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Biomedical subjects

M Ozesmi

Publications and source records attributed to M Ozesmi.

At least 19 recordsLinked to original sources
PubMed2000

Low dose (1 microg) adrenocorticotropin stimulation test in the evaluation of hypothalamo-pituitary-adrenal axis in patients with active pulmonary tuberculosis.

Adrenocortical function in patients with active pulmonary tuberculosis is a debate of matter. Previous studies related to adrenocortical function in patients with active pulmonary tuberculosis demonstrated a high rate of suboptimal cortisol response to standard dose ACTH (250 microg) stimulation test. The aim of this study was to assess the hypothalamo-pituitary-adrenal (HPA) axis in low dose (1 microg) and standard dose ACTH (250 microg) stimulation tests in the patients with active pulmonary tuberculosis. Twenty-seven patients and 21 healthy subjects were included in the study. Cortisol levels were measured before, 30 and 60 min after ACTH (1 microg or 250 microg iv) injection. Cortisol responses to 1 microg ACTH at 30 and 60 min were significantly higher in the patient group than in the control group (p<0.05). Peak cortisol levels were significantly higher in the patient group than in the control group after both 1 microg and 250 microg ACTH administration (p<0.05). Cortisol responses to 250 microg ACTH at 30 and (at 30 and 60) 60 min were significantly higher in the patient group than in the control group (p<0.05). Peak cortisol levels obtained after 250 microg ACTH and after 1 microg ACTH were similar in the patient group (p>0.05). This study shows that 1 microg ACTH iv gives an equivalent peak cortisol value to 250 microg ACTH in patients with activated HPA axis. The cortisol levels obtained at 08:00, 11:00, 17:00 and 24:00 h were significantly higher in the patients than in the controls. This study clearly shows that HPA axis is activated in active pulmonary tuberculosis rather than underactivated.

Adolescent↗
PubMed2000

Prevalence of chronic bronchitis and associated risk factors in a rural area of Kayseri, Central Anatolia, Turkey.

This population-based cross-sectional survey was carried out to determine the prevalence of chronic bronchitis and associated risk factors in a rural area of Kayseri, Central Anatolia, Turkey. Subjects (1,023) aged 20-83 yrs (81.8% of eligible subjects) were interviewed using a modified version of the adult questionnaire compiled by the European Community Respiratory Health Survey. Subjects with "presence of cough and phlegm on most days during at least three months per year for at least the two previous years" were classified as having chronic bronchitis. According to the criteria used, 138 (13.5%) were classified as having chronic bronchitis. The prevalence was higher in males (17.8%) than females (10.0%). There was no overall significant association between chronic bronchitis and age in males, but, in females, the difference between age groups was important. There was no association between chronic bronchitis and family income, although the prevalence was highest in the low-income group. Subjects who reported childhood respiratory illnesses had a 1.7-fold increased risk of chronic bronchitis compared to those without such a history. The prevalence was much higher among people exposed to biomass fuel combustion and among smokers and exsmokers than among nonsmokers. In multivariate analyses, a significant increase in the prevalence of chronic bronchitis was seen in males, those who had received poor schooling, those reporting childhood respiratory illnesses, and those exposed to biomass fuel combustion and according to smoking habit.

Adult↗
PubMed2000

The outcome of tuberculosis in patients on chronic hemodialysis.

AIM: In patients on regular hemodialysis, the incidence of tuberculosis is high. MATERIAL: We present 18 (6.08%) tuberculosis patients among 296 patients on regular hemodialysis between 1980 and 1996. RESULTS: Pulmonary tuberculosis was seen in 11 (61%) patients, 7 (38%) of whom presented with pleural effusion. Tuberculosis was extrapulmonary in 7 (38%) patients. There were 4 (22.2%) patients with tuberculous lymphadenitis, 2 (11.1%) with tuberculous peritonitis, 1 (5.5%) with urinary tuberculosis. Intermittent fever, malasia and dyspnea were the most common symptoms. The mean duration on hemodialysis before diagnosis of tuberculosis were 22.22+/-7.19 months and the mean duration of symptoms prior to treatment were 34.16+/-3.36 days. Tuberculosis was diagnosed in 10 (55.5%) patients within the first 4 months of dialysis and in 8 (44.4%) between the 1st and the 8th year of hemodialysis treatment. Our patients were treated with isoniazid, rifampicin, morfazinamid and ethambutol. Four patients died within the first 4 months of the antituberculosis therapy, in all of whom tuberculosis was diagnosed within the 4 months of dialysis. In patients who died, duration of symptoms ranged from 30 days to 60 days, mean 42 days. Overall mortality was 22.2% and correlated with the duration of symptoms prior to initiation of antituberculosis and hemodialysis therapy. Fourteen patients (77.7%) who survived longer than one year were clinically cured. CONCLUSION: Our results suggest that the mortality of tuberculosis is high in patients in the early phase of maintenance dialysis and delay in the disease treatment of tuberculosis. Because of their generally poor state of nutrition, and depressed cellular immunity, the mortality is high in patients in the early stage of maintenance hemodialysis. Therefore, if the diagnosis is delayed, mortality is higher. Tuberculosis should be considered strongly and treated promptly if suspected.

