Biomedical subjects

D Yuksel

Publications and source records attributed to D Yuksel.

8 recordsLinked to original sources

PubMed2006

Comparison of two endoscopically assisted procedures in primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years: balloon dilatation and bicanalicular silicone tube intubation.

OBJECTIVES: To determine the success of two transnasally endoscopic assisted procedures as balloon dilatation and bicanalicular silicone tube intubation for the primary surgical treatment of congenital nasolacrimal duct obstruction in children older than 3 years. STUDY DESIGN: Prospective randomized clinical trial. METHODS: An interventional case series of consecutive primary endoscopic assisted balloon dilatation (BD) and bicanalicular silicone tube intubation (STI) for congenital nasolacrimal duct obstruction in children older than 3 years was reviewed. BD was performed in 20 eyes of 17 patients and STI was performed 24 eyes of 20 patients. Clinical success was defined as a complete remission of epiphora at the end of follow-up period of 12 months and a continuation of the remission at least for 4 months. RESULTS: Eighteen out of 20 eyes (90%) nasolacrimal ducts responded to BD whereas the rate was 15 out of 24 eyes (62.5%) in STI group. No significant complications occured in BD group while the complication rate in STI group was 8 out of 24 eyes (33.3%). chi(2)-Statistical analysis showed significantly better results for BD in clinical success and complication rates than those of STI. CONCLUSIONS: BD should be the first choice therapy instead of invasive approaches with high rate of complications and lower success rates such as silicone intubation, in patients who are older than 3 years.

Catheterization↗

PubMed2005

Quantification of cells expressing the thyrotropin receptor in extraocular muscles in thyroid associated orbitopathy.

BACKGROUND/AIM: Thyroid associated orbitopathy (TAO) and Graves' disease (GD) have an autoimmune pathogenesis, possibly related to the thyrotropin receptor (TSHR). The aim of this study was to determine whether TSHR immunoreactivity is correlated with disease severity or serum TSHR antibody (TRAB) levels. METHODS: Orbital tissues from 30 patients with TAO were compared with those of 20 patients with strabismus and four with non-thyroid orbital inflammation. TSHR was detected by immunohistochemistry and TRAB were measured by radioreceptor assay. RESULTS: No TSHR immunoreactivity was detected in the 24 control orbital tissues, whereas in all TAO biopsies elongated fibroblast-like cells, expressing TSHR, were present. These cells were located between the muscle cells, which were separated by oedema in the acute phase but fibrous tissue in the chronic phase of disease. Semi-thin sections showed numerous mast cells present in the chronic phase and in close contact with adipocytes. The number of TSHR immunostained cells was high in early disease, decreased with disease duration, and was positively correlated with TRAB levels at the onset of TAO. CONCLUSION: TSHR immunoreactivity was demonstrated specifically in TAO orbits which highlights the importance of TRAB early in the pathogenesis.

Adult↗

PubMed2001

Comparison of In-111 octreotide and Tc-99m (V) DMSA scintigraphy in the detection of medullary thyroid tumor foci in patients with elevated levels of tumor markers after surgery.

PURPOSE: In this retrospective study, the authors evaluated the utility of In-111 octreotide (OctreoScan) and Tc-99m (V) DMSA scintigraphy for the localization of recurrent metastatic tumor foci in patients with medullary thyroid cancer (MTC) and compared the findings with those of conventional radiologic imaging methods. METHODS: The scintigraphic images were compared with computed tomography (CT) and magnetic resonance imaging (MRI) and ultrasonography (US) in 14 patients (8 men, 6 women; age range, 22 to 74 years) with elevated calcitonin and carcinoembryonic antigen levels after total thyroidectomy. All scintigraphic image findings were evaluated qualitatively as mild uptake (+) and moderate to marked uptake (++). RESULTS: In-111 octreotide may be superior to Tc-99m (V) DMSA for the detection of tumor foci of patients with MTC on a patient basis (78.5% versus 57.1%) and on a lesion basis (44.1% versus 30.2%). The sensitivity rate for In-111 octreotide (78.5%) was also similar to that of CT and MRI on a patient basis. Conversely, the combined use of Tc-99m (V) DMSA and In-111 octreotide revealed the best sensitivity rate (85.7%) on a patient basis, whereas the combined use of CT and MRI showed the best sensitivity rate (81.3%) on a lesion basis. CONCLUSIONS: These findings suggest that In-111 octreotide is superior to Tc-99m (V) DMSA and has a similar sensitivity rate to CT and MRI for the diagnosis of recurrent or metastatic MTC. Although the combined use of In-111 octreotide and Tc-99m (V) DMSA was most sensitive, the combined use of CT and MRI with radionuclide imaging methods may better detect more metastatic tumor foci.

Adult↗

PubMed2001

Influence of inhaled steroids on pulmonary epithelial permeability to Tc99m-dTPA in atopic asthmatic children.

The lung permeability of asthmatic children has been reported to be similar, lower, or higher than that of healthy subjects. The aim of this study was to clarify these discrepancies and also assess the effect of inhaled steroids on lung permeability. Tc99m-diethylenetriaminepentaaceticacid (Tc99m-DTPA) clearance in children with mild unstable asthma (n = 13; mean age 9.3 +/- 0.7 years) was compared with that of a group of healthy subjects (n = 11; mean age 8.9 +/- 0.8 years). Symptom scores, forced-expiratory volume in the first second (FEV1), and peak expiratory flow rate variability (PEFR-v) of asthmatics were recorded and an inhaled steroid (budesonid) was recommended after first scintigraphic evaluation for 8 weeks. Two consecutive scintigraphic studies were performed before and after treatment. Symptoms, FEV1, and PEFR-v significantly improved throughout the study. Baseline DTPA clearance rate in the asthmatics was significantly higher from that of control group (1.3 +/- 0.2 and 0.7 +/- 0.1%/min, respectively) (p < 0.05). DTPA clearance rate of asthmatics significantly increased to 1.7 +/- 0.3%/min at end of inhaled therapy (p < 0.05). Our data show that DTPA clearance in unstable asthmatic children is significantly higher than that found in healthy subjects, and that a higher rate was obtained following inhaled steroid therapy. Thus, the clinical significance of these observations needs further studies to test whether DTPA clearance index is a valid tool for monitoring asthmatic children and to explore the mechanisms involved in radioaerosol clearance rates in pediatric asthma.

