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Biomedical subjects

M Ozcan

Publications and source records attributed to M Ozcan.

At least 19 recordsLinked to original sources

Circulating CD44 and intercellular adhesion molecule-1 levels in low grade non-hodgkin lymphoma and B-cell chronic lymphocytic leukemia patients during interferon-alpha-2a treatment.

BACKGROUND: Despite published reports regarding the association of elevated circulating CD44 and CD54 levels with unfavorable outcome in non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL), little is known about therapy-related changes in either adhesion molecule. In an attempt to evaluate the effect of interferon-alpha (IFNalpha), the authors measured serum CD44 (sCD44) and sCD54 in 22 low grade NHL and 14 CLL patients. METHODS: Twenty-six patients fulfilling the criteria for therapy received daily doses of 3 x10(6) IU IFNalpha-2a. Ten patients not requiring therapy also were observed for the same period. Fasting sera were collected at baseline and in 4 monthly intervals from all patients including the IFNalpha-treated (Group 1) and the untreated group (Group 2). RESULTS: Higher baseline sCD44 values were observed in Group 1 as compared with the Group 2 patients (P = 0.057). Within Group 1, patients were further divided between those who responded to IFNalpha, referred to as responders, and those who did not respond to IFNalpha, known as nonresponders. Responders showed a gradual decrease in sCD44 starting at the 4th month until the 12th month (P = 0.003, P = 0.002, and P = 0.01). Neither a difference in baseline nor an IFNalpha effect on the sCD54 levels could be shown. Soluble CD44 levels between responders and nonresponders were not different at the baseline but were significantly lower in responders, starting at month 4 and continuing throughout the therapy period (P = 0.04, P = 0.017, and P = 0.043). This decrease did not accompany a leukocyte or lactate dehydrogenase decrease and was not correlated with an early disappearance of the clinical findings. Similarly, after treatment, the sCD44 values of Group 1 were lower than the Group 2 levels at months 4 and 8 (P = 0.007 and P = 0.05, respectively). CONCLUSIONS: Soluble CD44, but not sCD54, can be used for monitoring therapy in patients with low grade NHL and CLL who have received IFNalpha, and for deciding whether further IFN therapy is necessary for those patients who have not responded to IFNalpha over a previous 12-month period.

Adolescent↗

Effect of Valsalva maneuver on surface electrocardiographic P-wave dispersion in paroxysmal atrial fibrillation.

The purpose of this study was to investigate the effect of the Valsalva maneuver on P-wave durations and dispersion. After the Valsalva maneuver, we found that maximum P-wave duration increased, minimum P-wave duration decreased, and P-wave dispersion increased in controls, whereas the opposite was true for unselected patients with paroxysmal AF. It was concluded that patients with paroxysmal AF performing the Valsalva maneuver normalized their P-wave dispersion, thereby correcting the inhomogeneous intra-atrial conduction.

Anti-Arrhythmia Agents↗

Allogeneic peripheral blood stem cell transplantation for standard risk leukemia: experience of Ibni Sina Hospital.

Fifty-three patients with standard risk leukemia who underwent allogeneic peripheral blood stem cell transplantation (alloPBSCT) from their HLA-identical siblings were analyzed for engraftment, incidence and severity of GVHD, and relapse rate. Standard risk leukemia was defined as AML in first complete remission or CML in first chronic phase within the first year after diagnosis. The median age was 34.5 years (range 13-47). Stem cells were mobilized by using 10 microg/kg G-CSF subcutaneously for 5 days. A median of 5. 7 (2.1-21.4) x 106/kg CD34+ cells was collected over a median of 2 (range 1-5) apheresis procedures. Cyclosporin A (CsA) plus short-course MTX were used for GVHD prophylaxis. Recovery to granulocytes >0.5 x 109/l and platelets >20 x 109/l occurred at a median of day +13 (range 8-32) and +13 (range 8-51), respectively. Day +100 transplant-related mortality was 13.2% (7/53). Acute GVHD occurred in 20 of 49 (41%) evaluable patients and only six (12.3%) of them had severe disease (grade III-IV). Chronic GVHD occurred in 30 of 42 (71.4%) evaluable patients. Relapse rate at 2 years was 7. 5%. The median overall and leukemia-free survivals were 22 (4-44) and 20 (3-44) months, respectively. Estimated 4 year leukemia-free and overall survival rates were 60% and 62%, respectively. In conclusion, alloPBSCT in standard risk leukemia seems to be associated with a low relapse rate and no increased risk of acute GVHD, but there is a trend for higher incidence of cGVHD. Bone Marrow Transplantation (2000) 25, 1229-1232.

