Biomedical subjects

M Cengiz

Publications and source records attributed to M Cengiz.

At least 37 records · Page 2Linked to original sources

PubMed1999

Effect of low-dose methyl prednisolone on serum cytokine levels following extracorporeal circulation.

The systemic inflammatory response to cardiopulmonary bypass (CPB) is associated with increased production of cytokines. This systemic inflammatory response characterized by the activation of interleukin-6 (IL-6) and interleukin-8 (IL-8) during and after CPB is well documented. A prospective, randomized, double-blind study was performed so as to understand the effects of low-dose methyl prednisolone sodium succinate (MPSS) on the circulating levels of serum cytokines and clinical outcome. Twenty patients were randomly divided into two groups on the basis of the administration of low-dose (1 mg/kg) MPSS (n = 10) and placebo (n = 10) into the pump prime solution. All patients were scheduled to undergo a primary elective coronary artery bypass grafting operation. Patients receiving concurrent corticosteroids, salicylates, dipyridamol or anticoagulants were excluded from the study. Other exclusion criteria were concurrent chronic obstructive pulmonary disease, chronic renal failure, insulin-dependent diabetes, congestive cardiac failure, peptic ulcer history, prior cardiac operations, recent (in a one-month period) myocardial infarction and steroid dependency. Mild systemic hypothermia (30-32 degrees C, rectal) was assured during the CPB. Four blood samples were drawn from the radial artery catheter immediately before starting CPB (T1), following protamine administration (T2) and at 24 (T3) and 48 h (T4) after completion of CPB. In each sample, creatine kinase-myocardial band (CK-MB), white blood cell (WBC), IL-6 and IL-8 levels were measured. IL-6 and IL-8 concentrations were measured by enzyme immunoassay and enzyme-linked immunoabsorbant assay methods. Serum IL-6 T2 and serum IL-6 T3 levels were significantly higher than IL-6 T1 levels in both groups (p < 0.001) and (p < 0.01), and there was no significant elevation in serum IL-8 levels in either group. Serum IL-6 levels were significantly higher in the placebo group than in the MPSS group at T3 (p < 0.009). There was no significant difference in CK-MB T1 levels between the groups. Although there was no significant difference between CK-MB T1 and T2 levels in the MPSS group, the CK-MB T2 and CK-MB T3 levels were significantly higher than T1 levels in the placebo group (p < 0.001) and (p < 0.05). There was significant elevation of WBC levels at T2 and T3 in both groups without notable difference between the groups (p < 0.05). This study has shown that low-dose MPSS suppresses CPB-induced inflammatory response. Further clinical studies (on larger and higher risk groups) may reveal more information on relations between morbidity and cytokine levels which may have some predictive value on clinical outcome following CPB.

Adult↗

PubMed1998

Effect of verapamil on lenticular calcium, magnesium and iron in radiation exposed rats.

PURPOSE: To investigate the effect of verapamil on lenticular calcium, magnesium, iron and on radiation-induced cataract in rats. METHODS: Thirty-seven, female, Wistar Albino rats, weighing 180-230 g were randomly grouped as follows: control group (10 rats), radiation group (13 rats) and radiation-verapamil group (14 rats). Both radiation and radiation-verapamil groups received 5 Gy radiation to the whole body in a single dose, including both eyes within the irradiation volume; in addition the verapamil group received daily subcutaneous injections of 8 mg/kg verapamil starting on the first day of radiation. At the end of an 8-week experimental period, the animals were killed by decapitation. Lenticular calcium, magnesium, and iron levels were studied. RESULTS: The mean lens calcium level for the radiation group was significantly higher than that for the control and radiation-verapamil groups and, there was no significant difference between the control and radiation-verapamil groups. The mean lens magnesium value for the radiation group was significantly higher than that for the control group. In the radiation-verapamil group the mean lens magnesium content was significantly lower than that for the radiation group. The iron level in the radiation group was significantly higher than that for the radiation-verapamil group. CONCLUSIONS: The lens calcium, magnesium and iron contents increased after radiation exposure. Verapamil treatment significantly reduced the increase in the lenticular content of calcium, magnesium and iron, indicating a probable protective effect of verapamil in radiation-induced cataract formation.

Animals↗

PubMed1996

Venous lesions in Behçet's disease.

