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Biomedical subjects

M Karatas

Publications and source records attributed to M Karatas.

12 recordsLinked to original sources

Protection of the conjunctival flap from contact with mitomycin C during tunnel-trabeculectomy.

AIM: The mid-term appearance of the filtering bleb and surgical outcome following tunnel-trabeculectomy, in which protective measures were carried out to avoid contact between the mitomycin C (MMC) and the conjunctival flap, are presented. METHODS: In a retrospective study the records of 20 consecutive patients who had undergone tunnel-trabeculectomy >/=24 months earlier, using fornix-based conjunctival flap and MMC (0.4 mg/ml) application were evaluated. Inclusion criteria were patients in whom: (I) the MMC-socked sponge was applied without contact with the conjunctival flap; (II) during MMC washout, a second Weck cell sponge was held anterior to the conjunctival flap, to protect the flap from mitomycin contact during its back-flow. Excluded were five patients who either did not complete 24 months of follow-up (n=4) or underwent an intraocular surgery during that period (n=1). RESULTS: After 24-32 (26.9+/-2.2) months, the filtering bleb was completely vascularized and thick in 13/15 patients (86.7%), mostly vascularized with some para-limbal thick cysts in one and avascular and cystic in another. Mean intraocular pressure (IOP) dropped from a preoperative level of 25.3+/-7.0 mmHg with 3.5+/-0.9 hypotensive medications to 13.9+/-2.9 mmHg with 0.9+/-1.1 medications (P<0.0001, Wilcoxon test). Of the five excluded patients, the IOP ranged between 10 and 16 mmHg with 0-1 medications at the last examination, 1-15 months postoperatively. CONCLUSION: In this pilot study, an intraoperative protection of the conjunctival flap from mitomycin contact was mostly associated with a vascularized and thick filtering bleb after mid-term follow-up. Further controlled prospective studies are required to confirm these observations.

Adult↗

Bilateral drop-foot after orthotopic liver transplant.

Patients may demonstrate various neuromuscular abnormalities after liver transplantation. We report a patient who developed bilateral drop foot after orthotopic liver transplantation. He was diagnosed with critical illness polyneuropathy. During follow-up, his complaints gradually recovered and his electrodiagnostic findings improved.

Adult↗

Levetiracetam in Meige's syndrome.

The spontaneous occurrence of blepharospasm and dystonic movements in face muscles, particularly those of the perioral and mandibular regions, has been named as Meige's disease which was first described by Henry Meige in 1910. We report the case of a woman with Meige's syndrome whose symptoms improved with the use of levetiracetam.

Anticonvulsants↗

Diabetic vitreopapillary traction and macular oedema.

PURPOSE: To describe an association between optic disc traction and diabetic macular oedema (DME) unresponsive to laser treatment. METHODS: A retrospective review of all patients with DME who attended our clinic between September 2001 and November 2003 was undertaken. The patients had undergone ophthalmic history and examination, fluorescein angiography, and optical coherence tomography (OCT) of the macular area and optic nerve head (ONH). A total of 10 nonvitrectomized eyes that were found to have an elevation of the ONH secondary to vitreopapillary traction were included in the analysis. Eyes with additional traction at the posterior pole were excluded. RESULTS: Out of the 10 eyes (seven patients, aged 47-79 years) with vitreo-papillary traction, nine had previously undergone argon laser photocoagulation(s) for DME. In seven eyes (seven patients), OCT verified the vitreopapillary traction as the sole traction, whereas in the fellow eyes of three patients vitreomacular traction was evident as well. In the seven eyes with only vitreopapillary traction, OCT demonstrated parapapillary serous retinal detachment in two eyes and a diffuse DME in all eyes (mean foveal thickness, 396+/-144 microm). Maximal thickness of the papillo-macular bundle site was adjoining the elevated ONH in three eyes, and was maximal at the central macula in the other four eyes. Ultrasonography (n=5) revealed an incomplete detachment of the posterior hyaloid in each, adherent only at the ONH. CONCLUSIONS: Diffuse DME unresponsive to laser treatment may be associated with vitreopapillary traction. Further studies should indicate whether these two phenomena could suggest a cause and effect in such eyes.

Aged↗

Nickel adsorption on the modified pine tree materials.

Removal of nickel ions from aqueous solutions containing 1-100 mg l(-1), using pine tree (Pinus nigra) materials modified with HCl, was investigated on a laboratory scale. For this purpose, two natural adsorbents such as the modified pine bark (MPB) and the modified pine cone (MPC) materials with HCl solution were studied. At first, the required concentration level of the HCl solution for the modification was observed, and then this was followed by the determinations of optimum levels of adsorbent amount, stirring rate, contact time and pH values. Various adsorption isotherms were also obtained by using different concentrations of the heavy metal cations tested in the experiment. As a result, the maximum removal efficiency levels obtained were as follows; 97% for the modified pine bark at pH 8 and 80% for the modified pine cone at pH 8.

Adsorption↗

Effect of MnSO4 on the chromium removal from the leather industry wastewater.

