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Biomedical subjects

F Aksoy

Publications and source records attributed to F Aksoy.

At least 37 records · Page 2Linked to original sources

Effect of octreotide (Sandostatin 201-995) on bile flow and bile components.

Octreotide (Sandostatin 201-995) has an inhibitory effect on gastric, intestinal, and pancreatic secretions and hepatic and splachnic blood flow. We examined the effects of octreotide on bile flow and bile components in 10 patients with T-tube choledochostomy. A Fogarty balloon catheter was inserted distal to the T-tube of these patients for measurement of bile flow and bile components. Bile samples were obtained to analyze bile acid, phospholipid, lipoprotein, and cholesterol, and bile flow measurements were performed every 15 min for a period of 90 min before study and after normal saline and octreotide administrations. While octreotide had an inhibitory effect on bile flow, the concentrations of bile acid, phospholipid, and lipoprotein in bile were increased with octreotide.

Adult↗

Role of technetium tetrofosmin scintimammography in the diagnosis of malignant breast masses and axillary lymph node involvement: a comparative study with mammography and histopathology.

OBJECTIVE: To assess the role of Technetium-99m (99mTc) tetrofosmin scintimammography in the detection of breast cancer and involvement of axillary nodes. DESIGN: Open study. SETTING: General hospital, Turkey. SUBJECTS: 128 women who presented with masses in the breast. INTERVENTIONS: Scintimammography, standard mammography, and either excision or fine-needle aspiration biopsy to confirm the diagnosis. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value of scintimammography compared with mammography. RESULTS: Sensitivity, specificity, and positive and negative predictive value (%) of 99mTc scintimammography were 95, 96, 97 and 92, respectively. The corresponding figures for standard mammography were 87, 26, 68 and 52. Scintimammography changed the 34 false positive mammograms into true negatives, at the expense of four false negatives. The sensitivity of scintimammography in detecting axillary lymph node metastases was 72% and specificity 100%. CONCLUSION: Scintimammography with 99mTc tetrofosmin seems to be of value in the detection of breast malignancy and axillary metastases. It may help to avoid unnecessary operations in patients whose mammograms do not give a definite diagnosis.

Adult↗

Relationship between prostate specific antigen density, microvessel density and prostatic volume in benign prostatic hyperplasia and advanced prostatic carcinoma.

The aim of this study was to investigate the relationship between prostate specific antigen density and prostate volume with microvessel density in patients with benign prostatic hyperplasia and advanced prostatic carcinoma. Sixty-eight patients with benign prostatic hyperplasia and 11 patients with advanced prostatic carcinoma participated in the study. The paraffin blocks of all patients were stained with CD34 by the standard immunohistochemical technique and microvessel density, prostate specific antigen density and prostatic volume were determined. In patients with benign prostatic hyperplasia the mean microvessel density, mean prostate specific antigen density and mean prostatic volume were 74+/-89+/-22.73, 0.12+/-0.10 and 59.97+/-27.0 ml, respectively. There was no correlation between prostate specific antigen density and mean prostatic volume or microvessel density (r = 0.079 and -0.095, respectively). In patients with advanced prostatic carcinoma the mean microvessel density, mean prostate specific antigen density and mean prostatic volume were 147.90+/-47.55, 0.63+/-0.41 and 54.00+/-22.42 ml, respectively. In this group, while there was a good correlation between prostate specific antigen density and microvessel density (r = 0.785), no significant correlation was found between prostatic volume and microvessel density (r = -0.07). There was significant statistical difference in patients with advanced prostatic carcinoma compared to patients with benign prostatic hyperplasia in terms of mean microvessel density (p<0.0001). The findings that there was no correlation between prostatic volume and MVD either in benign prostatic hyperplasia or in prostatic carcinoma suggest that microvessel development is not correlated with prostatic volume but may be correlated with morphology.

Aged↗

Five-year results of the treatment of 23 patients with immunoproliferative small intestinal disease: a Turkish experience.

