Evisceration of the eye in a renal transplant recipient with cytomegalovirus chorioretinitis.
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Adult↗
Biomedical subjects
M Hayran
Publications and source records attributed to M Hayran.
Severe hypoglycemia in a patient with chronic renal failure due to amyloidosis.
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Adult↗
Intermediate cells detected in electron microscopic observation of the rat spiral ganglion.
Morphological features of the rat spiral ganglion cells were investigated in serial sections by electron microscopy. Materials were obtained from healthy rat temporal bones after perfusion with glutaraldehyde. Cochleas were removed and prepared by routine electron microscopic methods. EDTA was used for decalcification. When semithin sections were studied two distinct types of the neurons were observed, the large and the small cell bodies, which were mostly myelinated. The differences between the organelles of these two cell type were analyzed under electron microscope. The large cell bodies were rich in cytoplasmic organelles and intracytoplasmic microfilaments were sparse. The small neurons contained fewer cytoplasmic organelles and were rich in microfilaments. In addition to the known types of neurons, higher magnifications indicated 1-2% of all these cells were intermediate cells. The morphological structure was basically the same as that of the large neurons but they were rich in cytoplasmic organelles including the microfilaments.
Animals↗
Effects of obstructive jaundice and external biliary diversion on bacterial translocation in rats.
OBJECTIVE: To find out the rate of translocation of bacteria to visceral organs in obstructive jaundice, and whether the absence of bile within the intestine or the presence of obstructive jaundice itself promotes bacterial translocation. DESIGN: Prospective, controlled experimental animal study. SETTING: University hospital, Turkey. SUBJECTS: 40 Inbred albino rats weighing 160-220 g. INTERVENTIONS: Three groups of rats were studied: sham operated controls (n = 15), ligation of the common bile duct (CBD) (n = 15), and CBD-ligation and proximal external biliary division through a Silastic catheter (n = 10). Specimens of distal small bowel mesenteric lymph nodes (MLN), liver, spleen, and lung were obtained on the 10th postoperative day, and quantitative bacteriological analysis done. Caecal aerobic microflora were also measured for qualitative and quantitative comparisons. RESULTS: The translocation of bacteria to MLN, liver, and spleen, but not to the lungs, was slightly but not significantly increased by ligation of the CBD. Ligation of the CBD with simultaneous external biliary diversion caused increase translocation to all organs examined (with the increases to the MLN (p = 0.012), liver (p = 0.009), and spleen (p = 0.028) being significant). There was no difference in the raised bacterial counts in MLN and visceral organs after ligation of the CBD or biliary diversion. The pattern of caecal microflora did not change in any group. CONCLUSIONS: These findings suggest that the absence of bile from the gut may promote bacterial translocation to visceral organs.
Animals↗
Pre- and post-therapy thallium-201 and technetium-99m-sestamibi SPECT in nasopharyngeal carcinoma.
UNLABELLED: We prospectively studied the diagnostic potential of 201Tl and 99mTc-sestamibi (MIBI) SPECT for evaluating the extent of primary disease and differentiating residual/recurrent disease from post-therapy changes in patients with nasopharyngeal carcinoma (NPC). METHODS: Fifty patients (20 initial presentation, 30 post-therapy evaluation) underwent 201Tl and MIBI imaging. The findings were correlated with CT/MRI results. Tumor-to-background ratios were obtained. Biopsy confirmation (14 patients) and/or 6-12 mo clinical follow-up data (16 patients) were available in the post-therapy group. RESULTS: All primary disease sites were accurately detected by both imaging studies in the pretherapy group. However, MIBI-SPECT was superior to 201Tl SPECT (p = 0.0057) in detecting regional metastases (sensitivities of 95% versus 68%). In the post-therapy group, MIBI and 201Tl imaging were true-positive in 14 of 16 patients with proven residual/recurrent. In 17 patients who had no evidence of residual/recurrent tumor. CT/MRI was false-positive in 13 when MIBI and 201Tl imaging were true-negative in 10 and false positive in 3. MIBI, 201Tl and CT/MRI had sensitivities of 87.5%, 87.5%, 100%, specificities of 82.4%, 76.5%, 23.5% and accuracies of 85%, 82%, 61%, respectively. Tumor-to-background ratios were < or = 1.5 in all false-positive cases except one. CONCLUSION: MIBI-SPECT proves more accurate than 201Tl SPECT in detecting regional metastases at initial presentation. MIBI and 201Tl imaging have higher specificity and accuracy than CT/MRI and MIBI-SPECT is slightly more specific than 201Tl SPECT in differentiating residual/ recurrent disease from post-therapy changes in patients with NPC.
