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Biomedical subjects

M Ozcan

Publications and source records attributed to M Ozcan.

At least 19 recordsLinked to original sources

Autonomic dysfunction in vitamin B12 deficiency: a heart rate variability study.

This study was arranged to examine whether vitamin B12 deficiency may cause autonomic dysfunction. Time-domain and long-term frequency-domain heart rate variability parameters from 12 patients with pernicious anemia were compared to 12 age and sex matched controls. In B12 deficient patient group time-domain parameters; SDNN (100.4 +/- 37.86 vs. 131.91 +/- 26.94, P = 0.05), SDANN (87.00 +/- 37.77 vs. 118.83 +/- 26.22, P = 0.05) SD (39.41 +/- 13.32 vs. 53.41 +/- 15.39, P = 0.0221), rMSSD (21.41 +/- 10.00 vs. 28.5 +/- 8.42, P = 0.046) were significantly lower when compared to controls. Difference in pNN50 between groups were not statistically significant. In B12 deficient patients frequency-domain parameters; total power (23.08 +/- 9.89 vs. 34.75 +/- 9.56, P = 0.0078), low frequency power (13.5 +/- 6.57 vs. 22.75 +/- 7.25, P = 0.0069) and high frequency power (7.58 +/- 4.25 vs. 11.58 +/- 3.80, P = 0.0175) were significantly lower when compared to controls. It was concluded that B12 deficiency may cause autonomic dysfunction.

Adult

Combined treatment of digital degloving injuries: a case report.

In a digital degloving injury of four fingers, a combined treatment of tripedicle dermal flap, free hemipulp web flap, and skin graft was used. The functional and cosmetic results of the hand were satisfactory. The patient had an excellent sensory recovery in the free hemipulp web flap and did not complain of any disability from the donor site.

Adult

Randomised unicenter trial for comparison of three regimens in de novo adult acute nonlymphoblastic leukaemia.

Various regimens have been explored in the treatment of acute nonlymphoblastic leukaemia (AML), but so far none has been shown to be superior. Here we report on a comparison of three widely used protocols defined by Berman (Group 1), MRC AML 10 (Group 2), and Arlin (Group 3). Group 1 includes cytosine arabinoside (Ara-C) (100 mg/m2/d, days 1-7) and idarubicin (Ida) (12 mg/m2/d, days 1-3) for induction, and Ara-C (200 mg/m2/d, days 1-6) and Ida (15 mg/m2/d, day 1) twice for consolidation. Group 2 includes Ara-C (200 mg/m2/d, days 1-10), daunorubicin (Dnc) (50 mg/m2/d, days 1, 3, 5) and etoposide (VP16) (100 mg/m2/d, days 1-5) for induction. The first consolidation therapy consisted of the same schedule except for Ara-C given on days 1-8. The second consolidation regimen consisted of Ara-C (200 mg/m2/d, days 1-8), VP16 (100 mg/m2/d, days 1-5) and amsacrine (100 mg/m2/d, days 1-5). Mitoxantrone (Mitox) (10 mg/m2/d, days 1-5) and Ara-C (200 mg/m2/d, days 1-3) were given as the third consolidation therapy. Group 3 was identical to Group 1 except for Ida being replaced with Mitox. During the study period 99 patients were enrolled and 34 were allocated randomly to Group 1, 36 to Group 2, and 29 to Group 3. Except for age distribution all patients' characteristics were similar between the groups. As there were more elderly patients in Group 1, time to complete remission (CR) was longer in this group as they needed more second induction. Induction deaths were 9.7%, 12.9% and 14.8% in Groups 1, 2 and 3, respectively. Patients in Group 2 received a higher amount of Ara-C compared with the other groups (P < 0.001). After a median follow-up period of 45 months (1-67 for survivors) an advantage in Group 1 was observed. Relapse-free survival (RFS) was better in Group 1 (P = 0.014) at 3 years. Fourteen of the patients were transplanted (11 allografts, 3 autografts). When patients with transplants were excluded, overall survival was longer in Group 1 both at 3 years and 5 years (P = 0.05). In conclusion, despite patient advanced age and lower dose of Ara-C, the idarubicin-containing treatment was superior to the other regimens.

Adolescent

Effect of early water contact on solubility of glass ionomer luting cements.

