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Biomedical subjects

G Demir

Publications and source records attributed to G Demir.

At least 19 recordsLinked to original sources
PubMed2005

Influence of Bacillus Calmette-Guèrin vaccination at birth and 2 months old age on the peripheral blood T-cell subpopulations [gamma/delta and alpha-beta T cell].

The neonatal immune system is immature and may be affected by Bacillus Calmette-Guèrin (BCG) vaccine. We investigated the influence of BCG given at two different ages on the peripheral blood (PB) T-cell subpopulations. Forty full term healthy newborns were randomly chosen. Twenty of them were vaccinated with BCG at birth (group I) and the remaining at the age of 2 months (group II). The cell analysis were carried out before (pre-BCGI and pre-BCGII), and 2 months after (post-BCGI and post-BCGII) the vaccination. The analysis of the gamma/delta and alpha/beta T-cell receptor (TCR) antigens was done by two-colour flowcytometer. The purified protein derivative (PPD) response was investigated 2 months after vaccination. The results showed that although T-cell (TCR+ cell) counts showed no difference in PB before and after vaccination in both study groups, the total lymphocyte and non-T cell (TCR- cell) populations increased significantly whereas alphabetaT-cell population significantly decreased after vaccination. On the contrary, gammadeltaT-cell counts in PB increased significantly 2 months after vaccination in group I but not in group II. Total lymphocyte and non-T cell counts in vaccinated infants at 2 months of age (post-BCGI) were significantly higher than in unvaccinated infants of the same age whereas alphabetaT-cell count in vaccinated infants was significantly low. However, total T-cell and gammadeltaT-cell counts showed no difference. PPD positivity was similar in both study groups (61% in group I, 66% in group II). Neither alphabetaT- nor gammadeltaT-cell counts were different in PPD positive and PPD negative infants. Our study shows that BCG causes marked quantitative changes in the PB T-cell subpopulations in young infants.

BCG Vaccine↗
PubMed2001

The effect of prolactin and bromocriptine on human peripheral immune status.

The aim of this study was to determine the influence of elevated serum prolactin (PRL) levels on the peripheral lymphocyte subsets in patients with hyperprolactinemia. For this purpose we studied 20 hyperprolactinemic patient lymphocyte subsets by flow cytometry on their hyperprolactinemic state and after their serum prolactin concentration was normalized with bromocriptine (BC) alone or BC and surgery. We observed decreased absolute numbers and percentage of Natural Killer (p=0.0009 and 0.0001, respectively) and CD3/CD25 lymphocytes (p = 0.009 and 0.002) in hyperprolactinemic patients, compared to 8 sex- and age-matched normal controls. There was no correlation between PRL levels and CD16/56 and CD3/CD25 numbers (p=0.72 and 0.33, respectively). We did not find any significant difference in absolute numbers (p = 0.95) and percentage (p = 0.84) of B-lymphocytes of hyperprolactinemic patients, as compared with normal controls. We did not detect any increase in absolute cell numbers of CD16/CD56 (p = 0.21) and CD3/CD25 (p = 0.61) of BC-treated patients when compared to their hyperprolactinemic state. We demonstrated an increase in CD8-cells (p = 0.0173) and a decrease in CD4/CD8 ratio (p = 0.036) in hyperprolactinemic patients treated with BC. There was also an increase in the number of activated T-cells (CD3/HLA DR) in this group, compared to normal controls and the hyperprolactinemic state of the same patients (p = 0.04). In conclusion, elevated PRL levels do not lead to an "overstimulation" of the B-cells, but deteriorate the cytotoxic function.

Adenoma↗
PubMed2000

Serum erythropoietin level in anemic cancer patients.

