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Biomedical subjects

M Yilmaz

Publications and source records attributed to M Yilmaz.

At least 19 recordsLinked to original sources
PubMed2003

A very rare anatomic variation of the left brachiocephalic vein: left retro-aortic brachiocephalic vein with tetralogy of Fallot.

An anomalous course of the left brachiocephalic vein behind the aortic arch was identified in a patient with tetralogy of Fallot. A 6-year-old male patient had been admitted to the hospital with a diagnosis of tetralogy of Fallot and patent foramen ovale. At the beginning of the operation the left brachiocephalic vein could not be found. The pericardium was opened longitudinally and there was no persistent left superior vena cava. After careful examination, the left brachiocephalic vein was found behind the aorta. Especially during open heart surgery this pathology is very important. We conclude that when the left brachiocephalic vein can not be found, the possibility of persistent left superior vena cava and retro-aortic left brachiocephalic vein should be borne in mind.

Aorta, Thoracic↗
PubMed2003

Analgesic effects of intrathecal neostigmine in perianal surgery.

BACKGROUND AND OBJECTIVE: In recent human and animal studies, intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The aim was to examine the effects of intrathecal neostigmine and bupivacaine in patients undergoing perianal surgery under spinal anaesthesia. METHODS: The patients were randomly allocated into three groups of 15: Group 1 (controls) received hyperbaric bupivacaine 10 mg + dextrose 5%, 1 mL, to a total volume of 3 mL; Group 2 received hyperbaric bupivacaine 10 mg + neostigmine 25 microg in dextrose 5%, 1 mL, to a total volume of 3 mL; and Group 3 received hyperbaric bupivacaine 10 mg + neostigmine 50 microg in dextrose 5%, 1 mL, to a total volume of 3 mL. RESULTS: The onset of sensory block was significantly earlier for Group 2 and 3 patients compared with Group 1 patients (P < 0.05). The full time to recovery of motor block and sensory block was significantly longer in Group 3 compared with Group 1 (P < 0.05). In Group 3, the average time until the first dose of tramadol was longer than Group 1 (P < 0.05). The incidence rate of nausea and vomiting was significantly higher in Groups 2 and 3 than in Group 1 (P < 0.05). CONCLUSIONS: The use of intrathecal neostigmine as an analgesic drug in perianal surgery is unsatisfactory because of prolonged motor blockade and nausea.

Anal Canal↗
PubMed2003

The effects of dexamethasone on leukemic cells derived from patients with AML.

This study was performed to investigate the effects of dexamethasone on acute myelocytic leukemia (AML) cells. The study has been designed to investigate the in vitro effects of dexamethasone on the proliferative capacity, maturation and apoptosis of leukemic cells derived from patients with AML. Dexamethasone induced leukemic cell apoptosis and decreased cell count compared to the control. The percentage of cellular maturation increased in the dexamethasone groups compared to the control groups. Proliferative capacity of the cells was similar in all groups. These effects of dexamethasone on leukemic cells may be related to activation of the genes which stimulate apoptosis and maturation. More comprehensive studies are needed to evaluate the apoptotic effect of dexamethasone on AML cells.

Antineoplastic Agents, Hormonal↗
PubMed2003

Philadelphia negative, Bcr-Abl positive chronic myeloid leukemia associated with pure red cell aplasia.

Pure red cell aplasia (PRCA) is a rare disorder which is associated with thymoma, viral infections and autoimmune diseases. A few cases of PRCA during the clinical course of CML have been reported and these usually terminate in blastic crisis and death, suggesting a poor prognosis. However, only one case of Philedelphia chromosome negative, Bcr-Abl positive CML associated with PRCA has been reported. Here, we present a second case report of a Philedelphia negative, Bcr-Abl positive CML associated with PRCA who was unresponsive to all the chemotherapeutic regimens. We conclude that the present case supports the idea that the development of PRCA in the course of CML may be a bad prognostic sign.

Fusion Proteins, bcr-abl↗
PubMed2002

Efficacy of methylprednisolone in acute experimental cauda equina injury.

