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B Cakir

Publications and source records attributed to B Cakir.

At least 19 recordsLinked to original sources

Cardiovascular risk factor levels in a lower middle-class community in Ankara, Turkey.

STUDY OBJECTIVE: To assess the prevalence of risk factors for coronary heart disease (CHD) in a lower middle-class urban community of Turkey. DESIGN: Cross-sectional study in an age- and sex-stratified random community sample with equal sample size per stratum. Direct age-standardization using the standard world population to allow international comparison of findings. Logistic regression modelling to identify risk factors for obesity. SETTING: Gülveren, a residential area in Ankara, total population 23,000 persons. PARTICIPANTS: A total of 1672 adults aged 25-64 years and resident in the study community were interviewed, 1272 (76.1%) of those came for physical examination. MAIN RESULTS: The age-standardized prevalence of hypertension according to WHO MONICA criteria was 18.6% (95% confidence interval: 16.1-21.1%) among women and 12.3% (9.7-14.9%) among men; of obesity (body mass index, BMI > or =30 kg/m2) 51.0% (47.6-54.3%) among women and 15.1% (12.0-18.2%) among men; of current smoking 20.1% (17.5-22.6%) among women and 64.8% (61.4-68.2%) among men; of hypercholesterolaemia 20.1% (17.4-22.9%) among women and 13.8% (10.8-16.8%) among men; and of low high density lipoprotein (HDL) 48.4% (44.8-52.1%) among women and 40.6% (36.0-45.2%) among men. In the regression model, age, female sex, non- and ex-smoking were associated with obesity. CONCLUSIONS: The prevalence of smoking, obesity and low HDL is high in this urban, lower middle-class population, even in comparison with industrialized countries. Unexpectedly, women have less favourable CHD risk profiles than men, except for smoking. Preventive action should be community-wide and address the common risk factors simultaneously to avoid replacement effects such as becoming obese after quitting smoking.

Adult↗

Distribution of Lewis (FUT3)genotype and allele: frequencies in a biethnic United States population.

The objective of the study was to examine the prevalence and distribution of four major single nucleotide polymorphisms (SNPs) (T59G, T1067G, T202C, and C314T) of the Lewis ( FUT3)gene in a biethnic United States population. This population-based cross-sectional study was based on data from the Atherosclerosis Risk in Communities (ARIC) Study, which included 761 males and females aged 45-64 years, who had no known/detected clinical atherosclerotic disease (577 Caucasians, 184 African Americans). The main outcome measures were prevalence of the Lewis genotype and allele frequencies for four SNPs of the FUT3gene. The most common genotype was the "wild type" at all four nucleotide positions ( WWWW), which was found to be present in 46.9% of ARIC participants. At least one mutant allele was detected in 51.7% of Caucasians, and 56.7% of African Americans ( P=0.59). The frequencies of mutant alleles ranged from 6.3% to 18.4% at the four FUT3gene sites examined. The distribution of the Lewis genotype and allele frequencies differed significantly by ethnicity at sites 59, 202, and 314. The prevalence of the Lewis genotype suggesting a lack of alpha(1,3/1,4) fucosyltransferase activity was 11.6% in Caucasians and 9.9% in African Americans ( P=0.67). Four specific SNPs of the Lewis genotype are common in the population at large. However, these four SNPs seem to fail to explain the majority of Lewis-negative phenotype in African Americans, given that Lewis-negative genotype prevalence was about one-third of what was expected. Use of rapid DNA sequencing and simultaneous Lewis phenotype determination could avoid the problems associated with haplotype determination and Lewis genotype grouping. Further studies testing SNPs of the Lewisgene are warranted, in particular among African Americans.

Age Factors↗

Asymptomatic choroid plexus cysts in the lateral ventricles: an incidental finding on diffusion-weighted MRI.

We assessed the role of diffusion-weighted imaging (DWI) in the detection of choroid plexus cysts. We reviewed more than 1000 patients who had undergone MRI in a 1-year period. We reviewed echo-planar DWI with b=1000 s/mm(2), acquired at 1.0 tesla, for any difference in signal intensity which might indicate choroid plexus cysts. On conventional images, all cystic lesions were isointense with cerebrospinal fluid, and 72 cysts could not be identified. On DWI, 90 rounded high-signal foci were detected in 58 patients; 64 cysts were bilateral. Focal ventricular expansion due to large cysts was observed in nine cases. DWI were found to show choroid plexus cysts undetected within the cerebrospinal fluid on conventional images.