OBJECTIVES: Review of venous lesions in Behçet's disease (BD). DESIGN: Retrospective study. SETTING: University Hospital, Turkey. MATERIALS AND METHODS: One hundred and twenty nine patients with BD diagnosed and treated in our hospital during the last 10 years were reviewed. Fifty-two patients with 54 vascular lesions of Behçet's disease were identified. MAIN RESULTS: The incidence of isolated venous lesions in BD was 26%. Venous lesions developed after the initial diagnosis of BD in all patients within 10 years. Thirty-four (63%) of the 54 vascular lesions were venous and 15 (28%) were arterial. In 5 (9%) patients, both arterial and venous lesions were present. Deep vein thrombosis was the most frequent lesion (76%), followed by superficial thrombophlebitis (10%), superior vena cava thrombosis (10%) and inferior vena cava thrombosis (2%) and varicose veins (2%). CONCLUSIONS: Venous lesions are not rare and affect the prognosis of BD. For this reason, venous lesions of BD should always be sought at follow-up of patients with BD.

Adult↗

PubMed1996

Glutathione and related enzymes in rat liver treated with methyl nitrosourea.

In vivo effects of methyl nitrosourea (MNU) on rat liver glutathione, glutathione S transferase and glutathione reductase have been studied. MNU was injected (20 mg per kg i.r.) weekly for 10 weeks. The animals were killed by decapitation 6 months later, livers were removed, homogenized and the enzymes were studied. Twenty-five animals were treated with MNU. Physiological salt solution was given to ten control animals. It was shown that the cytotoxic effects of MNU cause a decrease of glutathione levels. There was no difference in activity of glutathione reductase in the MNU treated group when compared to control, but glutathione S-transferase activity of the MNU treated group was found to be increased. Glutathione protects the cells against alkylating agents, which may cause cell damage due to depletion of glutathione levels. Increased levels of glutathione S-transferase may be a reaction of the organism to the alkylating agents. Because of depletion of glutathione levels, glutathione reductase levels may be unaffected.

Animals↗

PubMed1991

[Vascular lesions in Behçet's disease].

Vascular lesions in Behçet's disease are generally localized in the venous system: up to 24% of the cases reported in the literature are accompanied by thrombosis/thrombophlebitis. Reports of arterial involvement are rare but have increased during the last decade. Surgical treatments of arterial aneurysms and occlusions are often followed by recurrences due to progression or relapses of the inflammatory vessel wall lesions. Aneurysms of the pulmonary artery are rare. They may be complicated by thrombosis within the aneurysm and massive hemoptysis due to bronchial erosion and formation of an arterio-bronchial fistula. 27 cases of Behçet's disease are reported.

Adult↗

PubMed1984

Effects of compliance alteration on healing of a porous dacron prosthesis in the thoracic aorta of the dog.

In our study, the results reveal that a marked reduction in the compliance of an external-velour, weft-knit Dacron prosthesis did not impair healing of either the graft wall or of the anastomoses when these grafts were implanted in the upper part of the descending thoracic aorta of the dog for 56 days. These observations are clinically relevant, since they are important to the design of noncrimped fabric prostheses which are resistant to kink and compression when used for axillofemoral, femoropopliteal and femorotibial bypass. However, experimental studies of the influence of compliance disparity should be extended to such grafts implanted for several years.

Animals↗

PubMed1983

Prolonged mechanical ventilation for respiratory failure: a cost-benefit analysis.

To define the costs and benefits associated with prolonged mechanical ventilation, we studied retrospectively the records of 137 consecutive patients who required at least 48 h of ventilator support. The patients were physiologically unstable and required intensive care. Causes of respiratory failure included pulmonary diseases, post-operative complications, neuromuscular diseases, cardiac dysfunction, and GI disease. Forty-nine (36%) patients survived the hospitalization, and 38 (28%) patients were alive 3 yr after receiving prolonged mechanical ventilation. The mean total hospital cost was +16,930/patient (U.S. dollars, 1976-1977). The cost-benefit averaged +1826/yr of extended life. These costs varied from +460/yr of extended life for patients with respiratory failure complicating asthma to +8026/yr for patients with cardiac dysfunction. The cost-benefit ratio increased sharply for men older than 56 yr and for women older than 75 yr. These data document the importance of the basic disease process and the patient's age in the cost-benefit relationship.