BACKGROUND: Currently, there is no agreement regarding optimal treatment strategies for immunoproliferative small intestinal disease (IPSID). In this article, the authors report the treatment outcomes of a group of 23 Turkish patients with IPSID. METHODS: Between December 1988 and July 1993, 23 consecutive patients with IPSID, including 5 with secretory type, were included in the study. Seven patients with Stage A disease (according to the criteria of Galien et al.) received tetracycline (1 g/day, orally) for a median duration of 7 months (range, 6-11 months) initially, whereas the remaining patients (9 Stage B patients and 7 Stage C patients) received combination chemotherapy (cyclophosphamide, vincristine, procarbazine, and prednisolone [COPP regimen]) followed by tetracycline at a dose of 1 g/day for 6 more months in patients with complete response (CR) after the COPP regimen. RESULTS: The median follow-up was 68 months (range, 38-89 months). As first-line therapy in Stage A patients, tetracycline yielded a 71% CR and 43% disease free survival (DFS) rate. Eleven of 16 patients (69%) with Stage B or C disease who received the COPP regimen achieved CR and only 2 patients had a recurrence (DFS rate of 56%). The 5-year overall survival (OAS) rate for the entire group was 70%, and the 5-year DFS rate for patients with CR was 75%. However, the median OAS for 3 patients with immunoblastic lymphoma was only 7 months. CONCLUSIONS: The COPP regimen, with its acceptable toxicity, appears to be a good alternative as a first-line treatment for patients with Stage B or C IPSID with low grade lymphoma whereas tetracycline appears to be the initial treatment of choice for patients with Stage A disease.

Adolescent↗

Antenatal diagnosis of lethal osteopetrosis.

We describe a case of the lethal form of osteopetrosis diagnosed prenatally by ultrasonography. Anomalies detected on ultrasound examination at 18 weeks' gestation included skeletal hyperdensity, communicating hydrocephalus and short long bones. At 21 weeks' gestation, cordocentesis was performed to measure the levels of calcium, phosphorus and alkaline phosphatase. The fetus was aborted at 22 weeks' gestation. The diagnosis of osteopetrosis was confirmed by postmortem radiological and histopathological analysis.

Abortion, Induced↗

Wilms' tumor: prognostic factors and survival.

A statistical analysis of 38 cases of Wilms' tumor treated and followed by the Pediatric Oncology Group of Cerrahpaşa Medical Faculty, from 1977 to 1984, is presented. The two-year survival rate was 67% and the five-year survival rate was found to be 63%. There was a strong correlation between the stage and age of the patients and prognosis. The median age was 16 months in stages I and II of the disease and the two-year survival rate was 87%. The median age was found to be 5 years in advanced stages and the survival rate at 2 years was 43%. No correlation was found between survival and initial symptoms of the tumor or its localization. The effects of histological grade on prognosis of disease were also investigated.

Adolescent↗

Sonographic findings in noncirrhotic portal fibrosis.

PURPOSE: The aim of this study was to evaluate the sonographic appearances of noncirrhotic portal fibrosis (NCPF). METHODS: Between 1983 and 1996, 12 patients between the ages of 16 and 60 years were diagnosed with NCPF on the basis of medical history and clinical, imaging, and biopsy findings. RESULTS: Sonograms for all patients showed hyperechoic bands surrounding the portal vein branches, which were separated from adjacent liver parenchyma by a hypoechoic stripe. All liver biopsy specimens showed nonspecific changes and no cirrhosis. Histologic findings included fibrosis and some obliteration of the intrahepatic portal veins. CONCLUSIONS: If sonography of the liver shows increased echogenicity of the walls of the portal vessels with a hypoechoic stripe between the wall and the adjacent liver parenchyma in a patient who has portal hypertension and normal liver function tests, NCPF should be considered.

Adolescent↗

Sonographically guided percutaneous treatment of hepatic hydatid cysts: long-term results.

