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Biomedical subjects

S Yilmaz

Publications and source records attributed to S Yilmaz.

At least 109 records · Page 6Linked to original sources
PubMed1998

Island V-Y tensor fasciae latae fasciocutaneous flap for coverage of trochanteric pressure sores.

The distal fasciocutaneous portion of the lateral thigh is supplied by the direct cutaneous branch of the lateral descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. This consistent vascular anatomy allows raising a distal skin island based on both arteries on the lateral thigh, and this flap can be advanced into a trochanteric defect according to the V-Y technique. Based on anatomic and clinical study, a new design has been developed of the tensor fasciae latae fasciocutaneous flap, which is supplied by two pedicles. Seven island V-Y tensor fasciae latae fasciocutaneous flaps have been used for the coverage of trochanteric pressure sores in six patients. It is believed that the island V-Y tensor fasciae latae fasciocutaneous flap could overcome the traditional drawbacks of the conventional tensor fasciae latae flap and its modifications, and this is an ideal flap for covering trochanteric pressure sores without any donor site deformity and morbidity, which greatly improves the aesthetic result.

Adult↗
PubMed1998

Macro-anatomical investigations on the skeletons of porcupine (Hystrix cristata). Part III: skeleton axiale.

The aim of this study was to investigate the axial skeleton of two porcupines (Hystrix cristata). The important features of the skull, observed in this study are as follows: The zygomatic process of frontal bone (os frontal) was found to be rudimentary, and the infraorbital foramen (for. infraorbitale) was very large. The zygomatic bone (os zygomaticum) has two processes (frontal and temporal) and the zygomatic arch (arcus zygomaticum) was composed of three bones. The dental formulae were 2 (I 1/1, C 0/0, P 1/1, M 3/3) = 20. The angular process (Proc. angularis) of mandible is well developed. The vertebral formula was found as C7, T15, L4, S4, Ca12. All of cervical vertebrae had the transverse foramen (for. transversarium). The first eleven spinous processes (proc. spinosus) of thoracic vertebrae were caudally-sloped, the twelfth as the anticlin vertebrae and the last three were directed cranially. Hemal arches (or ossa arcus hemalis) were presented as separate bones which articulate with the ventral surfaces of the caudal ends of the bodies of the second, third and fourth caudal vertebrae.

Animals↗
PubMed1998

Alveolar ridge reconstruction and/or preservation using root form bioglass cones.

Extraction of a tooth necessitated by factors such as developmental problems, trauma, severe periodontal disease and endodontic problems often causes deformities of the residual alveolar ridge in the maxillary anterior region. These cases are usually difficult to restore prosthetically and they result in poor esthetics and insufficient occlusal function. This study investigated the efficacy of root form bioactive glass cones implanted into (a) artificial sockets produced by bone splitting of previous extraction sites (group BS) and (b) fresh extraction sockets (group FES). We included conventional extraction sockets sutured without implanting the root form bioactive glass cones as a control (group C). A total of 16 patients were treated for whom extractions had been indicated due to severe periodontitis. 6 patients with 7 implant sites having Class II or III alveolar ridge deformities comprised the BS group. 5 patients with 10 implant sites comprised the FES group. Group C, comprised 5 patients with 10 extraction sites. Alveolar ridge width and height measurements were obtained using study casts preoperatively, immediately postoperatively, and at 3 and 12 months after operation. In the BS group, while the width of the alveolar ridge increased by 2.8+/-1.18 mm immediately after ridge augmentation procedure and by 2.4+/-0.93 mm at 1 year after operation (p<0.01), the height of the alveolar ridge increased by 1.8+/-1.99 mm and 1.4+/-1.74 mm respectively (p<0.05). In the FES group, the differences between preoperative original ridge height and width and postoperative measurements were not statistically significant, which demonstrated the efficiency of this method in preserving the alveolar ridge. In group C, while alveolar ridge width after 12 months had not significantly changed, alveolar ridge height decreased significantly (1.35+/-1.05 mm, p<0.01). After 12 months, no dehiscences were detected and the differences in height between the groups remained significant. The results of this study indicate that this procedure is efficient in reconstructing alveolar ridges deformed as a result of extraction, particularly relevant in relation to preparation for subsequent restorative treatment.

