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Biomedical subjects

M Unlü

Publications and source records attributed to M Unlü.

At least 19 recordsLinked to original sources
PubMed2003

Physicians' approach to the diagnosis and treatment of tuberculosis in Afyon, Turkey.

OBJECTIVE: To evaluate physicians' approaches to the diagnosis and treatment of tuberculosis in Afyon, Turkey. MATERIAL AND METHODS: A questionnaire on tuberculosis was filled out by 208 physicians (46 specialists and 162 general practitioners). RESULTS: Bacteriology was the preferred method of diagnosis among 75% (n = 156) of the physicians. For treatment of newly diagnosed tuberculosis, 64.4% prescribed a three-drug and 30.8% a four-drug combination. The combination most often selected was HRE (36.5%). Preferred treatment durations were 9 (38.5%) and 6 (34.6%) months. For patients with treatment failure, 20.2% of the physicians would add a new drug to the existing regimen, while 65.4% would refer the patient to a specialised tuberculosis unit. For the treatment of childhood tuberculosis, 38.5% of the physicians thought a two-drug treatment was adequate. For tuberculosis during pregnancy, 9.7% of the physicians offered treatment after the pregnancy, while 11.5% offered treatment after abortion. CONCLUSION: The knowledge of the physicians about the diagnosis and treatment of tuberculosis was deemed insufficient. Additional educational resources for physicians may contribute to improvements in tuberculosis control.

Adolescent↗
PubMed2003

Myocardial indium-111-antimyosin uptake in essential hypertension.

AIM: Evaluation of myocardial uptake of (111)In-anti-myosin antibodies in patients with essential hypertension for the verification of our hypothesis that it may increase in stage 1 in the left ventricle as a result of myocardial damage. PATIENTS, METHODS: Twelve men (mean age: 59+/-2.4 years) suffering from angina like symptoms and essential hypertension in clinical stage 1 according to the JNC-VI criteria were included into the study. These patients showed normal perfusion as revealed by thallium-201 myocardial study and coronary angiography. Left ventricular mass index was determined in echocardiography. Planar antimyosin images were obtained 48 h after the intravenous injection of the tracer. Heart to lung ratios were calculated as a parameter of myocardial tracer uptake using appropriate region of interests; values>1.52 were considered as abnormal. RESULTS: We observed increased anti-myosin uptake (mean: 1.71+/-0.12) consistent with myocardial damage in 11 of 12 patients. Nine of 12 patients had a left ventricular hypertrophy with left ventricular mass index values (mean: 131 g/m(2)+/-9.48) above 115 g/m(2). Heart to lung ratio was correlated significantly to left ventricular mass index (r = 0.902, p<0.001) and duration of hypertension (r = 0.948, p<0.001). CONCLUSION: Our results suggest that (111)In-antimyosin imaging may indicate myocyte damage in early phases of hypertensive heart disease.

Aged↗
PubMed2001

Changes in the mitochondrial proteome from mouse hearts deficient in creatine kinase.

Creatine kinase (CK) is an abundant enzyme, important for maintenance of high-energy phosphate homeostasis in many tissues including heart. Double-knockout CK (DbKO-CK) mice missing both the muscle (MM) and sarcomeric mitochondrial (ScMit) isoforms of CK have recently been studied. Despite a large change in skeletal muscle function in DbKO-CK mice, there is little functional change in the heart. To investigate whether there are specific changes in cardiac mitochondrial proteins associated with the loss of MM- and ScMit-CK isoforms, we have used difference gel electrophoresis (DIGE) to compare mitochondrial proteins from wild-type and DbKO-CK mice. Mass spectrometry fingerprinting was used to identify 40 spots as known mitochondrial proteins. We have discovered that the loss of MM- and ScMit-CK isoforms did not cause large scale changes in heart mitochondrial proteins. The loss of ScMit-CK was readily detected in the DbKO-CK samples. We have also detected a large decrease in the precursor form of aconitase. Furthermore, two mitochondrial protein differences have been found in the parent mouse strains of the DbKO-CK mice.

