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Biomedical subjects

S Buyukberber

Publications and source records attributed to S Buyukberber.

31 records · Page 2Linked to original sources
PubMed2000

Ticlopidine-induced severe agranulocytosis after the placement of coronary artery stent--a case report.

Ticlopidine is an oral antiplatelet agent frequently utilized in the treatment of cerebrovascular disease. It is rarely associated with severe bone marrow suppression. A case of an elderly woman is reported who developed febrile agranulocytosis two months after commencing ticlopidine but who had a favorable outcome after cessation of that drug and treatment with granulocyte colony-stimulating factor (G-CSF). All patients should have regular monitoring of their blood counts during therapy with ticlopidine.

Agranulocytosis↗
PubMed2000

The effects of abdominal and bimanual pelvic examination and transvaginal ultrasonography on serum CA-125 levels.

The need for the early detection of ovarian cancer continues to be one of the most important issues in women's health care. The three most extensively evaluated screening methods for ovarian cancer are pelvic examination, transvaginal ultrasonography, and serum CA-125 levels. The answers to questions such as should the levels of CA-125 be measured before bimanual pelvic examination or transvaginal ultrasonography or do abdominal examinations effect the levels of CA-125 are obscure. Fifty-four otherwise healthy female volunteers at the preovulatory phase of the menstrual cycle complaining of vaginal candidiasis were divided into 3 groups. Abdominal (group 1), bimanual pelvic (group 2), and transvaginal ultrasonography (group 3) examination was performed and serum CA-125 levels were evaluated prior to examination and 10 minutes, 6 hours, and 24 hours after the examination. As a result, serum CA-125 levels (U/ml) were found to be 8.13 +/- 4.76, 8.23 +/- 5.05, 8.32 +/- 4.88, and 8.33 +/- 4.94 in the group of abdominal examination, respectively, 8.23 +/- 4.89, 8.45 +/- 5.15, 8.77 +/- 4.96, and 8.79 +/- 5.50 in the group of bimanual pelvic examination, respectively, and 8.19 +/- 4.56, 8.30 +/- 5.10, 8.81 +/- 5.56, and 8.88 +/- 5.71 in the group of transvaginal ultrasonography, respectively. The serum CA-125 levels detected prior to examinations were statistically insignificant when compared with the results obtained at 10 minutes, 6 hours, and 24 hours later in all three groups. We concluded that physical examination, either abdominal or pelvic, and transvaginal ultrasonography do not change the serum levels of CA-125.

Adult↗
PubMed2000

Gluten-free diet improves iron-deficiency anaemia in patients with coeliac disease.

Two cases of newly-diagnosed asymptomatic coeliac disease with 3 years of unexplained severe iron-deficiency anaemia are presented. Oral iron supplementation had no effect on their serum iron levels and, therefore, had no influence on their anaemia. Upper gastrointestinal endoscopy confirmed normal macroscopic findings. Duodenal biopsies revealed subtotal villous atrophy of the mucosa of the small intestine. A strict gluten-free diet led to an increase in serum iron, resolution of anaemia, and restitution of normal mucosal morphology. Thus, severe iron-deficiency anaemia associated with asymptomatic coeliac disease is responsible to gluten-free diet.

Adult↗
PubMed1999

Fas-FasL-mediated CD4+ T-cell apoptosis following stem cell transplantation.

We report the preferential expression of Fas on CD4+ T cells and Fas ligand (FasL) on monocytes and their potential role in the selective loss of CD4+ T cells in breast cancer patients undergoing high-dose chemotherapy and peripheral blood stem cell transplantation (PSCT). A high frequency of apoptotic CD4+ T cells (28-51%) is observed during the first 100 days after PSCT concomitant with a significant increase in monocyte frequency and FasL expression (11.6-23%) on monocytes. The preferential expression of Fas on CD4+ T cells (73-92%) in the peripheral blood (PB) of these patients is associated with a significantly higher frequency of CD4+ T-cell apoptosis compared with CD8+ T cells (28-47%) and CD4+ T cells (46 +/- 5.7%) in normal PB. These data suggest that "primed" Fas+ CD4+ lymphocytes interact with activated monocytes that express FasL, resulting in apoptosis, leading to deletion of CD4+ T cells, an inversion in the CD4:CD8 T-cell ratio, and immune dysfunction. The prevention of CD4+ T-cell apoptosis and improved immune reconstitution by the manipulation of PB stem cell products, blockade of Fas-FasL interactions, or cytokine support after transplantation may be important adjuvant immunotherapeutic strategies in patients undergoing high-dose chemotherapy and PSCT.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

The relation between plasma endothelin-1 levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy in patients with Type 2 diabetes mellitus.

We evaluated the possible relation between plasma endothelin-1 (ET-1) levels and metabolic control, risk factors, treatment modalities, and diabetic microangiopathy, including nephropathy, neuropathy, and retinopathy in patients with Type 2 diabetes and healthy control group. Sixty-eight (39 females and 29 males) patients with Type 2 diabetes and 14 (6 females and 8 males) healthy subjects were included in the study. Plasma ET-1 levels were found to be 10.46+/-1.24 pmol/l in the diabetic group, whereas 7.97+/-0.41 pmol/l in the control group, which was statistically significant (P<.01). We also found elevated plasma ET-1 levels in patients with the least one microvascular complication when compared with the uncomplicated diabetes group (P=.02). Moreover, plasma ET-1 levels of the uncomplicated group was higher than the control group (P<.05). Plasma ET-1 levels were significantly elevated in hypertensive diabetics than normotensive diabetics (t=2.58, P=.012). It was also found to be elevated in diabetic patients with diabetes duration of more than 10 years when compared with patients less than 10 years (P=.02). These findings can be interpreted as the increased damage of microvascular complications in the disease process that may lead to elevated ET-1 levels. Mean plasma ET-1 levels in diabetic patients with a family history of diabetes was found to be higher than patients with no family history of diabetes. Genetical and environmental factors may have an effect on ET-1 level. We also studied the correlations of plasma ET-1 levels on age, sex, fasting blood glucose levels, treatment modalities HbA1c, hyperlipidemia, C-peptide, Body Mass Index, and smoking, but did not find any statistically significant difference. In conclusion, plasma ET-1 levels are well correlated with microangiopathy, hypertension, increased disease duration, and family history of diabetes, but poorly correlated with metabolic control, treatment modalities, age, sex, hyperlipidemia, obesity, and smoking.

