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Biomedical subjects

M Unal

Publications and source records attributed to M Unal.

At least 19 recordsLinked to original sources
PubMed2006

Arnold-Chiari type I malformation presenting as benign paroxysmal positional vertigo in an adult patient.

Arnold-Chiari malformations are a group of congenital hindbrain and spinal cord abnormalities characterized by herniation of the contents of the posterior cranial fossa caudally through the foramen magnum into the upper cervical spine. It is important to recognize Arnold-Chiari type I malformation in the differential diagnosis of adult vertigo cases. We present a 51-year-old patient with Arnold-Chiari type I malformation that was initially diagnosed as posterior semicircular canal benign paroxysmal positional vertigo.

Arnold-Chiari Malformation↗
PubMed2005

Moderate approach to the antenatally diagnosed unilateral ureteropelvic junction obstruction: experience with 93 patients.

To evaluate the results of the treatment in patients with antenatally detected unilateral ureteropelvic junction obstruction. Ninety-three patients were analyzed according to the radiologic and scintigraphic findings and mode of the treatment. Fifty-eight patients were treated surgically while 29 patients were followed conservatively. All patients were reevaluated at the first year of the treatment with diuretic renogram (DR). Follow-up procedure was finished at first postoperative year in surgically treated patients, while mean follow-up duration was 14.9+/-6.9 months for the conservatively treated group. In the operated group, pelvic diameter was greater than 20 mm on ultrasound and overall rate of mean split renal function was 38.65+/-9.55% on DR and 39.65+/-12.55% at first postoperative year. In the conservatively treated group, mean split renal function was 46.17+/-3.42 at the beginning and 47.48+/-4.00 at first year of follow-up. Sixty-three percent of the patients underwent pyeloplasty while 83% of them were showing obstructive pattern on DR. We believed that surgery should be done in renal units which showed pelvic diameter greater than 20 mm and less than 40% of split renal function, while others might be followed conservatively, with or without an obstructive pattern on DR.

Female↗
PubMed2005

The effects of chronic aerobic and anaerobic exercises n lymphocyte subgroups.

Exercise is the strongest stress to which the body is ever exposed. The body responds to this stress through a set of physiological changes in its metabolic, hormonal and immunological systems. In this study, responses of the immune system to the long-term aerobic and anaerobic exercises have been investigated. Twenty-four sedentary male university students and officers participated in this study. Subjects were divided into two groups, each consisting of twelve people. Group-1 (age: 25.67 +/- 3.79 years, height: 174.83 +/- 5.15 cm, body mass: 72.17 +/- 8.05 kg) and Group-2 (age: 24.83 +/- 2.89 years, height: 175.3 +/- 6.68 cm, body mass: 70.67 +/- 6.15 kg). After physical examinations of the two groups, resting ECG, respiratory function tests and metabolic tests with the use of the breath by breath method were completed, and anerobic heart rates at the threshold level were determined. The first group was subjected to exercise using Monark ergometry cycles at a heart rate 10% below the threshold level for 8 weeks, 3 days a week, 30 min a day. The second group exercised at a heart rate 10% above the threshold level for 8 weeks, 3 days a week, 20 min a day. Heart rates were checked with the Polar Test during exercises. Pre-exercise (Ep) venous blood samples were taken from each group before their 1st and 24th exercises. Hb (gr), Hct (%), erythrocyte (x10(6)/microl), leukocyte (x10(6)/microl), leukocyte subpopulations (neutrophil, lymphocyte, monocyte, eosinophil, basophil %) and thrombocyte (x10(6)/microl) values were determined. CD3, CD4, CD8, CD19 and CD56 values were determined by Flow Cytometry method using monoclonal antibodies. The chronic effects of exercise were examined through a comparison of Ep blood samples at the 1st exercise with Ep blood samples at the 24th exercise. While the increase in the total leukocyte number was significant (p<0.05) in the first group, increase in the second group was found to be non-significant. When percentiles of leukocyte subpopulations were taken into consideration, changes in the first and second group were found to be non-significant. When lymphocyte subgroups were examined; in the first group a decrease in CD3 and CD4 percentiles to 7% and 12%, respectively (p<0.05) and a 65% increase (p<0.01) in the CD56 value were observed. In the second group a decrease in CD3 and CD4 percentiles to 13% and 17%, respectively (p<0.05) and a 73% increase (p<0.01) in the CD56 value were observed. The Sample-t Test and The Wilcoxon Test were used for statistical analysis.

