Polycythemia vera presenting with rapidly progressive glomerulonephritis and pyoderma gangrenosum.
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Aged↗
Biomedical subjects
M Cetin
Publications and source records attributed to M Cetin.
A comparison of the E-test and proportion methods for susceptibility testing of Mycobacterium tuberculosis.
The aim of this study was to investigate the correlation between three antibiotic susceptibility methods, the proportion method on Löwenstein Jensen medium (LJ medium), the proportion method on Middlebrook 7H11 agar (7H11 agar), and the E-test for Mycobacterium tuberculosis. Fifty M. tuberculosis isolates were tested in vitro against isoniazid, rifampicin, streptomycin, and ethambutol according to the E-test, the proportion methods on 7H11 agar and LJ medium and then compared with a reference test which was the proportion method on 7H11 agar. The correlations between proportion method on 7H11 agar and proportion method on LJ medium for isoniazid, rifampicin, streptomycin, and ethambutol were 93.9%, 85.1%, 85.4% and 78.7% respectively. The correlations between the proportion method on 7H11 agar and the E-test were 83.1%, 78.8%, 84.7% and 80.5% respectively. There were no significant differences observed between the E-test and LJ medium compared to 7H11 agar. The average times to obtain susceptibility test results were 7 and 21 days for the E-test and agar proportion methods, respectively. The E-test may be suitable for replacing the proportion methods (7H11 agar and LJ medium) in routine practice due to its fast and easy application.
Antitubercular Agents↗
The prevalence and identification of risk factors for type 2 diabetes mellitus and impaired glucose tolerance in Kayseri, central Anatolia, Turkey.
Type 2 diabetes mellitus is a chronic disease which causes neurologic, cardiac, vascular, ocular and renal complications. The present study documented the prevalence of diabetes and associated risk factors in 1774 adults who were older than 30 years. An oral glucose tolerance test (OGTT) was conducted according to the World Health Organization (WHO) criteria. Of the 1452 subjects, 58 (4%) had diagnosed diabetes, 41 (2.9%) undiagnosed diabetes and 130 (9%) had impaired glucose tolerance. The total glucose intolerance was 15. 9%. The prevalences of type 2 diabetes mellitus (9.7%-4.1%) were significantly different in low occupational and high occupational activity groups, respectively (P<0.0001). The prevalence of type 2 diabetes mellitus was 17.9% among the hypertensive group (P<0.0001). The prevalence of type 2 diabetes mellitus was higher in smokers (P<0.05). Patients with diagnosed diabetes, undiagnosed diabetes and IGT were older, more obese and have higher blood glucose values, triglyceride values, systolic and diastolic blood pressures than healthy subjects (P<0.001). We conclude that type 2 diabetes mellitus and IGT prevalences are quite high in the urban area of Kayseri, central Anatolia and multivariate analysis indicated that low occupational activity, low leisure activity, family history for diabetes, hypertension and obesity were significant independent risk factors for diabetes mellitus.
Adult↗
Successful bone marrow transplantation in a case of Griscelli disease which presented in accelerated phase with neurological involvement.
Griscelli disease (GD) is a rare disorder characterized by pigment dilution, immunodeficiency and occurrence of accelerated phase consisting of hemophagocytosis, pancytopenia and neurological manifestations. Allogeneic BMT in the early period is an important modality of treatment for GD. We carried out an alloBMT from an HLA-identical sibling donor on a 4-year-old girl who presented in accelerated phase with neurological manifestations including convulsions, strabismus, severe dysarthria, ataxia and clonus. She was treated with etoposide, methylprednisolone and intrathecal methotrexate for 8 weeks and underwent alloBMT after receiving a conditioning regimen including ATG (rabbit, 10 mg/kg x 5 days), Bu/Cy. 8 x 108/kg nucleated bone marrow cells were given. Engraftment occurred early and the post-BMT period was uneventful. Currently, she is at 18 months post BMT with sustained engraftment and with a normal neurological examination except for minimal clonus. Long-term follow-up will determine the prognosis regarding the neurological findings.
Bone Marrow Transplantation↗
Frequency of flutamide induced hepatotoxicity in patients with prostate carcinoma.
To identify and describe the frequency and severity of hepatotoxicity in patients who received flutamide therapy for prostate cancer, 22 patients were treated with the combination of flutamide and goserilin or orchiectomy. After diagnosis and staging of prostate cancer, baseline results were obtained for a set of five liver function tests (LF Ts). Hepatotoxicity was assessed according to the WHO criteria. After initiation of flutamide therapy, LF Ts were performed at 4, 8 and 12 weeks and every 2 months thereafter. Severe hepatotoxicity appeared in two of 22 (9%) patients. Following the discontinuation of flutamide, one patient died due to acute liver failure. On the other patient an improvement of LF Ts occurred after cessation of flutamide. The observed severe hepatotoxicity in two of 22 (9%) patients occurred more frequent than is predicted in the literature. Patients treated with flutamide, having symptomatic or asymptomatic liver enzyme elevations, should be taken off therapy as soon as possible.