In this experimental study the efficacy of methylprednisolone was investigated by neurophysiological and histopathological evaluation in a rabbit cauda equina model where injury was produced with an aneurysm clip (closed pressure 192 gr). High dose methylprednisolone (kg/30 mg) was administered by intravenous infusion in the 8th, 16th and 24th hours after injury followed by infusion of the same dosage every 6 hours for 24 hours. Nerve conduction velocity was measured before and early after trauma and 3 weeks after injury. Both neurophysiological and histopathological investigations demonstrated the neuroprotective effectiveness of methylprednisolone if it was given in the 8th hour after trauma. Although recovery was observed its efficacy was less pronounced when it was given in the 16th and 24th hours.

Animals↗
PubMed2002

Therapeutic effects of intracarotid infusion of spermine/nitric oxide complex on cerebral vasospasm.

BACKGROUND: Vasospasm is one of the underlying causes of morbidity and mortality in subarachnoid haemorrhage (SAH). The therapeutic effects of intracarotid infusion of spermine/nitric oxide complex (SPER/NO) on cerebral vasospasm in an experimental model of SAH were investigated. METHOD: Twenty-four adult male New Zealand white rabbits (2.6-3.4 kg in weight) were randomly divided into four groups (n=6), as follows: (I) control group (without SAH and drug), (II) SAH alone group (with SAH, without drug), (III) SAH placebo group (with SAH and saline), and (IV) SAH-SPER/NO group (with SAH and SPER/NO). The fresh autologous non-heparinized blood was injected into the cisterna magna to induce a SAH, after 24 hour SAH, the substance (saline or SPER/NO) was delivered to animals. All rabbits were scarified at 48-hours of induced SAH. The basilar artery with surrounding tissue was removed from the cranium and processed for paraffin embedding. Histopathological and stereological examinations of the basilar artery were done. FINDINGS: In the SPER/NO treated group of rabbits, the histopathological changes were less severe than in the SAH-alone and SAH-placebo groups. Regarding the intracarotid pressure, there was a statistically significant difference between SAH-alone and SAH-SPER/NO groups and also between SAH-SPER/NO and control groups (p<0.05). The mean cross sectional area of basilar arteries was 0.26 mm(2) in the control, whereas in SAH alone, placebo and SAH-SPER/NO groups were 0.13, 0.15 and 0.20 mm(2), respectively. INTERPRETATION: It is well known that NO is a critical substance involved in cerebral vascular dynamics. Present results indicate that treatment of vasospasm with SPER/NO in SAH may be promising. However, further studies should be done on this substance to clarify its effect on vasospasm before using the drug in clinical situations.

Animals↗
PubMed2002

Environmental contamination during a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit.

During a three-month period in 1999, 25 strains of carbapenem resistant Acinetobacter baumannii were isolated from 12 of 170 hospitalized intensive care unit (ICU) patients, of which 16 were considered to be clinically significant. These strains were indistinguishable by biotyping and antibiograms, but genotyping was not performed. Appropriate antibiotic treatment, isolation precautions, and infection control education of the staff failed to halt the outbreak. Environmental contamination was therefore investigated, and A. baumannii was found out in 22 (39.3%) of 56 environmental samples obtained by swabbing. Different antibiotic sensitivity patterns were obtained in the majority of these isolates, but four (7.1%) of the strains were found to have the same sensitivity pattern as the strain causing the outbreak. As a result the ICU was closed, equipment and the environment cleaned, with hypochlorite and terminal disinfection carried out. No bacteria were grown on repeat environmental cultures. Environmental contamination has an important reservoir role in outbreaks of A. baumannii in ICUs and must be eradicated in order to overcome such outbreaks.

Acinetobacter Infections↗
PubMed2001

Significance of the catechol-O-methyltransferase gene polymorphism in migraine.

The objective was to assess the significance of the catechol-o-methyltransferase (COMT) enzyme polymorphism in migraine. For this reason, 62 migraineurs and 64 healthy volunteers were included in the study. The analysis of COMT polymorphism was performed using PCR. The H/H genotype was more frequent in the control group than in the patients group (P=0.032). The homozygous or heterozygous L allele was over represented in the migraineurs compared with the controls (P=0.013). The L/L genotype was over represented in the migraineurs who also had a family history of migraine (P=0.003). There was no relationship between aura and COMT genotypes. In conclusion, the COMT polymorphism may be of potential pharmacological importance regarding the individual differences in the metabolism of catechol drugs in migraineurs. Although altered catecholamine activity due to polymorphism of COMT gene may be one of the mechanisms involved in the pathogenesis of migraine, these mechanisms are not related to presence or absence of aura.

