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Biomedical subjects

Mustafa Yilmaz

Publications and source records attributed to Mustafa Yilmaz.

At least 55 records · Page 3Linked to original sources
PubMed2004

Tissue Doppler properties of the left atrial appendage in patients with mitral valve disease.

OBJECTIVE: The purpose of this study was to compare the left atrial appendage (LAA) tissue Doppler imaging (TDI) with the classical LAA function parameters in patients with mitral valve disease. METHODS: Twenty patients who had pure mitral regurgitation (group 1), 20 patients who had pure rheumatic mitral stenosis (group 2), and 20 healthy patients (group 3) were included in this study. All the cases were sinus rhythm. In order to determine the LAA functions, LAA late filling (LAALF), and late emptying (LAALE) flow velocities and LAA fractional area change (LAAFAC) were measured. LAA tissue Doppler evaluations were obtained from the PW Doppler, which was placed on the LAA lateral wall in a transverse basal short-axis approach. LAA late systolic (LAALSW) and late diastolic (LAALDW) wave velocities were obtained from TDI records transesophageal echocardiography (TEE). RESULTS: There were no significant differences among groups 1, 2, and 3 in terms of age, left ventricular (LV) ejection fraction, gender, and heart rate. No differences were observed between group 1 and the control group with respect to LAALE, LAALF, and LAAFAC. LAALE velocity and LAAFAC were significantly decreased in group 2 than group 1. LV diastolic diameter was significantly greater, whereas LAALSW and LAALDW velocities were significantly decreased in group 1 compared with group 3. There were no differences between groups 1 and 2 regarding to LAALSW and LAALDW velocities. LAALE, LAALF, LAALSW, LAALDW velocities, and LAAFAC were significantly decreased in group 2 than group 3. CONCLUSION: The TDI method may detect the LAA systolic dysfunctions, which cannot be detected using classical methods, on tissue level in patients with mitral regurgitation. In addition, the deterioration of the LAA functions at tissue level in patients with rheumatic mitral stenosis was also detected.

Adult↗
PubMed2004

Is procalcitonin a reliable marker for the diagnosis of infected pancreatic necrosis?

BACKGROUND: Infected necrosis in acute pancreatitis is the main factor in determining the prognosis of the disease. Early and accurate diagnosis of infected pancreatic necrosis might decrease mortality. The aim of the present study is to identify a reliable marker for the onset infection in three different experimentally induced pancreatitis models. METHODS: Ninety female Wistar albino rats were randomly divided into nine groups. In three different experimental models, including cerulein induced acute oedematous pancreatitis (AEP), sterile pancreatic necrosis due to taurocholate-induced acute pancreatitis (SPN) and infected pancreatic necrosis taurocholate-induced acute pancreatitis (IPN). Serum levels of procalcitonin (PCT), C-reactive protein (CRP), tumour necrosis factor a (TNF-alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8), amylase were measured. The degree of pancreatic damage also evaluated pathologically. RESULTS: Procalcitonin levels were increased significantly in AEP, SPN and IPN compared to control groups (P < 0.05). PCT and IL-6 level were the highest in the IPN group (P < 0.05). Serum amylase, CRP, TNF-alpha, IL-2, and IL-8 levels were similar between IPN and SPN groups (P > 0.05), but higher than in other groups. The results of histological evaluation also correlated with the advent of the disease. CONCLUSION: Procalcitonin and IL-6 acts as reliable acute phase reactant in an experimental model of AEP, SPN and IPN in the rat. PCT and IL-6 combination might be surrogate marker of infected pancreatic necrosis and should be preferred to other markers assay especially in severe pancreatitis.

Animals↗
PubMed2004

Surgical management of infants with congenital lobar emphysema and concomitant congenital heart disease.

