Is the cortical blindness due to diaschisis?
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Blindness, Cortical↗
Biomedical subjects
M Yilmaz
Publications and source records attributed to M Yilmaz.
Comparative methods of repairing left ventricular aneurysms.
Between 1 March 1992 and 31 June 1996, we enrolled 72 patients with left ventricular aneurysms in a prospective, nonrandomized study to compare--by study of cardiac indices, single-plane ejection fractions, and nuclear ventriculograms--the effects of classical aneurysmectomy (group 1, n = 36) with those of endoaneurysmorrhaphy (group 2, n = 36). Preoperative and postoperative cardiac index measurements were, respectively, 1.96 +/- 0.6 and 3.51 +/- 0.53 for group 1, and 1.96 +/- 0.31 and 3.43 +/- 0.41 for group 2. In this regard, there was not any significant difference between the groups preoperatively or postoperatively. Preoperative and postoperative multiple-gated acquisition measurements, were, respectively, 34.3 +/- 7.76 and 43.1 +/- 11.1 for group 1, and 37 +/- 3.88 and 66.5 +/- 5.2 for group 2. Although there was not any significant preoperative difference between the groups (P = 0.34), group 2 had significant postoperative improvement in left ventricular ejection fractions (P < 0.001). Preoperative and postoperative single-plane contrast ventriculographic ejection fractions were, respectively, 43.4 +/- 8.7 and 48.6 +/- 11.2 for group 1, and 43.8 +/- 5.5 and 60.8 +/- 15.1 for group 2. Again, there was not any significant difference between the 2 groups in preoperative left ventricular ejection fractions (P = 0.87), but the postoperative left ventricular ejection fractions of group 2 were significantly better than those of group 1 (P = 0.022). We conclude that left ventricular functional improvement with endoaneurysmorrhaphy is superior to that with classical aneurysmectomy.
Cardiac Output↗
Early and delayed thallium-201 scintigraphy in thyroid nodules: the relationship between early thallium-201 uptake and perfusion.
Seventy-six patients with thyroid nodules were studied. Initially, 74 MBq of thallium-201 was injected. The thyroid gland was imaged 15 min (early) and 3 h (delayed) after the injection. Thereafter, 185 MBq technetium-99m pertechnetate was injected. Immediately after the injection, a 1-min perfusion image was acquired, followed by an image at 20 min. Increased early and delayed 201Tl uptake compared with the contralateral thyroid tissue was adopted as the criterion for malignancy. Sensitivity, specificity and negative predictive values were found to be 85%, 64% and 78%, respectively, in operated patients, but these values were 86%, 87% and 95%, respectively, in the whole group, including patients followed with fine-needle aspiration biopsy. With the purpose of investigating the relationship between perfusion and early 201Tl uptake, both perfusion and early images were graded comparing nodular activity with contralateral thyroid activity. There was a poor correlation between perfusion and 201Tl uptake. The correlation was even worse in hyperactive nodules. It is concluded that early and delayed 201Tl imaging should not be used in the differential diagnosis of cold nodules and that early 201Tl uptake seems to be more closely related to factors other than perfusion.
Adolescent↗
99mTc-MIBI scintigraphy in metastatic renal cell carcinoma: clinical validation of the relationship between 99mTc-MIBI uptake and P-glycoprotein expression in tumour tissue.
Technetium-99m hexakis-2-methoxyisobutylisonitrile (MIBI) and thallium-201 imaging was performed in a patient with metastatic renal cell carcinoma (RCC), which is a well-known tumour type demonstrating P1-glycoprotein (PGP) overexpression. Two scintigraphic patterns - Tl(+)/MIBI(-) in primary tumour and Tl(+)/MIBI(+) in metastatic tumour - were observed, suggesting high- and low-level PGP expression, respectively. Immunochemical study for PGP revealed strong staining of the primary tumour cells. This case clinically validates the previously suggested relationship between 99mTc-MIBI uptake and PGP expression.
ATP Binding Cassette Transporter, Subfamily B, Mem↗
Free arterialised venous forearm flaps for limb reconstruction.
Arterialised venous flaps are an alternative method to conventional flaps. Arterialised venous flaps include only the venous network and afferent blood comes from the arterial system. Arterialised venous flaps have been mostly used for closure of small defects. We have designed an arterialised venous flap utilising the venous network of the forearm and applied this flap in 5 patients with various defects in the extremities ranging in size from 6 x 8 cm to 10 x 12 cm. Four flaps totally survived. One flap had 30% partial necrosis. Overall clinical results were successful. The free arterialised venous forearm flap provides large, thin, good quality tissue with less morbidity at the donor site without sacrificing one major artery of the hand and can be an alternative for the conventional radial forearm flap.
