Biomedical subjects

Mustafa Yilmaz

Publications and source records attributed to Mustafa Yilmaz.

At least 37 records · Page 2Linked to original sources

PubMed2005

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↗

PubMed2005

Follow-up form for patients undergoing orthognathic surgery.

Patients undergoing orthognathic surgery need quantitative follow-up of many parameters. Standardization and recording of data should be done with minimal paper work and time. The patient follow-up form presented enabled the authors' clinic to increase the quality of follow-up. The form consists of more than 20 variables that are routinely evaluated in all patients undergoing orthognathic surgery. It facilitates the cross-evaluation of many variables easily and more accurately. This type of accurate recording would also be beneficial in the event of medico-legal issues. The authors believe this form would be helpful to clinics that have a large number of patients undergoing orthognathic surgery.

Aftercare↗

PubMed2005

Management of close-range, high-energy shotgun and rifle wounds to the face.

Close-range, high-energy shotgun wounds of the face are life-threatening and devastating traumas of the face. Suicidal attempts are the main reason in the great majority of the patients in civilian life. There is no consensus on the timing of reconstruction for bone and soft tissue defects resulting from high-energy shotgun wounds. The conventional method is primary repair as soon as possible and serial debridements and definitive reconstruction in the delayed stage. An alternative to this approach is the immediate definitive surgical reconstruction of the patient during the first operation for acute management of trauma. We had 15 patients with close-range, high-energy shotgun wounds in 10 years. Six of 15 patients referred to our center for definitive reconstruction after the acute management of the patients were performed in another center and the rest were all admitted in the acute period. Either conventional approach with delayed reconstruction for 10 patients or immediate definitive surgical reconstruction for 5 patients was used. Immediate reconstruction eliminated disadvantages of the conventional method such as high infection and scarring rate and deformities resulting from contraction of tissues. The emotional conditions of the patients were evaluated and major depression signs were determined. Functional evaluation showed that there was great correlation between facial appearance after reconstruction and social activity level.

Adolescent↗

PubMed2005

The use of anatomic M-mode echocardiography to determine the left atrial appendage functions in patients with sinus rhythm.

Left atrial appendage (LAA) contractile dysfunction is associated with thrombus formation and systemic embolism. LAA function is determined by its flow velocities and fractional area change. This study was performed in order to determine the LAA functions with the anatomic M-mode echocardiography (AMME). Our study comprised 74 patients who had sinus rhythm and underwent transesophageal echocardiography (TEE) for various reasons. LAA fractional change (LAAFAC) was measured by manual planimetry in a transverse basal short-axis approach and LAA emptying and filling velocities also were measured. The AMME values were determined by an M-mode cross section from a cursor placed beneath the orifice of the LAA in transverse basal short-axis imaging. From these values LAA fractional shortening (LAAFS) and ejection fraction (LAAEF) were calculated. LAAEF was calculated by the Teicholz method. The comparisons were conducted, and no correlations between the LAA late filling and the anatomic M-mode values were found (for LAAFS r = 0.18; P > 0.05 and for LAAEF r = 0.19; P > 0.05). There were significant but poor correlations among the LAA late emptying with the anatomic M-mode measurements (for LAAFS r = 0.26; P < 0.05 and for LAAEF r = 0.30; P < 0.01), whereas, there were significant and good correlations between the LAAFAC and the anatomic M-mode values (for LAAFS r = 0.75; P < 0.01 and for LAAEF r = 0.78; P < 0.01). There were significant differences between the valvular heart disease group and the normal group, and between the valvular heart disease group and the ASD group (for LAAFAC P < 0.01, for LAAEF P < 0.01, for LAAFS P < 0.01). There was no difference between the normal group and the ASD group. Our study showed that the LAAEF and LAAFS in patients with sinus rhythm obtained via anatomical M-mode echocardiography is a new method, which can be used instead of left atrial appendage area change.

Adult↗

PubMed2005

Left atrial mechanical functions in pre-eclampsia.

