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Biomedical subjects

A Gürgey

Publications and source records attributed to A Gürgey.

At least 37 records · Page 2Linked to original sources
PubMed2000

Molecular analysis of turkish beta-thalassemia heterozygotes with normal Hb A2 levels.

Four parents of three unrelated families who are obligatory beta-thalassemia heterozygotes and two parents with Hb Knossos are presented. In these subjects, although the red blood cell counts and red cell indices were compatible with beta-thalassemia trait, the Hb A2 values were between 1.9-2.9% of the total hemoglobin. Examination of the delta-globin gene by Southern blot, restriction endonuclease analysis, and by direct sequencing of amplified DNA revealed the presence of the (delta0) -7.2 kb Corfu type deletion, the (delta+) codon 27 (G-->T) and (delta0) IVS-I-2 (T-->C) mutations in trans or in cis with a severe beta-thalassemia allele, and the (delta0) codon 59 (-A) deletion in cis with the betaKnossos allele.

Adult↗
PubMed2000

Beta-thalassemia intermedia associated with homozygosity for the -87 (C-->T) mutation in a Turkish family.

We report on two siblings with beta+-thalassemia intermedia. Molecular studies of the beta-globin gene indicated that the patients are homozygous for the -87 (C-->T) mutation. This genotype has not been previously described. Homozygosity for the -87 (C-->T) mutation produces a mild form of beta+-thalassemia associated with moderate Hb F elevation (26-38%) and highly elevated Hb A2 (10-8.6%) levels, respectively. Hematological parameters of homozygous -87 (C-->G) and -87 (C-->A) mutations, and compound heterozygous patients with either C-->T, C-->G, or C-->A at -87 and one of the severe beta+- or beta0-thalassemia mutations, are given for comparison.

Adult↗
PubMed1999

Human MLH1 deficiency predisposes to hematological malignancy and neurofibromatosis type 1.

Heterozygous germ-line mutations in the DNA mismatch repair genes lead to hereditary nonpolyposis colorectal cancer. The disease susceptibility of individuals who constitutionally lack both wild-type alleles is unknown. We have identified three offspring in a hereditary nonpolyposis colorectal cancer family who developed hematological malignancy at a very early age, and at least two of them displayed signs of neurofibromatosis type 1 (NF1). DNA sequence analysis and allele-specific amplification in two siblings revealed a homozygous MLH1 mutation (C676T-->Arg226Stop). Thus, a homozygous germ-line MLH1 mutation and consequent mismatch repair deficiency results in a mutator phenotype characterized by leukemia and/or lymphoma associated with neurofibromatosis type 1.

Adaptor Proteins, Signal Transducing↗
PubMed1999

Factor V Leiden and prothrombin 20210 A mutations in patients with central and branch retinal vein occlusion.

PURPOSE: The role of factor V Leiden and prothrombin 20210 A mutations has been investigated in patients with central retinal vein occlusion (CRVO), hemispheric retinal vein occlusion (HRVO), and branch retinal vein occlusion (BRVO). METHODS: Factor V Leiden and prothrombin 20210 A were investigated in DNA obtained from the peripheral blood of 52 patients with retinal vein occlusion. Twenty-five of the patients had either CRVO or HRVO, and 27 patients had BRVO. The control groups for factor V Leiden and prothrombin 20210 A were comprised of two separate groups of 81 and 87 healthy individuals, respectively, who had been previously investigated for the mutations at Hacettepe University Department of Hematology. The frequencies of factor V Leiden and prothrombin 20210 A mutations were compared between the patients and the controls using Fisher's exact test. RESULTS: Factor V Leiden mutation was found in 8% of all patients, 4% of the CRVO-HRVO group and 11% of the BRVO patients. Prothrombin 20210 A mutation was not found in any of the patients. Factor V Leiden and prothrombin 20210 A mutations have been previously found in 7% and 2% of the healthy controls, respectively. The differences of frequencies between the patients and the controls were not statistically significant. CONCLUSION: Factor V Leiden and prothrombin 20210 A mutations have not been found to be risk factors in either type of retinal vein occlusion.

Adult↗
PubMed1999

Paget-Schroetter syndrome associated with FV:Q506 and prothrombin 20210A--a case report.

Effort thrombosis of the axillary-subclavian vein (Paget-Schroetter syndrome) develops usually secondary to heavy arm exertion. An underlying chronic venous compressive anomaly at the thoracic outlet or intimal damage of the axillary vein following forceful hyperabduction, external rotation of the shoulder joint has been proposed to explain the pathophysiology of this thrombosis. This condition is usually not attributed to an underlying hypercoagulability such as deficiency of natural coagulation inhibitors. Here, the authors present a case with thrombosis of the axillary-subclavian vein following an effort, with factor V Leiden and prothrombin 20210A mutations. Both factor V Leiden and the genetic variant in the prothrombin gene have been shown to confer an increased risk for venous thrombosis. Although rare, effort thrombosis may develop in a patient with hereditary thrombophilia, so laboratory evaluation should include the common causes of thrombosis.

Adult↗
PubMed1999

Changes of hemostatic factors in children with acute lymphoblastic leukemia receiving combined chemotherapy including high dose methylprednisolone and L-asparaginase.

