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Biomedical subjects

M Yildirim

Publications and source records attributed to M Yildirim.

At least 55 records · Page 3Linked to original sources
PubMed1999

Report of a rare human variation: the superficial ulnar artery arising from the axillary artery.

A rare variation of the ulnar artery is presented on routine anatomical dissection in one male cadaver. The superficial ulnar artery was found to originate from the axillary artery. The free forearm flap is increasingly popular among plastic surgeons. As a result of this case, and a review of the literature to gain further knowledge of anatomical variations, it is advised that more attention should be paid clinically to this artery to prevent its injury.

Anatomy, Artistic↗
PubMed1998

Left gastric artery originating directly from the aorta.

During the dissection of a 48-year-old male cadaver, the left gastric artery was observed directly originating from the abdominal aorta. An unusual embryologic development of the ventral splanchnic arteries may lead to considerable variations. The rare occurrence of this variation is stated to be 0.5%-15%. This case of the left gastric artery is described in detail, especially its point of emergence which may be important in operative procedures on the supracolic organs, in stomach resection, and during dissection of lymph nodes along this artery in gastric cancer.

Aorta, Abdominal↗
PubMed1997

Comparison of the effectiveness of two types of toothbrushes on the oral hygiene of patients undergoing orthodontic treatment with fixed appliances.

The purpose of this study was to investigate whether orthodontic toothbrushes were superior to classical toothbrushes in the elimination of microbial dental plaque on teeth and brackets and in the maintenance of periodontal tissue health in patients, ages 12 to 22 years, with fixed appliances. Twenty patients undergoing orthodontic treatment with fixed appliances and brushing with the Bass technique were included in the study. Ten patients used the Oral B Ortho type toothbrushes (Oral B Laboratories Ltd.), whereas the remaining 10 patients used the Oral B Plus 35 type toothbrushes. Quigley-Hein plaque index, bonded bracket index, sulcus bleeding index, and periodontal pocket depth measurements were made at the beginning of the study and a month later. No statistically significant difference was found for plaque, sulcus bleeding, and periodontal pocket depth between Oral B Ortho and Plus 35 groups when the preinvestigatory and postinvestigatory measurements for the vestibular and proximal surfaces of upper and lower teeth were compared. This short-term study concluded that the Ortho-type toothbrush is not superior to the Plus 35-type toothbrush.

Adolescent↗
PubMed1997

Orthodontic anchorage capacity of short titanium screw implants in the maxilla. An experimental study in the dog.

The aim of this study was to investigate experimentally the effect of long term orthodontic loading on the stability as well as on the peri-implant bone findings of short titanium screw implants (Bonefit, submersion depth 6 mm, phi 4 mm) inserted in regions with reduced vertical bone height. For this purpose, 6 maxillary premolars (1P1, 2P2, 3P3) were extracted from each of 2 foxhounds and reduction of alveolar bone height was performed by osteotomy. After a 16-week healing period, 8 implants (4 per dog) were inserted in the edentulous areas. Simultaneously, 2 implants (1 per dog) were positioned in the palatal suture (one-stage surgery). After an 8-week implant healing period, the fixtures in the P1/P2 areas (n = 4) and the palate (n = 2) were loaded (test implants) by means of transpalatal bars running anteriorly, fixed on the implants in the P1/P2 areas, and Sentalloy traction springs (approximately 2 N continuous force) inserted midsagittally between palatal implants and bars (force application period: 26 weeks). The fixtures in the P2/P3 areas served as controls (n = 4). Clinical measurements and histological evaluation revealed no implant dislocation of the loaded fixtures. These results suggest that short titanium screw implants inserted in the alveolar bone and palatal suture region retain their stability during long-term orthodontic loading, even following a relatively short unloaded implant healing period. Furthermore, it seems that long-term orthodontic loading may induce marginal bone apposition adjacent to the implants.

Alveolar Process↗
PubMed1997

Small diameter versus conventional laparoscopy: a prospective, self-controlled study.

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 +/- 5.6 versus 7.6 +/- 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in micro-oriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

Adult↗
PubMed1996

Surgical treatment alternatives in stress incontinence.

OBJECTIVES: This study was performed to evaluate the different surgical treatment alternatives for urinary stress incontinence and their clinical results. METHODS: Of the patients who visited our clinic between January 1989 and June 1994 complaining of urinary stress incontinence, 408 were found to have genuine stress incontinence (GSI) after undergoing clinical and laboratory investigations. These 408 patients were treated with different surgical techniques. Their postoperative results are discussed. RESULTS: After postoperative follow-up, the success rates of the different surgical techniques were as follows: anterior colporrhaphy (Kelly plication) 66.2%, Marshall-Marchetti-Krantz 88.7%, Burch procedure 94.1%, and sling urethropexy 97.5%. CONCLUSIONS: Patients with a clear-cut diagnosis of GSI must be surgically treated. There are several different techniques, all of which have advantages and disadvantages. If the right technique is used for the right patient then the success rate is high.