Adult↗
PubMed1999

Posterior mediastinal goiter.

A patient with chronic cough and recent dysphagia was found to have a retrotracheal mass extending into the mediastinum on chest radiography. A computed tomographic scan confirmed a retrotracheal posterosuperior mediastinal lesion which was believed to have a neurogenic origin. A thyroid 131I scan revealed no uptake of tracer in the chest and results of thyroid function tests were normal. A large retrotracheal colloidal nodular goiter was excised through a right thoracotomy. The diagnostic approach and the safety of surgical access by thoracotomy for thyroid lesions in this unusual site are discussed.

Goiter, Substernal↗
PubMed1996

Does tuberculosis really cause hypercalcemia?

Hypercalcemia has been known to be associated with tuberculosis. In some studies it has been reported to occur commonly. It seems that the studies in which tuberculosis was complicated by hypercalcemia were retrospective and therefore the other causes of hypercalcemia could not be excluded. We have a great deal of experience concerning tuberculosis and have not seen a patient with hypercalcemia due to tuberculosis itself. Therefore we aimed to investigate whether tuberculosis really cause hypercalcemia in a prospective study. We evaluated 104 patients with tuberculosis aged between 14-85 (mean +/- SD 38.5 +/- 15) years, 73 males and 31 females, and 50 age-matched healthy subjects aged between 19-70 (mean +/- SD 39 +/- 13) years, 33 males and 17 females. No significant differences between the patients and healthy subjects were detected in terms of 250HD3, calcium and phosphate levels. Albumin levels were significantly higher in the control group than in the tuberculous group (p < 0.02). No significant difference was found between the calcium levels measured before the therapy (2.4 +/- 0.1 nmol/L) and after the therapy (2.4 +/- 0.2). We think that patients with tuberculosis are not at risk for hypercalcemia either before or during treatment and the development of hypercalcemia as a result of tuberculosis is rather doubtful and needs to be clarified.

Adolescent↗
PubMed1996

Changes in the size of adrenal glands in acute pulmonary tuberculosis with therapy.

Adrenal glands may be involved during both acute and chronic tuberculosis. They are enlarged in acute pulmonary tuberculosis. We aimed to investigate the changes in adrenal size in acute pulmonary tuberculosis before and after therapy in a prospective study. Eleven hospitalized patients with newly diagnosed sputum positive pulmonary tuberculosis were studied. Basal cortisol levels were measured in the patients before and after the therapy. Cortisol levels were also measured 30 and 60 min after Synacthen (250 micrograms i.v.) injection in the patients before the therapy. The size of the adrenal glands was measured by computerized tomography. The maximum width perpendicular to the long axis of the body of the gland, maximum width of the medial and lateral limbs and the length of the adrenals were measured. All measurements were done before and after the eight-month anti-tuberculosis therapy. All 11 patients had an intact adrenal cortisol reserve. Both the width and length of the right and left adrenal glands were significantly greater before the therapy than after the therapy. We conclude that adrenal enlargement demonstrated by computerized tomography in acute pulmonary tuberculosis is reduced after appropriate therapy.

Adolescent↗
PubMed1995

The effects of theophylline and caffeine on the isolated rat diaphragm.

It is a well known fact that theophylline enhances the force of diaphragmatic contraction and delays fatigue. The action of caffeine which is a methylxanthine analogue on skeletal muscle are complex. It was claimed in few studies that the caffeine was more effective on the diaphragmatic contractility than the theophylline. The aim of this study is to compare the effects of theophylline and caffeine on the tension generated by fresh and fatigued diaphragmatic muscle. Studies were performed in vitro on diaphragmatic muscle strips of rats activated by electrical stimuli applied via the phrenic nerve. Isometric twitch characteristics (twitch tension, contraction and 1/2 relaxation time) were measured. Force-frequency responses were generated using twitches and tetanic contractions produced by stimulating the phrenic nerve with 0.2 ms pulses at 10, 20, 50 and 100 Hz for 1 s with 30 s intervals. Moderate fatigue was then induced by repeated submaximal contractions (25 Hz, 160 ms, at the rate of 1/s for 45 contractions). In fresh muscle 1 mM theophylline and 1 mM caffeine increased diaphragmatic tension 40.98 +/- 8.50% and 82.30 +/- 12.21% of the initial value respectively. Theophylline did not alter contraction time but prolonged 1/2 relaxation time, whereas caffeine had no effect on any one. Theophylline induced force production in all frequencies. Caffeine caused an increase in force only in < 20 Hz, but a decrease in 50 and 100 Hz. In brief submaximal fatigue, both 1 mM theophylline and 1 mM caffeine partly prevented fatigue (effect of caffeine was more potent). This study suggests that caffeine has a greater effect than theophylline on the muscle. Possible mechanism(s) of action of theophylline and caffeine on diaphragmatic contractility and fatigue were discussed. It may well be the fact that they might have different mechanisms of action on the isolated rat diaphragm.