OBJECTIVE: Congenital lobar emphysema (CLE) is an uncommon cause of infantile respiratory distress. It is diagnosed on the basis of evidence of lobar overaeration, mediastinal shift, and compression of the adjacent lobe. Concomitant congenital heart disease (CHD) and CLE is not uncommon. In the literature a 12% to 20% concomitance rate is given. The optimal treatment of respiratory symptoms associated with CLE and CHD is not clear; however, there has been a great deal of progress in the treatment of CLE and CHD. The aim of this study was to evaluate a clinical experience with and long-term follow-up of the surgical treatment of 13 patients with concomitant CLE and CHD. MATERIAL AND METHODS: We reviewed the cases of 13 patients with concomitant CLE and CHD. The medical records were evaluated with reference to age, type of CHD, pulmonary artery pressure, clinical symptoms, and results of surgical management. RESULTS: One patient died. This patient had ventricular septal defect (VSD) and left upper lobe emphysema in the postoperative period. The remaining patients undergoing follow-up were clinically well at the final evaluation. Postoperative thoracic computed tomography revealed complete spontaneous regression of emphysema 3 months after division of ductus arteriosus in 1 patient. Pulmonary hypertensive episode was seen in 3 patients after the early postoperative period. Five of the patients were discharged with bronchodilator treatment after surgery. Six patients needed positive inotropic support. Among the patients with pulmonary hypertension and those with VSD who had undergone cardiopulmonary bypass, we found a greater need for inotropic support, a higher risk of postoperative infection, and a longer intubation period. Echocardiography in the late postoperative revealed decreased pulmonary artery diameter and pressure; myocardial performance was normal. Results of blood gas analyses revealed increased oxygen saturation and decreased partial pressure of carbon dioxide. Normal exercise activity was found in all patients. DISCUSSION: The presence of CHD, especially in infants with unusual respiratory distress symptoms, should be kept in mind, and echocardiography and/or cardiac catheterization should be considered in the diagnosis. In patients with high pulmonary artery pressure, palliative or corrective surgery for CHD in addition to lobectomy can be considered. We believe that for lesions without high pulmonary artery pressure, such as small atrial septal defect and patent foramen ovale, clinical follow-up is sufficient treatment after lobectomy. If the cause of CLE is compression of large ductus arteriosus, only division of the patent ductus arteriosus may be considered before lobectomy and clinical and radiologic follow-up. The cardiac lesion should be assessed as to severity and ease of management. A corrective procedure can be carried out at lobectomy. Because of the technical ease with which the cardiac operation can be performed at the time of lobectomy, we suggest that in addition to lobectomy, operative treatment of cardiac lesions be performed.

Child, Preschool↗
PubMed2004

Coexistence of prothrombic risk factors and its relation to left ventricular thrombus in acute myocardial infarction.

OBJECTIVE: Within the last few years a number of thrombophilic mutations have been identified. Pre-symptomatic testing for these established genetic risk factors identifies individuals predisposed to a disease and often allows to select suitable prophylactic interventions in time. We investigated whether or not the prothrombin G20210A allele, the factor V Leiden G1691A, and MTHFR C677T allele are risk factors for left ventricular thrombus (LV) in patients with myocardial infarction (AMI) or not. METHODS AND RESULTS: We analysed clinical, echocardiographic and biochemical data in 183 consecutive patients (aged 58 +/- 12 years; 34 women) with a first anterior acute myocardial infarction. Two-dimensional echocardiographic examination was performed on days 1, 3, 7, 15, and 30. LV thrombi were detected in 42 (23%) of the 183 patients with acute myocardial infarction. We have used multiplex assays based on PCR and DNA hybridization in microtitre plates for the simultaneous analysis of three mutations (FV Leiden G1691A, prothrombin G20210A, and MTHFR C677T). No significant differences in allele frequencies of FV Leiden G1691A (9.5% vs. 8.5%, p = 0.75), prothrombin G20210A (9.5% vs 7.1%, p = 0.74) and MTHFR C677T (47.6% vs. 50.3%, p = 0.74) were found in patients with LV thrombus when compared with those without LV thrombus. No significant differences in haemostatic factor levels were found in patients with LV thrombus when compared with those without LV thrombus. CONCLUSION: FV Leiden, prothrombin 20210 variant, and MTHFR mutation are no risk factors for left ventricular thrombus in patients with myocardial infarction.The presence of multiple mutations did not influence the development and outcome of LV thrombus in patients with myocardial infarction

Alleles↗
PubMed2004

Crimean-Congo hemorrhagic fever in Turkey.

In 2002 and 2003, a total of 19 persons in Turkey had suspected cases of Crimean-Congo hemorrhagic fever (CCHF) or a similar viral infection. Six serum samples were tested; all six were found positive for immunoglobulin M antibodies against CCHF virus. Two of the samples yielded CCHF virus isolates. Genetic analysis of the virus isolates showed them to be closely related to isolates from former Yugoslavia and southwestern Russia. These cases are the first of CCHF reported from Turkey. Eighteen patients handled livestock, and one was a nurse with probable nosocomial infection. The case-fatality rate was 20% among confirmed CCHF case-patients (1 of 5 patients), and the overall case-fatality rate was 11% (2 of 19 patients). In addition to previously reported symptoms and signs, we report hemophagocytosis in 50% of our patients, which is the first report of this clinical phenomenon associated with CCHF.