STATEMENT OF PROBLEM: Glass ionomer cements are susceptible to attack by moisture during the initial setting period that can result in an increased solubility. PURPOSE: This study was to evaluate the solubility of glass ionomer luting cements immersed in distilled water at early stages after mixing. MATERIAL AND METHODS: Four commercial glass ionomer cements were used (Ketac-Cem, Fuji Ionomer I; AquaCem; AquaMeron). For each material, 5 resin cement holders were made with 2 circular cavities (diameter = 5 mm; depth = 2 mm). One minute after start of mixing, the specimens were placed in a humidifier at 37 degrees C and 100% relative humidity. After 2, 5, and 8 minutes storage time, they were immersed in 50 mL of distilled water in a glass weighing bottle where they were stored for 3 hours at 37 degrees C. Next, the specimens were removed and the water was evaporated from the weighing bottle at 130 degrees C for 2 hours. The difference between the final and initial weights of the bottle was taken as amount of solubility. Data were analyzed by analysis of variance and Duncan's test. RESULTS: Solubility was greatest at 3 minutes immersion time and least at 9 minutes. The lowest cement loss was for AquaCem at 9 minutes immersion time (1.68 mg/cm2). The greatest loss was for Fuji Ionomer I after 3 minutes immersion time (14.98 mg/cm2). Solubility of cements decreased by 39% for Ketac-Cem, 61% for Fuji Ionomer I, 38% for AquaCem, and 37% for AquaMeron when the specimens were immersed in water 6 minutes after mixing. Comparison of all 4 cements revealed a relatively large difference between loss of substance from AquaCem and AquaMeron, and the 2 other conventional glass ionomer cements, Keta-cCem and Fuji Ionomer I. CONCLUSIONS: Increasing the time from start of mixing until immersion in water from 3 to 9 minutes resulted in a marked decrease in loss of substance from the surface of all 4 cements. Water-hardening glass ionomer cements (AquaCem and AquaMeron) were less sensitive to early water contamination.

Acrylic Resins

Use of a subcutaneous pedicle ulnar flap to cover skin defects around the wrist.

A subcutaneous pedicle ulnar flap used to cover a skin defect around the wrist is reported. Unlike the standard ulnar flap, which is isolated around the dorsal branch of the ulnar artery and its associated veins, this flap is based on the ascending branch of the dorsal branch of the ulnar artery more proximally to obtain a longer vascular pedicle. A subcutaneous pedicle flap that contained the ascending branch, its associated veins, and a superficial vein was obtained. The disadvantages of the standard ulnar flap can be overcome by this design, which provides greater mobility, preserves the healthy skin between the rotation point and the defect, and eliminates contour abnormalities.

Aged

Facial nerve paralysis in chronic suppurative otitis media: Ankara Numune Hospital experience.

Although the incidence of facial nerve paralysis (FNP) decreased with the use of contemporary diagnostic tools and the advent of antibiotics, it is still a challenging problem. In this retrospective study, the charts of 1188 patients with chronic suppurative otitis media (CSOM), treated between 1988 and 1996 in the First ENT Clinic of Ankara Numune Hospital, Turkey, were analysed to establish the pre-operative incidence of FNP in CSOM. There were 20 (1.7%) patients with FNP secondary to CSOM. Of these, 14 (70%) had cholesteatoma. There was a defect on the fallopian canal in 14 patients (70%) and it was most commonly located on the tympanic segment of the canal (35.7%). Paralysis was incomplete in all patients. A total of 14 patients had ear drainage more than 3 years. FNP was associated with vertigo in three patients (15%) and tinnitus in one patient (5%).

Adult

Acquired ichthyosis associated with chronic graft-versus-host disease following allogeneic peripheral blood stem cell transplantation in a patient with chronic myelogenous leukemia.

Acquired ichthyosis (AI) has rarely been described following bone marrow transplantation (BMT). We report a 29-year-old male, who underwent allogeneic peripheral blood stem cell transplantation (alloPBSCT) for chronic myelogenous leukemia, and who developed AI associated with chronic graft-versus-host disease (cGVHD). Both of these disorders were treated successfully with cyclosporin A. We conclude that AI may be related to an autoimmune process on the basis of cGVHD, and dermathopathologic evaluation must be performed in patients with skin changes suggesting AI following allogeneic bone marrow transplantation.

Adult

Simultaneous soft-tissue reconstruction and revascularization of the thumb with a flow-through distally-pedicled radial forearm flap.

The authors report the application of the flow-through concept to a distally-pedicled radial forearm flap for simultaneous thumb revascularization and soft-tissue coverage. A distally-pedicled radial forearm flap was used to cover a skin defect at the base of thumb and thenar area. The flap artery (reversed radial artery) was anastomosed to the distal ends of the defective digital arteries. The flap survived completely, and the thumb was well-vascularized.

Adult

The distally based ulnar artery forearm flap supplied by the dorsal carpal arch.

It is accepted that the ulnar artery forearm flap is dependent on the integrity of the palmar arches for ulnar arterial backflow and the patency of both radial and ulnar arteries. A patient is presented who demonstrates the successful use of the ulnar artery forearm flap supplied by the dorsal carpal arch via the dorsal branch of the ulnar artery. In this patient, the ulnar artery was damaged distal to the dorsal branch of the ulnar artery. A distally based ulnar forearm was dissected up to the dorsal branch of the ulnar artery and pivoted around this branch. This flap survived completely with no postoperative problem.

Adult

U-I flap.