In this study, protein C (PC), protein S (PS), heparin cofactor II (HCFII), prothrombin fragment 1+2 (PF 1,2), thrombin-antithrombin III complex (TAT), von Willebrand factor (vWF) and thrombomodulin (TM) were investigated in 19 patients with acute lymphoblastic leukemia, (ALL) receiving combined chemotherapy including L-asparaginase (L-ASP) and high dose methylprednisolone (HDMP). HDMP was administered in doses of 30 mg/kg/day for 7 days, and 20 mg/kg/day for another 7 days. In order to evaluate the effect of HDMP on the hemostatic system, the 8 patients studied here received HDMP (30 mg/kg/day) therapy for 4 days before the combined chemotherapy. These parameters were also studied in 12 healthy children as a control group. PC levels were normal in the patients while PS levels were decreased both before and after combined chemotherapies. Patients with ALL have laboratory signs of coagulation activation such as PF 1,2, TAT prior to initiation of chemotherapy. With combined chemotherapy, TAT levels were found to be normal while PF1,2 were not. TM levels were found to be increased both before and after therapies whereas HCFII and vWF levels were not different from those of the control group. The short course of HDMP therapy did not prominently influence these hemostatic parameters. These results indicate that both the malignant process and the drugs used in combined chemotherapy cause a decrease in natural inhibitors and an increase in procoagulant activity and endothelial injury. These hemostatic changes may contribute to a thrombotic tendency in the patients with ALL.

Adolescent↗
PubMed1998

Thrombomodulin levels in Behçet's disease with and without the factor V Leiden mutation.

The plasma levels of thrombomodulin (TM) in 34 patients with Behçet's disease and 79 healthy control subjects were studied. Eight patients had the factor V Leiden (FVL) mutation. The TM level was significantly lower in patients with the FVL mutation than in patients without the mutation and in the healthy controls (p < 0.05 and p < 0.01). However, there was no difference in overall mean plasma TM concentration between the patients without the mutation and the healthy controls.

Behcet Syndrome↗
PubMed1998

A comparison of the effect of high-dose methylprednisolone with conventional-dose prednisolone in acute lymphoblastic leukemia patients with randomization.

In this preliminary study the efficacy of high-dose methylprednisolone (HDMP) during remission-induction chemotherapy was evaluated on 166 children with acute lymphoblastic leukemia (ALL). The St. Jude Total Therapy Study XI protocol with minor modifications was used in this trial. Patients were randomized into two groups. Group A received conventional-dose (2 mg/kg/day orally) prednisolone, and group B received high-dose methylprednisolone (HDMP, Prednol-L, 900-600 mg/m2 orally) during remission-induction chemotherapy. Complete remission was achieved in 97% of the children. For the 80 patients who were followed up for 3 years, median follow-up was 44 (range 5-60) months and the 3-year event-free survival (EFS) rate was 68.5%) overall, 58.6% in group A and 78.4% in group B. The EFS among patients in group B was significantly higher than in group A (p=0.05). When we compared the 3-year EFS of groups A and B in the high-risk groups and high-risk subgroups with white blood cell (WBC) counts > or = 50 x 10(9)/l and age > or = 10 years, the survival rates were 45% versus 77.2%, 33% versus 78% and 45% versus 89%, respectively. During the follow-up of 162 patients, relapses were significantly higher in group A. Bone marrow relapses in 162 patients, and also in a subgroup of patients > or = 10 years of age were significantly higher in group A. These results suggest that HDMP during remission-induction chemotherapy improves long-term EFS, particularly for high-risk patients.

Adolescent↗
PubMed1998

Factor V Leiden mutation in patients with Behçet's disease.

OBJECTIVE: To determine the relation between factor V Leiden and Behçet's disease (BD), which is described as chronic relapsing vasculitis with pathogenetic mechanisms that seem to be related to anticoagulant pathways. METHODS: Using polymerase chain reaction, the factor V Leiden mutation was investigated in 44 patients with BD, of which 5 had thrombotic histories. RESULTS: Ten patients were found to have the factor V Leiden mutation. This frequency (22.7%) was higher than that of our general population (7.1 %) (p < 0.05). Of the 5 patients with BD with thrombotic histories, 3 (60%) had factor V Leiden mutation (one homozygote, 2 heterozygote), while 7 of 39 (17.9%) patients with no thrombotic history had the factor V Leiden mutation (2 homozygotes, 5 heterozygotes). There is no statistical difference in the frequency of the factor V mutation between patients with BD with no thrombosis and the control group. The frequency of thrombosis in BD with and without factor V Leiden mutation was (3/10) 30% and (2/34) 5.9%, respectively. CONCLUSION: These findings suggest that homozygosity or heterozygosity for factor V Leiden is not always associated with occurrence of venous thrombosis in BD, but it may be a contributing risk factor for venous thromboembolic events in these patients.

Adolescent↗
PubMed1997

Cerebral infarct associated with factor V Leiden mutation in a boy with hemophilia A.

An 11-year-old boy with mild hemophilia A was admitted to our hospital because of focal convulsions. Magnetic resonance imaging showed an old occipital infarct. Protein C, S, antithrombin III, anticardiolipin antibodies and fibrinogen were normal. Heterozygosity for factor V Leiden mutation was detected. We suggest that factor V Leiden mutation should be studied in hemophiliacs with thrombosis.

Cerebral Infarction↗
PubMed1997

Portal vein thrombosis in association with factor V Leiden mutation in a patient with hepatocellular carcinoma.

We report a case of hepatocellular carcinoma associated with portal vein thrombosis. Analysis of whole cellular DNA demonstrated heterozygosity for the factor V Leiden mutation. The patient also had marked protein C deficiency. The presence of the mutation associated with protein C deficiency may increase the risk of thrombosis in this patient with hepatocellular carcinoma.

Carcinoma, Hepatocellular↗