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Biomedical subjects

A Yilmaz

Publications and source records attributed to A Yilmaz.

At least 55 records · Page 3Linked to original sources
PubMed2001

Cell type accuracy of transthoracic fine needle aspiration material in primary lung cancer.

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of transthoracic fine needle aspiration (TFNA) materials in establishing the specific cell type in primary lung cancer, and to study the influence of several factors on this accuracy. METHODOLOGY: The present study included 129 patients [(12 females, 117 males; mean age 54.6 years (range 25-75)] who underwent thoracotomy. The initial diagnosis was obtained by means of TFNA biopsy in all patients. Transthoracic fine needle aspiration was performed by 22-gauge Chiba needle with fluoroscopy guide in 93 patients and with computed tomography guide in 36 cases. RESULTS: The overall concordance was 73.6% (Kappa = 0.52). The worst agreement was obtained for the large cell carcinoma (40%; Kappa = 0.48). The likelihood of a correct diagnosis using the TFNA specimens was 6.2-fold higher for well-differentiated tumours than for poorly differentiated tumours (P < 0.005). The stage of tumour and diameter of the lesion had no effect on cell agreement. Cell agreement was higher in central lesions than peripheral lesions, but the difference was not statistically significant (P = 0.097). This difference was more significant between patients with central and peripheral epidermoid carcinoma (P = 0.057). CONCLUSION: In our opinion, cell typing by TFNA may lead to incorrect results in the presence of poor differentiation, mixed tumours and peripheral epidermoid carcinomas.

Adult↗
PubMed2001

The value of Ca 125 in the evaluation of tuberculosis activity.

The aim of the present study was to investigate the value of Ca 125, a tumour marker, in evaluation of pulmonary tuberculosis activity. This study included 96 subjects who were divided into three groups. Group 1 consisted of 40 patients with active pulmonary tuberculosis. Group 2 included 20 patients with inactive pulmonary tuberculosis. There were 36 healthy subjects in group 3. While measurement of serum Ca 125 level was performed only once in groups 2 and 3, Ca 125 levels were measured five times in group 1. The measurements were performed before the treatment, at the second, fourth and sixth months and the third year following the end of the treatment. Mean +/- SD serum Ca 125 concentrations were 109.7 +/- 86.9 U ml(-1) in group 1, 14.5 +/- 7.8 U ml(-1) in group 2 and 10.5 +/- 7.3 U ml(-1) in group 3. Serum Ca 125 levels were significantly higher in group 1 than in the other groups (P < 0.0001), but there was no significant statistical difference between the values of groups 2 and 3 (P > 0.05). Ca 125 levels in group 1 showed a significant decrease after treatment (P < 0.0001). For estimation of the activity of tuberculosis, the sensitivity and specificity of Ca 125 were found 97.5% and 100%, respectively at a 31 U ml(-1) cut-off point. Our results suggest that Ca 125 is beneficial in the determinaton of tuberculosis activity and in differentiation between active and inactive pulmonary tuberculosis.

Acute Disease↗
PubMed2001

Delays in the diagnosis and treatment of hospitalized patients with smear-positive pulmonary tuberculosis.

The aim of present study was to investigate whether there was any delay in the diagnosis and treatment of inpatients with smear-positive pulmonary tuberculosis followed-up in our centre. We reviewed clinical records in February 1999 and identified 134 hospitalized patients with smear-positive pulmonary tuberculosis. Clinical files of the patients were analysed and a questionnaire was completed. Several intervals and delays were calculated. Median application interval was 17.5 days [95% confidence interval (CI) 21.3-32.4 days], median referral interval was 3.5 days (95% CI 6.8-11.4 days), median diagnosis interval was 3 days (95% CI 3.3-4.5 days) and median initiation of treatment interval was 1 day (95% CI 1.1-1.6 days). Patients delay was present in 28.4% of cases. The referral interval was longer than 2 days in 82 patients (institutional delay). Ninety-three patients (69.4%) had delays in the diagnosis and 34 patients (25.4%) had delays in the treatment. There was a doctor's delay in 119 of 134 patients (88.8%) and clinic's delay in 98 patients (73.2%). Our results have suggested that hospitalized patients with smear-positive pulmonary tuberculosis experience several delays. These delays may result in increased risk for transmission of infection. Decrease in the risk of infection for community and medical personal may only be obtained by preventing these delays.

Adolescent↗
PubMed2001

Efficacy of inhaled budesonide and oral theophylline in asthmatic subjects.

