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Mustafa Cengiz

Publications and source records attributed to Mustafa Cengiz.

At least 19 recordsLinked to original sources

Spinal morphine administration reduces the fatty acid contents in spinal cord and brain by increasing oxidative stress.

It is well known that oxidative stress damages biomolecules such as DNA and lipids. No study is available on the morphine-induced oxidative damage and fatty acids changes in brain and spinal tissues. The aim of this work was to determine the effects of morphine on the concentrations and compositions of fatty acid in spinal cord segments and brain tissues in rabbits as well as lipid peroxidation (LP) and glutathione (GSH) levels in cortex brain. Twelve New Zealand albino rabbits were used and they were randomly assigned to two groups of 6 rabbits each. First group used as control although morphine administrated to rats in second group. Cortex brain and (cervical, thoracic, lumbar) samples were taken. The fatty acids between n:18.0 and 21.0 were present in spinal cord sections and n:10 fatty acids in control animals were present in the brain tissues. Compared to n:20.0-24.0 fatty acids in spinal cord sections and 8.0 fatty acids in the brain tissues of drug administered animals. The concentration and composition of the fatty acid methyl esters in spinal cord and brain tissues was decreased by morphine treatments. LP levels in the cortex brain were increased although GSH levels were decreased by the morphine administration. In conclusion, unsaturated fatty acids contents in brain and spinal cord sections and GSH were reduced by administrating spinal morphine although oxidative stress as LP increased. The inhibition oxidative damage may be a useful strategy for the development of a new protection for morphine administration as well as opiate abuse.

Animals↗

Change in blood chemistry may explain higher toxicity of total body irradiation for bone marrow transplantation.

Total body irradiation (TBI) is a well established conditioning regimen for patients who had undergone bone marrow transplantation. TBI not only offers a slightly significant survival advantage over Busulphan-based conditioning regimens but also lower toxicity profile. However the biological process after TBI seems rather different than conventional routine partial body irradiation. Not only the tolerance doses but also time to occurrence of the organ toxicities show a variation. It has been shown that there are alterations in trace element content in kidney after TBI in addition to cytokines and redox-active metal composition of blood. Acute phase proteins also have been shown to rise after irradiation. Considering all these evidences we suggest that TBI changes the blood content of trace elements, acute phase response proteins with probably many other inflammatory proteins and cytokines within the blood and this change in blood content may sensitize the organs to radiation.

Blood Chemical Analysis↗

Increased expression of cyclooxygenase-2 (COX-2) in radiation-induced small bowel injury in rats.

BACKGROUND: Radiation therapy is a widely used adjuvant therapy for various abdominal and pelvic cancers. On the other hand, it is not a benign treatment modality, as most radiation patients suffer from some kind of radiation enteritis. Currently available treatments are only palliative and no ideal compound has as yet been discovered. The aim of this study was to evaluate cyclooxygenase-2 (COX-2) expression, and to investigate the possible protective effect of the selective COX-2 inhibitor, Rofecoxib, in acute and late stages of radiation-induced intestinal injury in rats. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were randomly divided into eight groups. After abdominal irradiation of all of the animals except the six in the control group, the expression of the enzyme cyclooxygenase-2 (COX-2) was evaluated in different cell types present in the intestinal wall 2 h post exposure (study day 0) and again on study days 4, 14, and 60. The effects of Rofecoxib on histological damage, intestinal myeloperoxidase (MPO) activity, and malondialdehyde (MDA) levels were also measured. RESULTS: Expression of COX-2 in vascular endothelial cells was found to be significantly increased on post exposure days 4 and 14 (2.4 and 2.9 stained vessels/high power field [hpf] respectively compared to 1.3 vessels/hpf for controls) (P = 0.002). Expression of COX-2 in fibroblasts increased immediately after irradiation (29 cells/hpf 2 h after irradiation compared to 12 cells/hpf for non-irradiated control animals) and remained high during the entire study period (P < 0.001), whereas there was a peak COX-2 expression (54.9 cells/hpf) on day 14 that was similar to what was observed in endothelial cells. Irradiation of rats significantly increased intestinal epithelial damage, MPO activity, and MDA levels in comparison to the control group in a time-dependent fashion. Treatment with rofecoxib significantly decreased these elevations except on day 4 of the study. CONCLUSION: The current study suggests that the COX-2 pathway is involved in radiation induced intestinal injury and that targeting COX-2 may be useful in limiting radiation enteritis.