AIM: To assess the effect of short-term pressure overload on left atrial (LA) mechanical function in pre-eclampsia. METHODS: Twenty women with pre-eclampsia and 17 age-matched healthy pregnant women were included. LA volumes were measured echocardiographically at the time of mitral valve opening (Vmax), onset of atrial systole (p-wave at the electrocardiography = Vp) and mitral valve closure (Vmin) according to the biplane area-length method. RESULTS: The mean age, gestational age, weight and body surface area were similar in pre-eclampsia and controls. The ventricular septal and posterior wall thickness were greater in pre-eclampsia (P < 0.001). There were no significant differences in LA diameter, Vmax, Vmin, Vp, LA-passive emptying volume, LA-passive emptying fraction, LA-active emptying volume, LA-active emptying fraction, conduit volume, LA-total emptying volume and LA-total emptying fraction between the groups. CONCLUSION: Left atrial mechanical function didn't change in pre-eclampsia. We conclude that short-lasting pressure overload is not capable of inducing changes in LA function.

Adult↗

PubMed2005

Idiopathic hypereosinophilic syndrome associated with multiple intracardiac thrombi.

A 17-year-old man was referred for dyspnea, fatigue, and fever. Idiopathic hypereosinophilic syndrome was diagnosed. Transthoracic echocardiography demonstrated multiple intracardiac thrombi in the left ventricular apex. Dissolution of thrombi was not seen despite intensive medical therapy. The patient died because of cerebral embolus.

Adult↗

PubMed2005

[Molecular identification of Candida albicans and Candida dubliniensis strains isolated from clinical samples].

Candida dubliniensis is a recently identified opportunistic pathogen, which has close phylogenetic relation with Candida albicans. The aim of this study was the genotypic differentiation of 55 germ tube-positive Candida strains isolated from clinical specimens (30 blood, 25 throat swab specimens). The isolates were phenotypically identified by API ID 32C system, and genotypically identified by using polymerase chain reaction-restriction fragment lenght polymorphism (PCR-RFLP) method. Initially ITS2 region has been amplified by using universal fungal primers with PCR. After amplification and purification of approximately 340 base pair products, they were treated with species-specific restriction enzymes (MspA1 I and BsmAI for C. albicans and C. dubliniensis, respectively). As a result, API ID 32C system identified 52 (94.5%) isolates as C. albicans and 3 (5.5%) isolates as C. dubliniensis, whereas PCR-RFLP analysis yielded 50 (90.9%) C. albicans and 5 (9.1%) C. dubliniensis. It can be concluded that PCR-RFLP method may be used for the differentiation of C. dubliniensis and C. albicans isolates in clinical samples.

Candida↗

PubMed2004

Effects of dexamethasone, all-trans retinoic acid, vitamin D(3) and interferon-alpha on FO myeloma cells.

BACKGROUND: Since multiple myeloma responds poorly to conventional chemotherapy or radiotherapy, new therapeutic approaches are needed. This study investigated the effects of dexamethasone, all-trans retinoic acid (ATRA), the active metabolite of vitamin D(3) [1,25(OH)(2)D(3)] and interferon-alpha on FO mouse myeloma cells (non-immunoglobulin-secreting myeloma cell line) in single drug or drug combination groups in vitro. METHODS: Apoptosis ratio and change in cell counts in 4 single drug groups (dexamethasone, ATRA, vitamin D(3) and interferon-alpha) and 6 combination drug groups (dexamethasone + vitamin D(3,) dexamethasone + ATRA, dexamethasone + interferon-alpha, vitamin D(3) + ATRA, vitamin D(3) + interferon-alpha, interferon-alpha + ATRA) were compared with the control group. RESULTS: When treatment groups were compared with the control group, there was a significant increase in apoptosis in all, but this was most prominent in the group treated with dexamethasone alone. The apoptosis ratios were 0.10 and 6.82% in the control and dexamethasone-only groups, respectively. We also found that there was a significant decrease in cell count, particularly in the dexamethasone-only, ATRA-only, and ATRA-vitamin D(3) combination groups. CONCLUSION: ATRA, interferon-alpha, vitaminD(3) and particularly dexamethasone have significant effects on FO mouse myeloma cells resulting in a decreased cell count and an increased apoptosis ratio. This study should be repeated with human myeloma cell lines for further information.