Brain Diseases↗

Secondary osteoporosis in women. A retrospective analysis.

Secondary osteoporosis comprises a minority of all osteoporosis cases. In this study we summarize the causes of secondary osteoporosis we encountered in patients currently on follow-up in our osteoporosis outpatient clinic. A total of 1015 female patients are involved in the study. Recorded data of the patients are evaluated retrospectively. Patients with spine bone mineral density (BMD) 2.5 standard deviation below a reference range established using our own data obtained from a Turkish population of normal healthy women using dual energy X-ray absorptiometry (T score less than -2.5) were accepted as having osteoporosis. We detected osteoporosis in 384 (38%) of the female patients. A secondary cause for osteoporosis has been found in 33 (8.6%) of the 384 osteoporotic patients. Thyrotoxicosis (n=10), parathyroid adenoma (n=10), and glucocorticoid administration (n=7) constituted 82% of the causes of osteoporosis. The data obtained in our study indicate that appropriate search for secondary causes of osteoporosis is essential because different modalities are needed for treatment.

Absorptiometry, Photon↗

Effects of aminoguanidine and tolrestat on the development of ocular and renal structural changes in experimental diabetic rats.

Studies that researched the role of aminoguanidine and tolestat in the prevention of diabetic retinopathy and nephropathy resulted in conflicting data. We investigated the effects of these agents in the prevention of ocular and renal changes in streptozotocin (STZ)-induced diabetic rats. Diabetes was induced by intravenous injection of STZ in 30 rats. Ten rats that were not given STZ served as non-diabetic control (Group 1). Ten STZ-diabetic rats that were not given any treatment served as diabetic control (Group 2). Groups 3 and 4 were composed of STZ-induced diabetic rats (10 each) that were given tolrestat and aminoguanidine respectively. Eyes and kidneys were examined at the 24th week under electronmicroscopy. Cataract was observed in all six of the surviving rats in Groups 2 and 4, and in one of 6 surviving rats in group 3. Cataract development was lower in Group 3 than Groups 2 and 4. All retinal samples obtained from group 2 demonstrated a number of structural abnormalities, whereas there were no significant ultrastructural changes in groups 3 and 4. Groups 2 and 3 demonstrated mesangial proliferation and expansion, diffuse glomerular basement membrane (GBM) thickening, and focal GBM thickening in the bulb form. Group 4 demonstrated a normally appearing mesangial space, minimal diffuse but no focal GBM thickening. The urinary albumin excretion (UAE) was lower in Group 4 than the other groups. In conclusion, our results suggest that aminoguanidine may be an important agent for the prevention of renal changes, whereas tolrestat may be effective for the prevention of ocular changes in diabetes mellitus.

Aldehyde Reductase↗

Nocturnal enuresis and upper airway obstruction.

PURPOSE: The purpose of this paper is to investigate the relationship between nocturnal enuresis (NE) and upper airway obstruction (UAO) in pediatric population. MATERIAL AND METHODS: This study presents the results of our experience with 321 children who underwent adenotonsillar surgery. RESULTS: Among 321 children who were operated on, 111 (35%) had NE. Seventy-four of the 111 children who had NE have been evaluated postoperatively. After a follow-up period of 3 months 47 (63%) patients were free of their complaints, while three (4%) of them reported decrease in the frequency of NE and 24 had no change in their complaints. CONCLUSIONS: We do suggest that UAO is probably a more common etiological factor in NE than previously recognised.

Adenoids↗

Synthesis and antinociceptive activity of [(2-oxobenzothiazolin-3-yl)methyl]-4-alkyl/aryl-1,2,4-triazoline-5-thiones.