Adult↗
PubMed2005

Investigation of serum leptin levels and VO2max value in trained young male athletes and healthy males.

The present study aimed at investigating serum leptin levels of elite young male athletes who have been regularly exercising for a long period of time and males who do not exercise. The study included 24 trained young male athletes and 22 healthy sedentary male subjects. Athletes who participated in the study were from different sports branches and have been regularly exercising for at least 2 years. Serum leptin levels were determined by RIA. VO2max levels were identified during maximal exercise. Lactic acid levels were identified one minute before and one minute after exercise from the fingertip by Pro-lactate kit. As a result of the tests, although BMI values of trained young male athletes and healthy males were close to each other, leptin levels were significantly lower (p<0.01), VO2max values were significantly higher (p<0.01) and test periods were significantly longer (p<0.001) in the former. In conclusion, regular exercise, by reducing body fat percentage, suppresses serum leptin levels.

Adolescent↗
PubMed2004

Psychosocial factors and sexual dysfunctions: a descriptive study in Turkish males.

The study of human sexuality has dramatically changed in the last decade. The conceptualization of sexual dysfunction developed in the West is now mushrooming in different parts of the world and there is a dearth of research on characteristics of patients seeking treatment for sexual dysfunction in non-Western countries. This paper describes the demographic characteristics, related factors, and clinical symptomatology of 40 male patients with various sexual dysfunctions attending the psychiatric out-patient clinic of Cukurova University, Turkey. Turkey's population is predominantly Muslim and the country unites Europe and Asia, showing the cultural characteristics of both continents. Our results suggest that the patterns of manifestation are similar to those reported elsewhere with the exception of premarital patterns of sexuality.

Adult↗
PubMed2004

Mucociliary clearance after external dacryocystorhinostomy.

We investigated the nasal mucociliary clearance time in 17 patients who underwent a primary unilateral external dacryocystorhinostomy operation. Mucociliary clearance function in both nasal cavities was assessed with the saccharin test. The results were compared with each other using paired samples t-test. We found significantly worse mucociliary clearance time on the operated side (mean: 6.3 min) than on the non-operated side (mean: 5.5 min) (P = 0.004). External dacryocystorhinostomy negatively affected the mucociliary clearance function in this study.

Adult↗
PubMed2004

Atrial septal defect repair with minithoracotomy using two stage single venous cannula.

AIM: Repair of atrial septal defect (ASD) via minimal access has been the preferred method to improve cosmesis and fast rehabilitation. A 2-stage single venous cannula introduced via the femoral route allows better vision of the surgical field and improves surgical acts through a limited incision. METHODS: From February 1999 to December 2001 a minithoracotomy approach was used for closure of secundum type ASD by using single bicaval venous cannula in 17 adult patients. A 6 to 7 cm anterior minithoracotomy (submammary) approach with femoral arterial and 2-stage single venous cannula were utilized. Defects were closed primarily by running suture in 14 and with a patch in 3 patients. RESULTS: Calculated flow levels were maintained with a single venous cannula without assisted venous drainage in all patients. The postoperative course was uneventful in all patients except 1 who required revision for bleeding which was done through the same incision. Extension of the thoracotomy or shifting to the classic sternotomy was never required. CONCLUSION: Single venous bicaval cannula allows efficient drainage of both vena cavae and improves the surgical vision and manipulation through the right minithoracotomy. With this technique, repair of ASD can be done safely with good cosmesis.