Adolescent↗
Monosize poly(ethylcyanoacrylate) microspheres: preparation and degradation properties.
Monosize, biodegradable poly(ethylcyanoacrylate) (PECA) microspheres in the size range of 0.5-2.5 microns were prepared by a relatively new polymerization technique, the so-called dispersion polymerization. The polymerizations were performed by using a stabilizer system containing a poly(ethyleneoxide)/poly(propyleneoxide) (PEO/PPO) copolymer and dextran in the aqueous HCl solution as a dispersion medium. Phosphoric acid was used as a catalyst, stabilizer, monomer concentrations, and the pH of dispersion medium on the monomer conversion, average size, and size distribution of the PECA microspheres were studied. The resultant microsphere size was mainly controlled by PEO/PPO copolymer and HCl concentrations. To explain the degradation mechanism, the degradation of monosize PECA microspheres was studied in in vitro conditions. The partially degraded beads were observed by electron microscopy. The results indicated that the degradation of monosize PECA microspheres occurred mainly by surface erosion.
Biodegradation, Environmental↗
The effect of extracorporeal electromagnetic shock waves on the morphology and contractility of rabbit ureter.
PURPOSE: Although extracorporeal shock wave lithotripsy (ESWL) is known to cause pathologic changes in various organs, little is known about its effects on the ureter, the target organ in ESWL of ureteral stones in situ. In this study, we sought to determine the short-term effects of ESWL on the ureter. MATERIALS AND METHODS: Left lower ureteral segments of 21 rabbits were removed to serve as the control group and 2000 shocks were applied to the right lower ureters. Groups of 7 rabbits were sacrificed 1, 3 and 5 days after shock wave exposure. While histomorphological alterations were examined under light and transmission electron microscopy, contractility of all ureters was determined in organ baths. RESULTS: The epithelial cells disclosed no change after shock wave application. Histologically the muscular layer was the most affected part of the ureter. There was interstitial and intracellular edema on light microscopy and marked chromatin and mitochondrial changes at the subcellular level. The adventitial layer was also edematous. These changes were prominent on days 1 and 3 and returned to normal on day 5. The contractility of the ureters on day 1 was significantly reduced (p < 0.05). However, the contractility of the samples on days 3 and 5 were not significantly different from controls. CONCLUSION: Our findings demonstrate that electromagnetic shock waves produce reversible morphological and functional changes in rabbit ureteric muscle.
Animals↗
Efficacy of a three-day course of azithromycin in the treatment of community-acquired pneumococcal pneumonia. Preliminary report.
Azithromycin is an azalide antibiotic with activity against many of the respiratory pathogens and with marked tissue affinity. In a prospective study, the efficacy of a short-course of azithromycin was evaluated in 25 patients with community-acquired pneumococcal pneumonia. Gram-positive diplococci were abundant in the sputum smears of all patients, and Streptococcus pneumoniae was isolated in the sputum cultures of 15; one patient had pneumococcal bacteremia, as well. Azithromycin was administered at a single dose of 1,000 mg on day 1, and 500 mg on subsequent days for a total of three days in 19 patients, five days in four patients, two and four days in one patient each. Defervescence occurred within 24 hours after the first dose. The overall clinical cure and bacteriologic eradication rates were 96% and 93%, respectively. One patient with pneumococcal bacteremia failed to respond and died in respiratory failure. Side-effects were encountered in three (12%) patients. In conclusion, three-day therapy with a total azithromycin dose of 1,500 mg seems effective and safe in patients with community-acquired pneumococcal pneumonia and no underlying pulmonary condition.
Adult↗
Efficacy of fluconazole in the treatment of upper gastrointestinal candidiasis in neutropenic patients with cancer: factors influencing the outcome.