Adolescent↗
The effect of allopurinol pretreatment on intestinal hypoperfusion encountered after correction of intestinal volvulus.
After reversal of blood flow following a prolonged period of ischemia, blood flow returns for a few seconds and is reduced afterward. This is called "no-reflow phenomenon." Antioxidants such as allopurinol have been shown to prevent the occurrence of this phenomenon in organs other than the intestine. An experimental study was conducted to investigate the effect of allopurinol pretreatment on intestinal blood flow after correction of intestinal volvulus in rabbits. In group 1, baseline intestinal blood flow (IBF) was evaluated using radiolabeled red blood cells. In group 2, 720 degrees intestinal volvulus was created and IBF was evaluated 6 hours later. In group 3, intestinal volvulus was created and devolvulus was performed 6 hours later. Intraperitoneal isotonic saline was injected 60 minutes before correction of the volvulus. IBF was evaluated after correction of the volvulus. Group 4 had the same procedures as group 3, but allopurinol (200 mg/kg) was injected in place of the isotonic saline. IBF stopped 6 hours after volvulus. Compared with the baseline group, IBF was significantly lower in the group with volvulus + devolvulus (P < .01). The IBF of the allopurinol-treated group was significantly higher than that of the isotonic saline group (P < .01) and it did not differ significantly from that of the baseline group. Histopathological examination showed that intestinal volvulus leads to histological injury. The histological injury was more pronounced in the devolvulus group and was less severe in the allopurinol group in comparison to the isotonic saline pretreatment group (P < .01). It is concluded that allopurinol pretreatment prevents the intestinal hypoperfusion (no-reflow phenomenon) and histological injury encountered after correction of intestinal volvulus of 6 hours' duration.
Allopurinol↗
Free arterialized venous forearm flap.
Arterialized venous flaps are the result of the search for new flap techniques because conventional flaps are sometimes insufficient and have donor-site morbidity problems. In the patient presented here, a free arterialized venous flap measuring 12 x 8 cm was transferred from the forearm to a burn-scarred area on the face. This flap contained two parallel main veins, one was arterialized for perfusion and one was for the venous drainage. The flap we have designed is advantageous in that it is not bulky, it has less donor-site morbidity, it does not sacrifice one major artery, and it uses the rich venous network of the forearm. The operative and postoperative results are satisfactory.
Adult↗
Influence of smoke exposure on serum IgE levels of atopic patients.
The effect of environmental tobacco smoke on serum total immunoglobulin E (IgE) of respiratory allergic patients was evaluated in this study. A total of 558 patients with respiratory allergies (311 boys and 248 girls) aged between 1 and 17 years (mean 6.92 +/- 3.81 years) were included. None of the subjects were active smokers. IgE levels were significantly higher in children with smoking parents compared with non-smokers (P < 0.05). Children with smoking mothers were found to have higher levels of IgE than children with smoking fathers. The highest level of IgE was found in children when both parents were smokers (P < 0.005).
Adolescent↗
Penetration of cyclosporin A into the rabbit cornea and aqueous humor after topical drop and collagen shield administration.
We used commercially available 12-hour collagen shields to deliver cyclosporin A (CsA) to the cornea and aqueous humor in rabbit eyes. Six New Zealand white rabbits were divided into three groups. The first group (four eyes) received 6 mg of CsA in castor oil and the second group (four eyes) received 6 mg of CsA in olive oil applied as topical drops to rabbit eyes within 12 hours. In the third group (four eyes) 12-hour collagen shields soaked in 6 mg CsA in olive oil were applied to rabbit eyes. The amount of CsA in corneal and aqueous samples from eyes treated with CsA castor oil and CsA olive oil were compared with each other and with collagen shield treated eyes. CsA concentrations were measured by radioimmunoassay. After the total dose of 6 mg CsA, percentage penetration was measured as follows: CsA castor oil--0.51% in aqueous and 20.75% in cornea; CsA olive oil--0.17% in aqueous and 11.13% in cornea; and with collagen shields--0.44% in aqueous and 11.84% in cornea. These results show that the CsA levels of castor oil drops were higher than those obtained with olive oil drops. In eyes with collagen shields, CsA levels were higher than olive oil drops but nearly equal to the castor oil drops. Collagen shields may be useful as an ocular delivery system for CsA.