The aim of present study was to evaluate clinical, functional, and anti-inflammatory effects of inhaled budesonide and oral theophylline treatments in patients with mild to moderate asthma. The study included 38 patients. After a 10-day run-in period, the patients were randomly assigned into two groups. Group 1 received inhaled budesonide (Pulmicort Turbuhaler) 800 microg/day for 4 weeks. Group 2 received oral theophylline (Talotren tablets, 200 mg twice daily) for 4 weeks. Inhaled budesonide therapy was accompanied by a significant decrease in serum interleukin (IL)-5 levels (p < 0.0005) and blood, sputum, and nasal eosinophil counts (p < 0.005). It produced a significant reduction in daytime (p < 0.01) and nighttime (p < 0.005) symptom scores and an increase in morning (p < 0.005) and evening (p < 0.05) peak expiratory flow (PEF) and forced expiratory volume in I sec (FEV1) values (p < 0.01). Theophylline therapy was associated with a significant decrease in blood (p < 0.02) and nasal (p < 0.01) eosinophil counts and serum IL-5 levels (p < 0.01). It resulted in significant improvements in daytime and nighttime symptom scores (p < 0.05), and morning PEF and FEV1 values (p < 0.05). These changes were more significant in group I than in group 2. There was no statistically significant difference between the two groups with respect to post-treatment values. Our results confirm the role of inhaled corticosteroids in the treatment of asthma and are consistent with the recommendation that theophylline exerts an anti-inflammatory effect. Further studies should be conducted to determine long-term benefits of theophylline.

Administration, Inhalation↗
PubMed2001

Usefulness of various diagnostic techniques during fiberoptic bronchoscopy for endoscopically visible lung cancer: should cytologic examinations be performed routinely?

BACKGROUND: The question of which combination of procedures gives the best diagnostic yield following fiberoptic bronchoscopy is controversial. OBJECTIVES: To evaluate the value of various diagnostic techniques following fiberoptic bronchoscopy in the diagnosis of endoscopically visible lung cancer. METHODS: The study included 98 patients found to have endobronchially visible tumor during routine daily bronchoscopy. Endobronchial lesions were classified as mass, submucosal lesion and infiltration. Washings, brushings and forceps biopsies were obtained in all subjects. Transbronchial needle aspirations were performed in 67 of 76 cases with mass or submucosal lesions. RESULTS: Bronchoscopy was diagnostic for cancer in 88 (89.8%) of the 98 patients. Forceps biopsy specimens gave positive result in 82.7% of cases, transbronchial needle aspirates in 68.6%, brushings in 68.4%, and washings in 31.6%. Combination of forceps biopsy and brushing cytology yielded a positive result for lung cancer in 87 patients. The addition of brushings increased the diagnostic yield of bronchoscopy from 82.7% to 88.8% (p < 0.05). Collection of washing specimens in addition to forceps biopsy did not increase the yield of forceps biopsy. Transbronchial needle aspiration gave an additional yield of 1%. CONCLUSIONS: Routine cytological examination of bronchial washings does not increase the yield of forceps biopsy specimens. Transbronchial needle aspiration may give an additional positive yield to forceps biopsy. We conclude that a combination of forceps biopsy and brushing is the best strategy in the diagnosis of bronchoscopically visible lung cancer.

Adult↗
PubMed2001

Implications of proposed changes in bulk tank somatic cell count regulations.

Several changes in bulk tank SCC (BTSCC) regulations were proposed at the 1998 annual meeting of the National Conference of Interstate Milk Shippers (NCIMS) by the National Mastitis Council and other proponents. Proposals included 1) using a geometric mean BTSCC in place of the arithmetic mean, reducing the current limit for BTSCC from 750,000 to 400,000, and modifying current regulatory protocols. The purpose of this research was to evaluate possible impacts of proposed changes upon producers in warm climates. Data were monthly BTSCC values, provided by state regulatory agencies in West Texas, Louisiana, and Mississippi. Fifty producers from each state were selected by lot, and all 1998 monthly records were included (n = 1602). Computer simulation was used to compare regulatory actions that would have resulted under current and proposed regulations. Possible regulatory actions were 1) notification of noncompliance and 2) suspension of permits to sell milk. At the 750,000 BTSCC limit, both programs resulted in 41 regulatory actions, but the proposed program had a higher rate of suspensions to notices. A twofold increase in regulatory actions per 100,000 incremental decrease in BTSCC limit below 750,000 resulted under both programs. Actual results could be lower due to the assumption that no management adjustments were made by producers in response to changes in regulations. However, the magnitude of increased actions against producers indicated that lowering limits quickly could be disruptive if producers failed to adjust management quickly and effectively to comply with lower limits.

