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Biomedical subjects

E Unal

Publications and source records attributed to E Unal.

At least 19 recordsLinked to original sources
PubMed2006

Outcome of renal allograft in Turkish patients with pretransplantation hepatitis C virus infection.

BACKGROUND: The aim of the present study was to investigate the impact of hepatitis C virus (HCV) infection on the long-term survival of renal transplant recipients. METHODS: Outcomes and survivals among 325 patients who received renal allografts from July 1991 to September 2005 were compared between those known to have pretransplantation HCV infection (Group I, HCV+ group, n = 33) versus a matched cohort of those without this infection (Group II, HCV- control group, n = 33). Allograft performance, liver function, cholesterol, and glucose levels were determined both at transplantation and at a mean of postgrafting year 8. A one-way analysis of variance (ANOVA) statistical method was used for multivariate analysis. RESULTS: Thirty-three patients (10.15%, 19 women and 14 men) were positive for HCV antibody. The mean follow-up period was 8 years (range, 0.5-14 years). The mean survival rates were similar in Groups I and II (96.6% and, 100%, respectively). Although the allograft survival rate was lower in Group I (84.8% vs 90.9%), the rejection rate among the HCV- group was 6%; only 1 patient died of hepatic failure. In spite of a significant rise in both total and direct bilirubin values (P < .01) in both groups, we failed to observe an adverse effect on graft survival. A significant rise in the fasting glucose level was seen in both HCV+ and HCV- patients. CONCLUSIONS: Chronic HCV infection before transplantation did not have a significant impact on graft survival or mortality compared with noninfected patients.

Adult↗
PubMed2002

Laparoscopic repair of congenital diaphragmatic hernias.

Bochdalek and Morgagni hernias are the least common congenital diaphragmatic hernias, with the prevalence of Bochdalek hernia being 1/2200 births and the prevalence of Morgagni hernia being 1/1 million births. Although they are usually asymptomatic, congenital diaphragmatic hernias, especially Bochdalek and Morgagni hernias, are diagnosed in early childhood. In adulthood, they are diagnosed incidentally or when they become symptomatic. The repair of congenital diaphragmatic hernia is indicated in all children and symptomatic adults. We present three cases of congenital diaphragmatic hernia, two Morgagni and one Bochdalek hernias, repaired laparoscopically. We describe the operational methods. The results of the operations were satisfactory, with cure defined with radiological images after 1 month. We propose the use of laparoscopy in the repair procedure because it is a safe and effective method. Benefits include that it provides an excellent view of the surgical field, ease of execution, minimal surgical trauma, excellent cosmetic results, rapid recovery, and shorter hospitalization stay.

Adult↗
PubMed2002

An intensive approach to the treatment of disseminated BCG infection in a SCID patient.

There is an appreciable mortality associated with BMT in patients with SCID and advanced BCG infection. We present a girl with T-B+ SCID complicated by spina ventosa and disseminated BCG osteitis after receiving a fully matched sibling marrow transplant. Considerable progression characterised by two clinical activations and multiple pleural and perivertebral abscess formations occurred with conventional anti-mycobacterial chemotherapy. She finally recovered with full immune reconstitution after BMT and intensive treatment comprising five conventional and alternative agents that she received for 36 months. No side-effects and/or complications have been seen other than hearing loss.

Antibiotics, Antitubercular↗
PubMed2001

Relationship between production of 3-indoleacetic acid and peroxidase-laccase activities depending on the culture periods in Funalia trogii (Trametes trogii).

The relationship between production of 3-indoleacetic acid (IAA) and peroxidase and laccase activity was investigated in white-rot fungus Funalia trogii (Trametes trogii). F. trogii produced IAA and peroxidase and laccase as both primary metabolite and secondary metabolite; the levels of IAA may be influenced by peroxidase and laccase. A correlation exists between the levels of IAA and peroxidase-laccase activity.