Adolescent↗
PubMed2004

Extra-anatomic coronary artery bypass graftings in patients with porcelain aorta.

AIM: Severely atherosclerotic (porcelain) ascending aorta is associated with increased morbidity and mortality during coronary artery bypass grafting (CABG) due to the increased risk of perioperative atheroembolism. Three maneuvers during CABG can cause atheromatous embolism from the diseased ascending aorta: 1) cannulation of the ascending aorta; 2) cross- clamping; 3) partial clamping for the construction of the proximal anastomosis. METHODS: In our hospital, extra-anatomic CABG was performed in 8 patients with heavily calcified ascending aorta: 6 patients were men and 2 women. Operations were performed on the beating heart in 5 patients, 2 patients operated on beating heart and another patient on fibrillating heart with supportive cardiopulmonary bypass (CPB). Arterial cannulation was done through the right femoral artery on these patients. Apart from internal mammary artery (IMA) grafts, proximal anastomotic sites were the right axillary, right subclavian and innominate arteries. RESULTS: One patient who preoperatively had dialysis dependent chronic renal failure, died as a result of dialysis complication on the 5th day. The postoperative course was uneventful in the other patients and no patient experienced either any cerebrovascular or visceral organ injury as a result of atheroemboli. CONCLUSION: We think that extra-anatomic CABG procedures are safe and reliable in patients with severely atherosclerotic (porcelain) ascending aorta to minimize the prevalence of perioperative stroke and systemic embolization.

Aged↗
PubMed2003

The seroprevalence of Helicobacter pylori infection in patients with obstructive sleep apnoea: a preliminary study.

We investigated the seroprevalence of Helicobacter pylori in patients with obstructive sleep apnoea. A prospective clinical study consisting of 19 patients, aged 23-72 years with confirmed obstructive sleep apnoea by overnight polysomnography, and 36 control subjects, aged 25-61 years with no history of obstructive sleep apnoea and gastroesophageal reflux complaints, was conducted. Titres of serum H. pylori IgG antibody were assayed by a serum enzyme-linked immunoabsorbant assay. The difference between the study and control groups was analysed by chi-squared test. Seventeen of the 19 patients (89.5%) were found to be H. pylori positive. However, 21 of the 36 control subjects (58.3%) were H. pylori positive. The seropositivity of H. pylori in obstructive sleep apnoea patients was found to be significantly higher than the control group (P = 0.017). The result of our study shows that there is a high association between H. pylori infection and obstructive sleep apnoea. This data may be important for future treatment strategies of the disease.

Adult↗
PubMed2003

Ventilatory and metabolic response to rebreathing the expired air in the snorkel.

The snorkel, which allows swimmers to keep their face down in the water while breathing, is widely used by divers, spear fishermen and monofin swimmers. A snorkel adds an additional dead space of 160-170 ml and causes an increase in the concentration of CO2 in the inspired gas due to expired air trapped in the snorkel which is then re-inspired. In this study the metabolic and the ventilatory response to rebreathing the expired air in the snorkel were investigated in twelve human subjects. A 2900 C Sensor Medics gas analyzer was used in breath-by-breath mode for the measurements. Ventilation (VE), respiratory rate (RR), tidal volume (TV), oxygen consumption (.VO 2) and carbon dioxide production (.VCO 2) were measured at rest and during light exercise both with and without the snorkel dead space. We observed a significant increase in all variables except RR, when subjects rebreathed the gas in the snorkel. The increase in ventilation resulted from an increase in tidal volume rather than increasing respiratory rate. We conclude that the work of breathing is increased when CO2 concentration is high in inspired gas and re-breathing while snorkelling can be prevented by a new snorkel design with a low-resistance two-way non-rebreathing valve, which will allow the expired air flow into the water.

Adolescent↗
PubMed2003

The role of posterior pericardiotomy on the incidence of atrial fibrillation after coronary revascularization.