Adolescent↗

An experimental study of bilateral repositioning of the Stensen's duct orifices with autologous vein and artery grafts in dogs.

Sialorrhoea is an indication of dysfunction in the coordination of the swallowing mechanism. Disturbance in this coordination results in excess pooling of saliva in the anterior mouth and resultant drooling. Several surgical techniques have been described for the management of sialorrhoea. In this experimental study, we planned to try a more safe and physiologic technique by repositioning of the parotid duct orifices into the glossopalatal arch, using autologous free grafts of vein and artery in dogs. Ten adult dogs were used. In each dog, both of the parotid duct orifices were included in the study. The surgical procedure involved the dissection of both parotid duct orifices and their relocation via a submucosal tunnel into the glossopalatal arch, using a vein graft for the right side and an artery graft for the left side. Functional assessment was based on the clinical observations and retrograde sialography done on the 60th day. Results were excellent. No stricture or obstruction was noted. Histological examinations done on the 90th day showed the replacement of endothelium by multilayered cubic Stensen's duct epithelium in both artery and vein grafts. There was no difference between the results of artery and vein grafts. Surgical transposition of Stensen's duct into the glossopalatal arch with autologous vein or artery graft is a safe technique which may be used in clinical cases of drooling as an alternative to the other techniques described.

Animals↗

Use of the distally-based radial forearm flap supplied by the dorsal carpal arch, or palmar carpal arch, or both, in mutilating injuries. Two case report.

The distally-based radial forearm flap is safe, easy, and versatile as a regional, one-stage procedure to reconstruct soft tissue defects of the hand. However, there is a general perception that the deep and superficial palmar arches have to be intact to raise a distally-based radial forearm flap. We successfully used two flaps supplied by the dorsal carpal arch, or the palmar carpal arch, or both, despite the fact that the deep and the superficial palmar arches were damaged in mutilating injuries.

Adult↗

A modified reversed digital island flap incorporating the proper digital nerve.

A standard reversed digital artery flap is based on the digital artery and vena comitantes alone, leaving the proper digital nerve intact. In the authors' opinion, in situations in which the fingertip pulp is lost completely, it is unnecessary to leave the nerve in situ. Using their technique, the proper digital nerve is included in the pedicle. The pedicle is raised as a monobloc of fatty tissue containing the small veins important for drainage. The proper digital nerve in the flap is sutured to the stump of the opposite proper digital nerve. They found this flap to be very reliable, and quite easy and quick to raise. A patient is presented and discussed in detail.

Adult↗

Effect of surgical denervation on the viability of inferior epigastric neurovenous flaps in the rat.

The purpose of this study was to examine how the inferior epigastric neurovenous flap in the rat reacts to surgical denervation. The survival of a denervated flap was compared with that of an innervated flap. A 2 x 2-cm flap was raised in 30 female Wistar rats assigned randomly to six groups of 10 rats each: group 1, innervated neurovenous flap; group 2, denervated neurovenous flap, acute model; group 3, denervated neurovenous flap, chronic model; group 4, innervated inferior epigastric island flap; group 5, denervated inferior epigastric island flap, acute model; and group 6, control, composite graft. Acute denervation produced a significant decrease in the survival of the inferior epigastric neurovenous flap (p < 0.05). The surviving area of the innervated flaps decreased from 94+/-14% (mean +/- standard deviation) to 16+/-34% by acute denervation. Chronic denervation was effective in decreasing flap necrosis in these flaps (survival, 99+/-5%). There were no differences between the average viable area of the standard inferior epigastric flap in the denervated and innervated groups.

Animals↗

Central response selection is present during memory scanning, but hand-specific response preparation is absent.

Two experiments were performed to replicate the results of Ilan and Miller that response selection but no response-hand specific preparation is present during memory scanning. Letter-case determined which hand would respond, while memory set membership status determined whether the response was to be executed (go) or withheld (nogo). In Exp. 1, the LRP was observed as an index of response-hand specific preparation. In Exp. 2, the consistency effect derived from the response priming paradigm was observed as an index of more central response selection. The results replicate those of Ilan and Miller and suggest that central response selection is present during short-term memory scanning, but hand-specific response preparation is absent. Apparently, preliminary information is transmitted to the response selection stage during memory scanning, a finding that is inconsistent with serial stage models, but memory scanning interferes with hand-specific response preparation.

Functional Laterality↗

Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe.