Indoleacetic Acids↗
PubMed2001

Serum levels and differential expression of CD44 in childhood leukemia and malignant lymphoma: correlation with prognostic criteria and survival.

BACKGROUND: The CD44, a cell surface proteoglycan, participates in a variety of function including tumor dissemination and metastasis. However, there are no available data on the prognostic significance of CD44 expression of tumor tissue correlated with serum sCD44 level in childhood leukemias and lymphomas. METHODS: Serum levels and leukemic cell tumor tissue expression of CD44 were detected in 54 children with acute leukemia and malignant lymphoma. Serum samples were obtained from all patients before treatment and during remission. Twelve age-matched healthy children were included as a control group. RESULTS: The serum CD44 levels were significantly higher in patients with Hodgkin's disease (HD), non-Hodgkin's lymphoma (NHL), Burkitt's lymphoma (BL) and acute lymphoblastic leukemia (ALL) than those in the control group. The median values were 1627.0, 1336.0, 1318.5, 1730.4, 902.7 ng/mL, respectively, and P<0.001, P<0.01, P<0.01, P<0.05 in comparisons, respectively. However, there was no significant difference between acute myeloid leukemia (AML) and the control group (median values: 900.3 and 902.7 ng/mL, respectively, P>0.05). Serum sCD44 levels significantly declined in HD, NHL and ALL patients who were in complete remission (median values: 684.0, 573.8 and 1101.1 ng/mL, respectively, P<0.05 in each comparison). Patients with HD had higher levels of serum sCD44 and correlated well with higher erythrocyte sedimentation rate (ESR), B-symptoms and advanced-stage disease (P<0.05, P<0.05 and P<0.01, respectively). Expression of CD44 was significantly high in patients with HD and NHL who were in advanced stages of disease. High serum CD44 level was also associated with high tumor tissue expression of CD44 in patients with HD and BL. In addition, patients with higher levels of serum sCD44, had a poorer outcome and survival than those with lower sCD44 levels in HD and NHL groups. CONCLUSIONS: A high serum sCD44 level and/or tumor tissue expression at diagnosis is associated with poor prognostic criteria and/or unfavorable outcome in childhood leukemias and lymphomas.

Adolescent↗
PubMed2001

Intraluminal duodenal obstruction by a gastric band following erosion.

BACKGROUND: Duodenal obstruction occurred 4 years following gastric banding for morbid obesity, which had had a good result. METHOD: A 56-year-old female with a history of gastric banding presented with duodenal obstruction. RESULT: Physical and radiological examination was able to give the diagnosis. At surgery, the gastric band in the distal duodenum was removed. She was discharged on postoperative day 4, with no complication. At 6 months following discharge, her nausea and vomiting have not recurred. CONCLUSION: Following gastric banding, band erosion through the gastric wall and internalization into the lumen can cause small bowel obstruction.

Abdominal Pain↗
PubMed2001

Conversion of failed vertical banded gastroplasty to open adjustable gastric banding.

BACKGROUND: Occasionally, patients with failed vertical banded gastroplasty (VBG) present for secondary treatment. We performed the reoperations using adjustable gastric banding (AGB) technique. METHODS: From 1991 to 1997, 80 morbidly obese patients underwent VBG. In 7 (8.7%), staple-line disruption and weight regain were detected within 2 years of follow-up. Conversion to AGB was performed between 1994 and 1998. Meanwhile, another 80 morbidly obese patients underwent primary open AGB. RESULTS: In the 7 patients, staple-line disruption was seen on radiography as a leak of contrast material across the gastric partition. After conversion of "failed" VBGs to AGB, postoperative results have been very satisfactory and similar to those of the primary open AGB group. CONCLUSIONS: VBG is a safe technique, although conversion rates were significant. Staple-line disruption constituted the chief cause of insufficient weight loss and frequently indicated the need for further surgery. Our results of the revisional surgery confirm that the reoperations for failed VBG can be performed using AGB technique.