The synthesis and pharmacological evaluation of new [(2-oxobenzothiazolin-3-yl)methyl]-4-alkyl/aryl-1,2,4-triazoline-5-thiones are reported. All compounds were screened for analgesic and antiinflammatory activities by using the AcOH induced-stretching test, the hot plate test, the tail clip test, and the tail flick test. All of the title compounds showed more potent activity than the standard compound aspirin in the AcOH induced-stretching test. In the hot plate test [(2-oxobenzothiazolin-3-yl)methyl]-4-phenethyl-1,2,4-triazoline-5-thione 5j were revealed to be two-fold more potent in antinociceptive activity than novalgine. However, in the tail flick and tail clip test none of the compounds showed an antinociceptive activity as high as that of novalgine. On the basis of available data the structure-activity relationship in the [(2-oxobenzothiazolin-3-yl)methyl]-4-alkyl/aryl-1,2,4-triazoline-5-thiones was also discussed.

Analgesics↗

Squamous cell carcinoma of the lip. Patterns of relapse and outcome: Reporting the Westmead Hospital experience, 1980-1997.

Australia has one of the highest rates of squamous cell carcinoma of the lip in the world. Despite a high cure rate, many studies report relapse rates of between 5% and 20% with an associated mortality of 5-10%. The aim of this study was to review the patterns of relapse and outcome for patients treated at Westmead Hospital, Sydney. Ninety-three eligible patients were identified in a retrospective review of all lip cancer patients referred to Westmead Hospital between 1980 and 1997. Relevant data were extracted from the treatment files and included contact with referring doctors and utilizing the Cancer Council Registry. Equal numbers of patients were treated with radiotherapy alone or surgery (+/- adjuvant radiotherapy). The majority of patients were male (78.5%) with T1N0 cancers (64.5%) of the lower lip. A minority (5.4%) had nodal disease at diagnosis. Following treatment, 31 (33.3%) patients relapsed, 11 at the primary site, 18 at the regional nodes and two at both sites simultaneously. Patients treated with a combined approach (RTx/Sx) experienced a better outcome. Overall cancer-specific survival at 5 years was 85%. These findings highlight a disturbing relapse rate and mortality for a subgroup of patients diagnosed with a more aggressive form of lip cancer. Treatment and follow up of these patients should accordingly be more aggressive.

Adult↗

Effects of granulocyte-colony stimulating factor in the treatment of diabetic foot infection.

AIMS: Foot infections and the subsequent amputation of a lower extremity are the most common cause of hospitalization among patients with diabetes mellitus. Although there are several reasons for susceptibility to infection in diabetic patients, white blood cell dysfunction is considered to be an important cause for this tendency. Granulocyte-colony stimulating factor (G-CSF) increases the release of neutrophils from the bone marrow and improves neutrophil functions. Based on this knowledge, the aim of the present study was to investigate the effects of addition of G-CSF to the treatment of foot infections in diabetic patients. METHODS: Thirty diabetic patients with foot infection were included in the study. Fifteen of the patients received standard treatment consisting of local wound care and antibiotics (standard group), and the other 15 patients received G-CSF besides standard treatment (G-CSF group). The objectives of this study were to determine the time to resolution of infection, time to hospital discharge, need for surgical intervention, and the effects of G-CSF on phagocytosis and respiratory burst of neutrophils. RESULTS: Treatment with G-CSF led to significantly higher neutrophil counts on the 5th and 10th days, and at the end of treatment in the G-CSF treated group compared to the standard group. Respiratory burst of neutrophils increased significantly in both the G-CSF group (from 1.6 +/- 0.3 to 2.3 +/- 0.5, p = 0.001) and the standard group (from 2.0 +/- 0.4 to 2.3 +/- 0.4, p = 0.02) with treatment. But, while phagocytosis of neutrophils increased significantly in the G-CSF group (from 70.4 +/- 2.0 to 74.5 +/- 1.9, p = 0.004), it did not change significantly in the standard group (from 68.1 +/- 0.2 to 69.4 +/- 1.9, p = 0.3) with treatment. Duration of hospitalization (26.9 +/- 2.0 vs. 28.3 days, p < 0.05), duration of parenteral antibiotic administration (22.9 +/- 2.0 vs. 23.3 +/- 1.9 days, p < 0.05), time to resolution of infection (23.6 +/- 1.8 vs. 22.3 +/- 1.7 days, p < 0.05), and need for amputation (13.3% vs. 20%, p > 0.05) were similar between the G-CSF and the standard groups. CONCLUSIONS: Although G-CSF improves neutrophil function as well as increasing the absolute numbers, this improvement is not associated with shortening of duration of antibiotic administration, duration of hospital stay or need for amputation in diabetic foot infection.