Adult↗
PubMed1998

The relationship between probing bone loss and standardized radiographic analysis.

This study evaluated the validity of radiographic alveolar bone defect depth measurements to direct probing measurements. The study was planned in two parts. The first part consisted of the evaluation of artificially prepared defects in dry mandibles. These consisted of 3-mm intrabony defects created at the mesial aspect of the second mandibular molar and a Class II furcation defect on the buccal aspect of the first molar. A total of six standardized periapical radiographs with grids were obtained. They were then evaluated by 10 independent examiners who recorded the distance between the alveolar crest (AC) or root junction (RJ) and base of defect (BD) in the proximal and furcation areas of the teeth. Intra- and inter-examiner differences were assessed. Radiographic results showed that these measurements overestimated the mean defect depth values within 0.12 mm in intrabony defects and underestimated within 0.40 mm in Class II furcation defects. The differences between the radiographic and direct dry mandible defect depth measurements were found to be statistically significant (P < .05) with correlation values r = .50 and r = .46, respectively. The clinical part of the study included evaluation of 64 preoperative radiographs taken from patients who underwent various types of periodontal surgery. Mean clinical bone defect depth was found to be 4.20 mm and the mean of the radiographic defect depth measurements was found to be 3.92 mm in intrabony defects. In furcation defects these values were 3.92 mm and 3.55 mm, respectively. The results revealed that (1) a strong correlation existed between the radiographic and clinical assessments in both type of defects (r = .85, P < .001), and that (2) the difference between the two types of assessment methods was generally within 1 mm (58%). It can be concluded that in both dry mandible and clinical studies radiographic interpretation of the intrabony and furcation defects showed differences from the actual bone defect depths.

Adult↗
PubMed1997

How to diagnose chronic rejection. A study in porcine intestinal allografts.

Porcine small bowel allografts were followed for 18 weeks during immunosuppression with cyclosporine-A (CyA), azatioprine and prednisone. The mucosal alterations noted at the 12th week were epithelial vacuolation and loss of Goblet cells. Moderate infiltration of inflammatory cells, mainly lymphocytes, was found in the lamina propria. In addition, a few grafts exhibited oedema and fibrosis. Vessels already showed endothelial swelling and intimal proliferation at the 12th week. In the submucosa, the infiltration of inflammatory cells was not present till the 18th week. Further changes in the mucosa at the 18th week were the blunting of villi, cuboidal epithelium, crypt abscesses and epithelial atrophy. The histological alterations of mucosa and lamina propria existing in the full thickness biopsies were mostly also detectable in mucosal biopsies, provided that multiple biopsies were taken. Thus these parameters analyzed from mucosal biopsy material are suitable for the diagnosis and monitoring of chronic small bowel rejection. In autopsy, the most prominent features were in the mesenterial arteries: intimal proliferation, vasculitis, proliferation of media and endothelial alterations. The activity of the mucosal disaccharidases maltase and sucrase remained near the initial level till the 12th week and had decreased markedly by the 18th week.

Abscess↗
PubMed1997

Guided tissue regeneration in conjunction with hydroxyapatite-collagen grafts for intrabony defects. A clinical and radiological evaluation.