Body Mass Index↗
PubMed2000

Brucellosis transmitted by bone marrow transplantation.

We report a unique case of brucellosis transmitted by BMT. An 8-year-old boy with the diagnosis of Fanconi's anemia received an allogeneic BMT from his HLA-identical sibling. Routine culture from the infused marrow suspension grew Brucella abortus on day +4 post BMT. Spiking fevers occurred on days +2 and +16. The first febrile episode responded to broad-spectrum antibiotic therapy. However, the second episode did not. B. abortus was isolated from blood cultures taken during the second febrile episode. The Brucella agglutination titer was negative. Antibiotic therapy with oral doxycycline and i.v. gentamycin was successful with no recurrence of infection during 13 months of follow-up. The donor's blood culture was also positive for B. abortus and Brucella antibodies were detectable at 1:320 titer when he presented with fever and hepatosplenomegaly on day +32. We emphasize the need to consider brucellosis in patients undergoing BMT. We suggest that donor and recipient be evaluated for brucellosis especially in countries where the incidence of this infection is relatively high.

Bone Marrow Cells↗
PubMed2000

Natural killer cell numbers and cytotoxic activity in pediatric Hodgkin disease.

In this study peripheral blood natural killer (NK) cell activity was evaluated in 17 pediatric cases with Hodgkin disease (HD) (9 untreated, 8 in remission) and 20 age-matched healthy children. Peripheral blood CD16 and CD56 molecule expressions were also examined. No difference related to NK cell numbers and cytotoxic activity was detected at either stage of the disease. In cases in which long-term remission has been achieved (> or = 5 years) NK cell activity was slightly but not significantly increased in parallel with remission duration. Finally, no relation between NK cell activity and the etiology, prognosis, and severity of the disease has been established in children with HD.

Adolescent↗
PubMed2000

Laparoscopy in Turkish bariatric surgery: initial experience.

BACKGROUND: The recent application of the laparoscopic method combines minimal invasiveness with reversibility, adjustability and shorter hospital stay. The first laparoscopic bariatric operation in Turkey was performed by us in 1998. METHODS: We report the results in 50 consecutive patients who underwent the laparoscopic application of SAGB between April 1998 and April 1999. The operation setting was the same as for the laparoscopic antireflux procedure. After a closed CO2 pneumoperitoneum (16-18 mmHg), in the first 20 cases five and in the remaining 30 cases four trocars were inserted. A 30 degrees laparoscope was placed on the line between the umbilicus and the xiphoid through a 10 mm trocar. We followed and respected the main steps of the operation as well. Pre and postoperative body weight (BW), body mass index (BMI) and percent excess weight (%EW) values were calculated and compared. RESULTS: Our early results were quite satisfactory and promising. After an average follow-up period of 1 year (range 6-18 months), the 50 patients of our laparoscopic series showed a BW of 74 kg (range 56-112), a BMI of 29 (range 21-40), and an EW of 62% (range 22-86). CONCLUSION: With its lower morbidity rate, shorter hospital stay and better cosmetic results, the laparoscopic approach may be considered the first choice in bariatric surgery.

Adult↗
PubMed1999

Fungal colonization and infection in children with acute leukemia and lymphoma during induction therapy.

