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Biomedical subjects

Ahmet Kaya

Publications and source records attributed to Ahmet Kaya.

11 recordsLinked to original sources

Open reduction and internal fixation in displaced juvenile Tillaux fractures.

BACKGROUND: Juvenile Tillaux fracture is relatively an uncommon injury for which there appears no established treatment protocol. MATERIALS AND METHODS: Ten patients with juvenile Tillaux fractures were treated by open reduction and internal fixation and the results were evaluated by an objective scoring system. RESULTS: At the latest follow-up (32-75 months) mean score was 99.3 (97-100) by the score of American Orthopaedic Foot and Ankle Society. Radiographically all fractures had healed in anatomical position. CONCLUSION: Treatment of juvenile Tillaux fractures with 2mm or more displacement by internal fixation without any attempt of closed reduction gives excellent results.

Adolescent↗

[Treatment of two-part proximal humeral fractures with external fixators].

BACKGROUND: We aimed to evaluate the results of the closed manipulation or transcutaneous reduction and external fixation in the treatment of two-part fractures. METHODS: Eight patients with two-part proximal humerus fractures who had been treated in our clinic with closed manipulation or transcutaneous reduction and external fixation between 1996-2001 were evaluated for this study. We evaluated the final functional status according to the Neer's classification system. RESULTS: Mean age of the patients was 42 (21-75) years. The major aetiologic factor was motor vehicle accident (in 5 cases). Follow-up time was 2 to 4.5 years. Mean union time was 16 weeks (10 to 24). Nonunion and avascular necrosis of the humeral head have not been observed in none of the cases. Superficial pin tract infection was developed in three cases. All of them were treated successfully with antibiotics. Functional results according to Neer's classification were as follows: 5 good. 2 fair and 1 failed. Mean score 77, 25 (50 to 89). CONCLUSION: External fixation of displaced two-part fractures of proximal humerus can be assessed as a reliable method with respect to satisfactory fracture reduction and stability, low rate of complications and good early functional results-obtained with this technique.

Accidents, Traffic↗

Assessment of anxiety in subclinical thyroid disorders.

It is well known that manifest thyroid dysfunction causes mood disorders. In the literature there are few studies related with subclinical thyroid dysfunction and anxiety. We aimed to determine if there exists a relation between the anxiety and subclinical thyroid dysfunction. This study was carried out in the Meram Medical Faculty of Selçuk University, Department of Endocrinology and Metabolism. Eighty-five outpatients were enrolled into the study. In the presence of normal fT(3) and fT(4), patients were grouped as subclinical hyperthyroid with TSH lower than 0.1 mU/L (n = 24), subclinical hypothyroid with TSH higher than 4.5 mU/L (n = 32) and euthyroid subjects (n = 29). Beck's Anxiety Inventory (BAI) was administered to all patients. There was no any statistically significant difference between euthyroid and study groups in terms of age, gender, weight and height (p<0.05). One-way ANOVA showed that both of the subclinical hypothyroid and subclinical hyperthyroid groups had significantly higher anxiety scores than euthyroid group (F: 11.4, p<0.001). Manifest hypothyroidism and hyperthyroidism, as causes of mental and neurological dysfunction have been known for a long time, but the relation between subclinical thyroid dysfunction and anxiety is less well studied. We have found that subclinical thyroid dysfunction increases the anxiety of patients whether hyperthyroid or hypothyroid. Overlap of symptoms common to both thyroid dysfunction and anxiety is an important limitation in this study. Mood changes especially anxiety due to subclinical thyroid dysfunction may have an important impact on the patient's quality of life. Negative effect on quality of life may be an indication of treatment in these patients. It is the first study evaluating anxiety in subclinical hypothyroidism in the literature.

Adult↗

Low serum total thyroxine and free triiodothyronine in patients with hepatic encephalopathy due to non-alcoholic cirrhosis.