This clinical and radiological study evaluated the healing of 3 + 2 + 1 wall-combined intrabony defects treated using the guided tissue regeneration technique (GTR) with and without hydroxyapatite-collagen alloplastic graft materials (HAC), in comparison to that of HAC alone and conventional flap surgery (CF). 40 interproximal defects with probing depth > 6 mm were treated in 18 adult periodontitis patients of ages 35-60 years. After non-surgical therapy, the defects were randomly grouped into 4 groups of 10 defects each. These groups were designated: (1) expanded polytetrafluoroethylene membrane (e-PTFE), (2) e-PTFE + HAC, (3) HAC alone and (4) CF. At 6 months, the following changes in parameters were recorded. Mean PPD reduction for each group was 5.83, 5.85, 3.80 and 3.17 mm respectively. PPD reduced very significantly in all groups (p < 0.01), the highest and lowest reductions in PPD being for the e-PTFE + HAC and CF group respectively. Comparison between the 4 groups showed higher PPD reduction in both membrane groups than in either of the non membrane groups (p < 0.05) with the difference between the e-PTFE and CF groups being very highly significant (p < 0.001). Mean attachment gain for the 4 groups was 3.70, 3.80, 2.60 and 2.1 mm, respectively. Similarly attachment gain for all groups was very significant (p < 0.01) and the highest and lowest attachment gains were for the e-PTFE + HAC and CF group respectively. Both membrane groups showed significantly more attachment gain than the CF group (p < 0.05). Change in probing bone level (BL) for the 4 groups was 1.60, 1.90, 1.0 and 0.65 mm respectively. Again the highest changes in BL were recorded for the e-PTFE + HAC group. Significant differences were found between both membrane groups and the CF group (p < 0.05). Radiological evaluation using standardized radiographs and millimeter grids showed change in radiographic bone level at the deepest point of the defect on the radiograph to be 1.50, 1.55, 0.85 and 0.60 mm, respectively and this was significantly higher in both membrane groups than in the CF group (p < 0.05). This study therefore found e-PTFE membranes both alone and when combined with HAC to lead to more attachment gain and bone fill than did HAC alone or CF. It found HAC combined with e-PTFE to perform better although not significantly better than e-PTFE alone.

Adult↗
PubMed1997

A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients.

The present study describes results on selected clinical and microbiological parameters obtained by treatment with local (Elyzol) and systemic (Flagyl) use of metronidazole alone and/or mechanical subgingival debridement in adult periodontitis. Patients were randomly divided into local and systemic treatment groups each comprising 5 individuals in each of whom 4 sites (one site/ quadrant) with a probing depth of > or = 5 mm were selected and treated with separate treatment modalities. The overall treatment design provided 6 different test groups. Groups of quadrants received: (1) scaling and root planing; (2) local metronidazole treatment; (3) systemic metronidazole treatment; (4) local metronidazole combined with scaling and root planing; (5) systemic metronidazole combined with scaling and root planing; (6) no treatment. The microbiological and clinical effects of treatment modalities were monitored over a period of 42 days. All treatments resulted in clinical improvements (gingivitis, probing pocket depth, attachment level) except for the untreated group. Parallel to the clinical changes, all treatments reduced the number of total bacteria and proportions of obligately anaerobic microorganisms. Although both of the combined treatment groups responded to therapy with better resolution of infection that the pure mechanical and pure metronidazole treatments, local metronidazole in combination with scaling and root planing seems to be more effective in terms of producing both clinical and microbial improvements.

Administration, Oral↗
PubMed1997

The kidney/pancreas transplant: an alternative for type I diabetics.

Whole pancreas transplantation is becoming a real and safe option for treatment of type 1 diabetic patients. Several controversial issues are still waiting for answers. Portal drainage has been reported to be a possible alternative to systemic drainage, but no prospective data comparing the two techniques is available yet. Further data comparing enteric and bladder drainage is also overdue. With new immunosuppressive agents, isolated pancreas transplantation may also gain better survival and wider application.

Adult↗
PubMed1997

Simultaneous pancreas-kidney transplantation at the Ohio State University Medical Center.

Simultaneous pancreas-kidney transplantation is possible in a large number of Type I diabetics with excellent patient and graft survival. Diabetic patients are prone to coronary artery disease (CAD) which remains the most common cause of death in both the pre- and posttransplant periods. Exclusion of significant CAD and/or cardiac dysfunction in the potential recipient is necessary. At The Ohio State University, one-year patient, pancreas and kidney graft survival rates were 92%, 80%, and 84%, respectively. Acute rejection following simultaneous pancreas-kidney transplantation remains a major problem but has been positively affected by newer agents. Enteric conversion is needed in less than 10% of the patients over a period of 53 months. Prospective studies comparing primary enteric drainage and bladder drainage are needed to determine the best technique, as well as immunosuppressive regimens.