Anemia is a frequent complication of cancer and its treatment. A defect in erythropoietin production has been advocated as being the main cause of anemia in cancer patients. We studied serum erythropoietin levels in 74 patients with solid tumors and in a control group consisting of 20 otherwise healthy individuals without any malignancy, who have only iron deficiency anemia. Serum erythropoietin levels were measured by enzyme immunoassay in cancer patients without anemia (n=34), and in anemic cancer patients (n=40); either receiving chemotherapy (n=21) or not (n=19). Anemic cancer patients were found to have decreased response of erythropoietin for a given hemoglobin level (mean, 40.1+/-34.7 u/ml), compared with the patients having only iron deficiency anemia (mean, 69.7+/-68.6 u/ml) (P<0.05). In patients with iron deficiency anemia having no malignancy, erythropoietin response was remarkably high and inversely correlated with the level of hemoglobin (r=-0.69; P=0. 05). Although there was no correlation between hemoglobin and erythropoietin response in cancer anemia (r=-0.07), serum levels of erythropoietin were found to be higher in anemic cancer patients (mean, 40.1+/-34.7 u/ml), compared with cancer patients with normal hemoglobin values (mean, 19.96+/-18.4 u/ml). There was not any statistically significant difference between erythropoietin levels in anemic cancer patients with or without chemotherapy (mean, 43. 7+/-37.7 u/ml and 41.9+/-30.08 u/ml respectively; P>0.05). No difference in serum erythropoietin levels were noted in patients treated with cisplatin or non-cisplatin containing regimens (mean, 48.36+/-33.12 u/ml and 38.55+/-43.52 u/ml, respectively; P>0.05). In this study, we demonstrated that anemia in cancer patients was caused by blunted erythropoietin response, rather than its quantitative deficiency. Serial measurements, however, should be considered in patients receiving chemotherapy.

Adolescent↗
PubMed2000

Detection of t(14;18) in turkish follicular lymphomas using the polymerase chain reaction.

A t(14;18) translocation is closely associated with the follicular lymphoma but is also seen in diffuse B cell lymphomas with a previous history of a follicular lymphoma as well as de novo diffuse lymphomas. Estimation of the frequency of t(14;18) in follicular lymphoma vary widely from 33 to 89%. Furthermore, no extensive data have been published on the frequency of t(14;18) in Turkish cases of follicular lymphoma. Representative tissue blocks from 67 patients with follicular lymphoma, 12 cases of diffuse large B cell lymphomas and 11 cases of reactive hyperplasias were examined for the presence of this translocation using PCR. DNA probes capable of detecting rearrangement at both the major and minor break point regions were employed. We could detect t(14;18) in 46 out of 67 cases (68.7%) of follicular and 25% of diffuse large B cell lymphomas. In follicular lymphomas 64.2% of these break points were at mbr and 4.5% were at the mcr region. Review of the literature showed that comparable results have been obtained previously using molecular techniques. Our data showed that despite the relative infrequency of follicular lymphomas in the Turkish population these lymphomas share a common molecular pathogenesis with involvement of bcl-2 gene and background incidence of such rearrangement is similar in all populations, regardless the incidence of folicular lymphoma.

Adult↗
PubMed2000

A case of metastatic malignant melanoma presenting with hematuria.

We report a case of metastatic malignant melanoma that presented with macroscopic hematuria and lower urinary tract symptoms. Effective palliation of urinary tract symptoms was achieved with transurethral resection of metastatic lesions in the bladder. However, the patient was lost due to widespread disease despite systemic therapy. Solitary or multiple dark blue-black nodular or vegetating lesions encountered during cystoscopy should raise the suspicion of metastasis of malignant melanoma and be investigated accordingly.

Female↗
PubMed1999

Effect of hematocrit on blood pressure via hyperviscosity.

Increase in blood viscosity, defined as resistance to flow, is one factor in hypertension and atherosclerosis that contributes to the morbidity and mortality associated with tissue ischemia. In this research we evaluated the effect of hematocrit on increasing viscosity, and possible related changes in blood pressure, flow rate, and the equivalent physiologic compensation ratios. Blood samples were taken from 32 healthy individuals and centrifuged for 5 min at 3000 rpm to obtain 2.5 mL of erythrocyte mass from each. Then, at each step 0.5 mL of plasma was consecutively added in a total of 17 steps. The resultant hematocrit and viscosity changes were measured. Viscosity measurement was performed by capillary viscometer. The results were evaluated by the Student t test. It was observed that in the range of 60.16% and 25.32%, a 10.99% increase of hematocrit produced an increase of 1 unit relative viscosity, which means approximately a 20% increase in blood viscosity for a healthy individual. According to Poiseuille's equation, with a constant vessel length, if viscosity is increased by 20%, the decrease in blood flow rate will be 16.67% (100/120 = 83.33%; 100 - 83.33 = 16.67%). For the physiologic compensation of 20% increased viscosity, blood pressure increase will be 20% or vasodilation will be 4.66% in radius. Atherosclerotic and some healthy vessels with little vasodilatory capacities might benefit from treatment modalities to decrease the viscosity by hemodilution.

Blood Pressure↗
PubMed1999

Magnetic resonance imaging of bone marrow versus bone marrow biopsy in malignant lymphoma.