Age Factors↗

PubMed1983

The effect of ventilation on the accuracy of pulmonary artery and wedge pressure measurements.

A comparison was made of automated versus manual measurement of pulmonary artery (PA) and wedge (WP) pressures. The manual pressure measurements were taken at end-expiration whereas the automated measurements were taken using existing monitor and computer algorithms. A total of 40 critical care patients were divided into groups according to the ventilatory mode used (spontaneous, intermittent mandatory ventilation [IMV], or assist/control). In patients who were breathing spontaneously, the automated method underestimated mean PA pressure (MPAP) (p less than 0.01), WP (p less than 0.001), and PA diastolic (p less than 0.001) pressure but not PA systolic pressure. In patients on IMV, the automated method underestimated MPAP (p less than 0.05), WP (p less than 0.001), and PA diastolic (p less than 0.001) pressure and overestimated PA systolic pressure (p less than 0.05). In patients on assist/control, the automated method overestimated WP (p less than 0.001) and PA systolic (p less than 0.005) pressure pressure, underestimated PA diastolic (p less than 0.001) pressure and did not affect MPAP. The error was not affected by respiratory rate, thoracic compliance, or level of PEEP. The errors in automated pressure measurements believed to be clinically important varied with the ventilatory mode used. Patients breathing spontaneously had the largest measurement error, with 42% of these patients having a clinically important error in WP and 99% having a clinically important error in PA diastolic pressure. Patients on assist/control had the fewest errors in automated pressure measurements. In all ventilatory modes used, automated measurement of PA diastolic pressure had the largest amount of error.

Automation↗

PubMed1982

Cardiovascular alterations in the adult respiratory distress syndrome.

We reviewed the hemodynamic data of 27 patients with severe adult respiratory distress syndrome (ARDS) and found significant elevations in heart rate, pulmonary artery pressure, and pulmonary vascular resistance and depressions of stroke index and left ventricular stroke work index. Altered left ventricular performance was suggested by a left ventricular stroke work index lower than expected for the level of wedge pressure in 19 patients and decreased slopes in nine of 11 ventricular function curves. Hemodynamic values in a subgroup receiving 0 to 5 cm H2O of positive end expiratory pressure (PEEP) were similar to those in the overall group (mean PEEP 12.5 +/- 7.9 cm H2O). Improvement in pulmonary and systemic hemodynamics occurred in survivors. Eight of 11 patients who underwent postmortem examination had cardiac abnormalities. The findings in this study suggest that changes in cardiovascular performance commonly occur in severe ARDS and that several mechanisms may contribute to the alterations.

Adolescent↗

PubMed1981

Pulmonary function and exercise gas exchange in survivors of adult respiratory distress syndrome.

Pulmonary function studies were performed on 13 survivors of adult respiratory distress syndrome (ARDS). Six of these 13 patients had a forced vital capacity (FVC) and total lung capacity (TLC) less than 80% of predicted within 2 months of the onset of ARDS. Seven patients followed 6 months or more showed no significant difference between measured and predicted FVC (p = 0.26) or TLC (p = 0.12). The diffusing capacity of carbon monoxide was significantly lower than predicted normal values (p less than 0.001). Although the alveolar arterial oxygen tension gradient (delta AaPO2) was within the predicted normal range for 11 nonsmokers at rest, for 7 patients who exercised (1.0 less than VO2 less than 1.5 L/min), delta AaPO2 increased. The ratio of dead space to tidal volume decreased to less than 0.25 when VCO2 exceeded 1.0 L/min. We concluded that lung mechanics return to predicted normal values within 4 to 6 months after ARDS, but abnormalities of pulmonary gas exchange persist. Pulmonary vascular obstruction does not appear to explain persistent abnormalities of gas exchange.

Adolescent↗

PubMed1978

Civilian ground and air transport of adults with acute respiratory failure.

The intermountain Respiratory Intensive Care Unit (IRICU), established in 1973 at the LDS Hospital in Salt Lake City, provides specialized care for adults and older children with severe respiratory failure in the intermountain West. Because of the large area serviced by the IRICU, a transportation system for the critically ill was developed. Our report describes the transport system, including team organization, techniques, and experiences. Of 44 attempted transports during the last three years, 43 (98%) were safely accomplished without obvious ill effect to the patient. Patients with severe respiratory failure, if their conditions are adequately stabilized, can be safely transported hundreds of kilometers by ground and air by a well-equipped and well-trained team of physicians and nurses.