Aconitate Hydratase↗
PubMed2001

Penicillin resistance in Streptococcus pneumoniae in Isparta.

OBJECTIVE: The first case reports of infection with penicillin-resistant pneumococci were made in Australia in 1967 and South Africa in 1977. Since this time the increasing emergence of penicillin- resistant strains of Streptococcus pneumoniae have been a serious therapeutic problem. Therefore, the aim of the present study was to determine the penicillin resistance of S. pneumoniae strains isolated in the laboratory. The effect of procaine penicillin treatment against these strains was also investigated. METHODS: Sensitivity testing was done by disc diffusion method using oxacillin discs. Minimal inhibitory concentration (MIC) values were determined in tests with penicillin by the use of E-test (AB Biodisc, Solna, Sweden). Patients were treated with 2 x 800,000 U of i.m. procaine penicillin every 12 h for 10 days. RESULTS: Thirty-seven strains of S. pneumoniae were isolated from the sputa of adult patients who had pneumonia. Moderately resistant (0.12-1.00 microg/mL) and penicillin-sensitive (< or = 0.06 microg/mL) strains were identified in nine (24.3%) and 28 (75.7%) isolates, respectively. There were no high-level penicillin-resistant strains in the study. There was no therapeutic failure. CONCLUSION: These results suggest that procaine penicillin may still be useful in the empirical therapy of pneumococcal pneumonia.

Adult↗
PubMed2001

Pulmonary involvement in Behçet's disease: evaluation of 123 I-MIBG retention.

Pulmonary involvement in Behçet's disease (BD) is reported to indicate poor prognosis and high mortality. Our aim was to evaluate the pulmonary vascular status in BD. As 123I-meta-iodobenzylguanidine (123I-MIBG) shares the same uptake, storage and release mechanisms as norepinephrine, associated with the functional state of pulmonary endothelium, it may reflect endothelial injury. Twenty-five patients (13 males, 12 females; mean age, 36.44 years) and 12 age-matched controls were included. After intravenous injection of 123I-MIBG, thorax images were taken at 15 min and 4 h. Appropriate regions of interest were drawn, and heart to mediastinum (H/M) ratios and lung retention indices (LRI) were calculated. The difference between the LRI of controls (75.6+/-4%) and patients (87.7+/-10%) was found to be extremely significant (P<0.005). The LRIs of active (92.85+/-12%) and inactive (83.65+/-5%) states of BD were significantly different (P<0.05) from each other. There was no significant difference between the H/M ratios of controls (2.4+/-0.27) and patients (2.39+/-0.31) or between patients in active and inactive disease states. Our study revealed prolonged lung retention of 123I-MIBG in BD, probably reflecting the severity of the disease. In conclusion, 123I-MIBG lung retention is a valuable finding in the evaluation of pulmonary vascular status and may be a potential marker of prognosis in BD.

3-Iodobenzylguanidine↗
PubMed2001

The value of small-bore catheter thoracostomy in the treatment of malignant pleural effusions.