Administration, Inhalation↗

PubMed1999

[Congenital toxoplasmosis: presentation of a case].

We report a case of a 4 months old boy with esotropia of the left eye with large bilateral chorioretinal toxoplasmic macular scars. Chorioretinal scars are the most common eye finding in congenital toxoplasmosis and are often located in the macular region. Most infants with congenital infection are asymptomatic at birth but will develop retinal and/or neurologic damage later in life with consequent loss of vision. A routine examination of the fundus and computed tomography of the head can be negative. Serologic testing is essential for the diagnosis and the follow-up of the infection. Every infant with evident or suspected congenital infection by Toxoplasma gondii must be treated by Pyrimethamine, Sulphadiazine and Folinic Acid during at least the first year of life with regular serologic testing and ophthalmologic examination. Neurologic outcome is better with treatment and the risk of chorioretinitis seems reduced.

Child, Preschool↗

PubMed1998

[Symmetric or asymmetric surgery for basic intermittent exotropia].

Surgical results after symmetrical and asymmetrical surgery performed by the same surgeon (M.S.) as initial procedure for basic intermittent exotropia were retrospectively analysed in 55 young patients. Twenty-five patients underwent unilateral recess-resect surgery on the non-fixating eye (Groupe 1) and 30 patients bilateral lateral rectus recessions (Group 2). The average age at surgery was 6.5 yrs (range: 2-18). The average post-operative follow-up was 2.81 yrs (range: 0.50-8 yrs), (p = 0.143). Sensory fusion was assessed by the Bagolini straited glasses and/or the Worth test and stereopsis by either the TNO and/or Lang stereoacuity test prior and after surgery. Prior to surgery, 84% of the patients had reached isoacuity. Ocular motility was normal in all patients. The average size of preoperative exotropia measured by prism and alternate cover test was 28 PD (SD = 5) for both Groups. In the immediate postoperative period, 53% of the patients were overcorrected without any statistically significant difference between the 2 groups (p = 0.053). Nine (16%) patients had a "mixed" deviation (from eso- to exo depending of the fixation distance), 8 (15%) patients were orthophoric (20% in Group 1 vs 10% in Group 2) and 9 (16%) patients were undercorrected (12% in Group 1 vs 20% in Group 2). The results at last exam, were similar between the 2 Groups; good or fair alignment was achieved in 29 (53%) patients (p = 0.512); 23 (42%) patients had still X(T) (p = 0.829) and 3 (5%) patients were overcorrected. We concluded that even if the immediate postoperative results seem better with asymmetrical surgery, in the long-term there is no significant difference between the two surgical procedures.

Adolescent↗

PubMed1996

[Amblyopia from anisometropia without strabismus].

Fifty non-strabismic children with primary anisometropia were reviewed retrospectively. At entry, patients ranged in age from 1 to 10 years with an average of 4.5 years. The follow-up ranged from 0.5 to 9 years with an average of 3.5 years. Criteria for inclusion were a difference in refractive error between the two eyes of at least 1.00 D of spherical value and/or 0.75 D of cylindrical value. In all cases, anisometropia was totally corrected by prescribing glasses. Anisometropic amblyopia was considered to be present when isoacuity at far was not reached despite the glasses, part-time occlusion therapy of the good eye was prescribed. Amblyopia was present in 86% of the patients and was found with all types of anisometropia. It was more severe in anisohyperopia and/or anisoastigmatism. After adequate treatment, amblyopia was clinically cured or less severe in 78% of the patients.

Amblyopia↗

PubMed1995

[External sclerostomy using the THC:YAG Holmium laser in the treatment of glaucoma].

Ab externo THC:YAG Holmium laser sclerostomy is an interesting alternative to standard full thickness filtering surgery. We report our retrospective experience over a total number of 38 sclerostomies between march 1993 and september 1994 on 32 patients (33 eyes) with primary or secondary glaucomas composed of 17 phakic and 16 aphakic and/or pseudophakic eyes. The mean patient age is 62.9 years (range: 10 to 90 years). The mean follow-up time is 7.5 months (1 to 18 months). We used a long pulsed (300 microsec) laser emitting in the near infrared (2.1 microns). A conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a 22 G probe which delivers energy at a right angle to the long axis of the fiber. We used 100 mJ per pulse laser energy delivered at a rate of 5 impacts per second. The mean delivered energy to produce a functional sclerostomy was 16.1 J. All patients received subconjunctival injections of 5 Fluorouracil (mean number of injections: 7.4). Criteria for success included an IOP of 22 mmH or less with or without additional medical treatment and a decrease of at least 30% of IOP when the preoperative IOP was 22 mmHg or less. The mean preoperative IOP was 35.8 mmHg (21 to 54 mmHg). By 3 months, the mean IOP of the 14 eyes over 19 successfully controlled was 15.2 mmHg (8 to 22 mmHg) with additional medical treatment in 3 cases. By 6 months, 11 eyes over 11 successfully controlled was 14.1 mmHg (6 to 21 mmHg) with additional medical treatment in 3 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