Acute Disease↗

Opioid analgesia for hysterosalpingography: controlled double-blind prospective trial with remifentanil and placebo.

BACKGROUND/AIMS: A hysterosalpingogram is an integral part of the evaluation of infertility, however, it is often painful. METHODS: We conducted a randomized double-blinded, placebo-controlled trial of intravenous infusion of remifentanil in women undergoing hysterosalpingography (HSG). We randomly allocated 62 patients scheduled for HSG to receive either a continuous infusion of 0.25 microg.kg(-1) of remifentanil or placebo. The degree of pain was documented via 10-cm visual analog scales (VAS). Patients' discomfort, side effects and recovery times were also recorded. RESULTS: The VAS scores during HSG were 1.25 +/- 1.31 in the remifentanil group and 4.78 +/- 1.7 in the placebo group (p < 0.001). There were more patients in the remifentanil group that rated their condition as excellent (p < 0.001). The groups did not differ with regard to the incidence of side effects. The recovery times were found statistically longer in the remifentanil group (14 +/- 5 vs. 10 +/- 3 min). All the patients were discharged 30 min after the procedures without any side effects. CONCLUSION: Remifentanil infusion during HSG is superior to placebo for relief of pain with minimal opioid side effects.

Adult↗

Oral sedation with midazolam and diphenhydramine compared with midazolam alone in children undergoing magnetic resonance imaging.

BACKGROUND: The purpose of this study was to compare the safety and efficacy of oral midazolam and midazolam-diphenhydramine combination to sedate children undergoing magnetic resonance imaging (MRI). METHODS: We performed a prospective randomized double-blind study in 96 children who were randomly allocated into two groups. Group D received oral diphenhydramine (1.25 mg x kg(-1)) with midazolam (0.5 mg x kg(-1)), and Group P received oral placebo with midazolam (0.5 mg x kg(-1)) alone. Sedation scores, onset and duration of sleep were evaluated. Adverse effects, including hypoxemia, failed sedation, and the return of baseline activity, were documented. RESULTS: Diphenhydramine facilitated an earlier onset of midazolam sedation (P < 0.01), and higher sedation scores (P < 0.01). In children who received midazolam alone, 20 (41%) were inadequately sedated, compared with 9 (18%) children who received midazolam and diphenhydramine combination (P < 0.01). Time to complete recovery was not significantly different between the two groups. CONCLUSIONS: Our study indicates that the combination of oral diphenhydramine with oral midazolam resulted in safe and effective sedation for children undergoing MRI. The use of this combination might be more advantageous compared with midazolam alone, resulting in less sedation failure during MRI.

Administration, Oral↗

Characteristics of poisoning cases in adult intensive care unit in Sanliurfa, Turkey.

OBJECTIVE: The aim of this prospective study was to analyze the rate and characteristics of acute poisoning cases admitted to adult intensive care unit (ICU). METHODS: All cases of acute poisoning admitted to ICU of the Harran University Hospital, Turkey, between July 2002 and May 2005, were included in this study. Clinical, laboratory, and demographic characteristics, type of poison and patient's outcomes were recorded. RESULTS: There were 86 poisoning cases among 844 patients admitted to the ICU. The mean age was 26 +/- 9 years and the majority of the patients (56.9%) were 15-24 years of ages. Eighty percent of acute poisonings were self-inflicted and 65.2% of these patients were singles. Medical drugs overdose were the major cause (51.2%) of intoxication followed by agricultural chemicals (37.2%). The most frequently involved medicinal drugs were benzodiazepines, antidepressants and analgesics. Eleven patients in pesticides-rodenticides and 9 patients in other medical drugs poisoning have required mechanical ventilation between 1-12 days. The duration of the intensive care stay was 6.4 +/- 4.3 days. Five cases (5.8%) with acute poisonings were fatal. CONCLUSION: There was a high rate of suicides attempt in young singles, predominantly female population. These data were the highest agricultural activity of the country that provide important information about the characteristics of poisoning at the city.

Adolescent↗

Radiotherapy in the management of Kaposi's sarcoma: comparison of 8 Gy versus 6 Gy.