BACKGROUND: Malignant pleural effusions can cause severe debilitating symptoms and impair the quality of life. Treatment is often palliative, usually consisting of sequential thoracenteses or tube thoracostomy with or without sclerotherapy. Large-bore thoracostomy tubes have traditionally been used for drainage and sclerotherapy. More recently, the use of small-bore catheters has been studied. OBJECTIVES: To assess the efficacy and safety of small-bore catheter (Pleuracan) thoracostomy combined with talc sclerotherapy for palliative treatment of malignant pleural effusions. METHODS: Between May 1998 and March 2000, 24 consecutive patients presenting at our inpatient clinic were studied. Follow-up radiography at the end of the 1st month (immediate response) and 3rd month (long-term follow-up) after talc pleurodesis was performed to assess the response rates. RESULTS: Of the 24 patients included, 2 patients did not show lung expansion after pleural drainage. Two patients died within 30 days after talc pleurodesis and 1 did not undergo 30-day postpleurodesis radiography. The remaining 19 patients made up the study group to assess the response rates (8 men, 11 women). Overall response rates of talc pleurodesis via small-bore catheter were found to be 84.2% [complete response (CR): 68.4%, partial response (PR): 15.8%] at 30-day and 78.6% (CR: 57.2%, PR:2 1.4%) at 90-day follow-up, respectively. One patient reported moderate pain during catheter placement. Four patients experienced mild to moderate pleuritic chest pain, shortness of breath, or both within 4 h after instillation. Seven of the 22 patients (31.8%) had a transient fever (< or =39.0 degrees C) 6-24 h after talc instillation that lasted less than 24 h and was successfully treated with acetaminophen. One patient had significant subcutaneous emphysema that resolved in 24 h. Four patients died because of tumor progress (2 patients in the 1st month and 2 patients between 30 and 90 days). CONCLUSION: Pleurodesis can successfully be performed via a small-bore catheter in patients with recurrent malignant pleural effusion. To validate the results of the study, a prospective randomized study, comparing this device (Pleuracan) and a 'standard' 16- to 24-french chest drain, should be performed.

Adenocarcinoma↗
PubMed2001

Lipid peroxidation and glutathione peroxidase activity in chronic obstructive pulmonary disease exacerbation: prognostic value of malondialdehyde.

Results of recent studies have indicated that during exacerbation of chronic obstructive pulmonary disease (COPD), antioxidant capacity is lower and the levels of lipid peroxidation products are higher than those in age-matched healthy subjects. The aim of this study was to assess the time course of changes in oxidant stress during the treatment of exacerbation of COPD. For this purpose, we measured erythrocyte glutathione peroxidase (GPx) activity and serum levels of the lipid peroxidation product malondialdehyde (MDA) in 18 male patients with acute exacerbation of COPD. Fifteen healthy non-smokers having no history of lung disease served as control subjects. Mean erythrocyte GPx values of patients were 45.54 +/- 9.04 u/gHb on admission and had increased to 72.77 +/- 9.68 by the tenth day of treatment, but still remained lower than those of healthy subjects (83.13 +/- 10.91) (p=0.007). Serum MDA values in patients were Vol. 12, No. 1, 2001 significantly higher (2.68 +/- 1.28 nmol/ml) than those in control subjects (1.04 +/- 0.36 nmol/ml) (p=0.000) and returned to normal values by the tenth day of treatment (1.08 +/- 0.36 nmol/ml) (p=0.766). Erythrocyte GPx values in patients who were current smokers (39.87 +/- 3.82 u/gHb) were lower than those in ex-smokers (49.15 +/- 9.67 u/gHb) (p=0.021). Moreover, serum MDA values in patients who were current smokers (3.32 +/- 1.18 nmol/ml) were higher than those in ex-smokers (1.66 +/- 0.60 nmol/ml) (p=0.007). The results show that oxidative stress in patients with acute exacerbation of COPD is related to higher MDA levels that return to normal conditions during the course of treatment. In conclusion, the results suggest that MDA levels can serve as a marker of prognosis and of the success of treatment of the exacerbation of COPD.

Biomarkers↗
PubMed2001

Allergic rhinitis in Rosa domescena cultivators: a novel type of occupational allergy?