Adult↗
PubMed1996

Retained Tubocornual Endometrium and the TUMA Procedure

We performed total uterine mucosal ablation (TUMA), a laparoscopic-assisted alternative to hysteroscopic endometrial ablation, in 10 women (mean age 41.2 yrs, mean parity 3.7) with therapy-resistant dysfunctional uterine bleeding. The endometrial cavity, adjacent myometrium, and fundus were ablated under general anesthesia. Hemostatic sutures were applied to the fundus and cervix. Mean operating time was 53 &plusmn; 7.3 minutes. In two women bilateral salpingo-oophorectomy was performed due to benign ovarian pathology. The rest of the patients had functional ovaries, and menstruation returned in five of them. Three of the five had hematometra due to blunt perforation of the cervix. One woman had a hysterosalpingogram to assess the uterine cavity and two had total abdominal hysterectomy due to pelvic pain. The endometrial cavities in these three women were normal, without synechiae. The results of TUMA were considered satisfactory by 70% of women.

Journal Article↗
PubMed1996

An extraperitoneal burch procedure: a case report.

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.

Catheterization↗
PubMed1996

Endometrial assessment by vaginal ultrasonography might reduce endometrial sampling in patients with postmenopausal bleeding: a prospective study.

The purpose of this study is to compare transvaginal sonographic endometrial assessment with histology obtained by endometrial curettage in postmenopausal patients and to determine a cut-off point for endometrial thickness to reduce unnecessary diagnostic curettage for postmenopausal bleeding. A total number of 289 postmenopausal women were studied prospectively; 192 patients with postmenopausal bleeding and 97 postmenopausal women without bleeding comprised the study and control groups respectively. All patients were scanned by ultrasound transvaginally, then dilatation and curettage was performed for endometrial evaluation. In all women with and without postmenopausal bleeding, endometrial thickness of 4 mm or less as depicted by sonography correlated well with 'atrophic endometrium' (100%). Of 158 women with an endometrium > 4 mm in both groups, 40 women (25.1%) had a negative result (tissue insufficient for diagnosis or atrophic endometrium), while 118 patients (74.8%) had a positive result which included proliferative and secretory endometrium, endometrial hyperplasia, polyps and cancer. As the endometrial thickness increased, the probability of finding pathology with curettage was increased linearly in postmenopausal bleeding (PMB) positive and negative groups and there was a significant linear positive correlation between PMB (+) and (-) cases (Linear regression, R = 0.91, p < 0.03). A significant difference was found between endometrium carcinoma and all other endometrial pathologies concerning the mean endometrial thickness of 22.7 +/- 10.2 mm (chi-square, p < 0.0001). Also, the mean endometrial thickness of 4.7 +/- 3.3 mm for atrophic endometrium and 6.1 +/- 3.7 mm for 'tissue insufficient for histological diagnosis' were found significantly different than all other endometrial pathologies (chi-square, p < 0.0001). Endometrial thickness of < or = 4 mm may serve as cut-off point for predicting pathology negative cases with an accuracy of 100% in postmenopausal bleeding positive and negative cases. Then as the endometrial thickness increases, the probability of finding endometrial pathology in curettage increases linearly with a positive predictive value of 74.6%.

Adult↗
PubMed1996

The effects of 3-day clomiphene citrate treatment on endocrine and ovulatory responses.

A prospective cohort, paired clinical trial was carried out to test a shorter clomiphene citrate regimen of 3 days, measuring the endocrine outcomes and ovulatory responses. The trial took place at Gazi University Medical School Department of Obstetrics and Gynecology. The 28 infertile patients were newly accepted to the clinic with hypothalamopituitary disorder according to WHO classification Group II. They were treated with 50 mg/day clomiphene citrate (CC) for 3 days in 63 cycles. The control group of 28 paired patients were treated with 50 mg/day CC for 5 days in 40 cycles. The main outcome measures were: serum estradiol levels on day 11 (E-11), 14 (E-14) and postovulatory day 7 (E+ 7); serum progesterone levels on postovulatory day 7 (P+ 7); endometrial thickness on day 14 of the cycle; mean follicular phase length; and ovulation rates. The mean ages, gravidas, paritas, menstrual histories, E-11, P+ 7 levels, mean follicular phase length and luteal phase length were similar in both groups. E-14 (229.76 +/- 156.05 pg/ml vs. 338.25 +/- 350.60 pg/ml) and E+ 7 (217.30 +/- 114.95 pg/ml vs. 310.6 +/- 11.05 pg/ml) were significantly lower, whereas mean endometrial thickness on day 14 (10.30 +/- 1.39 mm vs. 9.52 +/- 1.96 mm) were significantly higher in the study group compared to controls (p < 0.05). Ovulation occurred in 82.53% of cycles in the study group and 95% in controls. In the study group, pregnancy was achieved in 17.3% of the ovulatory cycles; this rate was 10.5% in the control group. To decrease the peripheral antiestrogenic effects of CC, a regimen of 50 mg/day for 3 days may be used as a starting dose instead of the standard 5-day regimen.

Adult↗
PubMed1994

Surgical treatment of urinary stress incontinence by a suburethral sling procedure using a Mersilene mesh graft.