Diabetes Mellitus↗

The use of combined nasolabial V-Y advancement and glabellar flaps for large medial canthal defects.

BACKGROUND: Reconstruction of the medial canthal area presents many challenges for surgeons. It has many functional and cosmetic peculiarities. The combined use of glabellar and nasolabial V-Y advancement flaps is an effective method for repairing large medial canthal defects. OBJECTIVE: To describe and illustrate a technique to repair medial canthal defects. METHODS: Our experience with combined usage of nasolabial V-Y flap and glabellar flaps for medial canthal closure after tumor resection in 23 patients is reported. RESULTS: All resections and reconstructive procedures were performed under local anesthesia. All patients were treated without any complications such as flap loss, wound dehiscence, lymphedema, or ectropion. Fine results were achieved from both the functional and aesthetic point of view. CONCLUSION: This combination has many advantages over skin grafts and other local flaps. It is easy to design, reliable, and offers good cosmetic results. This combination is recommended to plastic surgeons as a safe and effective procedure for reconstruction of medial the canthal area.

Basal Cell Carcinoma↗

Insulin resistance in nonobese patients with polycystic ovary syndrome.

OBJECTIVES: Most patients with polycystic ovary syndrome (PCOS) are obese and known to have insulin resistance. Obesity per se is a cause of insulin resistance. This study was performed to determine whether insulin resistance occurs in patients with PCOS in the absence of obesity and acanthosis nigricans. METHOD: For this purpose, an euglycemic hyperinsulinemic clamp study was performed in 12 nonobese patients with PCOS and in 10 healthy control subjects matched for age and weight. RESULTS: The mean serum testosterone and luteinizing hormone (LH) levels were significantly elevated (4.09 +/- 1.32 vs. 1.18 +/- 0.53 pg/ml, p < 0.001, and 11.63 +/- 5.37 vs. 4.98 +/- 2.73 mIU/ml, p < 0.001, respectively), and the serum sex hormone binding globulin level was significantly reduced (40.96 +/- 14.94 vs. 73.98 +/- 30.40 nmol/l, p < 0.001) in patients with PCOS as compared with the values in control subjects. The mean serum insulin level was also elevated in patients with PCOS as compared with control subjects (32.33 +/- 4.98 vs. 19.56 +/- 2.21 microU/ml, p < 0.05). The insulin sensitivity was lower in patients with PCOS as compared with the control subjects (200 +/- 27.8 vs. 427.8 +/- 88.9 micromol x kg(-1) x min(-1), p < 0.001). In patients with PCOS, the serum levels of free testosterone (r = -0.89, p < 0.001) and LH were inversely correlated with the insulin sensitivity (r = -0.63, p < 0.05). Serum follicle-stimulating hormone, prolactin, and dehydroepiandrosterone sulfate levels were similar in both groups. CONCLUSIONS: These results indicate that a significant degree of insulin resistance exists in nonobese patients with PCOS and that this insulin resistance is significantly related to serum LH and free testosterone levels. Thus, measures to decrease insulin resistance may have to be considered earlier to decrease the potential risks of developing diabetes mellitus and coronary artery disease at later ages of life in these patients.

Adolescent↗

Intraoperative management of the thyroid gland in laryngeal cancer surgery.

