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Biomedical subjects

M Simsek

Publications and source records attributed to M Simsek.

At least 19 recordsLinked to original sources

Misoprostol in second and early third trimester for termination of pregnancies with fetal anomalies.

OBJECTIVES: To assess the effectiveness of a prostaglandin E1 analog, misoprostol, using different regimens compared with dinoprostone in termination of pregnancies in second and early third trimester complicated by either congenital fetal anomalies or intrauterine fetal demise. METHODS: A retrospective review of 59 pregnancies between 15 and 30 weeks was performed which were terminated due to congenital fetal anomalies or intrauterine fetal demise. In group 1 (n=29) 400 microg oral and 600 microg vaginal misoprostol, in group 2 (n=12) 600 microg vaginal misoprostol and in group 3 (n=18) 0.5 mg dinoprostone gel were given for the termination of the pregnancies. All these groups were evaluated for demographic characteristics and delivery findings. Statistical analysis were performed by one-way ANOVA, Kruskal-Wallis and chi(2)-test. RESULTS: No significant statistical difference was observed in terms of age, gravidity, parity, previous abortion, gestational week, frequency of prostaglandin usage, and birth weights among the three groups. The time intervals between the first administration and delivery were 20.3 h for oral vaginal misoprostol, 17.3 h for vaginal misoprostol and 22.5 h for the dinoprostone group (P=0.594). Evacuation rates after single doses were similar in all groups (83%, 73% and 72%, respectively). Uterine tachysystole was the only major side effect encountered in the oral-vaginal misoprostol group. CONCLUSIONS: All three regimens yielded similar results for termination of pregnancies in second and third trimester. The major advantage of misoprostol was the cost.

Abortifacient Agents, Nonsteroidal↗

The effect of platinum-based combination chemotherapy on the lymph nodes in advanced-stage epithelial ovarian cancer: does it decrease the incidence of lymph node involvement?

This paper aims to determine the impact of platinum-based combination chemotherapy on the lymph nodes in advanced-stage epithelial ovarian carcinoma. From 1997 to 2000, the patients in whom we performed lymphadenectomy before (group A) or after chemotherapy (group B) in the Department of Obstetrics and Gynecology, Akdeniz University School of Medicine were enrolled in this study. A total of 47 cases were included in the study. Twenty five cases had lymphadenectomy during the initial laparatomy and 22 cases during second-look procedures. Lymph node metastasis was detected in 14 (56%) patients in group A and in 10 (45.4%) cases in group B (P > 0.05). Platinum-based combination chemotherapy does not decrease significantly the incidence of involved lymph nodes in advanced-stage epithelial ovarian carcinoma.

Adult↗

Absence of deafness-associated connexin-26 (GJB2) gene mutations in the Omani population.

We have investigated the prevalence of mutations in the connexin 26 (GJB2) gene in Omani population using both PCR-RFLP and direct DNA sequencing methods. Two common GJB2 gene mutations (35delG and 167delT) were screened in 280 healthy controls and 95 deaf patients using two different PCR-RFLP methods. To investigate other GJB2 mutations, we have amplified and sequenced DNA from 51 unrelated deaf patients and 17 control subjects. None of the samples studied, either by RFLP or sequencing, revealed any deafness-associated mutations in the coding region of the GJB2 gene. These findings disagree with many reports on the GJB2 gene, describing various mutations as the cause of congenital recessive deafness. Although, an amino acid substitution (S86T) was identified by sequencing, we conclude that this change could not be associated with deafness since it was present in all the control and patient samples sequenced.

Amino Acid Sequence↗

Confounders?

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Drug Therapy, Combination↗

Investigation of the vertebrobasilar arterial system in vertigo by vestibulocochlear test, SPECT and angiography.