Bone marrow involvement is a frequent finding in malignant lymphoma. Bone marrow biopsy of the posterior iliac crest is routinely performed for staging. Abnormal magnetic resonance imaging (MRI) signals of bone marrow was also reported to be indicative of bone marrow involvement. This study included 60 patients with malignant lymphoma. Unilateral bone marrow biopsy of the posterior iliac crest was performed. MRI of lumbar spine was studied within 24 hours of bone marrow biopsy. 22 healthy controls were used for the detection of MRI objectivity during visual evaluation. In 83% of patients (50/60), biopsy and MRI results agreed completely. In two patients, histologic sections failed to show any evidence of bone marrow involvement despite abnormal MRI signals suggestive of involvement. In three patients, MRI was completely normal despite biopsy proven bone marrow infiltration. False negativity (3/60) and false positivity (2/60) rates were very low. Negative biopsy findings with positive or equivocal MRI results should not exclude bone marrow involvement and needs further evaluation with bilateral or guided biopsy. Thus, we conclude that MRI of bone marrow is a fairly sensitive, noninvasive modality and might be of potential value in detecting bone marrow infiltration in malignant lymphoid neoplasms which can be utilized as a useful adjunct to standard staging procedures.

Adult↗
PubMed1999

Anaphylaxis from intraperitoneal infusion of cisplatin: a case report.

Anaphylactic reactions to platinum compounds and paclitaxel are well-recognized complications during their systemic administration. Although there have been reports describing anaphylaxis during intravesical instillation of chemotherapeutic agents, to the best of the authors' knowledge, no hypersensitivity reactions after intraperitoneal administration of chemotherapeutic drugs has been reported in the English literature. The authors report an unusual case of anaphylaxis occurring in a 33-year-old woman who has been treated with paclitaxel and cisplatin for ovarian cancer. She developed a hypersensitivity reaction during her ninth cycle of chemotherapy, immediately after institution of intraperitoneal infusion of cisplatin. It is important to be aware of the possibility of anaphylaxis during chemotherapy administration other than the systemic route so that appropriate premedication or effective treatment can be promptly instituted.

Adult↗
PubMed1999

Bilateral inflammatory breast metastases of epithelial ovarian cancer.

Metastases to the breast are rare. Secondary breast involvement from an epithelial ovarian cancer heralds widespread dissemination and a very poor prognosis. We report an unusual case of a patient who had epithelial ovarian cancer and who showed signs of recurrence with inflammatory metastases to both breasts, 2 years after her diagnosis of ovarian cancer. She died within 3 months of breast involvement. Our case has unique features, with both bilateral breast metastases and also with its inflammatory pattern of metastasis, which is extremely rare.

Breast Neoplasms↗
PubMed1999

Usefulness of the epithelial tumor marker CA-125 in non-Hodgkin's lymphoma.

CA-125, a commonly used tumor marker for epithelial ovarian cancer, is a glycoprotein found in normal tissues derived from coelomic epithelia. Increased serum levels of CA-125 have also been found in nongynecologic tumors and nonmalignant diseases involving the peritoneum. A few recent studies and sporadic case reports have reported increased CA-125 levels in patients with non-Hodgkin's lymphoma (NHL). In our study, we aimed to evaluate the serum levels of CA-125 in patients with NHL and determine its potential role to show disease activity in NHL. Serum levels of CA-125 were measured in 61 patients with NHL and were found to be correlated with clinical stage, site of involvement, and disease activity.

Abdominal Neoplasms↗
PubMed1999

Primary splenic tuberculosis in a patient with nasal angiocentric lymphoma: mimicking metastatic tumor on abdominal CT.

Tuberculosis may be difficult to diagnose when it presents in an uncommon extrapulmonary site. The authors report a case of splenic tuberculosis mimicking metastatic tumor on computed tomography in a 60-year-old woman who had been treated with combination chemotherapy for nasal angiocentric lymphoma. Diagnostic splenectomy revealed multiple necrotic masses in the spleen, which were consistent with caseating granulomas microscopically. Diagnosis was confirmed by positive cultures in Lowenstein medium, which grew typical Mycobacterium tuberculosis organisms. Following splenectomy, the patient was also treated with a triple-drug antituberculosis regimen with no recurrence of her symptoms.

Diagnosis, Differential↗
PubMed1999

Anorectal melanoma metastatic to the breast.