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of sonographically guided percutaneous drainage and irrigation of hepatic hydatid cysts. METHODS: Sixty-one patients with 84 hepatic hydatid cysts were treated using the puncture, aspiration, injection, and reaspiration (PAIR) technique under sonographic guidance. Patients with cysts larger than 6 cm in diameter underwent PAIR followed by percutaneous drainage (PAIR-PD). The cysts were sterilized by the injection of 1 of 2 scolicidal agents, 20% hypertonic saline solution (38 patients) or 0.5% silver nitrate (23 patients). All patients underwent follow-up examinations for 1 month-6 years after aspiration. Clinical and radiologic examinations and laboratory analyses were performed every month for the first 6 months and then at 3-month intervals. RESULTS: Serial sonographic examinations revealed a heterogeneous echo pattern in 78 cysts (93%); a progressive decrease in diameter in 76 cysts (90%); calcification of the cyst wall, cystic contents, or both in 10 cysts (12%); and complete disappearance of 1 cyst (1%) in a patient who had been monitored for over 6 years. Five patients developed urticaria, and 6 developed fever. One patient developed a biliary fistula after the first aspiration attempt. Two patients developed infection of the cyst cavity after PAIR-PD and were successfully treated with oral antibiotics. An anaphylactic reaction developed in 2 patients and was successfully treated with antiallergenic medication. No recurrence of hydatid disease after PAIR or PAIR-PD was observed in any patient over the follow-up period of 72 months (mean, 26 +/- 27 months). CONCLUSIONS: Percutaneous drainage of hydatid cysts is a safe, effective, and reliable treatment. Antiallergenic medication is required before PAIR or PAIR-PD. Both sclerosing agents, hypertonic saline and silver nitrate solutions, gave excellent results.

Adolescent↗

Comparison of meshes for the repair of experimental abdominal wall defects.

The aim of this experimental study was to compare the effects of polytetrafluoroethylene patch, polypropylene mesh, and porcine dermal collagen implant in rats for the repair of abdominal wall defects. We created experimental abdominal wall defects in 45 rats (three groups of fifteen) and repaired them with polytetrafluoroethylene, polypropylene mesh, and porcine dermal collagen implant by onlay technique. We sacrificed 4 rats from each group at 4, 8, 10, and 12 weeks after implantation and observed if hernia, adhesion, effusion, or infection occurred. We measured the tensile strengths of meshes by a digital tensometer. We made histological and electron microscopic evaluations of the meshes. Postoperative infection and effusion occurred in one rat in each group. Hernia was not found throughout the trial. The tensile strength of polytetrafluoroethylene patch and polypropylene mesh increased more than porcine dermal collagen implant until the end of week 12. Adhesion formation was minimal in the porcine dermal collagen group and moderate in the polytetrafluoroethylene patch and polypropylene mesh groups. Polytetrafluoroethylene patch showed minimum absorption and maximum foreign body reaction. Our results show that although none of the material reached the criteria of ideal mesh, polypropylene mesh is the better mesh for the repair of abdominal defects. Polytetrafluoroethylene patch though expensive, can also be used as a reliable mesh. We do not advise porcine dermal collagen implant as a mesh for abdominal defects due to its weak structure.

Abdominal Muscles↗

Body stalk anomaly in monozygotic twinning: a case report.

We describe a case of concordant body stalk anomaly in a monozygotic twin. Autopsy of the fetus showed abnormalities compatible with the maldevelopment of embryonic folding. Abdominal viscera were in a sac covered by the amnion and were attached directly to the placenta. The anus was not visible and no discernible external genitalia were noted. Other findings included a neural tube defect and a rectal duplication as an enteric cyst. Umbilical cord had only one vein and an artery. No abnormalities were found on pathologic examination of the placenta. Although we encountered cases previously with gastroschsis and omphalocele, this was the first case of body stalk anomaly that we recognized as an enteric cyst, which is extremely rare in twins.

Abdominal Muscles↗

Congenital generalized infantile myofibromatosis and neonatal hemochromatosis. An autopsy case report.