Animals↗
PubMed2000

The relation between event related potential and working memory in healthy subjects.

In numerous investigations the P300-component of the event related potential has proved a valid indicator of memory activities. The present study explores the amplitude and latency of the components of event-related potential regarding short-term memory task. Event related potentials, elicited by auditory stimuli, were recorded in 40 healthy subjects. For evaluating short term memory capacity of a subject, software in Delphi for Windows language was written. Algorithm of the software was the presentation of randomly selected four different digits for 4 seconds, removing it and waiting for subject's response, adding one digit, if response was true, otherwise decreased by one. After 20 trials, mean of recall time for true answers was computed. The subjects with high recall time showed prolonged latency of P300. A positive correlation was found between P300 latency and recall time. No correlation was found between N1, P2 and N2 latency or amplitude and recall time. These results suggest that memory problems are well correlated with the abnormalities of P300.

Adult↗
PubMed2000

A comparative analysis of the biochemical parameters used to distinguish between pleural exudates and transudates.

OBJECTIVE: The aim of the present study was to compare the various parameters used to identify exudates. METHODOLOGY: The study included 255 patients with pleural effusions. According to aetiological diagnosis, 105 pleural effusions were labelled as transudates and 150 were labelled as exudates. RESULTS: Using the criteria of Light et al., 94.5% of the effusions were correctly classified, yielding a sensitivity and specificity of 99.3% and 87.6%, respectively. Use of the pleural fluid/serum bilirubin ratio produced results of 92.9%, 90.7%, and 96.2%, respectively. Using pleural fluid cholesterol level yielded results of 95.7%, 95.3%, and 96.2%, respectively. When the combination of pleural fluid cholesterol level and lactate dehydrogenase (LDH) level was used, the specificity and accuracy were found to be higher than that using the criteria of Light et al. We found that there was no significant difference among the parameters with respect to accuracy. CONCLUSION: When the accuracy and cost are considered, differentiation of pleural exudates and transudates can be achieved only by pleural fluid cholesterol level or LDH level; and when two parameters were used together, the accuracy and specificity were higher than that using the criteria of Light et al.

Adult↗
PubMed1999

Deaths among homeless people in Istanbul.

The number of the homeless people in Istanbul, one of the largest cities in the world, is at present unknown. There has been no previous study in Turkey on cases and causes of death occurring among these individuals. In this paper, documents and autopsy reports of the Mortuary Section of the Council of Forensic Medicine, Istanbul, covering the period January 1st, 1991-December 31st, 1995, were reviewed. We established that there were 126 cases of death among homeless individuals in Istanbul during this period, 120 of them being males (95%), four (3%) females, and two (2%) transsexuals. Ninety-four corpses were found outdoors, 32 indoors. No personal documents, such as identity cards, were found in 110 individuals (87%), whereas only 16 individuals could be identified. Most deaths occurred in the age group of 41-50 years. One hundred and three of the cases (82%) died in the cold season between October and April. The deaths of 98 cases were attributable to natural causes, whereas the remaining 28 cases died from unnatural causes. Respiratory tract diseases occupied the first rank among cases of death from natural causes (44%). Alcohol abuse and other infections were further striking factors contributing to the fatal outcome. This is the first retrospective study on this topic in Turkey. However, more detailed and anterospectively programmed studies on this subject, a growing social problem, should be carried out.

Adult↗
PubMed1999

The effect of alpha-lipoic acid on the neurovascular reflex arc in patients with diabetic neuropathy assessed by capillary microscopy.