PRINCIPLES: We evaluated serum thyroid hormone levels in non-alcoholic cirrhotic patients with and without hepatic encephalopathy. METHODS: 15 consecutive patients with hepatic encephalopathy secondary to non-alcoholic cirrhosis (8 males and 7 females, age 37-75 years) and 33 non-alcoholic cirrhotic patients without encephalopathy (22 males and 11 females, age 36-74 years) were investigated. A control group consisted of 20 healthy subjects (10 men and 10 women aged 26-69 years). The levels of serum triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), free T3 (FT3) and free T4 (FT4) were studied in serum samples drawn in the morning. Thyroid function tests were set in relation to the severity of hepatic dysfunction and to the presence or absence of hepatic encephalopathy. RESULTS: Serum levels of FT3 and total T4 (but not total T3 and FT4) were significantly lower in patients with hepatic encephalopathy compared to decompensated cirrhotic patients without encephalopathy (p = 0.006 for T4, P <0.05 for FT3). Prothrombin-time also differed significantly between decompensated cirrhotic patients (Child C) with and without encephalopathy groups (p = 0.002). CONCLUSIONS: These results suggest that patients with hepatic encephalopathy secondary to decompensated non-alcoholic cirrhosis are typified by low FT3 and low total T4, as well as by a prolonged prothrombin time. Low FT3 does not obviously put patients at risk for hepatic encephalopathy, and thyroid parameters are secondary and late events.

Adult↗

Contrast media-enhanced power Doppler sonography for evaluation of hemangiomas and malignant tumors in the liver.

AIM: To evaluate the characterization of liver hemangiomas and malignant tumors using power Doppler sonography before and after intravenous injection of a sonocontrast agent. METHODS: Forty-five patients with 57 liver tumors (22 hemangiomas, 24 metastases, 10 hepatocellular carcinomas (HCC) and one cholangiocellular carcinoma) were examined prospectively. The distribution (peripheral, central, mosaic) and extent (none, minimal, moderate and strong) of intratumoral flow pattern in each sonographic examination was subjectively classified. RESULTS: The administration of the sonocontrast agent by bolus injection caused enhancement to gradually increase up to 2 min and lasted for 4-5 min. After injection of contrast agent, flow signals appeared or increased in 34 tumors. No signal enhancement was observed in 18 hemangiomas, four metastases and one HCC. The sensitivity and specificity of intratumoral vascularity for the detection of malignant liver tumors was 37.1 and 90.9% for unenhanced power Doppler sonography, and 85.7 and 81.8% for contrast-enhanced power Doppler sonography, respectively. CONCLUSION: Contrast-enhanced power Doppler sonography is superior to unenhanced power Doppler sonography in the demonstration of malignant tumor vascularity, and is helpful in differentiating between hemangiomas and malignant liver tumors. A specific flow pattern within the tumor is not established in primary and metastatic malignant tumors with contrast-enhanced power Doppler sonography.

Adult↗

Rhabdomyolysis in a patient with hypothyroidism.

We describe a case of rhabdomyolysis associating hypothyroidism. Hypothyroidism frequently leads to myalgias, muscle stiffness, cramps and sometimes elevated levels of muscle enzymes, but rhabdomyolysis is quite rare. This report describes a case of rhabdomyolysis associating hypothyroidism in a 19-year old man. Muscle enzyme levels were typical of rhabdomyolysis. Muscle biopsy and electromyographic findings were compatible with hypothyroid myopathy. Muscle functions completely recovered with levothyroxine therapy. The present case represents rhabdomyolysis secondary to undiagnosed hypothyroidism in a developed stage which manifests itself with rhabdomyolysis.

Adult↗

Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothyroidism.