Aged↗
Differentiation of leukemic cells induced by short-course high-dose methylprednisolone in children with different subtypes of acute myeloblastic leukemia.
Differentiation of myeloid leukemic cells to mature granulocytes by high-dose methylprednisolone (HDMP, 20-30 mg/kg/day) with a favorable antileukemic effect has previously been demonstrated in children with acute promyelocytic leukemia and acute myeloblastic leukemia (AML) M4. In the present study, three children with other morphological subtypes of AML (two AML M1, one AML M2) were given methylprednisolone (30 mg/kg/day) orally in a single dose. After a short-course (3 or 7 days) of HDMP treatment alone, a striking decrease in blast cells associated with an increase in maturing and abnormally nucleated polymorphonuclear-like cells some containing Auer rods were detected in all patients in peripheral blood or bone marrow smears. During HDMP treatment, in parallel to morphological improvements, marked increases in the percentage of cells expressing granulocytic antigen (CD15) were observed. The increase of CD15 expression on myeloid cells, together with the steady expression of CD34 and CD117 antigens in Casel(AML M1) , is suggestive of aberrant CD34 + CD117 + CD15 + cells, which may indicate the leukemic origin of the maturing myeloid cells. These results suggest that HDMP treatment may induce differentiation of myeloid leukemic cells in some children with different morphological subtypes of AML, and that the differentiation-inducing effect of HDMP should be explored in other malignant diseases.
Administration, Oral↗
Risperidone for the treatment of monosymptomatic hypochondriacal psychosis.
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Adult↗
Effects of endothelin-1 and calcium channel blockers on contractions in human myometrium. A study on myometrial strips from normal and diabetic pregnant women.
OBJECTIVE: We studied the effect of endothelin (ET)-1 on spontaneous contractions and the effects of nimodipine and isradipine on ET-1-induced contractions in myometrial tissue from normal and diabetic pregnant women. STUDY DESIGN: We isolated myometrial strips from seven normal pregnant and seven gestational diabetic women undergoing elective cesarean section at term. Three sets of experimental studies were performed with three myometrial strips obtained from every woman and mounted in organ baths for recording of isometric tension. In the first set, the effect of increasing concentrations of ET-1 (10(-11)-10(-8) M) on spontaneous contractions was recorded. In the second and third sets, effects of increasing concentration of nimodipine (10(-6)-3.10(-5) M) and isradipine (10(-5)-3.10(-4) M), respectively, on contractions following pretreatment with 10(-8) M ET-1 were recorded. RESULTS: ET-1, beginning from 10(-9) M and 10(-10) M, significantly increased the amplitude of contractions in normal and diabetic strips, respectively. ET-1, beginning from 10(-9) M, also increased the frequency of contractions in normal and diabetic strips. The amplitude of contractions was significantly higher in diabetic strips as compared with normal strips at 10(-9) and 10(-8) M. There was no significant difference in the frequency of contractions between normal and diabetic strips. ET-1 at 10(-8) M also increased the basal tone of all normal and diabetic strips. Nimodipine, beginning from 10(-6) M and 3.10(-6) M, and isradipine, beginning from 10(-5) M and 3.10(-5) M, significantly decreased the amplitude of contractions in normal and diabetic strips, respectively. Nimodipine at 10(-5) M and 3.10(-5) M and isradipine at 3.10(-4) M significantly decreased the frequency of contractions in normal strips. Nimodipine, except at 3.10(-5) M, and isradipine did not significantly decrease the frequency of contractions in diabetic strips. CONCLUSION: Gestational diabetes increases ET-1-induced contractile response in human myometrium. The contractile effect of ET-1 in normal and diabetic myometrium is mediated partly by dihydropyridine-sensitive calcium channels since it is significantly reduced by nimodipine and isradipine. The promising data from this study warrant clinical studies on the definitive place of nimodipine and isradipine in the treatment of preterm labor, especially in a diabetic woman, to avoid metabolic complications of beta-mimetic tocolytics.
Calcium Channel Blockers↗
Congenital erythropoietic porphyria successfully treated by allogeneic bone marrow transplantation.