After the diagnosis of allergic rhinitis due to Rosa domescena was suspected in one subject with skin prick and nasal provocation tests, we recruited all other workers employed in rose cultivation in Yakaören village, Isparta. From May 2000 to July 2000 (exposure period 'time of rose handling'), we studied 600 individuals employed in rose cultivation. A questionnaire was administered by a physician, and skin testing was done by a nurse on 75 individuals suffering from asthma and/or rhinitis. Sera from these 75 subjects were available for immunologic testing. The diagnosis of atopy against rose was based on the presence of work-related symptoms, positive skin prick test (SPT) with rose extracts, and positive RAST. While no subject reported asthmatic symptoms, twenty of them reported either rhino-conjunctivitis, rhinitis or both on exposure to Rosa domescena. Fourteen of these subjects had increased specific IgE levels to Rosa domescena. Eleven (78.5%) also had a positive skin reaction to Rosa domescena. Out of the six negative sera with normal specific IgE levels to rose, only two (33.3%) had positive skin reactivity. No subject had significant daily peak expiratoy flow rate (PEFR) variations. We conclude that exposure to Rosa domescena may represent a risk for allergic rhinitis. The possibility of an occupational rose allergy should therefore be taken into consideration in the subjects working in rose cultivation.

Adult↗
PubMed2000

Detection of complement factor B in the cerebrospinal fluid of patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy disease using two-dimensional gel electrophoresis and mass spectrometry.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary condition with onset in mid-adulthood and is associated with mutations in the Notch-3 gene. (Joutel, A., Corepechot, C., Ducros, A., Vahedi, K., Chabriat, H., Mouton, P., Alamowitch, S., Domenda, V., Cecilion, M., Marechal, J., Vayssiere, C., Cruaud, C., Cabanis, E.A., Ruchoux, M.M. , Weissenvach, J., Bach, J.F., Bousser, M.G. and Tournier-Lasserve, E., Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia. Nature, 383 (1996) 707-710) Ultrastructural examination of the pathology of the cerebral infarcts reveals deposits in the vascular smooth muscle cells of the small arteries of the brain, but there is no obvious indication how the Notch-3 mutations give rise the observed pathology, nor is there any information on the exact nature of the deposits. We have investigated cerebrospinal fluid (CSF) from three CADASIL cases with known mutations in Notch-3 using two-dimensional gel electrophoresis. CSF from these patients was compared to that of six controls. We detected a single spot in the protein maps of patients which was absent from all the controls. In-gel tryptic digestion of this protein followed by mass spectrometric analysis of the tryptic fragments and a database search identified the spot as human complement factor B. These preliminary findings suggest that the alternative complement pathway may play a role in the pathogenesis of CADASIL.

Adult↗
PubMed2000

Evaluation of dysrhythmia in children with muscular dystrophy.

Myocardial involvement and dysrhythmia are common findings with muscular dystrophy and are among the leading causes of death. The authors evaluated rhythm and conduction abnormalities in children with muscular dystrophy by electrocardiography, signal-averaged electrocardiography, and Holter monitoring. Twenty-nine patients (mean age, 8 years) and 29 healthy control subjects were included in the study. Sixty-two percent of patients had electrocardiographic abnormalities defined as deep Q waves in V6, tall R waves in V1, and QRS axis deviation. The cardiomyopathy index was significantly greater in the patient group whereas QT and QTc dispersion values showed no significant difference. Holter monitoring revealed premature atrial and ventricular contractions more frequently than normal. However all were classified as Lown I and II. Mean heart rate was significantly higher in the patient group. The electrocardiograms of 41% of the patients showed late potentials. No relationship with these changes and cardiac function was observed. During the study, one patient died whose cardiomyopathy index was longer and had late potentials detected with signal-averaged electrocardiography. In conclusion, standard electrocardiography, cardiomyopathy index, signal-averaged electrocardiography, and Holter monitoring are valuable and reliable monitoring methods in children with muscular dystrophy.

Adolescent↗
PubMed1999

Experimental evaluation of retrograde cerebral perfusion by single photon emission computed tomography technique (SPECT).