Administration, Topical↗
Changes in the fundus caused by blunt ocular trauma.
Generally encountered during adolescence, blunt ocular trauma results in a variety of changes in the fundus. Our study investigated the distribution of trauma-induced changes in the fundus on the basis of the incidence and the latent interval between the trauma and the occurrence of the symptoms. In addition, we studied the distribution of the cases in regard to patient age and sex and the cause of the trauma. Included in this study were the 445 eyes, whose fundi could be evaluated, of 435 patients, who applied to the Eye Clinic of the Faculty of Medicine, Ankara University, because of blunt eye trauma and patients from private practice during the period between 1980 and 1991. The following are the changes found in the fundus, either isolated or combined, that were detected in the 445 eyes included in this study: retinal detachment (194), retinal and choroidal atrophy (52), vitreous hemorrhage (50), optic atrophy (43), Berlin's edema (42), choroidal rupture (36), macular hole (18), macular hemorrhage (16), retinal hole (9), papillary-macular membrane (8), arterial occlusion (7), evulsion of the optic nerve (5), and retinal-papillary edema (3). Seventy-nine percent were male patients, and 21% were female. The most frequently encountered age group was 11 to 20 years (32.2% of the cases included in our study).
Adolescent↗
Povidone-iodine in experimental peritoneal hydatidosis.
The effect of polyvinylpyrrolidone-iodine (PVP-I) on experimental peritoneal hydatidosis was evaluated in this randomized blind controlled study. Seventy-five white, 3-month-old rats were subjected to laparotomy. After the intraperitoneal inoculation of viable scolices, the rats were randomly divided into three groups. Their peritoneal cavities were irrigated with either 1 per cent PVP-I solution (the PVP-I group), hypertonic saline (the HS group) or Ringer's lactate (the control group). Each group was assigned a separate code number; observers blind to the meaning of the code numbers noted all findings during a period of 4 months, after which the rats were killed to allow assessment of the abdominal cavity. The results were decoded after the statistical analyses were completed. The incidence of peritoneal cysts was found to be lower (8.7 per cent) in the PVP-I group compared with the HS (50 per cent) and control (90.9 per cent) groups; the mean number of hydatid cysts per animal was also lower in the PVP-I group compared with the other two groups. We conclude that the scolicidal activity of PVP-I is significantly higher than that of hypertonic saline and that it can be employed as a prophylactic agent against peritoneal hydatidosis.
Animals↗
[The existence of sinusitis in rabbits and the use of bromhexine as a mucolytic nose drop in the treatment of sinusitis].
To make an experimental sinusitis, 38 maxillary sinus ostia of 19 rabbits were closed by silicon plastic and 24 hours later 10(8)-10(10) germs/ml. of Streptococcus pneumoniae type C III were given to the antrums of sinuses. 5 days later all the rabbits showed sinusitis clinically, radiologically, bacteriologically and histopathologically. Viscous, purulent secretions collected in the antrums of sinuses. We thought that the medical treatment of sinuses which had drainage treatment necessitated to decrease the viscosity of secretions. Because of this bromhexine as a mucolytic nose drop was investigated for the first time for the treatment of sinusitis in two groups of rabbits. As a result of the study bromhexine as a nose drop in the eradication of sinus infections was seen a useful drug.
Administration, Intranasal↗
Intravenous immunoglobulin for prophylaxis of nosocomial sepsis.
A total of 76 premature newborn infants with gestational age of 34 weeks or less were enrolled in a randomized controlled study to determine whether intravenously administrated immunoglobulin (IVIG) is able to prevent nosocomial sepsis. Forty infants were given 0.5 g/kg IVIG on the first day of life and 36 infants with similar gestational age and birth weight were selected as controls and did not receive IVIG. The frequency of proven sepsis, with a positive blood and/or cerebrospinal fluid culture, was significantly lower in infants who received IVIG as compared to controls (42.5 vs 80.0%) (p < 0.01). The mortality rate attributable to infection was not different in IVIG recipients and in controls (41 vs 48%) (p > 0.05). The overall mortality rates in the two groups were not different either (35.0 vs 44.4%) (p > 0.05). The majority of micro-organisms isolated from the blood culture of the patients were gram negative microorganisms (Klebsiella, Enterobacter). IVIG therapy was believed to be effective for prophylaxis of nosocomial infection, but such therapy was not able to reduce overall mortality rate or mortality rate due to systemic infection in prematurely born infants in our intensive care unit where the causative pathogens are usually gram negative microorganisms.