Animals↗

PubMed2004

MTHFR C677T polymorphism and its relation to ischemic stroke in the Black Sea Turkish population.

The MTHFR C677T mutation has been shown to be associated with venous thrombosis. The role of this mutation in ischemic stroke is unclear. We investigated whether the MTHFR mutation is a risk factor for patients with ischemic stroke in the Black Sea Turkish population or not. We analyzed 30 patients (19 male, 11 female) [median age: 50 years (range: 28-78)] with ischemic stroke who had no known predisposition factors for stroke and 242 (182 male, 60 female) healthy controls [median age: 42 years (range: 18-65)]. Detection of the MTHFR C677T mutation was performed by using commercially available allele-specific PCR-ELISA kits. Prevalence of the MTHFR C677T genotype was 49.1% (CT, 45.8%; TT, 3.3%) in controls and 50% (CT, 43.3%; TT, 6.6%) in patients [OR: 1.03, 95% CI (0.45-2.35]). The prevalence of homozygous gene mutation for MTHFR was higher among patients with stroke than control subjects, but this difference was not statistically significant. The MTHFR gene mutation is not a risk factor for ischemic stroke formation in patients from the Black Sea region in Turkey.

Adult↗

PubMed2004

The first spontaneous coronary artery perforation due to disruption of atherosclerotic plaque.

Spontaneous coronary artery rupture is rarely seen and most of the reorted cases in the world literature are related to rupture of a coronary artery aneurysm or of a saphenous vein graft. There is no report in the literature of a patient with spontaneous coronary artery perforation due to disruption of coronary atherosclerotic plaque. We can confirm that our patient is the first to be successfully treated with intracoronary grafted stent implantation for spontaneous coronary artery perforation as a result of disruption of atherosclerotic plaque.

Aortic Dissection↗

PubMed2004

Mitral annular calcification is associated with osteoporosis in women.

BACKGROUND: Few studies have suggested association between mitral annular calcification (MAC) and osteoporosis in women who are post-menopausal. However, the association of MAC with osteoporosis in women, in relation to bone resorption, as assessed by using the dual-energy x-ray absorptiometry method (DEXA), have not been performed. We sought to examine the association between MAC and osteoporosis. METHODS: In this prospective, observational study carried out in a tertiary referral center, 340 women (mean age +/- SD, 56 +/- 10 years; age range, 33-85 years) underwent echocardiography, with specific assessment of MAC and bone mineral density measurement (T-scores) using DEXA. RESULTS: MAC was absent in 123 patients (group I) and present in 217 patients (group II). Compared with the control group, the group with MAC had a significantly higher prevalence and severity of osteoporosis (18.2% vs 55.5%, P <.001). Severe osteoporosis was significantly more common in the severe MAC subgroup (n = 66) than in the control subjects (65.2% vs 17.1%; Pearson chi2, 70.02; df = 4; P <.001). With multivariate analysis, only T-scores and age were highly predictive of MAC, with an odds ratio of 2.66 (95 % CI, 1.85-3.83) and 1.04 (95% CI, 1.01-1.07), respectively. CONCLUSIONS: MAC is associated with osteoporosis. Bone mineral density measurement (T-scores) and age were highly predictive of MAC in women.

Absorptiometry, Photon↗

PubMed2004

The effect of pulmonary hypertension on left atrial mechanical functions in chronic obstructive lung disease.

