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Biomedical subjects

Mustafa Unal

Publications and source records attributed to Mustafa Unal.

12 recordsLinked to original sources
PubMed2006

Glutathione S transferase M1 and T1 genetic polymorphisms are related to the risk of primary open-angle glaucoma: a study in a Turkish population.

BACKGROUND: Genetic factors and oxidative damage have been shown to have a role in the development of primary open angle glaucoma (POAG). AIM: To determine the effects of genetic polymorphisms of glutathione S transferase (GST)M1 and GSTT1 on the risk of POAG in a Turkish population. METHODS: Using a multiplex polymerase chain reaction (PCR), GSTM1 and GSTT1 gene polymorphisms were analysed in 144 patients with POAG and in 121 otherwise healthy controls of similar age. RESULTS: The GSTM1 positive genotype and the GSTT1 null genotype had an increased risk of developing POAG (p<0.001, OR 2.93, 95% CI 1.66 to 5.20 and OR 4.25, 95% CI 2.30 to 7.80, respectively). The risk of glaucoma also increased significantly in subjects with a combination of GSTM1 positive and GSTT1 null genotypes (p<0.001, OR 3.46, 95% CI 1.64 to 7.38). CONCLUSION: The GSTM1 positive genotype and GSTT1 null genotype or the combination of both may be associated with the increased risk of development of POAG in the Turkish population.

Aged↗
PubMed2006

Phacoemulsification with topical anesthesia: Resident experience.

PURPOSE: To compare the intraoperative and postoperative complications and outcomes of phacoemulsification performed by residents using topical and retrobulbar anesthesia. SETTING: Two university ophthalmology departments. METHODS: One hundred fifty phacoemulsification procedures were performed by 3 residents who used retrobulbar anesthesia (retrobulbar group), and 146 phacoemulsification procedures were performed by another 3 residents who used topical anesthesia and who had no experience with retrobulbar or peribulbar anesthesia (topical group). Case notes were prospectively compared. The data analyzed included the ocular history, intraoperative and postoperative complications, and final best spectacle-corrected visual acuity (BSCVA). RESULTS: There were no differences between the 2 groups in complication rates. Anterior capsule tears occurred in 8 eyes (5.3%) in the retrobulbar group and 7 eyes (4.7%) in topical group. Capsulorhexis was continuous but not curvilinear in 14 eyes (9.3%) and 12 eyes (8.2%), respectively. Capsulorhexis tear or posterior capsule rupture that necessitated conversion to extracapsular cataract extraction occurred in 3 eyes (2.0%) in the retrobulbar group and in 1 eye (0.6%) in the topical group. Posterior capsule rupture with vitreous loss occurred in 10 eyes (6.6%) and 9 eyes (6.1%), respectively. Loss of lens fragments in the vitreous cavity occurred in 3 eyes (2.0%) and 4 eyes (2.7%), respectively. The 63 postoperative complications (41 eyes [27.3%], retrobulbar group; 22 eyes [15.0%], topical group) included cystoid macular edema, intraocular lens decentration, endophthalmitis, bullous keratopathy, transient intraocular pressure elevation, temporary corneal edema, and vitreous hemorrhage. Some cases had more than 1 complication. The BSCVA, including in eyes with preexisting ocular pathology, was 20/40 or better in 86.7% in the retrobulbar group and 84.9% in the topical group. CONCLUSION: When supervised and in selected patients, residents who have no retrobulbar or peribulbar anesthesia experience can safely perform phacoemulsification using topical anesthesia.

Adult↗
PubMed2006

Brinzolamide 1% versus apraclonidine 0.5% to prevent intraocular pressure elevation after neodymium:YAG laser posterior capsulotomy.

PURPOSE: To compare the efficacy of brinzolamide 1% with that of apraclonidine 0.5% in preventing intraocular pressure (IOP) rise after neodymium:YAG (Nd:YAG) laser posterior capsulotomy. SETTING: Department of Ophthalmology, Akdeniz University, Antalya, Turkey. METHODS: One hundred fifteen patients who had Nd:YAG laser posterior capsulotomy for posterior capsule opacification were prospectively randomized to receive brinzolamide 1% (57 patients) or apraclonidine 0.5% (58 patients) approximately 1 hour before laser surgery. A masked observer measured IOP by Goldmann applanation tonometry before treatment and after treatment at 1, 2, and 3 hours and 7 days. RESULTS: The mean IOP changes from baseline were not statistically different between the study groups at 1, 2, and 3 hours and 7 days (P =.109, P = .764, P =.275, and P =.879, respectively). The incidence of IOP elevation of 5 mm Hg or higher was 12.2% (7 of 57 eyes) in the brinzolamide group and 10.3% (6 of 58 eyes) in the apraclonidine group (P = .743); IOP elevations of 10 mm Hg and greater occurred in 3.5% (2 of 57 eyes) and 1.7% (1 of 58 eyes) (P = .618), respectively. There were no IOP elevations greater than 20 mm Hg in either group. CONCLUSION: Brinzolamide 1% and apraclonidine 0.5% given prophylactically before Nd:YAG laser capsulotomy were effective in preventing IOP spikes after treatment.