The long-term biochemical and clinical effectiveness of allogenic bone marrow transplantation (BMT) was shown in a severely affected, transfusion-dependent 18-month-old female with congenital erythropoietic porphyria (CEP), an autosomal recessive inborn error of heme biosynthesis resulting from mutations in the uroporphyrinogen III synthase (URO-synthase) gene. Three years post-BMT, the recipient had normal hemoglobin, markedly reduced urinary porphyrin excretion, and no cutaneous lesions with unlimited exposure to sunlight. The patient was homoallelic for a novel URO-synthase missense mutation, G188R, that expressed less than 5% of mean normal activity in Escherichia coli, consistent with her transfusion dependency. Because the clinical severity of CEP is highly variable, ranging from nonimmune hydrops fetalis to milder, later onset forms with only cutaneous lesions, the importance of genotyping newly diagnosed infants to select severely affected patients for BMT is emphasized. In addition, the long-term effectiveness of BMT in this patient provides the rationale for future hematopoietic stem cell gene therapy in severely affected patients with CEP.
Bone Marrow Transplantation↗
Effects of nimodipine and isradipine on endothelin-1-induced contraction of pregnant rat myometrium.
The purpose of this study was to investigate the effect of nimodipine and isradipine on endothelin-1-induced contractions of isolated pregnant rat myometrium. Endothelin-1 at 10(-10)-10(-8) M dose-dependently increased the amplitude and frequency of contractions and decreased the duration of contractions. Basal tone of myometrium was increased with the higher endothelin-1 concentrations (10(-9) and 10(-8) M). After pretreatment for 30 min with 10(-6) M nimodipine or 10(-5) M isradipine, amplitude and duration of endothelin-1-induced contractions were significantly decreased, but frequency of myometrial contractions increased markedly. However, neither agent abolished the stimulating effect of higher endothelin-1 concentrations (10(-9) and 10(-8) M) on the basal tone. Our study showed that phasic activity is inhibited by nimodipine and isradipine, whereas tonic activity is not inhibited. The contraction of myometrial strips isolated from the pregnant rat may be modulated by endothelin-1, and this effect is only partly modulated by dihydropyridine-type Ca2+ channels. The remaining resistance to nimodipine- and isradipine-induced inhibition may be explained by pregnancy-associated changes in the other electrophysiological and biochemical factors.
Animals↗
Diagnostic and therapeutic decision-making with transvaginal sonography for first trimester spontaneous abortion, clinically thought to be incomplete or complete.
The purpose of this study was to evaluate the diagnostic accuracy of transvaginal sonography for first trimester spontaneous abortions, thought to be incomplete or complete, in patients with postabortion bleeding or uterine cramping within 5 days of abortion. In a prospective study, 78 patients underwent transvaginal sonography to evaluate the maximum anteroposterior diameter of the uterine cavity on the long axis view and echo pattern of the retained products of conception. Patients were divided into three groups: those with a normal uterine cavity or a uterine cavity with fluid collection without echogenic foci (n = 13, group A), those with a uterine cavity containing fluid mixed with solid components (n = 38, group B), and those with a uterine cavity containing solid components (n = 27, group C). Group A was considered not to have retained products of conception, and the latter two groups were considered to have retained products of conception. Patients in group A were assigned to receive conservative treatment. In groups B and C, patients with significant vaginal bleeding during 48 h of follow-up underwent elective curettage and those with minimal-mild bleeding received conservative management. A total of 73 patients (12 in group A, 35 in group B and 26 in group C) completed the study. There were no differences in any of selected reproductive data of the groups (p > 0.05). In group B, all patients with uterine cavity diameter of 10 mm or greater underwent elective curettage. In group C, all patients with a diameter of the uterine cavity 8 mm or greater underwent elective curettage. The overall complication and patient satisfaction rates were approximately 14% and 88%, respectively. Transvaginal sonographic findings can be used as a decision factor in the management of patients with first trimester spontaneous abortion to reduce the need for an elective curettage by approximately 58%.
Abortion, Incomplete↗
A comparison of the effect of high-dose methylprednisolone with conventional-dose prednisolone in acute lymphoblastic leukemia patients with randomization.
In this preliminary study the efficacy of high-dose methylprednisolone (HDMP) during remission-induction chemotherapy was evaluated on 166 children with acute lymphoblastic leukemia (ALL). The St. Jude Total Therapy Study XI protocol with minor modifications was used in this trial. Patients were randomized into two groups. Group A received conventional-dose (2 mg/kg/day orally) prednisolone, and group B received high-dose methylprednisolone (HDMP, Prednol-L, 900-600 mg/m2 orally) during remission-induction chemotherapy. Complete remission was achieved in 97% of the children. For the 80 patients who were followed up for 3 years, median follow-up was 44 (range 5-60) months and the 3-year event-free survival (EFS) rate was 68.5%) overall, 58.6% in group A and 78.4% in group B. The EFS among patients in group B was significantly higher than in group A (p=0.05). When we compared the 3-year EFS of groups A and B in the high-risk groups and high-risk subgroups with white blood cell (WBC) counts > or = 50 x 10(9)/l and age > or = 10 years, the survival rates were 45% versus 77.2%, 33% versus 78% and 45% versus 89%, respectively. During the follow-up of 162 patients, relapses were significantly higher in group A. Bone marrow relapses in 162 patients, and also in a subgroup of patients > or = 10 years of age were significantly higher in group A. These results suggest that HDMP during remission-induction chemotherapy improves long-term EFS, particularly for high-risk patients.