Patients with diabetic polyneuropathy are known to have an impaired neurovascular reflex arc compared to healthy controls. This is seen in a delayed decrease in microcirculation of the ipsilateral hand after cooling of the contralateral hand. The aim of this pilot study was to investigate whether intravenous alpha-lipoic acid (ALA) (Thioctacid, Asta Medica) therapy might be able to improve this impaired neurovascular reflex arc in patients with diabetic neuropathy. In addition, clinical effects were evaluated with the aid of the neuropathy symptom score (NSS) and the neuropathy disability score (NDS). Ten patients with diabetes mellitus and polyneuropathy (5 females, 5 males, 2 smokers, 5 IDDM, 5 NIDDM, body mass index 26.1 +/- 1.0 kg/m2, age 58.3 +/- 9.5 years, diabetes duration 15.7 +/- 11.2 years, Hb A1c 6.8 +/- 0.3%) were investigated by nail-fold capillaroscopy after contralateral cooling before and after intravenous therapy with 600 mg alpha-lipoic acid per day over 3 weeks. Cardiac autonomic neuropathy was excluded by beat-to-beat variation analysis. Symptoms of diabetic neuropathy were evaluated before and after therapy with the aid of the NSS and NDS. Capillary blood cell velocity (CBV) of the hand was determined before, during, and for the following 30 min after cooling (3 min at 15 degrees C) of the contralateral hand. Blood pressure, heart rate, and local skin temperature were monitored at 2-min intervals. ALA therapy resulted in a significant improvement of the microcirculatory response to cooling, as seen by an immediate decrease in CBV of 12. 3% (P < 0.02 vs before treatment), which was absent before therapy. Blood pressure, heart rate, and local skin temperature were not different between investigations. There was a significant improvement of the NSS after therapy (5.4 +/- 1.1 vs 8.6 +/- 1.1 points, P < 0.01). These results demonstrate that intravenous therapy with ALA has a positive influence on the impaired neurovascular reflex arc in patients with diabetic neuropathy.

Adult↗
PubMed1999

Influence of transition metal ions on NMR proton T1 relaxation times of serum, blood, and red cells.

The spin-lattice relaxation rates (1/T1) of serum, whole blood, and red cells were measured vs several concentrations of transition metal ions. For comparative purposes, the similar experiments were repeated in water. The rates show a linear dependence on concentration of each ion for water, but nearly a linear dependence for blood and its constituents. The influence of each ion on 1/T1 in a sample was expressed by the slope (relaxivity) of the least-squares fitting of 1/T1 vs ion concentration. The relaxivities of Mn(II) in serum and of Fe(III) in serum and blood are greater than those in water, whereas the relaxivities of these ions in the other cases and of all the other ions in call cases are smaller than those in water. However, the relaxivity data show that Cr(III) in serum and blood affects the 1/T1 rates. The ratio of relaxivity of each sample to that of water is known as proton relaxation enhancement (PRR) factor (epsilon). The epsilon factors for present data suggest that the added ions are bound to proteins, and only Mn(II) in serum and Fe(III) in blood and serum are accessible to water.

Blood↗
PubMed1999

The effect of direction on saccadic eye movement parameters.

The present study obtained saccadic eye movements from 25 right-handed normal subjects (aged 18-35 yr, mean 22.4 yr) to examine the effects of saccade direction on saccadic parameters (latency, duration and average velocity). Binocular saccadic eye movements were recorded with a direct-current electrooculographic system, and analysis was performed on a laboratory digital computer. The LED target positions were randomly selected 10, 15, 20, 25 and 30 degrees to the left or right of the fixation points. In general, the mean values of the saccadic parameters over large saccade angles were in agreement with those previously reported. There were no significant differences between saccades directed to the right and to the left.

Adolescent↗
PubMed1999

Reproductive performance of bulls divergently selected on the basis of blood serum insulin-like growth factor I concentration.

The objectives of this study were to examine differences in scrotal circumference, sperm motility, and percentage of normal sperm cells between two lines of Angus beef cattle divergently selected for blood serum IGF-I concentration. Data were obtained from an ongoing experiment involving 100 spring-calving (50 high and 50 low line) and 100 fall-calving (50 high and 50 low line) purebred Angus cows. Scrotal circumference, percentage of motile sperm cells, and percentage of normal sperm cells did not differ between high and low IGF-I line yearling bulls (P = .79, .50, and .56, respectively). The IGF-I concentrations measured at d 28, 42, and 56 of the postweaning test are abbreviated as IGF28, IGF42, and IGF56, respectively. Coefficients for the quadratic regression of scrotal circumference on IGF28 and IGF42 tended to be negative (P = .07 and .08, respectively), as did the coefficient for the quadratic regression of the percentage of motile sperm cells on IGF42 (P = .08). The coefficient for the linear regression of percentage of normal sperm cells on IGF28 was positive (P = .02). The coefficient for the quadratic regression of percentage of normal sperm cells on IGF56 was negative (P = .04). Coefficients for the quadratic regression of scrotal circumference and percentage of normal sperm cells on mean IGF-I concentrations were negative and important (P = .04 and .08, respectively). Thus, scrotal circumference and percentage of normal sperm cells are related to blood serum IGF-I concentration in yearling Angus bulls.

Animals↗
PubMed1998

Pulse treatment of human vascular endothelial cells with high doses of tumor necrosis factor and interferon-gamma results in simultaneous synergistic and reversible effects on proliferation and morphology.