Anorectal melanoma is an extremely rare malignancy with poor prognosis. Patients generally present with a sensation of mass and rectal bleeding, which is usually attributed to hemorrhoids or polyps. It can not be diagnosed early because of these benign symptoms, so it is bulky at the time of presentation. Despite aggressive surgery, 5-year survival is less than 10%. We present a case of inoperable anorectal melanoma which metastasized to the left breast and abdominal lymph nodes. We also briefly reviewed the appropriate literature, emphasizing the diagnostic and therapeutic approaches.

Anus Neoplasms↗
PubMed1999

Serum cardiolipin antibodies in cancer patients with thromboembolic events.

This study was undertaken to investigate a possible association of anticardiolipin antibodies (ACLAs) in cancer patients with thromboembolic events. Twenty-five patients with solid tumors complicated with acute thrombosis, 36 cancer patients without any thrombotic events, and a group of 20 healthy volunteers without thrombosis or malignancy were included. The mean age of the cancer patients with and without thrombosis and healthy subjects were 50 years (range 20-75), 45 years (range 23-66), and 40 years (range 20-68), respectively. Deep venous thrombosis (n = 16) and thrombosis of the central venous port-catheter systems (n = 9) were confirmed by Doppler sonography in all patients. IgG and IgM isotypes of ACLAs were quantitated by enzyme-linked immunosorbent assay with normal levels of < 23 GPL and < 11 MPL, respectively. Mean values of IgG ACLAs were found similar in cancer patients with acute thrombosis (13.8 +/- 4.9 GPL), without thrombosis (12.8 +/- 5.4 GPL) or in healthy subjects (14.8 +/- 5.5 GPL). Although the mean values of IgM ACLAs were within normal limits in all groups, cancer patients with thrombotic events had higher levels of IgM ACLAs (mean = 10.5 +/- 2.2 MPL) than cancer patients without thrombosis (mean = 4.6 +/- 2.4 MPL) (p = .01). Healthy subjects also had lower levels of IgM ACLAs (mean = 7.1 +/- 3.2 MPL) than cancer patients with thrombosis (p = .16). In addition, a higher percentage of cancer patients with or without thrombosis had IgM and IgG ACLA levels above normal limits compared with healthy controls. In conclusion, our study suggests an association between ACLAs or IgG and particularly IgM isotypes and venous thrombosis in malignancy. Identification of cancer patients who are at higher risk for developing thromboembolic events might lead to a better selection of patients for prophylactic anticoagulant therapy.

Adult↗
PubMed1995

Is awareness of its risk enough to stop people from smoking?

A questionnaire to elicit information about smoking habits and knowledge of the risks of smoking was administered to 100 students (53 men and 47 women) in the graduating class of 1993 at the Cerrahpaşa Medical School of Istanbul. Forty-three percent of the men and 27% of the women students were smokers. All but one of the 100 students were aware that smoking is a risk factor for both lung and laryngeal cancers, and 44% of the smokers believed that cessation of smoking by the smoking population could decrease the incidence of lung cancers to less than half of its present level. These data suggest that awareness of the risks of smoking is not enough to motivate smokers to quit, even when they are young physicians. Of the nonsmokers, 87.5% indicated that they would attempt to restrain their younger siblings from smoking, whereas the corresponding figure for smokers was 58.3%. The smokers and the nonsmokers answered two of the questions on the questionnaire significantly differently. Thirty-six percent of the mothers of the nonsmokers and 31% of their siblings were also smokers, whereas the corresponding figures for the nonsmokers were 18% and 13% (half of the fathers in both groups smoked). Thus, family and the environment appear to influence smoking behavior. Successful modification of smoking habits will necessitate more education of the general public.

Female↗
PubMed1994

Adapting undergraduate preclinical courses to changes in clinical applications.

The availability of new technologic tools has greatly changed differential diagnosis. To assess the importance of these tools in current clinical practice, the authors determined the frequencies of use of new imaging methods in diagnosis, staging, and follow-up in 71 oncology cases. The new methods were found to have replaced traditional diagnostic procedures to a substantial extent. To familiarize medical students with the new techniques, lectures on sectional anatomy given by radiologists were integrated into traditional anatomy courses for a group of 50 students. Two years later, after their initial exposure to clinical practice, the 42 students remaining in the group answered a questionnaire regarding the usefulness of the sectional anatomy segment of their anatomy training. Of these 42 students, 14 rated the sectional anatomy exposure "very helpful" to comprehension in the clinical internship and 21 rated it "helpful." The students suggested that the program be reinforced by an integrated textbook. This preliminary study suggests that basic preclinical courses should be modulated to reflect new methods that come into routine use in clinical practice.

Anatomy↗