BACKGROUND: Fungal infection represents a growing problem in children with hematologic malignancies. During chemotherapy induced neutropenia, colonization with fungi is considered a major risk factor for subsequent fungal infection. The rates and risk factors for mycotic infections in pediatric oncology patients is undetermined, particularly for centers in developing countries. The aim of this study was to evaluate the rates and risk factors of fungal colonization in children with acute leukemia and lymphoma at one of the major pediatric hematology/oncology centers in Turkey. PROCEDURE: Fifty-two consecutive children newly diagnosed with acute leukemia and lymphoma during intensive remission induction therapy were evaluated for the occurrence of fungal colonization (defined as at least one positive surveillance culture) and infection. RESULTS: Thirty-six of the 52 patients (69.2%) were colonized by Candida albicans which was the only fungus isolated from surveillance cultures. There were three (5.8%) proven systemic fungal infections: two cases of candidemia and one case of brain abscess with Aspergillus spp. isolated from tissue. All patients with fungal colonization were receiving prophylactic or curative antibiotics. No significant association was found between type of disease and fungal colonization, but there was a significant association with neutropenia. CONCLUSIONS: Our findings suggest that there is a high rate of fungal colonization in children receiving remission induction therapy for acute leukemia and lymphoma. Limiting the use of antibiotics and instituting antifungal chemoprophylaxis may decrease the rate, while the early initiation of empiric antifungal therapy in patients with fever and suspected mycotic colonization may increase survival in these patients.

Adolescent↗
PubMed1997

Calcium, magnesium, and zinc status in experimental hyperthyroidism.

In this study, experimental hyperthyroidism was established and used to investigate possible alterations in the calcium (Ca), magnesium (Mg), and zinc (Zn) homeostasis by assessing their concentrations in plasma and erythrocytes. In the L-thyroxine-induced hyperthyroidism condition, the experimental animals show a significant decrease in erythrocyte Ca, Mg, and Zn concentrations, and a significant decrease in plasma Mg concentration. Significant positive correlations were found for Mg and Zn both in plasma and in erythrocytes. The results suggest that the homeostasis of Ca, Mg, and Zn is altered during experimental hyperthyroidism.

Animals↗
PubMed1996

Reducing seroma formation with fibrin glue in an animal mastectomy model.

Mastectomy is a frequently performed surgical procedure which has some important complications that may prolong hospital stay. Seroma formation after mastectomies and axillary dissection has an incidence of 5.8-53%. A new technique for preventing seroma formation was studied in an animal mastectomy model. Radical mastectomy was performed in guinea pigs. A control group of 20 animals had no further procedure post-mastectomy other than drying the wound with sterile gauze. In the other group fibrin glue was topically applied to prevent seroma formation to the operative field. Ten days after the operation, necropsy was performed and fluid collections were drained with an 18-gauge needle. The results were statistically analysed with a Two-sample rank-sum test. A significant difference existed between Groups I and II (P < 0.00005). It is concluded that fibrin glue can be used to prevent seroma formation after mastectomies.

Animals↗
PubMed1995

Late effects of chemoradiotherapy in pediatric Hodgkin's disease.

We treated 137 Turkish children with biopsy-proven Hodgkin's disease, followed up between the years 1964 and 1989. Most patients were treated and were in advanced stage with histological subtype of mixed cellularity (67.5%). Radiotherapy (Mantle form) and/or MOPP, ABVD and OPPA combination chemotherapy regimens were used in 75.84% of patients. The follow-up period in these patients ranged from 5 to 24 years. The late effects in 28 patients who were evaluated for the late sequelae of chemoradiotherapy are presented. Seven out of 28 patients showed retarded sexual maturation. Testicular and ovarian functions were assessed in 11 patients, all of whom showed elevated serum FSH levels and 2 azoospermia. Analysis of thyroid functions was carried out in patients receiving radiotherapy to the neck. The thyroid gland was palpable in 6 patients. Further analysis showed diffuse hyperplasia in 5 and nodular in 1 patient. The nodule was excised and reported as "nodular colloidal goiter". Two patients had elevated TSH levels. "Swan-like neck" was observed in 3 patients who had received 40 to 42 Gy radiotherapy to the neck. Cirrhosis due to chronic hepatitis B infection was diagnosed in 2 patients as an unusual late complication. The secondary malignancy occurred in only 1 case in the form of "fibrosarcoma". The second neoplasm was probably radiation-induced as it occurred in the field of prior radiotherapy.

Adolescent↗