Adult↗
PubMed2001

Association of the T102C polymorphism of 5-HT2A receptor gene with aura in migraine.

OBJECTIVE: To find out the significance of the 5-HT2A receptor gene polymorphism in migraine. STUDY DESIGN: A PCR study in which 61 migraineurs and 44 healthy controls were included. METHODS: The T102C polymorphism of the 5-HT2A receptor gene was studied. The results of the migraineurs and controls were compared. The relationship between the gene polymorphism and aura was also assessed. RESULTS: The representations of the 5-HT2A genotypes were similar in migraineurs and controls (p>0.05) as well as in the male and female migraineurs (p>0.05). The family history of migraine did not associate with 5-HT2A receptor gene polymorphism (p>0.05). There was a significant relationship between the presence of C/C genotype and migraine with aura (p=0.02) while C/T and T/T genotypes were over represented in the patients with migraine without aura (p<0.01). CONCLUSION: The T102C polymorphism of the 5-HT2A receptor gene is not directly related to the increased risk of migraine. The associations between the genotypes of this gene and aura may suggest that 5-HT2A receptor gene polymorphism may be involved in determining the subtypes of or accompanying symptoms in the migraine disease.

Adult↗
PubMed2001

Significance of serotonin transporter gene polymorphism in migraine.

OBJECTIVE: To elucidate significance of the serotonin transporter gene (STG) polymorphism in migraine, and to address the polymorphic patterns of STG, both in the migraineurs and healthy people in this country. STUDY DESIGN: A PCR study of STG in 52 migraineurs and 80 healthy controls. METHODS: Using the PCR technique, STG polymorphism was studied in the DNA obtained from leukocytes of the patients and healthy controls. Polymorphism of the two regions (VNTR and 5-HTTLPR) of STG was assessed. RESULTS: VNTR STin 2.10 and STin 2.12 alleles were detected in migraineurs and healthy controls. Both homozygous and heterozygous STin 2.10 allele predominated in the migraine group (p=0.01), while STin 2.12 allele was more frequent in the healthy controls (p=0.02). There was no relationship between the migraine type, family history of migraine and STG polymorphism. CONCLUSION: STin 2.10 and STin 2.12 alleles of VNTR are frequent in this country. While the presence of STin 2.10 allele increases the risk of migraine, 5-HTTLPR polymorphism is not associated with this risk.

Adult↗
PubMed2001

Visual evoked potential changes in migraine. Influence of migraine attack and aura.

OBJECTIVE: To assess the visual evoked potential (VEP) changes in migraines with and without aura. STUDY DESIGN: A clinical study in which the VEP results of 45 migraineurs (study group) and 22 healthy volunteers (control group) were compared. Of 45 migraineurs, 29 had migraine with aura (MA) and 16 had migraine without aura (MOA), and they were examined both during and between the migraine attacks. METHODS: The patients and healthy controls underwent VEP assessment. On VEP recording, mono-ocular stimulation was performed by means of the pattern reversal check board. The latencies of N1, P1 and N2, and the N1--P1 amplitude were noted. The following comparisons were made between NI, P1 and N2 latencies and N1--P1 amplitudes of the migraine and control groups; during and between attack the VEP results of the patients with MA and MOA. RESULTS: The VEP results of the migraineurs and healthy controls were similar (P>0.05). The during attack results of MA, during and between attack results of MOA, and the results of the control group were also similar (P>0.05). N2 latency significantly elongated in patients with MA in the attack free period than it was during the attack (P=0.01), and was also longer than it was in the control group (P=0.01). CONCLUSIONS: There is involvement of the visual pathway in MA rather than MOA, and differentiation between these subtypes of the migraine disease may be performed on the basis of VEP findings manifesting by the prolongation of the N2 wave latency. This contention should be confirmed by further studies.

Adolescent↗
PubMed2001

Assessment of DNA strand breakage by comet assay in diabetic patients and the role of antioxidant supplementation.