BACKGROUND/AIMS: Hepatitis B virus can cause serious problems in individuals undergoing organ transplantation. The aim of this study was to evaluate the hepatic events among HBs-Ag positive recipients and HBs-Ag negative recipients who received products from hepatitis B virus carriers. METHODS: A total of 151 patients received an allogeneic hematopoietic stem cell transplantation at the Department of Hematology-Oncology, University of Ankara, between June 1989 and June 1998. Among these, eight HBs-Ag positive and four HBs-Ag negative recipients received a product from a hepatitis B virus positive donor. The median follow-up period for these 12 patients was 13.2 months. RESULTS: Three of the eight HBs-Ag positive recipients died (one from hepatic failure); of the remainder, two are HBs-Ag negative, two HBs-Ag positive with normal liver injury tests and one HBs-Ag positive with elevated ALT levels. Of the four HBs-Ag negative recipients who received stem cells from a hepatitis B positive donor, two died; none of the patients in this group became HBs-Ag positive after transplantation. CONCLUSION: Hepatitis B virus infection is a common problem in patients being considered for allogeneic hematopoetic stem cell transplantation, especially in areas where hepatitis B virus infection is endemic. We believe that the presence of HBs-Ag positivity is not an absolute contraindication for allogeneic hematopoetic stem cell transplantation unless the hepatitis B virus is in a replication phase.

Adolescent↗

The impact of the CD34+ cell dose on engraftment in allogeneic peripheral blood stem cell transplantation.

Forty-five patients who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) were evaluated in order to investigate any relationship between CD34+ cell dose given and hematological recovery. Granulocyte counts > 1.0 x 10(9)/L and platelet > 50 x 10(9)/L were considered as hematological recovery. Three different regimens were used for mobilization, by adjusting the recombinant granulocyte colony stimulating factor (rhG-CSF, Roche) dose. The first group (n = 3), whose donors mobilized with 5 micrograms/kg/d s.c. rhG-CSF received a mean of 5.9 x 10(6)/kg (95% confidence interval for mean (CI); 2.4-9.3) CD34+ cells. The second group (n = 37), mobilized with 10 micrograms/kg/d s.c. rhG-CSF and the third group (n = 5) mobilized with 15 micrograms/kg/d s.c. rhG-CSF, received a mean of 5.7 x 10(6)/kg (95% CI; 4.6-6.75) and 6.56 x 10(6)/kg (95% CI; 4.57-8.55) CD34+ cells, respectively. CD34+ cell dose was 5.82 x 10(6)/kg (95% CI; 4.97-6.68) for all the patients. All patients received rhG-CSF from day +1 until attaining granulocyte count > 1.0 x 10(9)/L for three consecutive days. Median granulocyte and platelet engraftment days for the whole group was 15 (range; 11-44) and 14 (11-54) days respectively. There was a close correlation (r = -0.301, p < 0.05) between the CD34+ cell dose and granulocyte recovery for the whole group. When these analyses were performed separately within groups, this correlation was also found significant for the first group (r = -0.99, p < 0.05) for granulocyte recovery. On the contrary the same analysis did not reach significance for the other groups, nor for platelet recovery for the whole group (r = 0.039, p = 0.821). We calculated a minimum dose of 4 x 10(6)/kg CD34+ cells for a safe alloPBSCT. There was no difference between patients who received more than 5 x 10(6)/kg CD34+ cells, and those who received more than 2 x 10(6)/kg and less than 5 x 10(6)/kg CD34+ cells. In conclusion, we have demonstrated a correlation between the CD34+ cell dose given and faster hematological recovery for alloPBSCT patients.

Adolescent↗

Autoimmune thrombocytopenia in a patient with small cell lung cancer developing after chemotherapy and resolving following autologous peripheral blood stem cell transplantation.

A 46-year-old white male with small cell lung cancer (SCLC) limited to the thorax developed autoimmune thrombocytopenic purpura (AITP), following a cyclophosphamide, paclitaxel and G-CSF-containing regimen for peripheral blood stem cell (PBSC) mobilization. AITP associated with small or non-small cell lung cancer has been reported. We considered that the AITP in this case may be a part of paraneoplastic syndrome, which is frequently seen in patients with SCLC. The patient received HDC and autologous PBSC transplantation (APBSCT) for SCLC and the AITP resolved following transplantation, thus supporting the concept of HDC + APBSCT for the treatment of autoimmune diseases.

Antineoplastic Combined Chemotherapy Protocols↗

Treatment of aregeneratoric anemia following an ABO-incompatible allogeneic peripheral blood stem cell transplantation: a case report.