This article describes the principle, vascular basis, and applications of a new flap derived from the dorsal hand skin. The principle is a pedicle-lengthening procedure that is to revert a "U"-shaped vascular structure into an "I"-shaped vascular structure. By using this principle, a dorsal metacarpal flap, comprising the second dorsal metacarpal artery, the dorsal carpal arch, the dorsal branch of the radial artery, and the first dorsal metacarpal artery, was developed. In this flap, the skin territory was placed over the first dorsal metacarpal artery. The flap was rotated around a web space-connecting vessel between the second dorsal metacarpal artery and the palmar arterial system. We used this flap for resurfacing large defects beyond the proximal interphalangeal joint and degloved fingers in six cases. In two cases, the flap was used as an innervated flap. In one case, the flap was used as a tenocutaneous flap with a segment of the extensor indicis proprius tendon. We found this flap to be useful in selected circumstances.

Adult

Acute myeloblastic leukemia associated with hyperleukocytosis and diabetes insipidus.

Two cases with acute myeloblastic leukemia (AML M4-FAB) associated with diabetes insipidus (DI) are presented here. Both patients presented with hyperleucocytosis. One had a white blood cell count (WBC) of 150 x 10(9)/L and the second patient had 200 x 10(9)/L. One of these patients was a 40 year-old male and MRI of the hypophysis showed an infindibuler mass. This patient did not respond to remission induction chemotherapy and reinduction chemotherapy was given. The other patient was a 16-year-old male with a normal CT scan of the head. Both patients had DI with typical clinical and laboratory findings. The first patient died early on during reinduction chemotherapy and the second patient died of intracranial bleeding before induction chemotherapy was given. These findings are consistent with the data in the literature suggesting that the prognosis of AML associated with DI is poor and that these cases generally present with hyperleucocytosis.

Adolescent

Incidence of tuberculosis after bone marrow transplantation in a single center from Turkey.

Tuberculosis (TB) is generally seen in immunodeficient states and its incidence would be expected to increase after hematopoietic stem cell transplantation (SCT), particularly in the allogeneic setting. However, recent reports from developed countries did not support this hypothesis. Turkey is one of the countries where the disease is endemic. Over a period of 10 years two cases of TB among 120 allogeneic and 65 autologous bone marrow or peripheral blood SCT were encountered. The first patient was a 42-year-old male with acute nonlymphoblastic leukemia (ANLL) who underwent allogenic SCT from his HLA-identical sister in first remission. His early post transplant period was unremarkable and showed no clinical acute or chronic graft versus host disease (GVHD). His chest X-ray and CT scan revealed alveolar infiltrate of the left apical lobe one year after the procedure and sputum showed acid-fast bacilli, later identified as Mycobacterium tuberculosis. He was put on combination chemotherapy. He is now well and disease-free 30 months after transplant with no complaints of pulmonary TB. The second patient with chronic phase CML underwent allogeneic peripheral SCT from his HLA-identical sister. He suffered from grade II acute and extensive chronic GVHD partially treated with immunosuppressive therapy. He showed pulmonary TB 15 months after transplantation. He is still on combination chemotherapy. Although our numbers are small, the annual incidence of TB after SCT is 1.1% (2/185) which is nearly 30 to 40 times higher than the incidence of TB in the general Turkish population. In other words, an immunosuppressive state after allogenic SCT seems to increase the risk of TB in Turkey. In conclusion, TB should be considered in the differential diagnosis of unexplained infections after SCT, especially in countries, where the disease is endemic.

Adult

Incidence of graft vs host disease in allogeneic bone marrow transplantation in a single center study from Turkey.

Graft versus host disease (GVHD) is one of the obstacles encountered in allogeneic bone marrow transplantation (alloBMT) and has a direct impact on the transplant outcome and survival. In this report, we summarized the incidence of acute and chronic GVHD among 71 HLA matched and 9 HLA mismatched sibling alloBMTs performed for various hematological malignancies, mainly leukemias seen at Ibn-i Sina Hospital. Fifty-five were male and 25 were female Turkish patients. Median age was 29 (12-48). Cyclophosphamide(CY)+total body irradiation (TBI)(12), CY+total lymphatic irradiation (TLI)(6), busulfan (BU)+CY(58) and ALG/ATG+CY(4) were the regimens used for conditioning. Cyclosporin A (CsA)+short term methotrexate were given for GVHD prophylaxis except for two syngeneic transplants who both received only CsA. In 22 of the patients ABO and in 30 patients sex mismatched bone marrow was given. Thirty-one (38.8%) patients showed acute GVHD (grade I-II: 22, grade III-IV: 9) and 8 (11.6%) showed chronic GVHD. In HLA matched and mismatched patients acute GVHD incidence were 33.7% and 44.4% respectively. All of the HLA mismatched patients that showed acute GVHD were in advanced stage. Of the patients with acute GVHD, 28 (96.5%) disclosed skin, 22 (75.9%) hepatic and 14 (48.3%) gut involvement. In the chronic form three patients had mild limited, two limited, two moderate and one advanced GVHD. Seven of the patients were lost due to GVHD. To determine the graft versus leukemia effect of alloBMT, we compared the disease free survival (DFS) of the 68 leukemia patients. Although the patients who had grade I-II acute GVHD showed a better DFS than the patients who did not have acute GVHD, it did not reach to a significance (15.9 vs 13.6 months: p = 0.43).

Adolescent