, as a specific differentiation marker for peritubular cells, was immunohistochemically detected in the testes of immature rhesus and adult rhesus and cynomolgus monkeys. Positive staining was localized in the wall of blood vessels and in peritubular myoid cells of adult animals. In the testis of vehicle-treated immature monkeys no positive staining could be detected in peritubular cells. Following follicle-stimulating hormone (FSH) or testosterone treatment, immunostaining for alpha-smooth muscle actin appeared in peritubular cells of immature animals. In comparison to FSH, testosterone was more effective in inducing the differentiation of peritubular cells. The most intense label for alpha-smooth muscle actin was, however, obtained after combined treatment with FSH and testosterone. A computer-assisted image analysis system was used to evaluate semiquantitative data for the alpha-smooth muscle actin positive area; this confirmed a significantly higher expression of alpha-smooth muscle actin in peritubular cells of immature monkeys after treatment with testosterone plus FSH in comparison to controls. These data present evidence that the differentiation of primate peritubular cells during pubertal sexual development is a hormone-dependent process, which may be predominantly regulated by androgens. FSH exerted additive effects on the androgen-induced differentiation of peritubular cells, suggesting that paracrine communication between peritubular cells and Sertoli cells existed. Maintenance of peritubular cell differentiation after withdrawal of hormonal stimuli in adult monkeys may be a possible explanation for different hormonal requirements during reinitiation of spermatogenesis after testicular involution.

Actins↗