Acute Disease↗

PubMed1977

Oxygen therapy: appropriate use of nebulizers.

Control of the inspired O2 concentration requires both an appropriate O2 fraction from the nebulizer and an adequate flow of gas to the patient. We evaluated the O2 fraction and total flow of commercially available nebulizers operated under conditions commonly encountered in clinical use. Total gas flow O2 fraction, and back pressure were measured in 8 commercially available nebulizers. Measurements were made with no outlet tubing ,with 72 inches of dry corrugated plastic tubing, and with 72 inches of corrugated plastic tubing partially occluded with water. Nebulizers were studied individually ,and in parallel sets of 2 and 3, at both 40% and 70% O2 settings. Total flow was always lower and O2 fraction higher than that predicted by the manufacture under all experimental circumstances. As the outlet resistance of the nebulizers increased, the O2 fraction increased and the total flow decreased. The O2 fraction was, in addition, increased with the addition of each nebulizer in parallel. Currently available nebulizers have operating characteristics that do not permit the easy administration of accurate O2 therapy.

Aerosols↗

PubMedDate not supplied

Plasma carnitine levels in children with Down syndrome.

Carnitine is responsible for several chemical processes, including lipid metabolism, nerve cell conduction, reduction in muscle hypotonia, and limitation in oxidative damage to cells. In patients with Down syndrome (DS), the process of growth is behind that of normal children and neuromuscular control is attained somewhat later. The purpose of this study was to assess variation in levels of carnitine in normal and DS children and the relationship between the amount of carnitine and age. The study involved 30 (15 girls, 15 boys) normal children and 40 (20 girls, 20 boys) DS patients of Turkish ancestry, 6 months to 13 years of age. Carnitine level was determined using Deufel's enzymatic method. Carnitine level was significantly lower in DS patients compared with normal children between 6 months to 5 years of age. Between 5 and 13 years of age, the level of carnitine was about the same in both the normal and DS groups. The results suggest that carnitine level shows a different pattern of age related increase in DS compared to normal children.

Adolescent↗

PubMedDate not supplied

Frequency of spinal reflex movements in brain-dead patients.

Spontaneous and reflex movements may occur in brain-dead patients. These movements originate from spinal cord neurons and do not preclude a brain-death diagnosis. In this study, we sought to determine the frequency and characteristics of motor movements in patients who fulfilled diagnostic criteria for brain death. Patients admitted to our department between January 2000 and March 2003 and diagnosed as brain-dead were prospectively evaluated in terms of spinal reflexes. Clinical brain death was diagnosed according to our national law. We also prefer to document the diagnosis of brain death with an EEG and/or TCD. Spinal reflex movements were observed in 18 out of 134 (13.4%) brain-dead patients during the study period. Lazarus sign, the most dramatic and complex movement seen in brain-dead patients, was observed a few times in two patients during an apnea test, an oculocephalic test, after a painful stimulus, and after removal of a ventilator. The other reflex movements observed in our brain-dead patients were finger and toe jerks, extension at arms and shoulders, and flexion of arms and feet. The occurrence of spinal reflexes in brain-dead patients may certainly delay decision making, such as starting a transplantation procedure, because of difficulties in convincing the family or even a physician taking part in the diagnosis of brain death. An awareness of spinal reflexes may prevent delays in and misinterpretations of the brain-death diagnosis.

Adolescent↗

PubMedDate not supplied

Brain death and donor management in the intensive care unit: experiences over the last 3 years.