OBJECTIVE: To determine if it is necessary to perform a hemithyroidectomy routinely with all total laryngectomies or if it should be reserved for selected cases. DESIGN: A retrospective analysis of 215 cases who had been operated on due to laryngeal cancer in our clinic between 1985 and 1999. SETTING: In only 182 cases, hemithyroidectomy and isthmectomy were performed together with laryngeal surgery. Of these, 98% were male. Their ages ranged between 42 and 70 years. The tumour was located in the supraglottic region in 93 (51%) and in the glottic region in 24 (13%) cases. In 65 cases (36%), the tumour was transglottic. Twenty cases of transglottic tumours (31%) and 3 cases of glottic tumours (12.5%) were found to have subglottic extension. METHODS: Total laryngectomy with unilateral or bilateral neck dissection and hemithyroidectomy on the tumour side plus isthmectomy were performed on all patients. On the pathologic specimens, subglottic extension was measured anteriorly and posteriorly from the free edges of the vocal cords. The specimens were stained with hematoxylin and eosin and examined under a light microscope. MAIN OUTCOME MEASURES: With glottic and transglottic carcinomas, the need for thyroidectomy may be based on the intraoperative assessment of the thyroid gland. In subglottic carcinomas, a hemithyroidectomy should routinely be performed. There may be no need to perform thyroidectomy in all total laryngectomy cases. RESULTS: The thyroid gland was invaded by squamous cell carcinoma in only 2 cases (1%). Both of these cases were transglottic tumours staged as T3 and T4 and had a subglottic extension more than 1 cm. CONCLUSIONS: We recommend routine hemithyroidectomy and isthmectomy during total laryngectomy only in cases with subglottic extensions more than 1 cm or thyroid cartilage invasion with tumour. In the other cases, assessment of extralaryngeal invasion and thyroid gland invasion by the tumour will determine whether thyroidectomy should be performed.

Adult↗

Persistent large choroid plexus cyst. A case report.

BACKGROUND: Prenatally diagnosed choroid plexus cysts regress or resolve spontaneously during pregnancy. A persistent large choroid plexus cyst with a prenatal diagnosis has not been reported previously. CASE: A 28-year-old, healthy primigravida was referred to our department at 32 weeks' gestation for a suspected fetal intracranial anomaly. Ultrasonography revealed a lateral ventricle 13 mm in width. The ventricle was dilated only in the atrium region. The choroid plexus was not distinct from the inner wall of the ventricle and did not fill the atrium of the lateral ventricle. The patient was followed with bi-weekly ultrasonography until delivery, and the left ventricular width increased from 13 to 17 mm. At 38 weeks' gestation the patient delivered a 3,350-g girl. Magnetic resonance imaging showed a 1.7 x 2.5 x 3.0-cm cyst in the left lateral ventricle. Follow-up magnetic resonance imaging scans at 6 and 11 months showed unchanged findings. Clinical and neurologic examinations at 11 months of age showed normal development. CONCLUSION: Although small (< 1 cm), postnatally persistent choroid plexus cysts are clinically insignificant variants of normal; the prognosis of large, persistent cysts (> or = 1 cm) is less clear. Long-term neurologic follow-up is mandatory for these neonates.

Adult↗

Staphylococcal pyomyositis in a patient with non-Hodgkin's lymphoma.

Pyomyositis is a rare disease, encountered mainly in tropical climates. The diagnosis of this entity is difficult, if not misdiagnosed, because of its rarity and its subacute presentation. We report of a 42-year-old man, in whom pyomyositis developed while he was receiving the standard chemotherapy for T-cell non-Hodgkin's lymphoma (NHL). Three months following splenectomy, multiple abscesses occurred in the muscles of both thighs while the patient was receiving the third course of the CHOP regimen. A purulent exudate was aspirated from the abscesses under computed tomographic guidance. Coagulase-positive Staphylococcus aureus was cultured in the aspirate. Pyomyositis was completely resolved following the surgical drainage and the antistaphylococcal antibiotic treatment. This patient has shown that immunosuppression due to splenectomy, NHL, and chemotherapy, especially when using steroids, could be risk factors for pyomyositis in nontropical or semitropical countries.

Adult↗

Genetic background of Lewis negative blood group phenotype and its association with atherosclerotic disease in the NHLBI family heart study.