Adrenergic alpha-Agonists↗
PubMed2006

Outbreak of toxic anterior segment syndrome associated with glutaraldehyde after cataract surgery.

PURPOSE: To present clinical findings of a cluster of cases of toxic anterior segment syndrome (TASS) after uneventful phacoemulsification cataract surgery. SETTING: Department of Ophthalmology, Akdeniz University, Antalya, Turkey. METHODS: Six eyes of 6 patients developed TASS after uneventful phacoemulsification cataract surgery with implantation of a 3-piece acrylic IOL performed by 2 ophthalmologists on the same day. Clinical findings included corneal edema, Descemet's membrane folds, anterior chamber reaction, fibrin formation, and irregular, dilated, and unreactive pupils. RESULTS: Glutaraldehyde 2% solution was used inadvertently by the operating room staff who cleaned and sterilized reusable ocular instruments before autoclaving. None of the affected corneas improved. Additional surgical procedures were required and included penetrating keratoplasty, trabeculectomy, and glaucoma tube implantation. CONCLUSIONS: Glutaraldehyde in concentrations generally used for cold sterilization is highly toxic to the corneal endothelium. The operating room staff involved in sterilizing instruments should be well educated about and careful to follow the protocols to properly clean and sterilize reusable ocular instruments.

Aged↗
PubMed2006

Early severe pre-eclamptic findings in a patient with Cushing's syndrome.

Cushing's syndrome occurs rarely in pregnancy because of ovulatory disturbances including anovulation which is caused by hypercortisolism, but it can cause maternal complications such as hypertension, gestational diabetes, spontaneous abortion, premature birth, pre-eclampsia and stillbirth. Herein we present the case of a 22-year-old patient in the 11th week of pregnancy who was admitted to our hospital with Cushing's syndrome complicated by early pre-eclampsia. Severe pre-eclampsia has high maternal and perinatal morbidities, and therefore the possibility of this complication requires that Cushing's syndrome, although rare in pregnancy, be given a high clinical suspicion. Medical therapy and/or surgical therapy should be considered promptly to influence outcome favorably.

Adrenal Cortex Neoplasms↗
PubMed2006

Filamentary keratopathy caused by corneal occlusion by large-angle paralytic strabismus.

PURPOSE: To report a case of filamentary keratopathy in a patient with large-angle paralytic strabismus. METHODS: A 31-year-old man who had a traffic accident was diagnosed to have third cranial nerve palsy and a large-angle exotropia in his right eye. The patient complained of foreign body sensation in his right eye 2 months after the accident. RESULTS: Slit-lamp examination showed multiple filaments on the right cornea. Debridement of the filaments and artificial tears relieved the symptoms and were used until the paralysis resolved. CONCLUSION: Large-angle paralytic strabismus with ptosis and poor elevation and depression of the eye may occlude the cornea and lead to filamentary keratopathy.

Accidents, Traffic↗
PubMed2005

Novel approach to aortic cannulation suturing: tangential suture technique.

BACKGROUND: Pursestring suture for ascending aortic cannulation in open heart surgery that requires cardiopulmonary bypass may cause serious events, especially in patients who have a thin or calcific aorta. We introduce a novel suturing method, called the 'tangential suture technique', and submit our clinical experience. METHODS: Adult patients undergoing cardiopulmonary bypass were included in this study. Patients in whom the tangential suture technique was applied (Group A; n = 146) were compared with patients in whom the classic pursestring technique was applied (Group B; n = 152). RESULTS: The age (38 +/- 11 years vs 36 +/- 10 years), sex (males 65.1% vs 62.5%) and operation types were similar in both groups. Although the difference was not significant (P > 0.05), subadventitial haematoma occurred more frequently in Group B (13 patients; 8.6%) than in Group A (3 patients; 2.1%). However, none in Group A required opening the adventitia. No aortic dissection was observed in peri- or postoperative periods in either group. In Group B, seven (4.6%) patients required repair by suture after tying of pursestring sutures following decannulation because of bleeding, while none was required in Group A (P = 0.0156). CONCLUSIONS: Tangential suture technique allows the needle to take a longer segment from the media layer while decreasing the likelihood of entering the lumen. Because the tract of the suture almost perfectly fits to the needle curve, tissue injury is less, even on fragile aortas, and this ensures more stable closure of the hole when the suture is tied following decannulation. By considering both its theoretical advantages and our clinical experience, we believe tangential suture technique should be preferred to the classic method.