BACKGROUND: Protection of the brain is of vital importance during aortic arch aneurysms. In this study efficiency of retrograde cerebral perfusion was evaluated with the use of single photon emission computed tomography technique (SPECT) by using 99mTc hexamethylpropylene amine oxime (HMPAO). METHODS: Four animals were used. The internal maxillary vein was the site of retrograde cerebral perfusion. The animals were studied after the heart rate and respiration were stopped with the use of the high dose drug administration and the brain was perfused with cold Ringer's lactated solution. After this procedure, 99mTc HMPAO-SPECT study was performed. RESULTS: In one animal we did not get any cerebral image because of the competent venous valve in the internal maxillary vein. In the remaining animals, normal brain perfusion was achieved. CONCLUSIONS: 99mTc HMPAO-SPECT study documented that blood flow via the retrograde way meets the metabolic demand of the brain. Retrograde delivery of 99mTc HMPAO did not conclude any poorly perfused area in the brain when in given both sides and all parts of the brain can be effectively perfused by cerebral venous system in hypothermic conditions.

Animals↗
PubMed1998

Arteriovenous shunting in patients with multiple myeloma and high-output failure.

UNLABELLED: High-output cardiac failure is one of the cardiovascular problems associated with multiple myeloma and frequently seen in patients with extensive bone lesions. The purpose of this study was to search arteriovenous shunting in patients with multiple myeloma and cardiac failure. METHODS: After the exclusion of other causes of congestive heart failure, 11 patients whose cardiac indices were higher than or equal to 4 liter/min/m2 were selected for the study (7 women, 4 men; mean age 59.64 +/- 8.92 yr). All patients had Stage II-III disease and femoral involvement in radiological examination. Arteriovenous shunting was determined by means of intra-arterial injection technique of 99mTc-macroaggregated albumin (MAA) particles. A quantitative analysis of all scans was performed, and the results were correlated with cardiac index. RESULTS: Mean cardiac index was 4.33 +/- 0.36 liter/min/m2 in the study group. In all cases, arteriovenous shunting was detected (18.70% +/- 17.29%), and inhomogenous, increased radioactivity accumulation was revealed in the femoral region (lesion-to-background ratio 2.71 +/- 2.08). This zone corresponded to the area of infiltration in a radiograph. A significant correlation was found between shunting values and cardiac indices (r = 0.7899, p = 0.004, Spearman). Although all patients had varying degrees of anemia, we did not find such a relationship between the degree of anemia and cardiac index. CONCLUSION: Arteriovenous shunting within involved skeleton contributes significantly to the development of high-output cardiac failure in multiple myeloma.

Cardiac Output↗
PubMed1998

Prolonged lung retention of iodine-123-MIBG in diabetic patients.

UNLABELLED: Iodine-123-MIBG has been introduced as a biochemical marker in assessing pulmonary endothelial cell integrity and myocardial beta-adrenergic sympathetic innervation. The aim of this study was to evaluate 123I-MIBG lung uptake in diabetic patients with and without coronary artery disease. METHODS: Forty-four nonsmoking patients with normal respiratory function tests were included: 12 diabetics, 11 diabetics with coronary artery disease, 14 nondiabetic patients with coronary artery disease and 7 age-matched controls were imaged with 123I-MIBG and 201Tl scintigraphy. The lung retention of 123I-MIBG, cardiac sympathetic innervation (heart-to-upper mediastinum ratio of 123I-MIBG) and 201Tl lung-to-heart ratio were determined in all cases. RESULTS: In diabetics with coronary artery disease, significantly prolonged lung retention and decreased cardiac uptake of 123I-MIBG were found. The lung retention of 123I-MIBG was inversely correlated with the heart-to-upper mediastinum ratio in this group. Lung-to-heart ratios of 201Tl were significantly increased in patients with coronary artery disease but there was no significant difference between diabetics and nondiabetics. CONCLUSION: Prolonged lung retention of 123I-MIBG was associated with decreased cardiac sympathetic innervation in diabetic coronary artery disease patients. It seems that passive pulmonary congestion or cardiac dysfunction itself did not influence 123I-MIBG lung uptake. Increased lung extraction of 123I-MIBG is highly suggestive of ongoing pulmonary endothelial dysfunction together with ischemic events in diabetics.