Adolescent↗
Myelodysplastic syndrome associated with Griscelli syndrome.
Myelodysplastic syndrome (MDS) in children has been reported to be associated with various constitutional anomalies; however, it has not been described previously in patients with Griscelli syndrome (GS). In this report, we present a case with GS and refractory anemia with an excess of blasts. We believe that careful evaluation of peripheral blood and bone marrow could increase the number of patients who are found to have GS-associated MDS.
Hepatomegaly↗
Shedding of the nails due to chemotherapy (onychomadesis)
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Acute Disease↗
Inhibitory effects of isradipine on spontaneous and oxytocin- and carbachol-stimulated contractions of rat myometrium.
Our aim was to investigate the effect of isradipine, a second-generation calcium channel blocker, on spontaneous and oxytocin- and carbachol-stimulated contractions of myometrium isolated from nonpregnant and pregnant rats. Amplitude, frequency, duration and integrated area of spontaneous and oxytocin- and carbachol-stimulated contractions of nonpregnant and pregnant rat myometrium were compared before and after the treatment with isradipine (10(-6) to 10(-4) mol/l). Isradipine inhibited contractions of myometrial strips isolated from nonpregnant and pregnant rats in a concentration-dependent manner, with a significant effect on the amplitude (10(-5) to 10(-4) mol/l) and integrated area (3 x 10(-6) to 10(-4) mol/l) of spontaneous and oxytocin- and carbachol-stimulated contractions. Isradipine induced similar concentration-dependent effects on the frequency and duration of spontaneous and carbachol-stimulated contractions at higher concentrations (3 x 10(-5) to 10(-4) mol/l) but had no effect on frequency and duration of oxytocin-stimulated contractions. Isradipine appears to be an effective relaxant in rat myometrium. This effect of isradipine may become therapeutically advantageous in clinical application for preterm labor.
Animals↗
Dramatic resolution of pleural effusion in children with chronic myelomonocytic leukemia following short-course high-dose methylprednisolone.
High-dose methylprednisolone (HDMP) which can induce--differentiation and -apoptosis of myeloid leukemic cells has been shown to be very effective in the treatment of extramedullary infiltration (EMI) of children with acute myeloblastic leukemia (AML). In the present study 2 children with chronic myelomonocytic leukemia (CMML) who had pleural effusions were given a single daily dose of oral methylprednisolone (20 mg/kg or 30 mg/kg). In addition to dramatic improvement of respiratory symptoms, pleural effusions disappeared in four days in both patients possibly due to apoptotic cell death induced by HDMP treatment. Further studies are needed to determine whether high-dose corticosteroids are also effective on the resolution of pleural effusions associated with other malignant disease.
Adolescent↗
Allogeneic bone marrow transplantation in Fanconi anemia from Turkey: a report of four cases.
Bone marrow transplantation (BMT) is currently the treatment of choice for patients with Fanconi anemia (FA) if a suitable donor is available. Four children with FA underwent allogeneic BMT from HLA-identical siblings during the period from 1995 to 1996. Pretransplant conditioning was Cyclophosphamide (Cy) (20 mg/kg) + Thoracoabdominal irradiation (TAI) (500 cGy) +/- Antithymocyte globulin (ATG) (2 mg/kg/day x 3). Cyclosporin A (CsA) was used as GvHD prophylaxis. The time of neutrophil (ANC>500) and platelet (>50,000) recovery were at 11-14 and 17-25 days, respectively. One patient with a pretransplant history of multiple transfusions experienced graft rejection and died at day +29 with infection and bleeding. Although three patients sustained engraftment one developed donor originated acute lymphoblastic leukemia (ALL) 18 months after BMT and died with CNS hemorrhage and infection at +25 months following 7 months of chemotherapy. None of the patients developed grade 3-4 acute GvHD. Cytotoxicity included grade II mucositis in all and severe gastroenteritis in one patient. During a follow-up period of 10 months and 2 years, two patients are well with normal blood count, recovering immune function and have a Karnofsky score of 90%.
Adolescent↗