OBJECTIVE: Perfusion of the areas of cochleovestibular structures was investigated using Tc-99m HMPAO single photon emission computerized tomography (SPECT) in the young patients with vertigo presumed to have peripheral vestibular abnormalities and compared the results with cochleovestibular test results, and vertebrobasilar angiography findings. METHODS AND PATIENTS: The study was performed on 20 patients with vertigo and 17 control subjects who had performed vertebral arteriography due to another disease. The patients with vertigo presumed to be on peripheral vestibular disorder were included in the study. Systemic and otorhinolaryngological examination were carried out. Audiovestibular function was evaluated in all patients and control subjects. Brain SPECT was performed with a one-head rotating gamma camera system from 64 projections into a 64x64 matrix, using low energy and high-resolution fan beam collimators with a sampling time of 30 s. The images taken from cerebellum, temporal, parietal and occipital lobes which are supplied by a vertebrobasilar system were compared visually with the other side and asymmetry in the perfusion was searched. After cochleovestibular tests and laboratory had been completed, vertebral arteriography was performed bilaterally in all patients. Results of digital subtraction angiography (DSA) and the vestibulocochlear test were compared with images of SPECT. Data analysis was done with Yates Chi(2) and percentages of sensitivity and specificity were calculated. RESULTS: There was vestibular test and cochlear test abnormalities in eight and ten of the patients with vertigo, respectively. SPECT imaging showed hypoperfusion and decreased regional blood flow in 12 of the patients. There was statistically significant differences between the study and control groups in SPECT (P<0.05). Five patients showed abnormal findings in DSA examinations. CONCLUSION: It is believed that SPECT may be helpful in the detection of vascular pathology in the patients with vertigo.

Adult↗

A seminested PCR test for simultaneous detection of two common mutations (35delG and 167delT) in the connexin-26 gene.

BACKGROUND: Several mutations described in the connexin-26 gene cause nonsyndromic autosomal recessive deafness (NARD). The prevalence of two frame-shift mutations, known as 35delG and 167delT, was relatively high in patients with NARD from different populations. METHODS AND RESULTS: A seminested PCR test has been developed for simultaneous detection of two common mutations in the connexin-26 gene. The test is based on PCR amplification of a 285-bp DNA fragment that covers both the 35delG and 167delT mutations. The latter mutation destroys a Pst I site and is easily detected by Pst I digestion of the 285-bp DNA fragment. However, the 35delG mutation does not destroy or create a restriction site. To create a site, we designed a mismatched primer that generated an EcoN I site in an 87-bp DNA fragment, but only if the 35delG mutation was present. The test was validated using five DNA samples previously characterized for the connexin-26 mutations. After validation, we screened 45 unrelated patients with NARD and 280 healthy Omani subjects for the presence or absence of the 35delG and 167delT mutations. Neither mutation was found to be present in patients or control subjects. CONCLUSION: We developed a seminested PCR test for the simultaneous detection of both common mutations in the connexin-26 gene. In our analysis of 45 patients and 280 control subjects, the 35delG and 167delT mutations were absent in both groups.

Connexin 26↗

Giant polypoid tumor of the esophagus.

A patient with a giant polypoid tumor of the esophagus, measuring 22 cm in length is described in this report. The patient presented with cough attacks and respiratory distress. Diagnostic and therapeutic intervention required aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Benign esophageal tumors are rarely seen and originate from the upper third of esophagus, frequently close to the cricopharyngeus muscle. They may attain giant proportions. A variety of clinical presentations are described, the most serious being asphyxia secondary to laryngeal obstruction. We observed a giant esophageal tumor which was interpreted as angiofibromyolipoma that caused laryngeal obstruction. We present the clinical picture and histopathological findings of the tumor.

Angiofibroma↗

Epidermoid cyst of the ovary: a case report.

In the ovary, epidermoid cysts are rare and their origin is controversial. This rare lesion was uniformly an incidental finding in the study of hysterectomy specimens. The patient was a 48-year-old woman. Because of multiple leiomyomas she had a total hysterectomy and bilateral salpingo-oopherectomy operation. A Epidermoid cyst was found incidentally in the right ovary on the microscopic examination.

Epidermal Cyst↗

Lumbar epidural brucellar abscess causing nerve root compression.