Adolescent↗
PubMed2005

Herpes simplex type-2 encephalitis masked by diabetic ketoacidosis.

Diabetic ketoacidosis is a life-threatening acute complication of type-1 diabetes mellitus. Infection is the most common precipitating factor for diabetic ketoacidosis and is responsible for more than 50% of the cases. Here, we present a case study of a young man with herpes simplex virus type-2 encephalitis masked by diabetic ketoacidosis. We aim to orient clinicians towards being vigilant against such clinical scenarios.

Adult↗
PubMed2002

Creating a bicuspid valve from the aortic wall: a new surgical approach on aortic valve disease (in vitro study).

We described a new technique (called 'bicuspidization'), which is performed by using autogenous material, without replacement of the aortic valves for the surgical treatment of aortic stenosis and/or insufficiency and tested it in in vitro sheep model. Different stress conditions were simulated by applying three different flow patterns (hemodynamic challenge tests) successively by using a centrifugal pump. It was demonstrated that the competency of the new bicuspid valves was excellent (zero insufficiency). There was a 10-11 mm Hg-increase on trans-valvular gradient comparing the normal hearts. The autogenous bicuspid valve has not blocked the way of the coronary flow in the closed position.

Animals↗
PubMed2002

Microbiologic evaluation of frequent-replacement soft contact lenses.

PURPOSE: This article reports a microbiologic study of two kinds of monthly frequent-replacement daily wear soft contact lenses, with different amounts of water content, in asymptomatic contact lens wearers. METHOD: We studied 35 lenses of 18 patients who wear frequent-replacement soft contact lenses with a water content of 38% and 40 lenses of 20 patients using frequent-replacement contact lenses with a water content of 55%. The lenses worn by patients regularly for 1 month were removed from their eyes in a sterile manner on the 30th day and were studied microbiologically to isolate pathogenic agents. RESULTS: In the group of monthly frequent-replacement soft contact lenses with a water content of 38%, microorganisms were isolated at a rate of 91%; and in the group of monthly frequent-replacement soft contact lenses with a water content of 55%, microorganisms were isolated at a rate of 85%. When the two groups were compared, there was no statistically significant difference (P=0.31). Although coagulase-negative staphylococci, Corynebacterium spp, and gram-negative rods were detected in both groups, Staphylococcus aureus, non-hemolytic streptococci, Neisseriae spp, and Penicillium spp also were isolated in the group with the higher water content. CONCLUSION: Bacteria spreading from the environment or from skin flora to the eyes showed more diversity in the group of frequent-replacement soft contact lenses with a high water content. Additionally, Penicillium spp also was isolated in this group. Therefore scrupulous attention to daily lens care is crucial for people who wear frequent-replacement soft contact lenses.

Adolescent↗
PubMedDate not supplied

Acquired ptosis secondary to vernal conjunctivitis in young adults.

PURPOSE: To establish a relation between prolonged severe vernal conjunctivitis and upper eyelid ptosis. METHODS: The study consisted of 12 patients between the ages of 19 and 32 years with acquired ptosis who presented in our clinic between September 2001 and February 2005. Potential factors responsible for acquired ptosis were investigated in all patients, with specific attention to the history and severity of vernal conjunctivitis. RESULTS: We found vernal conjunctivitis to be the identifiable cause in 8 men and 4 women with acquired ptosis. There was neither contact lens usage nor trauma or ocular surgery history in their medical records. The blepharoptosis was caused by levator disinsertion and recession of the aponeurosis. The pathology improved in each case after reattachment of the aponeurosis to the superior tarsal border. CONCLUSIONS: These findings suggest that prolonged severe vernal conjunctivitis may induce a lower position of the upper eyelid and eventually lead to ptosis through levator disinsertion that is similar to involutional ptosis. We believe that chronic inflammation of the upper eyelid with giant papillary conjunctivitis and persistent rubbing of the eyelids may be responsible for the development of this pathology.

Adult↗