OBJECTIVE: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS: Between 1994 and 2004, 47 patients with Kaposi's sarcoma were treated at Hacettepe University, Department of Radiation Oncology. Thirteen (28%) patients received chemotherapy before radiotherapy and were referred due to recurrent or progressive disease or intolerance to chemotherapy. All lesions were treated locally with a 2-3-cm safety margin with 4-6-MeV electron beams. Radiotherapy consisted of a single fraction of 8 Gy in the first four years and 6 Gy thereafter. RESULTS: The male:female ratio was 4:1. The median age was 61 years (range 18-87). Eight out of 47 patients (17%) had an underlying immunocompromised state, and one had a previous diagnosis of Hodgkin's disease. Of 203 fields treated, 51 and 152 fields were treated with 8 Gy and 6 Gy, respectively. Overall response rates (RR) at 12 months for 8- and 6 Gy were 93% and 86%, which were not statistically different. However, the difference between complete RRs at 12 months (93% and 60% for 8 Gy and 6 Gy respectively) was significant (p<0.0001). Progression-free survival and reirradiation rates were not significantly different. Side effects were tolerable in all but three patients with grade 2-3 fibrosis and edema. CONCLUSION: Radiotherapy is an effective mode of treatment for Kaposi's sarcoma, and a single dose of 8 Gy is more effective in terms of complete RR compared to 6 Gy, though overall response and progression-free survival rates were similar.

Adolescent↗

A mean red blood cell volume loss in tonsillectomy, adenoidectomy and adenotonsillectomy.

OBJECTIVE: To calculate a mean red blood cell volume (RBCV) loss per kilogram (kg) in adenoidectomy, tonsillectomy, and adeno-tonsillectomy. MATERIALS AND METHODS: Pre- and post-operative complete blood cell count, and pre-operative clotting studies of 144 patients were measured. Total blood volume (75 or 70 ml/kg), pre- and post-operative RBCV (hematocritxtotal blood volume), RBCV loss, per kg RBCV loss and per cent RBCV loss were calculated. RESULTS: There was significant differences between pre- and post-operative RBCV, Hb, and Htc values for tonsillectomy, adenoidectomy and A&T groups, respectively (p<0.001 for all groups). We found a mean RBCV loss of 33 ml (5.56% of total RBCV) for adenoidectomy, 128 ml (10.63% of RBCV) for tonsillectomy and 60 ml (10.71% of RBCV) for A&T. RBCV loss per kg was 1.57+/-1.29 for adenoidectomy, 2.96+/-1.91 for adeno-tonsillectomy, and 3.02+/-1.66 for tonsillectomy. CONCLUSION: According to us, for management of the patients, knowledge of a mean nature loss of RBCV per kg is important because bleeding seems to be unavoidable in the intra-operative or maybe post-operative period in these operations.

Adenoidectomy↗

Assessment of quality of life of nasopharyngeal carcinoma patients with EORTC QLQ-C30 and H&N-35 modules.

PURPOSE: The current study reports on long-term quality of life (QoL) status after conventional radiotherapy in 187 nasopharyngeal carcinoma patients from 14 centers in Turkey. PATIENTS AND METHODS: Patients with the diagnosis of nasopharyngeal carcinoma, who were treated in 14 centers in Turkey with minimum 6 months of follow-up and were in complete remission, were asked to complete Turkish versions of EORTC QLQ-C30 questionnaire and the HN-35 module. Each center participated with the required clinical data that included age at diagnosis, gender, symptoms on admission, follow-up period, treatment modalities, radiotherapy dose, and AJCC 1997 tumor stage. Each patient's 33 QoL scores, which included function, global health status, and symptoms, were calculated as instructed in EORTC QLQ-C30 scoring manual. All of the scales and single-item measures range from 0 to 100. A high score represents a higher response level. Kruskal-Wallis and Mann-Whitney U nonparametric tests were used for comparisons. RESULTS: One hundred eighty-seven patients with median age of 46 years (range, 16-79 years) participated and completed the questionnaires. Median follow-up time was 3.4 years (range, 6 months-24 years). All patients have received external-beam radiotherapy. Beside external-beam radiotherapy, 59 patients underwent brachytherapy boost, 70 patients received concomitant chemotherapy, and 95 patients received adjuvant/neoadjuvant chemotherapy. Most of the patients in the analysis (75%) were in advanced stage (Stage III, n = 85 [45.4%]; Stage IV, n = 55 [29%]). Mean global health status was calculated as 73. Parameters that increased global health status were male gender, early-stage disease, and less than 4-year follow-up (p < 0.05). Functional parameters were better in males and in early-stage disease. Factors that yielded better symptom scores were short interval after treatment (10 scores), male gender (7 scores), and lower radiation dose (6 scores). Neoadjuvant or adjuvant chemotherapy did not have any effect on QoL, whereas concomitant chemotherapy adversely affected 5 symptom scores. CONCLUSION: Quality of life is adversely affected in our nasopharyngeal carcinoma patients treated with combined therapies. The factors that adversely affect quality of life are advanced tumor stage, female gender, and long-term follow-up. Further controlled studies to evaluate both preradiotherapy and postradiotherapy status are necessary to clarify the contribution of each treatment modality to QoL.