Regional administration of high doses of tumor necrosis factor (TNF), interferon gamma (IFNgamma) and melphalan to patients with advanced cancers of the limbs, results in rapid and specific tumor necrosis, while the normal adjacent tissues remain unaffected. The tumor vasculature is selectively destroyed by this treatment, and neovascular endothelial cells appear to be an early and specific target of TNF and IFNgamma. To further understand some of the cellular events underlying these in vivo effects, we have investigated the response of human macro- and microvascular endothelial cells in vitro, after exposure to high doses of TNF and IFNgamma (up to 40 x 10(3) U/ml each). TNF and IFNgamma synergistically inhibited endothelial-cell proliferation by up to 80% after 72 hr of treatment. Achievement of synergy required the simultaneous presence of both cytokines. A cytokine pulse as short as 30 min was sufficient to induce maximal growth inhibition measured after 48 hr. Both cytokines also induced progressive and dose-dependent elongation of the endothelial-cell morphology. The effects on endothelial-cell proliferation and morphology were reversible upon removal of the cytokines. Moreover, replating of treated cells onto a fresh substrate immediately resulted in re-acquisition of their normal shape. In contrast to the effect on cell proliferation, there was little or no effect on the rate of endothelial-cell apoptosis. The presented data extend reports on the effects of TNF and IFNgamma on human endothelial cells in vitro, and suggest that the in vivo disruption of the tumor vasculature caused by high doses of TNF and IFNgamma is not due to a direct cytotoxic effect on endothelial cells but occurs through an indirect mechanism.

Apoptosis↗
PubMed1998

Firearm fatalities in Edirne, 1984-1997.

During the 14-year period from 1984 to 1997 there were 85 firearm fatalities investigated by the Department of Forensic Medicine and the Department of Pathology in Edirne, Turkey. We determined the characteristics of these 85 firearm deaths which comprised 17.03% of all medicolegal autopsies. The overall incidence was 1.58 per 100,000 population. The median age was 35.5 years. Fifty-four percent of the victims were aged between 20 and 40 years. Males constituted 82% of the victims. The most frequent manner of death was homicide (68.3%). Handguns accounted for 62.4% of the weapons used. The most common sites for the firearm entrance wounds were both head-neck-nape (32.8%) and chest (32%). In conclusion, our study shows that, in spite of legal restrictions, illegal access to firearms is easy and deaths by firearms are still increasing.

Adolescent↗
PubMed1998

Selective suppression of cytokine secretion in whole blood cell cultures of patients with colorectal cancer.

We have investigated the secretion of interferon alpha (IFN-alpha), IFN-gamma, interleukin-1alpha (IL-1alpha), IL-1beta, IL-2 and tumour necrosis factor alpha (TNF-alpha) in whole blood cell cultures (WBCCs) of colorectal cancer patients upon mitogen stimulation. Whereas the values for IL-1beta and TNF-alpha remained virtually unchanged in comparison with healthy control subjects, WBCCs of colorectal cancer patients secreted significantly lower amounts of IFN-alpha (P < 0.005), IFN-gamma (P < 0.0001), IL-1alpha (P < 0.0001) and IL-2 (P < 0.05). This reduction correlated with the progression of the disease. The total leucocyte and monocyte population were almost identical in both groups. In contrast, a dramatic depletion of lymphocytes was observed in colorectal cancer patients, which affected both lymphocyte counts (P < 0.0005) and their distribution (P < 0.0001). Our results suggest a selective suppression of cytokines in colorectal cancer patients that is related to tumour burden. Several mechanisms might account for this phenomenon, one of which might be lymphocyte depletion.

Adult↗
PubMed1998

Evidence for the involvement of endothelial cell integrin alphaVbeta3 in the disruption of the tumor vasculature induced by TNF and IFN-gamma.

Administration of tumor necrosis factor (TNF) and gamma interferon (IFN-gamma) to melanoma patients causes selective disruption of the tumor vasculature but the mechanism of this disruption is unknown. Here we report that exposure of human endothelial cells to TNF and IFN-gamma results in a reduced activation of integrin alphaVbeta3, an adhesion receptor that plays a key role in tumor angiogenesis, leading to a decreased alphaVbeta3-dependent endothelial cell adhesion and survival. Detachment and apoptosis of angiogenic endothelial cells was demonstrated in vivo in melanoma metastases of patients treated with TNF and IFN-gamma. These results implicate integrin alphaVbeta3 in the anti-vascular activity of TNF and IFN-gamma and demonstrate a new mechanism by which cytokines control cell adhesion.

Apoptosis↗