Adult↗
PubMed2004

Triple valve surgery: a 25-year experience.

OBJECTIVE: Surgical treatment of rheumatic valvular disease still constitutes a significant number of cardiac operations in developing countries. Despite improvements in myocardial protection and cardiopulmonary bypass techniques, triple valve operations (aortic, mitral and tricuspid valves) are still challenging because of longer duration of cardiopulmonary bypass and higher degree of myocardial decompensation. This study was instituted in order to assess results of triple valve surgery. METHODS: Between 1977 and 2002, 34 patients underwent triple valve surgery in our clinic by the same surgeon (EB). Eleven patients underwent triple valve replacement (32.4%) and 23 underwent tricuspid valve annuloplasty with aortic and mitral valve replacements (67.6%). RESULTS: There was no significant difference between the two groups of patients who underwent triple valve replacement and aortic and mitral valve replacement with tricuspid valve annuloplasty. There were 4 hospital deaths (11.8%) occurring within 30 days. The duration of follow-up for 30 survivors ranged from 6 to 202 months (mean 97 months). The actuarial survival rates were 85%, 72%, and 48% at 5, 10, and 15 years respectively. Actuarial freedom from reoperation rates at 5, 10, and 15 years was 86.3%, 71.9%, and 51.2%, respectively. Freedom from cerebral thromboembolism and anticoagulation-related hemorrhage rates, expressed in actuarial terms was 75.9% and 62.9% at 5 and 10 years. Major cerebral complications occurred in 10 of the 30 patients. CONCLUSION: We prefer replacing, if repairing is not possible, the tricuspid valve, with a bileaflet mechanical prosthesis in a patient with valve replacement of the left heart who will be anticoagulated in order to avoid unfavorable properties of bioprosthesis like degeneration and of old generation mechanical prosthesis like thrombosis and poor hemodynamic function. In recent years, results of triple valve surgery either with tricuspid valve conservation or valve replacement in suitable cases have become encouraging with improvements in surgical techniques and myocardial preservation methods.

Adult↗
PubMed2004

The pathogenicity and antibiotic resistance of coagulase-negative Staphylococci isolated from the maxillary and ethmoid sinuses.

AIM OF THE STUDY: To investigate the pathogenicity and antibiotic resistance of coagulase-negative staphylococci (CNS) isolated from the maxillary and ethmoid sinuses of patients undergoing endoscopic sinus surgery for chronic sinusitis. PATIENTS AND METHODS: Ninety-three patients (63 males, 30 females) aged between 19 - 68 years, who had undergone functional endoscopic sinus surgery (FESS) for chronic sinusitis, were included in the study. Nasal mucosa, skin and adjacent structures were cleansed with povidone-iodine solution before surgery to prevent a probable contamination. In all patients, nasal swabs were taken before and after the application of povidone-iodine solution. Colonies isolated and identified as Staphylococci in cultures were further investigated for pathogenicity and antibiotic susceptibility. Slime test was used to determine the pathogenicity of CNS. The relationship between antibiotic resistance of pathogenic and non-pathogenic CNS was compared by chi2 analysis. RESULTS: While bacterial growth rate was 62.3% in nasal swab cultures taken before the application of povidone-iodine solution, it decreased to 12.9% after the application of solution. Microorganisms were isolated in 95.6% of cultures taken from maxillary sinuses and in 91.3% of cultures obtained from ethmoid sinuses during the FESS. The most frequently isolated microorganism in each of the sinuses was CNS. Slime test was carried out in 30 CNS isolated. Twelve of these were slime positive and 18 were slime negative. While 83.3% of CNS isolated was resistant to penicilin, all of CNS were sensitive to vancomycin and teikoplanine. The difference between slime positive and slime negative CNS for gentamicin and ciprofloxacin resistance was statistically significant (p<0.05). CONCLUSION: We consider that the pathogenicity tests like slime production and antimicrobial susceptibilities of CNS frequently isolated from the patients with chronic sinusitis should be investigated and also these microorganisms should be kept in mind in the selection of empiric treatment.

Adult↗
PubMed2003

The effects of intestinal ischemia on the levels of serum immunoglobulin A in rats.