Animals↗
PubMed1995

Dependence of fatigue properties on the pattern of stimulation in the rat diaphragm muscle.

Diaphragm fatigue was studied in isolated phrenic nerve diaphragm strips from 28 Swiss Albino rats. Three procedures were used to estimate the isometric twitch characters and force frequency responses to fatigue of the rat diaphragm at different rates of phrenic nerve stimulation. Diaphragm fatigue was induced by using low frequency stimulation (0.2 ms pulse duration, at 5 Hz frequency, 3 min), high frequency stimulation (0.2 ms pulse duration, at 50 Hz frequency, 3 min), and by production brief submaximal contraction (25 Hz, for 160 ms at the rate of 1/s for 45 contractions). Tension was reduced to 26.67 +/- 5.10% and 6.59 +/- 2.64% and 68.69 +/- 2.45% of the initial value at the end of the low and high frequency and brief submaximal stimulation, respectively. In all the fatigue experiments, twitch tension and tetanic tension decreased, contraction and 1/2 relaxation time prolonged and force-frequency curves shifted to the right. The most significant changes were observed in low frequency fatigue whereas the most moderate ones were recorded in brief submaximal fatigue. It was concluded that fatigue in the rat diaphragm depended on the frequency and duration of stimulation as well as on the number of stimuli delivered to the muscle. Various mechanisms of muscle fatigue are described in the discussion to explain the observations made in the present investigation.

Animals↗
PubMed1994

A hormonal and radiological evaluation of adrenal gland in patients with acute or chronic pulmonary tuberculosis.

OBJECTIVE: The adrenal glands may be involved in tuberculosis. The exact frequency and extent of adrenal involvement in tuberculosis are not well known. Although there are some studies regarding adrenal gland involvement, they are not sufficient because of inadequate endocrinological tests and radiological procedures. The aim of this study was to assess the adrenal gland in acute and chronic pulmonary tuberculosis and to compare it with the findings obtained in healthy subjects. DESIGN AND PATIENTS: We studied 20 patients with acute pulmonary tuberculosis, 41 patients with chronic pulmonary tuberculosis and 20 healthy subjects. Involvement of the adrenal gland was assessed by basal cortisol level, cortisol response to Synacthen and adrenal computed tomography. MEASUREMENTS: Cortisol levels were measured before, 30 and 60 minutes after Synacthen (250 micrograms i.v.) injection. Computerized tomography of the adrenals was carried out in 61 patients with tuberculosis and 20 healthy subjects. RESULTS: Mean basal cortisol level and 60-minute cortisol response to Synacthen were significantly higher in acute pulmonary tuberculosis than in chronic pulmonary tuberculosis and healthy subjects. Two patients with Addison's disease were diagnosed among the chronic tuberculous patients. Both length and thickness of the right and left adrenal gland were greater in patients with acute tuberculosis. CONCLUSION: Adrenal enlargement demonstrated by computerized tomography is common in patients with acute pulmonary tuberculosis, but our findings show that cortisol reserve is normal, in contrast to previous suggestions.

Acute Disease↗
PubMed1990

Prospective clinical and radiologic study of zeolite-exposed Turkish immigrants in Sweden.

Ninety-four persons from the village of Karain, Turkey, now residing in Stockholm, were investigated clinically and radiologically. In this village, environmental exposure to erionite, a fibrous zeolite, occurs, and there is an extremely high risk of mesothelioma among the villagers. Since an earlier investigation of the cohort in 1980, another 4 young persons have fallen ill with malignant mesothelioma in this group, where the incidence thus approaches 1%/year and is the most common cause of death. Solitary pleural plaques were found in 6%, thickening of the interlobar pleura in 4% and other radiologic signs of affection of the pleura in 2%. Thickening of the interlobar fissures were observed in 1 patient as the first sign of mesothelioma which has remained asymptomatic until 1 year later. The comparatively low incidence of pleural lesions in the cohort is probably due to the low mean age (36 years). Further follow-up could give clues to the pathogenesis of malignant mesothelioma.

Adolescent↗
PubMed1990

[Knowledge of carcinogenic and immunologic findings caused by the zeolite fiber erionite].