AIM: Pericardial effusion and atrial fibrillation (AF) are two common complications in coronary revascularization surgery. The aim of this study was to evaluate the efficiency of posterior pericardiotomy in pericardial effusion and AF. METHODS: This randomized prospective study includes 113 patients who underwent isolated CABG procedure between May 2000 and December 2000 in our hospital. Posterior pericardiotomy incision was done in Group I (n=54). Group II constituted the control group (n=59). Postoperative pericardial effusion was assessed by echocardiography and rhythm follow-up was done by the same cardiologist. RESULTS: There was no significant difference between study group and the control group considering the chest drainage (940.18+/-367.96 vs 894.92+/-360.65; p=0.507). The number of patients with remarkable intrapericardial effusion (>50 ml) was significantly lower in the posterior pericardiotomy group (25.93% vs 47.45%, p=0.020). The incidence of postoperative AF was no different between the posterior pericardiotomy group and the control group (12.96% vs 20.34%; p=0.32). In both groups, the incidence of AF was significantly higher in patients with mild or moderate pericardial effusion (29%), compared to patients with no or minimal pericardial effusion (10%), (p=0.017). CONCLUSION: Posterior pericardiotomy significantly reduces the pericardial effusion in coronary bypass procedure postoperatively. Patients with pericardial effusion were subjected to AF more frequently.

Aged↗
PubMed2002

The role of oxygen saturation measurement and body mass index in distinguishing between non-apnoeic snorers and patients with obstructive sleep apnoea syndrome.

The aim of this study was to examine the role of oxygen saturation (SaO2) measurement in identifying apnoeic snorers from non-apnoeic snorers and in the assessment of the severity of obstructive sleep apnoea. Ninety-two patients with clinically suspected obstructive sleep apnoea syndrome (OSAS) were assessed, using overnight polysomnography. The patients were classified as follows: 14 patients were non-apnoeic snorers, 27 patients had mild OSAS, 31 patients had moderate OSAS and 20 patients had severe OSAS. Minimum SaO2 level, mean SaO2, time below 85% of SaO2, the ratio between the time SaO2 and total sleep time and body mass index (BMI) were assessed retrospectively. There was a statistically significant difference between the non-apnoeic group and OSAS patients in Min SaO2 (P = 0.03). Patients who had Min SaO2 above 85% could be evaluated as non-apnoeic snorers; however, SaO2 and BMI were not found to be useful in the assessment of the severity of OSAS.

Adult↗
PubMed2002

Course of serum lipoprotein(a) and acute phase protein levels in patients undergoing open heart surgery.

BACKGROUND: Lipoprotein(a) [Lp(a)] is an important risk factor in the pathogenesis of coronary artery disease because of its thrombogenic and atherogenic properties. Lp(a) also displays another property by acting as an acute phase reactant. METHODS: In this work, the study group consisted of 20 male patients having coronary artery bypass under cardiopulmonary bypass (CPB). Preoperative and postoperative levels of plasma total cholesterol, triglyceride, apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), alpha-1 antitrypsin (a1-AT), alpha-2 macroglobulin (alpha 2-MG), alpha-1 acid glycoprotein (alpha 1-AG), Lp(a) were measured in all patients one day before and after the 1st, 2nd, 4th, and 10th days of CPB. RESULTS: It was observed that the levels of Lp(a) levels gradually reached the preoperative levels at the 10th postoperative day period. Observed change of the Lp(a) levels was similar to that of the other acute phase proteins which are synthesized and released from liver. In contrast, alpha 2-MG has shown different behaviour in terms of operative values. The changes observed for all these 3 parameters were found to be statistically significant (p<0.01). CONCLUSIONS: The data has indicated that Lp(a) levels show similar progress with alpha 2-MG levels. It can be concluded that serum levels of Lp(a) after coronary arterial bypass decrease depending upon several factors and reach basal levels at the end of a 10 day-period of postoperation. The main cause for this decrease might result from the contact of blood with foreign surfaces of the heart-lung machine.