A suburethral sling procedure using a Mersilene mesh has been performed in 24 patients. Six patients had recurrent incontinence after an unsuccessful past operation. A postoperative follow-up was done for an average of 24 months. Twenty-three patients were free of symptoms, while only 1 patient had recurrent incontinence. The suburethral sling procedure can be applied to all patients, particularly for recurrent stress urinary incontinence, with reasonable cure rates when performed with a proper technique.

Adult↗
PubMed1994

Urinary beta 2-microglobulin levels and urinary N-acetyl-beta-D-glucosaminidase enzyme activities in early diagnosis of non-insulin-dependent diabetes mellitus nephropathy.

To assess whether urinary N-acetyl-beta-D-glucosaminidase (NAG) and beta 2-microglobulin (beta 2-MG) levels could be used as predictors of diabetic nephropathy or not, 59 non-insulin-dependent diabetes mellitus (NIDDM) patients were included in our study (31 females, 29 males; mean age 54 +/- 10.1). The control group consisted of 20 healthy non-diabetic subjects (12 males and 8 females; mean age 47 +/- 13.9). The patients in the study group were classified according to the duration of diabetes. In all cases, urinary beta 2-MG levels were measured by specific enzyme immunoassays and urinary NAG enzyme activities were determined by colorimetric methods. The mean urinary NAG level in study group was higher than that of the control group (p < 0.01). It was observed that NAG activity begins to rise in the third year of NIDDM, makes a plateau between 3-10 years, and rapidly increases after the 10th year. No significant difference in NAG activity was found between chemical NIDDM and control groups. No significant difference in beta 2-MG levels was found between study and control groups. The mean NAG activity in patients with early glomerular hyperfiltration was significantly higher than those without early hyperfiltration and control group (p < 0.05), whereas the mean beta 2-MG level was not. As a result, urinary NAG enzyme activity significantly increases, while urinary beta 2-MG level remains unchanged in patients with NIDDM. It was concluded that measurement of urinary NAG enzyme activity may be a good indicator in early diagnosis of diabetic nephropathy.

Acetylglucosaminidase↗
PubMed1990

Fukuyama type congenital muscular dystrophy in a Turkish child.

Congenital muscular dystrophy (CMD) is a heterogeneous group of disorders which is associated with more or less degrees of cerebral involvement. There are four separate entities within CMD nosology. Among these Fukuyama's CMD (FCMD) is highly prevalent in Japan, whereas the classic form with normal or subnormal intelligence, also known as the occidental type, covers the vast majority of cases in the West. We report a case of FCMD seen in a Turkish child.

Female↗
PubMed1989

[Relation of genital tuberculosis and simple cysts of the ovary].

86 cases of genital tuberculosis were evaluated retrospectively by clinical, anatomical, laparoscopic and HSG findings. The authors observed in 24 cases out of 86 (27.9%) unilateral simple ovarian cyst. They conclude that genital tuberculosis must be suspected and investigated when simple ovarian cyst has been found in infertile women.

Adult↗
PubMed1988

[A comparative study of serum progesterone and biopsy of the endometrium in infertile females].

We have titrated the serum progesterone and performed an endometrial biopsy on 69 infertile women, on the 21st day of the cycle. In 19 cases (27.5%), the serum progesterone levels were normal and the endometrium was at an advanced secretory stage. In 28 cases (40.5%), although the serum progesterone levels were normal, the endometrium was at an early secretory stage in 9 cases. In 29 cases (42%), the serum progesterone levels were under 8 ng/ml but for 20 of them, the endometrium was at an advanced secretory stage. In 12 cases (17.5%), there were anovulatory cycles.

Adolescent↗
PubMed1988

[Tescher's metroplasty and its results].

16 women with uterine septum, between 20 and 32 years old, have been operated by Tescher operation and the results are exposed. 5-6 months after the operations the control x-ray examination have been applied to thirteen cases. In 12 of them, we saw excellent physiologic cavities. In ne last one, there was an sufficient size cavity but it was not excellent. We suggest that the results of Tescher operation are better than those of others technics.

Abortion, Habitual↗
PubMedDate not supplied

Effect of cisapride on gastric emptying in patients with gastro-oesophageal reflux disease.

To investigate the effect of cisapride in gastro-oesophageal reflux disease (GERD), gastric emptying time, measured using scintigraphy, and reflux symptoms were compared before and after cisapride therapy in 30 patients with endoscopically proven GERD. Gastric emptying time was also measured in 20 age-matched controls. Patients with GERD were treated with 30 mg cisapride orally three times daily for 7 days. Gastric emptying time was significantly reduced following cisapride therapy in 28 of these patients (71.6 +/- 18.1 min versus 57.9 +/- 13.9 min), although it was still longer than the gastric emptying time of the control group (i.e. 46.2 +/- 8.1 min). In addition, cisapride relieved heartburn, which is a representative symptom of GERD. These findings suggest that cisapride may be useful in treating reflux symptoms and oesophagitis in patients with GERD.

Adult↗