Cross Infection↗
A case of superoinferior ventricular heart with situs ambiguus, dextroventricular loop, and levo transposition of the arteries: prenatal and postnatal echocardiographic diagnosis.
A unique case of superoinferior ventricles, left atrial isomerism, concordant atrioventricular connection, and discordant ventriculoarterial connection is described. The associated anomalies were azygous vein continuation, large subpulmonary and apical ventricular septal defects, and left ventricular outflow tract obstruction (pulmonary stenosis). The diagnosis was mostly made by fetal echocardiography and the superoinferior location of the ventricles was confirmed by postnatal echocardiography. Fetal and postnatal echocardiography facilitated the precise morphologic diagnosis and segmental analysis of this defect.
Abnormalities, Multiple↗
Congenital subclavian artery to subclavian vein fistula presenting with congestive heart failure in an infant.
Contrary to acquired arteriovenous fistulas, the congenital malformations are very rare. Here we report a case of congenital arteriovenous fistula forming a communication between the right subclavian artery to subclavian vein. To our knowledge, there is no similar case in which an infant has been successfully operated on for cardiac failure.
Arteriovenous Fistula↗
A case with Weaver syndrome operated for congenital cardiac defect.
An 11-month-old Turkish female infant with Weaver syndrome together with atrial septal defect and patent ductus arteriosus which was operated successfully is reported. Weaver syndrome is a very rare disorder of unknown etiology characterized by accelerated growth of prenatal onset, advanced osseous maturation, special craniofacial features, umbilical hernia, and hoarse low-pitched cry. Congenital cardiac defect is not a usual finding. The presented case is the first reported child with Weaver syndrome in the literature operated for a congenital cardiac defect.
Abnormalities, Multiple↗
Frequency of spinal reflex movements in brain-dead patients.
Spontaneous and reflex movements may occur in brain-dead patients. These movements originate from spinal cord neurons and do not preclude a brain-death diagnosis. In this study, we sought to determine the frequency and characteristics of motor movements in patients who fulfilled diagnostic criteria for brain death. Patients admitted to our department between January 2000 and March 2003 and diagnosed as brain-dead were prospectively evaluated in terms of spinal reflexes. Clinical brain death was diagnosed according to our national law. We also prefer to document the diagnosis of brain death with an EEG and/or TCD. Spinal reflex movements were observed in 18 out of 134 (13.4%) brain-dead patients during the study period. Lazarus sign, the most dramatic and complex movement seen in brain-dead patients, was observed a few times in two patients during an apnea test, an oculocephalic test, after a painful stimulus, and after removal of a ventilator. The other reflex movements observed in our brain-dead patients were finger and toe jerks, extension at arms and shoulders, and flexion of arms and feet. The occurrence of spinal reflexes in brain-dead patients may certainly delay decision making, such as starting a transplantation procedure, because of difficulties in convincing the family or even a physician taking part in the diagnosis of brain death. An awareness of spinal reflexes may prevent delays in and misinterpretations of the brain-death diagnosis.
Adolescent↗
Brain death and donor management in the intensive care unit: experiences over the last 3 years.
We sought to examine the frequency of brain death in the ICU, the donation rate, and the problems encountered during donor management between the years of January 2000, the date we began treating patients with neurologic pathologies and traumatic brain injury, and March 2003. Between January 2000 and March 2003, 134 patients diagnosed with brain death in our ICU were studied prospectively for the reason of brain death, the time between admission to ICU, and the diagnosis of brain death, the frequency of diabetes insipidus, the inotrope requirement, hypothermia, electrolyte imbalance, arrhythmia, and cardiac arrest. Among the approximately 2600 patients admitted to the general 24-bed ICU, 940 had cerebral injuries. In this group, the mortality rate was 33.5% (315 out of 940 patients) including brain-dead patients. Donor care was performed in 94 patients with organs suitable for transplantation out of 134 brain-dead patients. Fifty (53.2%) out of 94 patients became organ donors. The donor ratio was 12 per million-population per year as a mean value of the study period, which was approximately 10 times higher than the average ratio in Turkey. Although we observed many life-threatening problems during donor management, none of these patients died or had acute organ dysfunction.
Brain Death↗