BACKGROUND: Left atrial (LA) function is an important determinant of left ventricular (LV) filling. However, the effect of pulmonary hypertension (PH) on LA mechanical function in chronic obstructive lung disease (COLD) has not been studied, yet. METHODS: 49 patients with COLD and 25 controls were included in this study. Patients were divided into two subgroups: patients without PH (group 1, n=21) and with PH (group 2, n=28). LA volumes were determined at mitral valve opening (Vmax), at onset of atrial systole (Vp) and at mitral valve closure (Vmin) according to biplane area-length method. The following LA parameters were calculated: passive emptying volume (PEV=Vmax-Vp), conduit volume [CV=LV stroke volume-(Vmax-Vmin)], passive emptying fraction (PEF=PEV/Vmax), active emptying volume (AEV=Vp-Vmin), active emptying fraction (AEF=AEV/Vp), total emptying volume (TEV=Vmax-Vmin), percent contribution of PEV, CV and AEV to LV stroke volume. RESULTS: Vmax (p<0.01), PEV (p<0.001) and TEV (p<0.05) were lower in group 2 than in the controls, and the differences between group 1 and control group were insignificant (p>0.05). Vp, Vmin, CV and AEV did not differ among three groups. Percent contribution to LV filling of the PEV was decreased in group 2 when compared to group 1 (p<0.05) and the controls (p<0.01). Percent contribution to LV filling of the AEV was increased in group 2 when compared to the controls (p<0.05). There were inverse correlations between pulmonary artery pressure and the following parameters: LV stroke volume (r=-0.43, p<0.01), mitral E/A (r=-54, p<0.001), Vmax (r=-0.35, p<0.05), PEV (r=-40, p<0.01) and PEF (r=-0.43, p<0.01). CONCLUSION: This study shows that the alterations of LA mechanical functions in patients with COLD are closely correlated to PH levels. Furthermore, these results underline the importance of maintaining a sinus rhythm in these patients.

Adult↗

PubMed2004

Are tonsils a reservoir for Helicobacter pylori infection in children?

OBJECTIVE: Helicobacter pylori (H. Pylori) has been associated with the development of gastritis, peptic ulcer and gastric cancer. Although H. pylori infects up to more than half of the world's population, to date the precise modes of transmission has not been fully understood yet. Therefore a study was planned to investigate whether the tonsils and the adenoid tissue were the reservoir or the gate for the entrance of H. pylori. METHODS: The adenotonsillectomy specimens obtained from 50 children, between two and 10 years of age were examined for H. Pylori colonization by the CLO-test method. Before tonsillectomy, anti-H. pylori IgG antibody titers were detected by commercial enzyme immunoassay method in venous blood and H. pylori antigen enzyme immunoassay for detection of H. pylori in stool was used to define current infection status. RESULTS: The stool antigen was positive in 25 (50%) of 50 children. Serum IgG antibody was positive in 28 (56%) patients and both tests were positive in 21 (42%) patients. H. pylori positivity was not detected in any one of the adenotonsillectomy specimens with the CLO-test method. CONCLUSION: In this study although H. pylori was detected in stools of children, it was not detected in adenotonsillectomy specimens with CLO-test method. The results may indicate that H. pylori does not colonize in either adenoid or tonsils and that these tissues do not constitute a reservoir for H. pylori infection.

Adenoidectomy↗

PubMed2004

Modifications of the inverted T-shaped silicone implant for treatment of temporomandibular joint ankylosis.

PURPOSE: Inverted T-shaped silicone implants have been used for reconstruction of ankylosed temporomandibular joints for 10 years. As the implant is custom made during the operation, dimensional adjustments according to individual need are routine. MATERIAL AND METHOD: A new modification to increase the stability of the inverted T-shaped silicone implant is presented. The modification consists of a middle process on the long arm of the T-shaped silicone implant, the first of which was inserted into the medullary cavity of the mandibular ramus. This modification further stabilizes the implant position and helps prevent its displacement. The modification was used on difficult cases such as bilateral ankylosis, osteotomies below the condylar notch or incompliant patients. This modification was used in six patients. RESULTS: No dislocation, nor extrusion of the implant or re-ankylosis of TMJ was observed.

Adolescent↗

PubMed2004

The role of food allergy in otitis media with effusion.

OBJECTIVE: To detect the relationship between food allergy and otitis media with effusion (OME). MATERIALS AND METHODS: This study was performed on three different groups. The patient group was made up of 56 patients with OME (group I). There were 28 patients with food allergy in group II and these patients were investigated for OME. The control group consisted of 28 patients without any complaints concerning food allergy or OME (group III). RESULTS: Food allergy was detected in 25 patients with OME (44.6%) (group I). In patients with food allergy (group II), OME was detected in 7 patients (25%). In the control group (group III) food allergy was diagnosed in 5 patients (18%) and OME in 1 patient (3%). The incidence of food allergy in OME group was statistically significant when compared to the normal group (P > 0.05). CONCLUSIONS: This study demonstrates that food allergy may play a role in the etiopathogenesis of OME.