Aregeneratoric anemia (AA) occurs rarely after ABO-incompatible allogeneic peripheral blood stem cell transplantation (alloPBSCT), and its management is generally difficult. Here, we present a 31-year-old white man with myelodysplastic syndrome who developed AA after receiving stem cells from his human leukocyte antigen (HLA) identical, but ABO-incompatible sibling. Because his anti-A antibody titers were high, therapy with conventional doses of erythropoietin and prednisolone failed to treat the AA. Following 8 cycles of plasma exchange and higher doses of erythropoietin and prednisolone as well as danazol administration, anti-A titers decreased, and his anemia improved significantly. In conclusion, to treat and obtain a low titer of antibodies in a patient with AA following an ABO-incompatible alloPBSCT, higher doses of erythopoietin and corticosteroids associated with plasma exchange have to be used.

ABO Blood-Group System↗

A retrospective comparison of allogeneic peripheral blood stem cell and bone marrow transplantation results from a single center: a focus on the incidence of graft-vs.-host disease and relapse.

To detect the effect of the stem cell source, allogeneic peripheral blood stem cell transplantations (alloPBSCTs) performed between 1995 and 1997 from human leukocyte antigen (HLA)-identical siblings in 40 patients with acute and chronic hematological disorders were compared with a historical group of 40 patients with similar variables who had received allogeneic bone marrow transplants (alloBMTs) between 1993 and 1995. Patients in both groups were identical except that both the recipient and the donor ages were, on average, higher in the alloPBSCT group (26 vs. 36 [p = 0.005] and 27 vs. 32 [p = 0.024], respectively). Patients received similar therapy excluding posttransplant granulocyte colony-stimulating factor administration (97% in alloBMT vs. 12.5% in alloPBSCT). The median time to reach neutrophil counts >0.5 x 10(9)/L and platelet counts >20 x 10(9)/L was 13 and 14 days, respectively, in patients receiving alloPBSCTs compared with 19 and 27 days in patients receiving alloBMTs (p = 0.0014 and p = 0.0002). The alloPBSCT group required similar transfusions of red blood cells or platelets. The incidence of grade II-IV acute graft-vs.-host disease (aGVHD) was similar in both groups. However, chronic GVHD (cGVHD) of all grades developed in 78.1% of patients in the alloPBSCT group after a median follow-up period of 12.5 (range 0.5-34) months. In alloBMT recipients, cGVHD of all grades developed in 21.4% after a median follow-up period of 38 (range 0.5-62) months (p = 0.00001). Day 100 transplant-related mortality was also similar: 20% (8 of 40) in the alloBMT patients and 17.5% (7 of 40) in the alloPBSCT group. Although not statistically significant, a relatively higher relapse rate occurred in the alloBMT group (21.4 vs. 10.7%). The estimated disease-free survival in month 24 was 51.3% for alloBMT and 54.6% for alloPBSCT, and the estimated overall survival in month 24 was 56.1% for alloBMT and 64.6% for alloPBSCT. In conclusion, this retrospective comparison suggests that alloPBSCT from HLA-identical donors is associated with faster engraftment, fewer transfusions, and no greater incidence of aGVHD, but a high incidence of cGVHD.

Adolescent↗

Differences in liver pathology and clinical outcome between two patients with hepatitis B virus and graft versus host disease.

Our two patients undergoing allogeneic bone marrow transplantation (AlloBMT) had both Hepatitis B virus (HBV) and graft-versus-host disease (GVHD). In the first patient, liver enzymes elevated three months after AlloBMT, and GVHD was diagnosed. Two weeks after the diagnosis of GVHD, HBsAg appeared in his serum. At that time, liver biopsy was not able to discriminate two disorders, but his sequential liver biopsies disclosed GVHD. Despite the patient was treated with cyclosporin A (CsA), he died for chronic GVHD. In contrast to the first patient, the second patient had HBsAg prior to GVHD. His liver enzymes deterioration was detected in the first month after AlloBMT, and reached the highest level in the third month while withdrawing CsA. In the fifth month he developed scleradermatous skin changes, and skin biopsy revealed chronic GVHD, whereas concurrent liver biopsy revealed chronic active hepatitis. This observation showed that immunosuppressive conditions such as GVHD or its prophylaxis may affect the appearance of liver pathology caused by HBV, which depends on the time of GVHD development, and the duration and depth of GVHD prophylaxis.

Adult↗

Preliminary report: the distally pedicled dorsoulnar forearm flap for hand reconstruction.

In this paper, a new flap for the coverage of soft tissue defects in the hand is described. To obtain a distally pedicled dorsoulnar flap, the dissection of the standard dorsoulnar flap is continued distally under the descending branch of the dorsal branch of the ulnar artery onto the dorsum of the wrist after the dorsal branch of the ulnar artery is ligated and divided. Our modification of the standard dorsoulnar flap converts this flap to a distally based flap, which provides a potentially longer pedicle and increases the arc of rotation of the flap. Two successful cases are reported.

Adolescent↗