Fluconazole has proved to be effective in treating oropharyngeal and esophageal candidiasis in immunocompromised patients. However, sufficient data are lacking regarding the efficacy of this agent in neutropenic hosts. The aim of the present study was to determine the clinical and mycological efficacy of fluconazole and to define the factor(s) affecting the outcome of fluconazole therapy in severely neutropenic patients (peripheral neutrophil count, < 500/microL) with cancer who have oropharyngeal and/or esophageal candidiasis. One hundred eleven patients with 129 episodes of candidal infections were treated with intravenous and consequently oral fluconazole (200 mg/d and 100 mg/d, respectively). Overall clinical cure and mycological eradication rates were 82% and 56%, respectively. Persistent neutropenia (P < .01), infection with a non-albicans strain of Candida (P = .012), and administration of antifungal therapy during the second or a later neutropenic episode (P < .002) were independently associated with a worse outcome. We conclude that fluconazole is effective in the treatment of upper gastrointestinal candidiasis in neutropenic patients with cancer. Effective treatment of the underlying malignancy, with the resultant recovery from neutropenia, and the determination of the species of infecting Candida isolates are required for the prediction of the outcome of antifungal therapy.
Adult↗
Warm blood cardioplegia: ultrastructural and hemodynamic study.
Forty patients with coronary artery disease were included in this study. Half of them received cold crystalloid and cold blood cardioplegia (group 1), and half received normothermic blood cardioplegia (group 2). In group 1, left ventricular stroke work index was 24 +/- 3 g.m/m2 1 hour after the operation, 29 +/- 8 g.m/m2 12 hours after the operation, and 33 +/- 6 g.m/m2 24 hours after the operation. In group 2, left ventricular stroke work index was 37 +/- 4 g.m/m2 1 hour after the operation, 37 +/- 4 g.m/m2 12 hours after the operation, and 44 +/- 7 g.m/m2 24 hours after the operation. Myocardial oxygen extraction 20 minutes after the termination of cardiopulmonary bypass was 0.28 +/- 0.03 in group 1 and 0.44 +/- 0.08 in group 2. Myocardial lactate extraction at the same time was -0.09 +/- 0.02 in patients receiving cold blood cardioplegia and 0.17 +/- 0.07 in patients receiving normothermic blood cardioplegia. Electron microscopic study revealed no calcium accumulation in the mitochondria in group 2 patients, whereas calcium accumulation was present in the other group.
Aged↗
Quinolones in treatment of human brucellosis: comparative trial of ofloxacin-rifampin versus doxycycline-rifampin.
Quinolones have been reported to be active against Brucella species in vitro. In this prospective randomized study, the efficacy and safety of the combination of ofloxacin plus rifampin were compared with the efficacy and safety of doxycycline plus rifampin, both combinations administered for a 6-week period in treatment of brucellosis. Sixty-one patients were enrolled in the study, and 49 had blood or bone marrow cultures positive for Brucella melitensis. Thirty patients received 200 mg of doxycycline plus 600 mg of rifampin once daily, and 31 patients were treated with 400 mg of ofloxacin plus 600 mg of rifampin once daily for 6 weeks. Nine patients in each group had complications of the disease. There was one therapeutic failure in the ofloxacin-rifampin treatment group, and one patient from each group relapsed (3.3% of those in the doxycycline-rifampin treatment group versus 3.2% of those in the ofloxacin-rifampin treatment group). Gastric discomfort was the major side effect observed in 13 patients (43.3%) who received doxycycline plus rifampin, whereas only 2 patients (6.5%) treated with ofloxacin plus rifampin complained of gastric irritation. These results suggest that the combination of ofloxacin plus rifampin administered for 6 weeks is as effective as doxycycline plus rifampin given for the same period, regardless of the presence of complications of the disease.
Adolescent↗
Detection of Mycobacterium tuberculosis in sputum samples by polymerase chain reaction using a simplified procedure.
A repetitive sequence of Mycobacterium tuberculosis DNA was amplified by polymerase chain reaction (PCR), from sputum samples, for the diagnosis of pulmonary tuberculosis. The method of heating the sample in a boiling water bath to break down the bacterial cell wall and to release the DNA was compared with that of enzymatic lysis of bacteria and then phenol-chloroform extraction of DNA. Heating the sample was the better method with a sensitivity of approximately 10 microorganisms. A total of 78 sputum specimens prepared by heating were examined by PCR, and the results were compared with the results of acid-fast stained smears, cultures, and clinical data. M. tuberculosis was detected by PCR in all smear- and culture-positive and smear-negative, culture-positive cases. Additionally, PCR was capable of detecting four of nine cases which were smear and culture negative but clinically suspected of tuberculosis. DNA amplification by PCR is a sensitive and specific method for the diagnosis of tuberculosis, and with this simplified DNA isolation procedure it can be used in routine clinical practice.
Bacteriological Techniques↗
Effect of right atrial appendicectomy on the release of atrial natriuretic peptide in humans.