Adolescent↗

PubMed2004

Increments in circulating homocysteine before and after coronary artery bypass surgery in diabetic and non-diabetic patients.

This study aims to assess total plasma homocysteine levels in diabetic and non-diabetic patients who underwent coronary artery bypass grafting (CABG) and to determine the effect of cardiopulmonary bypass (CPB) on homocysteine levels. Twenty diabetic and twenty non-diabetic patients who had CABG were enrolled in the study. Plasma samples for the assays were obtained before and after the CPB and on sixth day following the operation. Diabetic patients seemed to have higher levels of plasma total homocysteine in pre-CPB, post-CPB, and postoperative sixth day blood samples. There was a significant difference in total homocysteine levels between pre-CPB and post-CPB both in diabetic and non-diabetic patients. Although an association between the preoperative plasma total homocysteine levels and the frequency of 1-year graft occlusion could not be demonstrated, our data claims attention to the increased homocysteine levels during CPB, which sustained until the sixth day after the surgery.

Biomarkers↗

PubMed2004

Relationship between pollen counts and weather variables in east-Mediterranean coast of Turkey. Does it affect allergic symptoms in pollen allergic children?

BACKGROUND: Aeroallergen sampling provides information regarding the onset, duration and severity of the pollen season that clinicians use to guide allergen selection for skin testing and treatment. OBJECTIVES: This atmospheric survey reports (1) airborne pollen contributions in Adana in one-year period (2) pollen onset, duration and peak level (3) the relationship between airborne pollen and selected meteorological variables and; (4) effects on symptoms in pollen allergic children. METHODS: Pollen sampling was performed with a volumetric Burkard Spore Trap. Meteorological data were measured daily from April 2001 to April 2002. Asthma symptom scores were investigated in 186 pollen allergic children that were on follow up in pediatric allergy outpatient clinics during same period. RESULTS: Average measurements included 82.5% tree pollen, 7.7% grass pollen and 9.8% herb pollen 54 taxa were identified during one year. The most prominent tree pollens were Cupressaceae, Eucalyptus and Pinus. The most common herb was Chenopodiaceae pollen family. When airborne pollen levels were examined in relation to single meteorological conditions; daily variations in total pollen counts were not significantly correlated with any variable studied (humidity, rainfall, temperature and wind) (p > 0.05). On the other hand, statistically significant relationship between pollen concentration and symptom scores were found (p > 0.05). Positive correlations were seen between both Gramineae and Herb pollen, and humidity and rainfall from March to July. However, positive correlations were detected between tree pollen counts and temperature and humidity in May and June. CONCLUSION: This survey is the first volumetric airborne pollen analysis conducted in the survey area in Adana. This study suggested that the effects of weather on pollen count and symptom scores in this population could not be clearly identified with the evaluation of one-year data. However, pollen counts had effect on allergic symptoms in pollen allergic children. Examination of the complex interaction of multiple whether parameters would perhaps more fully elucidate the relationship between meteorology and aerobiology and provide the clinician with information necessary to forecast pollen prevalence. An awareness of the ever chancing, local aeroallergen patterns requires regular monitoring. Such awareness serves as a useful guide in the effective testing and treatment of atopic patients.

Adolescent↗

PubMed2004

Craniofacial reconstruction with high-density porous polyethylene implants.

Deformities of the facial skeleton may be reconstructed using autogenic or allogenic materials. Porous polyethylene is one of the few alloplastic materials currently in use having a well-documented history of reconstruction or augmentation in the maxillofacial region. High-density porous polyethylene, which is shown to be effective as a biomaterial, has additional advantages like tissue ingrowth, no capsule formation around it, and easy fixation. In this study, 83 implants in 71 patients were evaluated. Seven patients were in need of a second intervention. Three of the seven secondary interventions were for contour alignment, and four interventions were for extraction of the implants because of extrusion or infection. Placement of porous polyethylene implants directly under the skin without coverage of periosteum or another fascial envelope has an increased risk of early and especially late exposure. In cases like nasal dorsum or microtia reconstruction, we prefer autogenic grafts instead of allogenic materials.

Biocompatible Materials↗