Adolescent↗

Trismus as a presenting symptom in nasopharyngeal carcinoma.

Trismus is a more common symptom in NPC patients with young age and an indicator of advanced primary tumour. Overall response rate after treatment was 88%. Trismus recovered in majority of patients at the end of treatment and patients with complete recovery of trismus may have a better survival.

Adolescent↗

Induction chemotherapy with cisplatin and 5-fluorouracil followed by chemoradiotherapy or radiotherapy alone in the treatment of locoregionally advanced resectable cancers of the larynx and hypopharynx: results of single-center study of 45 patients.

BACKGROUND: Induction chemotherapy with cisplatin and fluorouracil and radiotherapy is an effective alternative to surgery in patients with carcinoma of the larynx and hypopharynx who are treated for organ preservation. METHODS: We designed a protocol to evaluate the possibility of organ preservation in patients with advanced, resectable carcinoma of the larynx and hypopharynx. Forty-five eligible patients who were followed up between April 1999 and May 2001 were enrolled. Initially, these patients were treated with two cycles of induction chemotherapy consisting of cisplatin, 20 mg/m2/day on days 1 to 5, and 5-fluorouracil, 600 mg/m2/day by continuous infusion on days 1 to 5. Patients who had a complete response to chemotherapy were treated with definitive radiotherapy; patients who had a partial response to chemotherapy were treated with chemoradiotherapy. Cisplatin, 35 mg/m2/week, was introduced throughout the duration of radiotherapy. Patients who had no response or progressive disease underwent surgery with postoperative radiotherapy. Patients with N2 or N3 positive lymph nodes underwent neck dissection after the treatment. RESULTS: The mean age was 56.6 years (range, 34-75 years). The overall response rate to induction chemotherapy was 71.1%, with a 17.8% complete response rate and 53.3% partial response rate. With a median follow-up of 13.7 months, 23 (51.1%) of all patients and 63.3% of surviving patients have had a preservation of the larynx or hypopharynx and remain disease free. The most common toxicities were nausea and vomiting and mucositis. CONCLUSION: Organ preservation, with multimodality treatment, may be achievable in some of the patients with resectable, advanced larynx or hypopharynx cancers without apparent compromise of survival.

Adult↗

Radiotherapy in the management of Klippel-Trénaunay-Weber syndrome: report of two cases.

Klippel-Trénaunay-Weber syndrome (KTWS) is characterized by combined vascular malformations of capillary, venous, and lymphatic types usually observed during infancy or childhood. In this report, we describe two KTWS patients treated with radiotherapy after long-term conservative treatment or multiple surgical interventions. The first patient, a 15-year-old female, presented with vascular masses located on the right upper extremity. She was treated conservatively for 14 years, and amputation was offered at the age of 14 due to cardiac failure. A course of radiotherapy to a total dose of 40 Gy with conventional daily fractionation was administered as an alternative to the mutilating surgery, and prominent improvement both subjectively and objectively was detected 1 year after radiotherapy. The second patient, a 40-year-old male, suffered from huge vascular masses of both the trunk and lower extremities. Despite multiple surgical interventions and conservative treatment, disease progressed and neurological symptoms occurred due to compression of vertebral structures. He was administered a course of 30 Gy radiotherapy with 1.5 Gy daily fractions to the lower thoracic region and whole abdominal cavity. Six months after radiotherapy, subjective relief described by the patient but without any objective response was detected. Though considered as a benign disease, KTWS can cause life-threatening complications. The response of one of our patients is a hopeful finding for considering radiotherapy as an alternative treatment modality for these patients.

Adolescent↗