Acute-Phase Proteins↗
PubMed2001

Proboscis lateralis: a case report.

Proboscis lateralis is a rare facial anomaly resulting in incomplete formation of one side of the nose. We report a left-sided proboscis lateralis case of a 9 months old male with left-sided heminasal aplasia, microphthalmi, coloboma iris and retina and an arachnoid cyst in the temporal fossa of the brain. We present the clinical, radiological features of this unusual case.

Abnormalities, Multiple↗
PubMed2001

Preoperative and postoperative cardiac and clinical findings of patients with adenotonsillar hypertrophy.

OBJECTIVE: Our aim was to determine if there was any detectable clinical and cardiac changes in hypertrophied adenotonsillary disease with obstructive sleep apnea syndrome and to demonstrate the curative effect of adenotonsillectomy on these patients. METHODS: Thirty-three children with adenotonsillary hypertrophy and sleep related breathing disorders were included in this study group. There were 16 female and 17 male patients and the mean age was 6.9+/-2 years. Age and sex matched control group consisted of 33 children (16 female, 17 male) with a mean age of 6.3+/-2. Complete clinical and laboratory examinations were done for each patient. The results were analysed with the SPSS (statistical package for social sciences) computer program. The significance of changes was performed by means of the independent samples of one-tailed t-test. For categorical variables, chi-square analysis was performed. RESULTS: According to our snoring scale, snoring was mild in six patients (18.2%), moderate in 19 patients (57.5%) and severe in eight patients (24.3%). Severe apnea was not observed in any patients, moderate apnea in ten patients (30.3%) and mild apnea was observed in 23 patients (69.7%) preoperatively. Nine patients had Grade IV tonsils, 14 patients Grade III, seven patients Grade II, three patients Grade I. Twelve patients had 3+ (obstructive) adenoids, 21 patients had 2+ adenoids. Chest X-rays showed cardiomegaly in two patients with moderate degree of apnea. Electrocardiogram results were abnormal in four patients. When we compared echocardiographic results of study and control groups, we found several significant differences (RV: 1.6+/-0.3 vs 1.4+/-0.2; P<0.05, LVEDD: 3.6+/-0.5 cm vs 3.3+/-0.4; P<0.05, IVS: 6.8+/-1.4 mm vs 6.1+/-1.1 mm; P<0.05). Also a decreased left ventricular compliance measured by prolongation of deceleration time was found in patient group (DT: 173+/-44 vs. 126+/-22 ms; P<0.001). The echocardiographic results in postoperative group were similar to control group. CONCLUSION: This study illustrated that adenotonsillary disease with obstructive sleep apnea symptoms leaded to right and/or left ventricular enlargement, hypertrophy when compared with control subjects, which were recovered postoperatively.

Adenoidectomy↗
PubMed2001

Elastic bandaging facilitates primary closure of large ventral hernias due to giant omphaloceles.

Large ventral hernias (VH) following conservative treatment of a giant omphalocele are a major challenge for pediatric surgeons. Although primary closure is accepted as the ideal procedure, these defects often require multi-staged operations, prosthetic support, and postoperative mechanical ventilation. Between 1990 and 2000, 34 patients with omphaloceles were admitted to our unit and 6 of them (17.6%) who had giant omphaloceles were treated conservatively. In the same period, a 5-year-old girl was admitted with a huge VH following application of subcutaneous tissue expanders in another center. In these 7 patients (6 girls, 1 boy, average age 20 months) we used preoperative elastic bandaging for facilitating primary closure. In all cases primary closure was successful following 3 to 6 weeks of bandaging. We did not use prosthetic material or postoperative mechanical ventilation in any case. Follow-up periods ranged from 2 to 10 years, and there were no recurrences or other problems. Out limited experience reveals that preoperative elastic bandaging is a safe and effective procedure for facilitating primary closure of the large VHs.

Bandages↗