OBJECTIVES: To evaluate the usefulness of MR sequences for the differential diagnosis of spinal brucellar abscesses which mimic lumbar disc herniation. METHODS: We analyzed six patients with brucellar abscesses who had symptoms mimicking lumbar disc herniation. The study group consisted of three women and three men who were 15-67 (mean = 37) years old. Patients were imaged in the axial and sagittal planes with a I.0-T MR scanner using a spine coil. RESULTS: The level of abscesses were accurate in 100% (six of six) of patients with MR imaging. MRI examinations revealed an extradural soft tissue mass which were iso- to hypointense compared to spinal cord on T1WI and hyperintense on T2-weighted images. By contrast study, diffuse homogeneous or slightly heterogeneous enhancements were seen. CONCLUSION: Lumbar extradural brucellar abscess can have lumbar disc disease symptoms. MRI may non-invasively and rapidly reveal the presence of spinal abscess and degree of extension to the spinal canal. Extradural brucellar abscess should be included in the differential diagnosis of radicular symptoms caused by disc herniation.

Abscess↗

Plasma beta-carotene concentrations in pregnancies, newborn infants and their mothers.

Concentrations of beta-carotene were determined in maternal and fetal blood. The samples were collected from 33 mothers, their 33 newborns and 50 pregnant and 29 non-pregnant women. Beta-carotene concentrations of the non-pregnant, pregnant, newborn infant and their mothers were 140.31, 171.54, 63.57 and 175.74 micrograms/dl, respectively. There was a significant correlation (P < 0.001) between beta-carotene values of the maternal plasma and cord plasma. Mean maternal plasma beta-carotene concentration was higher (P < 0.0005) than that of the cord. These results suggest that plasma transport capacity of beta-carotene was low from mother to their fetus.

Adult↗

Heredity of asthma in Saudi population.

In a cross-sectional study, the prevalence of asthma, hay fever and eczema was studied in 1150 schoolchildren attending school in Jeddah Western region of Saudi Arabia. The family histories of asthma, hay fever and eczema were examined in first degree relatives. The age range of children studied was 7-12 years, with a mean of 9.3 years (47% boys and 53% girls). A self-administered questionnaire was completed by the parents of the child to collect information concerning bronchial asthma, hay fever, and eczema in the target child and family history of respiratory allergy. A detailed family history and personal histories of asthma were available for 1035 Saudi children aged 7-12 years old. The rate of asthma and hay fever were significantly higher among siblings and offspring (cases) compared to their parents (p < 0.001). The results showed a high positive correlation between the relatives of affected children with respect to asthma and hay fever. These findings support the hypothesis that asthma and hay fever may be inherited in the Saudi population, but the mode of inheritance has yet to be determined.

Asthma↗

The human cytomegalovirus immediate early enhancer-promoter is responsive to activation by the adenovirus-5 13S E1A gene.

The stimulatory effects of the 13S adenovirus E1A gene product on the human cytomegalovirus (HCMV) major immediate early (IE) enhancer were examined. Chimeric plasmids containing cloned portions of the HCMV major IE enhancer-promoter positioned upstream of the chloramphenicol acetyltransferase gene (cat) were cotransfected into HeLa cells with the plasmid p13S-wt which contained a cDNA encoding the adenovirus 13S E1A gene product. CAT expression from chimeric plasmids containing at least one copy of the HCMV 19 base pair (bp) repetitive motif was stimulated 10-fold in the presence of p13S-wt. The 19-bp motif contains a potential binding site for the cellular transcription factor ATF/CREB. Deletion analysis indicated that the ATF/CREB site was crucial for E1A-mediated stimulation. Insertion of a synthetic oligonucleotide homologous to a 19-bp motif and containing an ATF/CREB binding site into an HCMV chimera lacking ATF/CREB motifs conferred E1A responsivity on HCMV promoter-mediated CAT expression whereas insertion of a similar oligonucleotide containing a change of two bases in the sequence of the ATF/CREB site did not. Measurement of CAT-specific RNA verified the results of the CAT enzyme experiments. The ATF/CREB motif may be a target for stimulation of HCMV gene expression through either viral or cellular transcription factors.

Activating Transcription Factors↗

Direct detection of human cytomegalovirus in urine specimens from renal transplant patients following polymerase chain reaction amplification.