Diabetes patients often show increased production of reactive oxidative species (ROS) together with vascular complications. The presence of these ROS may lead to increased DNA damage in peripheral blood lymphocytes that may be revealed by the comet assay. To test whether DNA is damaged in diabetes, peripheral blood samples were taken from 30 control individuals and 63 diabetic patients (15 insulin dependent (IDDM) and 48 non-insulin dependent (NIDDM)) and the alkaline comet assay was used to evaluate background levels of DNA damage. Significant differences were detected between control and diabetic patients in terms of frequencies of damaged cells. The extend of DNA migration was greater in NIDDM patients by comparison with IDDM patients which might indicate that IDDM patients are handling more oxidative damage on a regular basis. Smoker individuals had higher frequencies of cells with migration by comparison with the non-smokers in both groups. Also, clear differences between patients on placebo and on Vitamin E supplementation for 12 weeks were observed on the basis of the extend of DNA migration during single cell gel electrophoresis.

Adult↗
PubMed2001

Increased plasma adrenomedullin in patients undergoing percutaneous transluminal coronary angioplasty.

OBJECTIVES: Adrenomedullin (ADM) production and secretion have been reported in endothelial cells. The present study was designed to assess whether coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) affect plasma ADM levels. DESIGN AND METHODS: We measured plasma concentrations of ADM using a specific radioimmunoassay method in patients undergoing coronary angiography or PTCA before and after a 5-minute procedure. Patients were divided into three groups; group I: normal coronary angiography group (11 males, 10 females; mean age 55.90 +/- 11.03 yrs), group II: coronary artery disease (CAD), only coronary angiography performed (14 males, 8 females; mean age 60.95 +/- 9.80 yrs), group III: PTCA performed in patients with CAD (35 males, 11 females; mean age 55.89 +/- 10.41 yrs). RESULTS: The plasma ADM levels and left ventricular end diastolic pressures measured before the procedure were similar in the three groups (p > 0.05). Plasma ADM levels were 13.98 +/- 2.26, 15.59 +/- 6.70, 17.15 +/- 8.47 pg/ml respectively. ADM levels measured after CA showed no significant difference in group I (13.75 +/- 1.75 pg/ml) or group II (16.50 +/- 7.18 pg/ml) (p > 0.05). A marked elevation was observed in group III with ADM levels of 27.31 +/- 12.27 pg/ml after PTCA (p < 0.01). The ADM levels observed in group III after PTCA were significantly higher than those of group I and group II after coronary angiography (p < 0.001). CONCLUSION: The results of our study show an increase of ADM after PTCA but not after coronary angiography in patients with or without CAD. We think that the increase of ADM levels may be due to cardiac secretion from endothelial and smooth muscle cells following balloon injury.

Adrenomedullin↗
PubMed2001

Bronchiectasis: still a problem.

The prevalence of bronchiectasis (BR) has decreased significantly in industrialized countries, but is still commonplace in developing countries. We evaluated the causes and clinical features of BR in 23 children (13 boys (57%) and 10 girls (43%), with a mean age of 8.45 +/- 4.02 years). Infection was the major cause of BR in our region. In 8 patients, BR developed after tuberculosis or pneumonia, was associated with immune deficiency syndromes in 4 children, and with asthma in 4. Cystic fibrosis was diagnosed in 4 cases and ciliary dyskinesia in 3. In 10 patients, only one lobe was involved. Bronchiectatic lesions were most commonly found in the left lower lobe and were observed in 7 patients. Multilobar involvement was found in 13 patients. The initial treatment was primarily medical, but in 2 patients whose medical therapy failed, pulmonary resection was carried out. Three patients died from severe pulmonary infection and respiratory failure.

Adolescent↗
PubMed2001

The role of Tc-99m RBC scintigraphy in the differential diagnosis of orbital cavernous hemangioma.

The cavernous hemangioma is the most common benign orbital tumor in adults. Its presentation is during the forth to fifth decades with a slowly progressive unilateral proptosis. Intraconal cavernous hemangiomas may be difficult to differentiate from other intraconal lesions such as schwannomas, meningiomas and hemangiopericytomas. We report a case of orbital cavernous hemangioma diagnosed by Tc-99m RBC scintigraphy. Tc-99m RBC scintigraphy revealed a typical scintigraphic pattern in which there is intense focally increased uptake on the delayed image. We conclude that Tc-99m RBC scintigraphy can be a useful method in the differential diagnosis of orbital cavernous hemangioma as in hepatic hemangioma.

Diagnosis, Differential↗