3-Iodobenzylguanidine↗
PubMed1998

Technetium-99m-HMPAO brain SPECT in anorexia nervosa.

Eating disorders have been redefined in recent years. Brain imaging techniques are useful in demonstrating the association between the morphologic and the functional cerebral changes in these cases. We report 99mTc-HMPAO brain SPECT findings in two patients with anorexia nervosa, before and after the treatment. While the detailed neurologic and laboratory examinations, including EEG and cranial CT, were within normal limits before therapy, SPECT study revealed diffuse bilateral hypoperfusion in frontal, parietal and frontotemporal areas which was more prominent in the left hemisphere. Post-treatment SPECT studies obtained after a clinical remission period of 3 mo showed normal brain perfusion in both patients. The pre- and post-treatment SPECT studies accurately reflect the functional state of the patients, and this technique may be used to follow-up the effect of treatment and predict the clinical response to therapy in patients with eating disorders.

Adolescent↗
PubMed1998

D2 receptor imaging with iodine-123-iodobenzamide brain SPECT in infants with hypoxic-ischemic brain injury.

UNLABELLED: The purpose of this study was to evaluate the striatal dopamine D2 receptor density in infants with perinatal hypoxic-ischemic brain injury (HIBI) using 123I-iodobenzamide (IBZM) brain SPECT and to correlate the findings with the severity of HIBI and neurologic outcome. METHODS: Twenty infants who were diagnosed to have perinatal HIBI were included in this study. They were classified as having mild (n = 6), moderate (n = 10) or severe (n = 4) HIBI according to their neurologic findings at birth using the criteria of Sarnat and Sarnat. Neurologic outcome of these infants was determined by serial neurologic examinations and the Denver developmental screening test; 10 infants recovered without any deficit and the remaining 10 were affected to a degree varying from motor impairment to cerebral palsy. All 20 infants were examined using 123I-IBZM brain SPECT at age 7.8 +/- 2.3 mo. Transaxial slices were obtained 2 hr after intravenous injection of 300 micro ci (11.1 MBq) 123I-IBZM and the activity ratios of striatal to occipital cortex (ST/OC) were calculated. RESULTS: The mean ST/OC ratios in patients with mild, moderate and severe HIBI (1.219 +/- 0.078, 1.097 +/- 0.069 and 0.813 +/- 0.140, respectively) were significantly different from each other (p = 0.001). The infants who recovered from HIBI without any neurologic sequelae had higher mean ST/OC ratios than the others (1.184 +/- 0.010 versus 0.969 +/- 0.160, p = 0.002). CONCLUSION: The results of this study show that in infants with HIBI, striatal D2 receptor density decreases as the severity of injury increases. The D2 receptor density is higher in infants who recover without neurologic deficits compared to those who are affected neurologically. Dopamine D2 receptor imaging can be used to assess the severity of HIBI in children.

Benzamides↗
PubMed1997

Difference gel electrophoresis: a single gel method for detecting changes in protein extracts.

We describe a modification of two-dimensional (2-D) polyacrylamide gel electrophoresis that requires only a single gel to reproducibly detect differences between two protein samples. This was accomplished by fluorescently tagging the two samples with two different dyes, running them on the same 2-D gel, post-run fluorescence imaging of the gel into two images, and superimposing the images. The amine reactive dyes were designed to insure that proteins common to both samples have the same relative mobility regardless of the dye used to tag them. Thus, this technique, called difference gel electrophoresis (DIGE), circumvents the need to compare several 2-D gels. DIGE is reproducible, sensitive, and can detect an exogenous difference between two Drosophila embryo extracts at nanogram levels. Moreover, an inducible protein from E. coli was detected after 15 min of induction and identified using DIGE preparatively.

Animals↗