OBJECTIVES: To examine the prevalence of four mutations, T59G, T1067A, T202C and C314T, of the human alpha(1,3/1,4) fucosyltransferase 3 (FUT 3) gene amongst persons with Lewis negative and those with Lewis positive blood group phenotype. An additional objective was to explore the hypothesis that these mutations are associated with coronary heart disease and inflammatory reaction. DESIGN: A population-based cross-sectional study. SETTING: Analysis of samples and data from the National Heart Lung and Blood Institute Family Heart Study. SUBJECTS: All Lewis (a-b-) participants (n = 136) and a sample of Lewis positive participants (n = 136) of the Family Heart Study; all were of Caucasian ethnicity. MAIN OUTCOME MEASURES: The prevalence of examined mutations by Lewis phenotype. RESULTS: The examined mutations were common and strongly associated with the Lewis (a-b-) phenotype. Accordingly, 90-95% of Lewis (a-b-) individuals amongst Caucasians can be identified by screening for these four mutations. Exploratory analyses suggested that with the exception of T59G, all examined mutations were positively associated with prevalent coronary heart disease, although not statistically significantly, perhaps due to the small number of prevalent coronary heart disease cases. C-reactive protein tended to be higher amongst persons with a TC or CC genotype at position 202 (3.07 +/- 0.41 vs. 2.08 +/- 0.32 mg L-1, P = 0.06). CONCLUSIONS: Four specific mutations of fucosyltransferase 3 gene are responsible for the vast majority of Lewis (a-b-) phenotypes in Caucasians. These mutations are common in the population at large and may be associated with increased risk of coronary heart disease. Further studies using larger samples are warranted.

Arteriosclerosis↗

Leptin concentrations are related to glycaemic control, but do not change with short-term oral antidiabetic therapy in female patients with type 2 diabetes mellitus.

This study evaluated the relation of leptin with glycaemic control and the effect of 14 days of diet, or diet combined with gliclazide, glipizide-GITS or metformin treatment, on leptin concentration in 51 female patients with type 2 diabetes mellitus. Leptin levels were similar both at baseline and after treatment in diabetic and control groups. Diabetic patients with basal fasting plasma glucose (FPG) < 10 mmol/l or with basal postprandial plasma glucose (PPPG) < 13.9 mmol/l had significantly higher leptin levels than diabetic patients with basal FPG > or = 10 mmol/l or with basal PPPG > or = 13.9 mmol/l (19.6+/-8.7 vs. 13.65+/-5.4 microg/l, p < 0.05; and 20.2+/-7.9 vs. 12.9+/-5.2 microg/l, p < 0.05, respectively). Mode of treatment did not influence leptin levels. Delta leptin showed a weak correlation with basal FPG (r = 0.346; p < 0.05), basal and post-treatment PPPG (r = 0.335, p < 0.05 and r = 0.325, p < 0.05, respectively) and a moderate correlation with post-treatment FPG (r = 0.391, p < 0.01). In conclusion, leptin level is not affected by the presence of type 2 diabetes mellitus and by short-term treatment with diet or oral antidiabetic drugs but is directly related to glycaemic control in female patients with type 2 diabetes mellitus.

Administration, Oral↗

Plasma leptin concentrations in postmenopausal women with osteoporosis.

BACKGROUND: The obese are usually protected against osteoporosis and have increased bone mineral density and plasma leptin concentrations. A recent in vitro study demonstrated that leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts, suggesting an influence of leptin on bone mass. However, little is known about the relationship between plasma leptin and bone mass in postmenopausal women with osteoporosis. OBJECTIVE: To investigate plasma leptin concentrations in postmenopausal women with osteoporosis to improve the understanding of the role of leptin in determining bone mass. METHODS: Fifty postmenopausal women with osteoporosis (ages 61.18+/-6.51 years; body mass index (BMI) 28. 91+/-3.44kg/m(2), mean+/-s.d.) and 30 age- and BMI-matched healthy postmenopausal women were included in the study. Bone mineral densities (BMD) were measured by dual energy X-ray absorptiometry. Plasma leptin concentrations were determined using an immunoradiometric assay. RESULTS: The median spine BMD value in the patient group (0.695+/-8.26g/cm(2), median+/-s.e.m.) was significantly lower than that in the control group (1.006+/-1. 29g/cm(2), median+/-s.e.m.; z=-7.454, P<0.001). The median plasma leptin concentration in the patient group (18.70+/-1.78ng/ml, median+/-s.e.m.) was not significantly different from that in the control group (22.35+/-2.20ng/ml, median+/-s.e.m.; z=-1.630, P=0. 103). Plasma leptin concentrations were correlated with BMI in both groups (r(s)=0.394, P=0.031 in controls and r(s)=0.404, P=0.004 in the patient group). There was no correlation between plasma leptin concentrations and BMD values in controls (r(s)=-0.107, P=0.575) but a weak correlation was observed in the patient group (r(s)=0.285, P=0.045). CONCLUSION: Our data suggest that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.

Aged↗