Actuarial Analysis↗
PubMed1996

Rat cytomegalovirus infection and chronic kidney allograft rejection.

To investigate the effect of cytomegalovirus (CMV) infection on the development of experimental chronic kidney allograft rejection, orthotopic kidney allografts from DA donors (Ag-B4, RT1a1) to WF (Ag-B2, RT1u) recipients were used. The rats received cyclosporine A (CsA) for 12 weeks. A group of recipients was infected with 10(5) plaque-forming units of rat CMV (RCMV), and another group was left non-infected and used as controls. The grafts were removed 12 weeks after transplantation. RCMV infection significantly enhanced the development of chronic kidney allograft rejection as follows: the intensity of interstitial inflammation (P < 0.025), particularly the degree of pyroninophilic cells in the inflammatory infiltrate (P < 0.025); the glomeruli mesangial matrix increase (P < 0.05) and capillary basement membrane thickening (P < 0.01); the extent of endothelial cell swelling (P < 0.025) and intimal proliferation (P < 0.025) in the graft vasculature; and the extent of tubular epithelial atrophy (P < 0.025). The chronic allograft damage index (CADI) was significantly increased to 4.2 +/- 0.9 in RCMV-infected allografts, compared with 0.8 +/- 0.4 in non-infected (P < 0.02). At the molecular level, RCMV infection significantly increased vascular endothelial (P < 0.05) and tubular epithelial (P < 0.01) ICAM-1 expression. Viral antigens were detected in tubular epithelial cells and in some inflammatory cells.

Animals↗
PubMed1996

Cytomegalovirus infection-enhanced chronic kidney allograft rejection is linked with intercellular adhesion molecule-1 expression.

In human kidney allografts, association of acute rejection and glomerulopathy with cytomegalovirus (CMV) infection has been demonstrated. To investigate the effect of CMV infection on the development of experimental chronic kidney allograft rejection, heterotopic kidney allografts from DA (Ag-B4, RT1a1) rat donors to WF (Ag-B2, RT1u) rat recipients were used. The animals received cyclosporine A (CsA) 5 mg/kg/day s.c. either for 1 or 12 weeks. Two groups of recipients were infected with 10(5) plaque-forming units of rat CMV (RCMV) and two other groups were left noninfected and used as controls. The grafts were removed 12 weeks after transplantation for histology and immunohistochemistry. RCMV infection significantly enhanced the development of chronic kidney allograft rejection in rats on continuous CsA the intensity of interstitial inflammation (P < 0.025), particularly the degree of pyroninophilic cells in the inflammatory infiltrate (P < 0.025), the glomerular mesangial matrix increase (P < 0.05) and capillary basement membrane thickening (P < 0.01), the extent of endothelial cell swelling (P < 0.025) and intimal proliferation (P < 0.025) in the graft vasculature, and the extent of tubular epithelial atrophy (P < 0.025). Chronic allograft damage index (CADI) was significantly increased to 4.3 +/- 0.8 in RCMV-infected allografts, compared to 0.8 +/- 0.4 in noninfected (P < 0.02). In addition, RCMV infection significantly increased the number of acute rejection episodes (serum creatinine > 200 mumol/liter, P < 0.05) and almost doubled the end-stage serum creatinine. RCMV infection significantly increased ICAM-1 expression on the vascular endothelium (P < 0.05) and tubular epithelial cells (P < 0.01), and was linked with enhanced interstitial, glomerular, and tubular inflammation. In 80% of allografts on continuous CsA, RCMV antigens could be observed in sporadic inflammatory cells one week after infection and in tubular epithelial cells at 12 weeks. In heavily inflamed allografts where the CsA treatment was discontinued at one week, enhancement of RCMV infection on the histological changes attributable to chronic kidney allograft rejection could not be demonstrated. Our results show that during CsA immunosuppression, RCMV infection enhances chronic kidney allograft rejection associated with increased interstitial inflammation as well as vascular endothelial and tubular epithelial ICAM-1 expression.

Animals↗