Prompted by the unusually high death rate from cancer of the lungs, in 1975 in the Middle-Anatolian village of Karain, later in two other villages, X-ray screening investigations were carried out. These revealed pleural mesotheliomas similar to those seen following exposure to asbestos, although no asbestos was found neither in the village itself or in its immediate surroundings. Minerological tests and examinations of the lungs of the deceased, together with animal experiments involving dust obtained from the village itself, performed in 1980, demonstrated that erionite, a fibrous zeolite is responsible for tumour lesions in the lungs and pleura. Early stages of this tumour located in the pleura were also found in a group of Karain inhabitants working in Sweden. On the basis of the examination results, an immune deficiency that did not correlate with age, sex or duration of exposure was found, and thus cannot readily be classified as an epiphenomenon. Since fibrous zeolites are frequently employed in industry, industrial hygiene and occupational medical consequences need to be drawn.

Aluminum Silicates↗
PubMed1990

[BCG vaccination and the incidence of tuberculosis in students of urban Kayseri, Turkey].

The rate of new infections with tuberculosis amounting to approximately 20% among the youngest inhabitants of the town of Kayseri with a present recorded incidence of acute infectious tuberculosis of about 8:10000 makes it imperative to exercise every possible effort in disease prevention by vaccination and revaccination in addition to all other measures to combat tuberculosis.

Adolescent↗
PubMed1988

Phenotypes of peripheral blood lymphoid cells in patients with asbestos-related pleural lesions.

Asbestos-related parietal pleural plaques develop slowly and are of little clinical significance. Other asbestos-related pleural reactions, for example acute exudative pleurisy and progressive pleural fibrosis, are of clinical importance. The pathogenesis of these reactions is unknown, but one hypothesis is that immunological disturbances are involved. To investigate this hypothesis a phenotypic characterization of lymphoid cells was performed in the peripheral blood of 45 patients with asbestos-related pleural lesions; 20 with pleural plaques (PP), 15 with diffuse pleural fibrosis (DPF), and 10 with benign asbestos pleural effusion (BAPE). Twenty-four healthy blood donors were used as controls. All asbestos groups together had a significantly higher percentage of B-cells than the controls. The percentage number of "helper/inducer" T-cells was significantly lower in the BAPE and DPF groups than in the control and PP groups. Thus, significant aberrations in peripheral blood lymphoid cells were found in patients with DPF and BAPE. This differed from patients with PP only who were similar to normals.

Aged↗
PubMed1987

Byssinosis in carpet weavers exposed to wool contaminated with endotoxin.

All the 303 full time day workers in a carpet weaving factory were submitted to a physical examination, chest radiography, and vitalograph test, and answered a respiratory questionnaire. Fifty four healthy non-exposed subjects served as controls. Dust concentrations and concentrations of bacterial endotoxin were measured. Of the 303 workers, 259 (85.5%) had airway symptoms and 62 (20.5%) had maximum mid-expiratory flow (MMF) values of less than 60% compared with 9.2% of the controls. The symptoms in 68 workers (22%) were compatible with byssinosis and 36 of these workers underwent vitalography before starting work and after four hours work on Mondays when significant reductions of their FEV1 and MMF were found. Twenty one of these 36 workers were tested on Tuesday and no differences in these measurements were found between measurements before work started and four hours later. The airborne dust concentrations in the factory were high and bacterial endotoxin was found. These findings suggest that a large number of workers in this carpet weaving factory suffer from a disease indistinguishable from byssinosis even though wool is used almost exclusively, the only cotton being the warp. The finding of endotoxin together with the absence of cotton confirms the theory that "byssinosis" is due to bacterial endotoxin rather than to cotton per se.

Adult↗
PubMed1987

Benign asbestos pleural effusion: 73 exudates in 60 patients.

All patients seen in 1975 to 1984 with benign asbestos pleural effusion (BAPE) were studied. In all, 73 exudates occurred in 60 patients, 40 on the left side and 33 on the right. Relapses occurred on the same side in two patients; 11 had bilateral exudates, three of them concomitantly, in the other patients with a free interval of 1-15 years. The mean latency time from the first exposure to asbestos was 30 years, with a range of 1 to 58 years. The effusions lasted from 1 to 10 months, with a median of 3 months. The most common symptoms were pain, fever, cough, and/or dyspnoea; however, 46% of the episodes were symptomless. The total number of thoracocenteses was 66, with removal of 50 to 2000 ml (mean 460) each time. Fifty-three per cent of the pleural fluids were macroscopically haemorrhagic and 26% eosinophilic. Two findings contribute to a better understanding of the entity: first, even a comparatively slight occupational exposure can be sufficient; secondly, BAPE can occur many years after exposure to asbestos, and not only in the first one or two decades.

Asbestos↗