We sought to examine the frequency of brain death in the ICU, the donation rate, and the problems encountered during donor management between the years of January 2000, the date we began treating patients with neurologic pathologies and traumatic brain injury, and March 2003. Between January 2000 and March 2003, 134 patients diagnosed with brain death in our ICU were studied prospectively for the reason of brain death, the time between admission to ICU, and the diagnosis of brain death, the frequency of diabetes insipidus, the inotrope requirement, hypothermia, electrolyte imbalance, arrhythmia, and cardiac arrest. Among the approximately 2600 patients admitted to the general 24-bed ICU, 940 had cerebral injuries. In this group, the mortality rate was 33.5% (315 out of 940 patients) including brain-dead patients. Donor care was performed in 94 patients with organs suitable for transplantation out of 134 brain-dead patients. Fifty (53.2%) out of 94 patients became organ donors. The donor ratio was 12 per million-population per year as a mean value of the study period, which was approximately 10 times higher than the average ratio in Turkey. Although we observed many life-threatening problems during donor management, none of these patients died or had acute organ dysfunction.

Brain Death↗

PubMedDate not supplied

A possible mechanism of X-ray-induced injury in rat lens.

PURPOSE: X-ray and other radiation can cause cataract, but the pathogenic mechanism is largely unknown. The aim of this study was to investigate the accumulation of iron in the x-ray-exposed rat lens and its relationship to lens injury. METHODS: Fifty male Wistar rats were divided randomly into five groups of 10. Groups 2 and 4 rats were sham-exposed, groups 3 and 5 were x-ray-treated, and group 1 served as control. X-ray radiation and sham exposure were performed in a similar manner. After 10 and 30 days of exposure, a lens from each rat in groups 2 and 3, and 3 and 5, respectively, were analyzed by flame atomic absorption technique for the assessment of metal content. RESULTS: Significantly decreased zinc and increased iron and calcium concentrations were detected in the lens samples of groups 3 and 5 compared with groups 2 and 4 and controls. Similar results were obtained comparing groups 5 and 3. CONCLUSIONS: We propose that x-ray exposure may cause toxic cell injury of the rat lens via Fenton metals catalyzed damage. Initial lens membrane damage in the radiolytic phase may permit the access of iron resulting in lens damage.

Animals↗

PubMedDate not supplied

Radiotherapy in the management of Kasabach-Merritt syndrome: a case report.

A 21-day-old infant with hemangioma was brought to the hospital with enlargement of the hemangioma of the left thigh and purple discoloration around umbilicus. This led to the diagnosis of Kasabach-Merrill syndrome. Initial treatment with corticosteroid failed. The patient underwent radiotherapy that led successfully to improvement of both hemangioma and thrombocytopenia. After 2 years of follow-up, the patient has experienced long-term complications, including atrophy and growth retardation of the irradiated leg.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Postoperative vaginal brachytherapy alone is the treatment of choice for grade 1-2, stage IC endometrial cancer.

The aim was to determine outcome and toxicity in grade 1-2, FIGO stage IC endometrial cancer patients treated with external beam radiotherapy plus vaginal cuff brachytherapy or vaginal cuff brachytherapy alone. Between 1986 and 1999, a total of 132 patients were diagnosed with FIGO stage IC endometrial carcinoma. The median age was 67.5 years (range, 36-88). Median follow-up was 54 months (range, 6-157). Grade 1 disease was present in 64 patients, grade 2 in 45 patients, and grade 3 in 23 patients. Patients with grade 3 disease usually received external radiotherapy and were excluded from this analysis. Of the patients with grade 1-2 disease, 31 received brachytherapy alone and 78 received both external radiotherapy and brachytherapy. Ten (8%) patients experienced failure. Isolated pelvic relapse occurred in five patients. Three patients experienced both distant and local relapse. Two patients had isolated distant relapse. Nine failures occurred in patients treated with both external radiotherapy and brachytherapy. Only one failure occurred in those treated with brachytherapy alone. Overall survival and disease-free survival at 5 years were 85% and 92%, respectively. For those treated with both external radiotherapy and brachytherapy, 5-year locoregional control was 95%. For those treated with brachytherapy alone, 5-year locoregional control was 96.4%. There was no significant survival or local control difference between the two groups. Nine patients (9%) treated with both external radiotherapy and brachytherapy developed Radiation Therapy Oncology Group grade 3-4 toxicity. No patient treated with vaginal cuff brachytherapy alone developed grade 3-4 toxicity (P < 0.001). In patients with well-differentiated (grade 1-2) stage IC endometrial cancer, external beam radiotherapy plus brachytherapy versus vaginal cuff brachytherapy alone achieved equivalent local control and survival. However, vaginal cuff brachytherapy alone produced significantly less toxicity.

Adult↗