A polymerase chain reaction (PCR) assay was used to amplify human cytomegalovirus (HCMV) directly from urine specimens taken from renal transplant patients. In serial urine samples from patients who had at least one specimen positive for HCMV; the PCR assay consistently detected the presence of HCMV DNA sequences, whereas virus detection by other tests such as enzyme-linked immunosorbent assay (ELISA), nonradioactive DNA hybridization assay, and virus isolation were variable. Of 37 specimens positive by PCR, 36 were positive by either ELISA, hybridization assay, or virus isolation. Infectious virus was detected in 13 of the 37 PCR-positive urines. HCMV DNA was detected by PCR in all samples that were positive for HCMV by either hybridization assay or virus isolation. The viral genome copy number was determined by PCR assay for several urine samples that were positive by virus isolation but negative for HCMV by ELISA or hybridization assay. Viral genome copy number estimates indicated the presence of HCMV at very low levels in these urines verifying the fidelity of the virus isolation procedures. The consistency of the PCR assay makes it an ideal method for detection of infection and monitoring antiviral drug therapy in patients infected with HCMV.

Antigens, Viral↗

Polymerase chain reaction assay for detection of human cytomegalovirus.

Direct detection of human cytomegalovirus (HCMV) from clinical specimens was examined by using the polymerase chain reaction (PCR) for amplifying HCMV DNA. The efficiency of the amplification reaction was examined by using three different buffers and concentrations of deoxynucleotide triphosphates. The PCR assay was most efficient with a reaction mixture containing 17 mM ammonium sulfate, 67 mM Tris hydrochloride (pH 8.5), 7 mM MgCl2, 10 mM 2-mercaptoethanol, 170 micrograms of bovine serum albumin per ml, and each deoxynucleotide triphosphate at a final concentration of 1.5 mM. After 35 cycles of amplification, 0.15 fg of a plasmid containing the cloned target gene (corresponding to approximately six gene copies) was detected. The PCR assay correctly identified all of 24 clinical isolates of HCMV. Virus in urine specimens could be disrupted by heating at 93 degrees C for 30 min. The viral DNA was amplified directly from 5 microliters of preheated urine, with no further treatment before amplification. We tested the PCR assay on urine specimens from patients who had undergone renal transplantation that had been screened for the presence of HCMV by enzyme-linked immunosorbent assay, hybridization assay, and direct virus isolation. Specimens that were positive by one or more of these assays were screened by PCR. HCMV was consistently detected by PCR in all specimens that were positive by at least one other test. No cross-reactivity to other herpesviruses or MRC-5 cellular DNA was observed.

Cytomegalovirus↗

Translation of globin RNA spliced in vitro.

Pre-mRNA (precursor mRNA) enriched for globin-gene transcription products was prepared from murine erythroleukaemia cells induced to differentiate with dimethyl sulphoxide. The pre-mRNA was prepared from nuclear RNA by oligo(dT)-cellulose chromatography followed by sucrose-gradient centrifugation. The pre-mRNA thus obtained was utilized as the substrate for a splicing assay based on sequential splicing and translation reactions. Small nuclear ribonucleoprotein particles, which were shown to inhibit translation, were removed by an intermediate high-speed centrifugation step. The assay developed is based on a three-step procedure: (1) incubation of pre-mRNA with HeLa-cell nuclear extract in the presence of ATP; (2) incorporation of 3H-labelled amino acid into proteins by wheat-germ extract by using RNA from step 1; and (3) immunoprecipitation of globin chains with rabbit anti-(mouse globin) antibody. No incorporation of label into immune complexes was observed in the absence of HeLa-cell extract or ATP. Preincubation with these components was unnecessary for the incorporation of label into immune complexes when mature cytoplasmic RNA was used as a template for protein synthesis. The assay was further validated by fluorography after polyacrylamide-gel electrophoresis, when the only band detectable corresponded to globin chains. These results demonstrate, for the first time, translational activity of transcripts spliced in vitro. The current assay can be utilized with a few micrograms of pre-mRNA and may have potential for further characterization of the splicing system.

Cell Line↗