Bone turnover is reported to increase in favour of resorption in overt hyperthyroidism and the rate of resorption is associated with the levels of thyroid hormones. Hypothyroidism, on the other hand, was shown to cause no disturbance of calcium kinetics and found to associate lower trabecular resorption surfaces and increased bone cortical thickness. Similar studies are very rare in subclinical thyroid disorders and consequently we aimed to examine calcium and bone metabolism in subclinical thyroid disorders. Thirteen patients with subclinical hyperthyroidism secondary to untreated Graves' disease, 20 patients with subclinical hypothyroidism and 10 healthy subjects participated in this survey. Briefly calcium, phosphorus, and creatinine (Cre), urinary deoxypyridinoline (U-DPD) and serum osteocalcin (OC) were measured as biochemical markers for calcium metabolism. Concerning serum Ca and phosphorus levels, there were no differences between three of the groups, but urinary Ca excretion was higher in subclinical hyperthyroid patients compared to control and hypothyroid subjects. Hypothyroid patients had similar U-DPD levels with control subjects (p = 0.218). Serum OC and U-DPD were higher in subclinical hyperthyroid compared to control subjects (p<0.001 and p<0.001 respectively). We demonstrated a higher bone turnover and greater calcium excretion in subclinical hyperthyroid patients. Additionally, we found that subclinical hypothyroidism is not associated with disturbed calcium metabolism. As persistent increase in bone turnover is responsible for accelerated bone loss, patients with Graves' disease may have increased risk for osteoporosis.

Adult↗

Real-time sonography for screening of gallbladder motility in diabetic patients: relation to autonomic and peripheral neuropathy.

OBJECTIVES: Diabetes mellitus is known as one of the factors causing the cholesterol gallstone. Gallstone incidence is about 30% in diabetic patients over 20 years of age. Pathophysiology is still not clear. The aim of the present study was to investigate gallbladder (GB) functions in diabetic patients and determine its relationship with peripheral and autonomic neuropathy. DESIGN: Study was performed between October 2001 and may 2002 in fifty-one diabetic patients of similar age and weight. Diabetic patients (n=51) were chosen randomly among diabetic patients, who were being followed in Diabetes Out-patient clinics of Selcuk University, Meram Medical Faculty. Twenty-eight control subjects were chosen from healthy volunteers. We measured fasting and post-prandial gallbladder volumes and ejection fractions by real-time ultrasonography. The patients were divided into three groups; group A (n=18) had no diabetic autonomic and peripheral neuropathy, group B (n=13) had diabetic peripheral neuropathy, group C (n=13) had diabetic autonomic neuropathy. RESULTS: No significant difference in any biochemical parameters between diabetic and control group could be found. Fasting gallbladder volume was significantly higher in the diabetic group (5.31 +/- 0.28 cm(3)) compared to control group (4.19 +/- 0.25 cm(3), p<0.01). But there was no difference within diabetic subgroups. Gallbladder ejection fraction was significantly reduced in diabetic patients in groups B and C (29.7 +/- 1.43%, 28.7 +/- 1.28%) compared to group A (44.8 +/- 2.4%; p<0.05, p<0.025 respectively). CONCLUSIONS: Cholesterol crystal formation as a result of increased gallbladder volume and decreased ejection fraction in diabetic patients may result from hypotonicity and stasis and thus this may lead to gallstones.

Autonomic Nervous System Diseases↗

Gastric emptying in subclinical hyperthyroidism.

INTRODUCTION AND AIM: About 15% of hyperthyroid patients suffer from gastrointestinal symptoms such as diarrhea, constipation, nausea and early satiety the problem. Published reports on the topic of gastric emptying in hyperthyroidism are rare and discrepant in their results. PATIENTS AND METHODS: Thirteen patients (8 women, 5 male; aged 41.92+/-1.491 SE yr) with a recently established diagnosis of subclinical hyperthyroidism due to Graves-Basedow disease and as control group 10 age-matched healthy subject (7 women, 3 male; 39.6+/-2.918 SE yrs) participated in this study. Scintigraphic method (food labeled with 99mTc sulfur colloid) was used for measurement of gastric emptying. RESULTS: Gastric emptying time was similar in both subclinical hyperthyroid and control groups (p=0.413). DISCUSSION: There are few studies on the subject of gastric emptying in hyperthyroidism with either delayed emptying or with emptying time similar to controls. In the only one study in subclinical hyperthyroidism, gastric emptying was found to be delayed. We also found that gastric emptying was delayed in subclinical hyperthyroidism. On the basis of this and other studies, we may suggest that in subclinical hyperthyroidism, gastric emptying of solids were similar to that in age-matched healthy control subjects and gastrointestinal dysfunction is dependent on severity of the hyperthyroid state and might be a result of impaired neuro-hormonal regulation. Yet the data must be supported on larger groups.

Adult↗