Adult↗
PubMedDate not supplied

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Anti-Bacterial Agents↗
PubMedDate not supplied

Idiopathic hypoparathyroidism and celiac disease in two patients with previous history of cataract.

We report two patients with idiopathic hypoparathyroidism and celiac disease. Both had undergone surgery for cataract previously. The patients presented with tetany in the absence of gastrointestinal complaints. Investigations showed severe hypocalcemia, hypoparathyroidism, flattening of duodenal villi histologically, and diffuse cerebral and basal ganglia calcifications on CT scan. After a gluten-free diet with calcium supplementation, the clinical situation and biochemical values improved.

Adult↗
PubMedDate not supplied

Partial review of immunotherapeutic pharmacology in stem cell transplantation.

In two separate lymphoma populations, we examined immune reconstitution following high dose chemotherapy (HDT) and bone marrow transplantation (BMT). In the first study we followed immune reconstitution for one year after HDT and BMT. In the second study we examined the ability of the orally active immunomodulator, Bestatin to augment immune reconstitution following HDT and BMT. The studies on immune reconstitution following HDT and BMT were undertaken in a cohort of non-Hodgkin's lymphoma (NHL) patients (n = 35) and examined the peripheral blood (PB) leukocyte subsets and their in vitro functions. Our results demonstrate that monocyte and natural killer (NK) cell engraftment occurred more rapidly then did T cell reconstitution. We also observed a significant decrease in the CD4:CD8 ratio post-transplantation as compared to normal PB donors due to a decrease in CD4+ cells. In addition, following HDT and BMT, measures of T cell function (phytohemagglutinin [PHA] mitogenesis) and T helper cell activity (pokeweed mitogen [PWM] mitogenesis) were consistently depressed as compared to cells from normal PB. Further, we demonstrate a correlation between the loss of T cell function and the frequency of circulating monocytes, suggesting a cause-effect relationship. Despite the dysfunction in T cells following HDT and BMT, immune-modulating agents can still augment the immune function. One such drug is Bestatin (ubenimex), an inhibitor of aminopeptidase (AP) that binds to CD13 on macrophage/monocytes. To examine its immune modulatory activity after HDT and BMT, a dose finding (10, 30, 90 and 180 mg/day) phase Ib trial was conducted with 30 Hodgkin's disease (HD) and NHL patients who received no drug (control), or Bestatin daily for 60 days following BMT. In these studies, Bestatin administration was initiated when the absolute neutrophil count was greater than 250/mm3 on two consecutive days. These studies revealed that Bestatin significantly increased the PHA and PWM responses in a dose-dependent manner. Flow cytometric analysis revealed a significant increase in NK cells (CD56+), B cells (CD19+), as well as the CD4:CD8 cell ratio. The latter observation was associated largely with a depression in the percent of CD8+ T cells as opposed to an increase in CD4+ T cells. We conclude that despite the peripheral tolerance observed following HDT and BMT, Bestatin could significantly increase some, but not all, immune surrogates.

Adjuvants, Immunologic↗
PubMedDate not supplied

Elevated serum CA-125 levels in patients with nephrotic syndrome-induced ascites.

CA-125 is a sensitive, but not a specific, tumour marker especially used in the diagnosis and follow-up of ovarian cancer. Because of the elevated levels of CA-125 encountered during the etiological investigation of nephrotic syndrome (NS) a clinical study was designed to investigate the probable relationship between elevated CA-125 levels in patients with NS, with and without ascites. Twenty-four patients with NS due to non-tumoural pathologies, aged 24 to 56 (15 females and 9 males), were investigated. We detected elevated levels of serum CA-125 (275.92 +/- 154.71 U/mL) in 14 (70%) NS patients with ascites (p < 0.05). In the other 10 NS patients without ascites (Group 2) and in the control group, consisting of 52 age and sex-matched healthy volunteers, the serum CA-125 levels were found to be 13.60 +/- 5.12 U/mL and 8.50 +/- 5.02 U/mL, respectively (p > 0.05). There was no statistically significant difference between the control group and the patients without serosal fluids (p > 0.05). We concluded that serum CA-125 levels were elevated in NS patients with ultrasonographically detected ascites in the absence of an ovarian tumour or other diseases known to increase the levels of CA-125.

Adult↗
PubMedDate not supplied

Synchronous primary malignant neoplasms of colon and bladder.

Extracolonic and synchronous malignancies are rare in colorectal carcinomas. We report a 68-year-old man with complaints of rectal bleeding and hematuria. Endoscopic biopsies revealed synchronous adenocarcinoma of the colon and transitional cell carcinoma of the bladder. The patient was started on chemotherapy, and is alive (with disease) nine months later.

Aged↗