The present study evaluated the effect of right atrial appendicectomy on the release of atrial natriuretic peptide (ANP) and subsequent changes in postoperative haemodynamics in 20 men undergoing coronary artery bypass graft surgery. The right atrial appendix was removed in ten patients and saved in ten. Serum ANP, sodium levels and urinary sodium excretion were measured before and on days 1, 7 and 30 after surgery. Haemodynamic parameters were monitored before surgery and on day 30. Serum ANP levels fell significantly in patients undergoing appendicectomy (P < 0.05); haemodynamic parameters were unchanged. Hence, appendicectomy reduced serum ANP levels in the short term, though these tended to rise again with time; cardiac function was not affected by lowered levels of serum ANP. Consequently, saving the appendix in right atrial appendicectomy improves natriuresis and may decrease diuretic requirement.
Adult↗
[Ultrastructure and properties of Actinobacillus actinomycetemcomitans].
In this study, plaque samples taken from periodontal pockets were cultured on Tryptic-soy-serum-bacitracin-vancomycin agar and identified according to colony morphology, Gram stain, catalase reaction and nitrate reduction tests after an incubation of 48 hours in candle jar. Cells identified as Actinobacillus actinomycetemcomitans were evaluated under the transmission electron microscope for fine structure. Outer membrane was observed as an irregular structure containing microcapsules. Unlike previous studies, periplasmic space was observed separately from other layers. Cytoplasmic membrane was observed surrounded by an electron-opaque cytoplasm. Besides, extracellular vesicles were seen extending to the outer environment around cytoplasmic membrane. Pathogenic properties of organelles were discussed. As a result, it was concluded that, in the future studies, products released and structural alterations occurring during growth of the organism, their pathologic effects and ways to suppress them need to be investigated microbiologically, ultrastructurally and biochemically.
Actinobacillus Infections↗
An unusual insertion of the palmaris longus muscle.
In the course of an anatomical dissection at the School of Medicine, a variant form of the palmaris longus muscle was found on the right side; the fellow muscle of the left side being normal. The palmaris longus concerned was found to arise by fleshy fibers from the common tendon for the flexores antebrachii muscles to be divided into a lateral and a medial tendon. The lateral tendon of the muscle was inserted onto the thenar fascia and the scaphoid bone while the medial tendon was being inserted onto the hypothenar fascia and the triquentral bone.
Adolescent↗
Evaluation of the temporal bone by anatomic sections and computed tomography.
Serial Computed Tomography (CT) scans of isolated temporal bones have been obtained in transverse planes at 1.5 mm intervals. Then gross anatomic sections of same temporal bones were taken at 3 mm. intervals in planes parallel to the CT scans. These CT and anatomic sections were evaluated comparatively.
Humans↗
Factors influencing prognosis in bacteremia due to gram-negative organisms: evaluation of 448 episodes in a Turkish university hospital.
A total of 448 episodes of bacteremia due to gram-negative organisms observed during the 7-year period between 1983 and 1989 at Hacettepe University Hospitals were studied for evaluating the factors influencing the prognosis. The overall mortality rate was 45.0%. The mortality rates were not significantly different in "rapidly fatal" and "ultimately fatal" disease groups (48.3% and 45.5%, respectively), whereas it was significantly less (34.8%) in the "nonfatal" disease group compared with the "rapidly fatal" category. There were great differences in the mortality rates among different diseases within the same disease category. Shock, multi-organ failure, source of infection, hospital service, appropriateness of antibiotic therapy, and place of acquisition of infection were found to affect prognosis significantly in multivariate analysis. In conclusion, the identification of prognostic factors is a further step for making necessary interventions in reducing the mortality rate associated with bacteremia due to gram-negative organisms. Underlying disease is still an important prognostic factor; however, a new approach is needed for classification of underlying diseases.
Adolescent↗
[Staphylococcal biotyping and the use of computers].
Ninety coagulase negative staphylococci isolated from various clinical specimens in Clinical Microbiology laboratory of Hacettepe University Faculty of Medicine, were biotyped using a special computer program. Types of 30 strains isolated from pus were found to be S. epidermidis (36.7%), S. haemolyticus (20%), S. simulans (13.3%) and S. hominis (10%) respectively. Among the strains isolated from blood S. epidermidis was again the predominant microorganism (40%), followed by S. haemolyticus (20%) and S. simulans (10%).
Bacteremia↗