An autopsy case of congenital infantile myofibromatosis and neonatal hemochromatosis is reported. A thirty-six-hour-old baby girl had multiple subcutaneous nodules in addition to multiple visceral involvement of heart, lungs, pharynx, larynx, stomach, small bowel, large bowel, pancreas, kidneys, spleen, thyroid, adrenal glands, lymph nodes, peripheral nerves, meninges and soft tissues. In these tumoral nodules, three types of histological patterns were observed: 1-hemangiopericytoma-like, 2-mixed, and 3-pure spindle cell. Tumor cells were immunohistochemically positive for actin, and negative for desmin, muscle-specific antigen, and estrogen, related protein. The histological and immunohistochemical findings of the case suggested that a close relationship may exist between infantile myofibromatosis and infantile hemangiopericytoma. In addition to infantile myofibromatosis, neonatal hemochromatosis characterized by iron deposition in parenchymatous organs such as liver, pancreas, lungs, thyroid, and adrenal glands was another important characteristic of the case.

Fatal Outcome↗

Antenatal diagnosis of postductal coarctation of the aorta. A case report.

Fetal echocardiography can be used to detect congenital heart disease prenatally with a high degree of accuracy, and complex heart malformations have also been clearly described in the fetus. However, it is difficult to diagnose correctly or to exclude definitely aortic coarctation by fetal echocardiography. A 23-year-old woman was referred for fetal echocardiographic examination at 21 weeks' gestation after discovery of hydrops fetalis (nonimmune) on an obstetric ultrasound examination. Aortic isthmus appeared hypoplastic with a diameter < or = 3rd percentile for gestational age. There was a narrowing within the descending aorta immediately distal to the origin of the ductus arteriosus. Color flow imaging demonstrated acceleration and turbulent flow and the peak pressure gradient was measured 83 mmHg by continuous wave Doppler in the same area. The pregnancy terminated in spontaneous abortion at 22 weeks' gestation. The fetus was stillborn. The autopsy findings confirmed the prenatal diagnosis. We conclude that together with the quantitative estimation of the aortic arch, color Doppler and continuous wave Doppler are helpful in diagnosis and estimation of the pressure gradient.

Adult↗

Does estrogen cause low conversion rates in laparoscopic cholecystectomies for acute and chronic cholecystitis in women?

Laparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis. Severe local inflammation and scar formation are commonly responsible for conversion to open surgery. Fibrosuppressive effects of estrogen on peritoneal inflammatory conditions could provide low, dense fibrosis or scar formation around the gallbladder and make laparoscopic cholecystectomy easier in women and we believe that male sex is a conversion factor in laparoscopic cholecystectomy.

Acute Disease↗

Enterogenous cyst of the cervicomedullary junction. A case report.

Enterogenous cyst of the cervicomedullary junction extending from C2 level to the anterior aspect of the medulla oblongata was diagnosed in a 23-year-old male with a one month history of episodic tetraparesis and bilateral horizontal nystagmus. The cyst was removed subtotally except for a small portion at the point of the attachment to the anterior aspect of the medulla oblongata by a laminectomy of C1-C2 and a suboccipital craniectomy. Histopathological and immunohistochemical examinations revealed that the cyst originated exclusively from the endoderm.

Adult↗

Causes of fetal and neonatal death.

Autopsy was performed on 601 out of 654 (91.9%) fetus and newborn cases of death which occurred during a four-year period between 1988-1991 at Istanbul University Cerrahpaşa Faculty of Medicine, Gynecology Department and Neonatal Unit. According to autopsy findings, among the main causes of death in newborns were infection, hyaline membrane disease, congenital anomalies, perinatal hypoxia and immaturity, and in the fetal period, perinatal hypoxia, asphyxia and congenital anomalies. In these cases, when pathologic and clinical findings were examined, it was observed that in 204 out of 301 newborn cases (67.8%) the clinical findings were well correlated with the autopsy findings; in 97 (32.2%) of the remaining cases the main disease and primary causes of death could not be determined through clinical findings; in 69 (23%) cases, in addition to the clinical diagnosis on autopsy, minor defects were determined on autopsy which were not directly related to death. When clinical and autopsy findings were compared, diagnoses with the highest discordance were pulmonary hemorrhage infection and intracranial hemorrhage.

Autopsy↗