Chromium (VI) is one of the heavy metals in water and wastewater that has the most toxic characteristic. Consequently, it is dangerous for human and environmental health. Various methods are used for removal of the chromium from wastewater, and new methods have been developed in recent years. Recent studies and investigations on the removal of environmental pollution selected methods that were economical, of optimum efficiently and could be carried out easily. In this study, the removal of Cr6+ in the leather industry wastewater is investigated using MnSO4 that was used easily and economically. Experimental studies are performed in two phases. In the first phase, the optimum MnSO4 dose for removal of Cr6+ was determined. In the second phase, the optimum pH was studied. About 96% removal of chromium was launched with 530 mg l(-1) MnSO4 dose at pH value 9 in the wastewater sample.

Animals↗

Mucormycosis presenting with painful ophthalmoplegia.

Mucormycosis is a rare fungal infection that can involve the sino-orbito-cerebral region. Sino-orbito-cerebral mucormycosis is most common in patients who are immunocompromised or have diabetes mellitus, severe malnutrition or burns. This condition can be fatal if it is not diagnosed early and treated aggressively. This article presents 4 cases of mucormycosis, including 2 with orbital apex syndrome, 1 with cavernous sinus syndrome, and 1 with multiple cranial nerve involvement. All of the patients were presented with painful ophthalmoplegia. The predisposing factors for mucormycosis included diabetes mellitus (three patients) and chronic leukemia (one patient). In all cases, mucormycosis was diagnosed by examining endoscopic sinus drainage material and was treated with surgical debridement and amphotericin B. Two patients with central nervous system involvement died. The others have survived, but still exhibiting various neurologic abnormalities after aggressive treatment. Patients with mucormycosis rarely present with orbital apex syndrome. The possibility of mucormycosis should be investigated in any patient with painful ophthalmoplegia, and prompt otorhinolaryngologic examination is recommended to ensure rapid diagnosis and treatment.

Aged↗

Double spinal cord injury in a patient with ankylosing spondylitis.

Ankylosing spondylitis patients are more prone to spinal fractures and these fractures commonly result in mobile nonunion. We report a patient with a 30-year history of ankylosing spondylitis who sustained double spinal cord injuries following minor trauma. The first injury occurred at the lumbar level due to pseudoarthrosis of an old fracture, and the second at the thoracic level following cardiopulmonary arrest and an episode of hypotension. The possible mechanisms of the injuries are discussed and maintaining normal blood pressure in these patients is emphasized.

Aged↗

Assessment of spasticity using isokinetic dynamometry in patients with spinal cord injury.

OBJECTIVES: To determine the value of isokinetic dynamometric measurement of passive resistance in quantifying spasticity. SETTING: Turkey. METHODS: Thirty-three spastic spinal cord-injured patients and 14 age-matched normal individuals were studied. Five consecutive flexion-extensions of the knee, abduction-adductions of the hip, and dorsal-plantar flexions of the ankle were performed at specific velocities (15, 30, 60, 90 and 120 degrees /s) using a computerized isokinetic dynamometer set at the continuous passive motion mode. We recorded maximum torque and the sum of torque amplitudes for five repetitions of each type of joint motion at all velocities. RESULTS: Maximum torque values and the sum of torque amplitudes were both significantly higher in spastic patients than in controls, and there was a positive correlation between torque values and Ashworth scores. There was no significant linear increase in torque values associated with increasing velocity for any of the motions in either controls or patients. CONCLUSION: Isokinetic dynamometric measurement of passive resistance appeared to be a valuable tool for assessing and quantifying spasticity, as well as other types of hypertonus.

Adult↗

Cerebral responses elicited by stimulation of the vesico-urethral junction (VUJ) in diabetics.

To investigate the involvement of the visceral afferent nerves in diabetes mellitus, we enrolled 46 male patients in a study, examining the cerebral potentials evoked by stimulation of the vesico-urethral junction (VUJ CEP) and the pudendal (penile CEP) and posterior tibial nerves (tibial CEP). The age range was 23-67 (mean 45.8) years. The epithelial surface of the vesico-urethral junction was stimulated bipolarly with an electrode attached to a specially produced Foley catheter. Cerebral responses were recorded bipolarly at vertex. VUJ CEPs were absent (27 patients) or protracted and/or of low amplitude (4 patients) (total 31 patients; 67.8%). Penile CEP and/or tibial CEP could be obtained in all cases; however, protracted P1 peak latencies were detected in 15 (32.8%). The abnormalities of VUJ CEP did not correlate with the presence of peripheral neuropathy, while the abnormalities of penile CEP and/or tibial CEP invariably coincided with the presence of peripheral neuropathy. Although neither age nor the duration of diabetes correlated with abnormal CEPs as determined by any of the tests, insulin dependence correlated with abnormal penile CEP and to a lesser extent with VUJ CEP. We conclude that VUJ CEP is informative in evaluating the physiological condition of visceral afferents, and can be used in diagnosis of the early involvement of visceral afferents in diabetes mellitus.

Adult↗

Erectile dysfunction in sleep apnea and response to CPAP.

This study assessed characteristics of sexual dysfunction in sleep apnea and the efficacy of treatment with continuous positive airway pressure (CPAP). Twenty-two men with sleep apnea syndrome and also sexual dysfunction served as subjects in this study. Tests included physical, psychological, neurological, and penile vascular examinations, along with polysomnography, nocturnal penile tumescence (NPT), and penile rigidity. All patients clinically had a history of snoring and difficulty getting and maintaining erections. Results indicate that erectile dysfunction in patients with sleep apnea could be related to patient's age and chronic cerebral hypoxia due to apnea. Treatment with CPAP relieved erectile dysfunction in one-third of these patients.

Adult↗