Many biochemical markers have been investigated in intestinal ischemia. However, the effects of intestinal ischemia on the level of serum immunoglobulin A (IgA) has apparently not been investigated in the literature, although the gastrointestinal system is one of the main sources of serum IgA. The aim of our study was to evaluate the changes of serum IgA levels during intestinal ischemia of varying duration in rats. Group 1 ( n=5) was created for control purposes, including the detection of the baseline values and the effects of the anesthetic agents. Group 2 ( n=20) rats underwent sham laparotomy. Group 3 ( n=20) had 50% of small intestine ischemia by the strangulated obstruction model. Serum samples were obtained by cardiac puncture 1 h after anesthetic agents were given in group 1. On the other hand, serum and intestine samples were obtained at 1 (T1, n=5), 2 (T2, n=5), 4 (T4, n=5) and 6 (T6, n=5) h after the operation in groups 2 and 3. The levels of serum IgA, lactic dehydrogenase (LDH) and alkaline phosphatase (ALP) were determined. Pathologic specimens were graded in a masked manner. IgA levels were abruptly decreased to 8.49+/-1.58 mg/dl in rats with intestinal ischemia at 1 h after the operation. This decrease in serum IgA at T1 in group 3 was statistically significant compared with the control and sham-operated groups (18.80+/-1.15 mg/dl, 22.07+/-1.54 mg/dl, respectively; P<0.01). On the other hand, IgA levels were significantly elevated at T2 in the sham-operated group compared with control and intestinal ischemia groups (26.99+/-2.96 mg/dl, 18.80+/-1.15 mg/dl, 14.35+/-2.62 mg/dl, respectively; P<0.05). The serum IgA levels decreased to above baseline values at T6 in group 2 (19.60+/-2.78 mg/dl), while they increased to below baseline values in group 3 (17.60+/-1.28 mg/dl). In group 3, IgA levels were elevated to baseline values, while a significant ischemia occurred at 4 and 6 h after operation. These results suggested that serum IgA is affected earlier by intestinal ischemia and intestinal manipulation. The increase in serum IgA levels may be related to stimulation of the local immune responses in the intestine. On the other hand, abruptly decreasing serum IgA levels in this experimental study may be related to inadequate transport of the synthesized IgA to the systemic circulation, because serum IgA levels were returned to baseline values while a significant ischemia occurred at T4 and T6. According to these results, we conclude that serum and peritoneal fluid IgA levels may be changed by intestinal ischemia and may be used to make an early diagnosis of intestinal ischemia in humans.

Alkaline Phosphatase↗
PubMed2003

Giant ganglion cyst of the quadriceps femoris tendon.

We present the case of a ganglion cyst with 11 x 3 x 2 cm dimensions originating from the quadriceps femoris tendon. The patient presented with palpable mass and chronic pain in the anterolateral thigh region. The pain increased with walking. Ultrasonography and computed tomography revealed a cystic, well defined lesion in the vastus lateralis muscle. The patient was operated on and the cyst excised; it was seen to be a ganglion cyst. The patient is asymptomatic 6 months after surgery. This is a very rare localization for a giant synovial cyst, and preoperative diagnosis is a challenge for the surgeon.

Adolescent↗
PubMed2003

ST segment elevation in leads V1 to V3 due to isolated right ventricular branch occlusion during primary right coronary angioplasty.

It is rare to observe ST elevation in anterior derivations caused by isolated right ventricular branch occlusion. We described the case with acute inferior and right ventricular myocardial infarction (MI) who developed ST segment elevation in precordial leads V(1) to V(3) due to isolated right ventricular branch occlusion during primary right coronary angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed2003

Pulsed Doppler tissue imaging can help to identify patients with right ventricular infarction.

This study was planned to assess whether tissue Doppler imaging is a useful method for the detection of the right ventricular myocardial infarction. Forty-eight patients with acute inferior myocardial infarction and 24 age- and sex-matched healthy controls were included in this study. Twenty-four patients had electrocardiographic signs of inferior myocardial infarction without right ventricular infarction (group I), and the other 24 patients had electrocardiographic signs of inferior myocardial infarction with right ventricular infarction (group II). From the echocardiographic apical four-chamber view, peak systolic, early diastolic, and late diastolic velocities of the tricuspid annulus at the right ventricular free wall were recorded with the use of pulsed-wave Doppler tissue imaging. The tricuspid annular peak tissue Doppler imaging systolic velocity was significantly lower in group I (14.03 +/- 2.57 cm/s, P << 0.005) and in group II (8.50 +/- 0.84 cm/s, P << 0.005) than in controls (16.63 +/- 2.31 cm/s). The tricuspid annular peak systolic (8.50 +/- 0.84 cm/s vs 16.63 +/- 2.31 cm/s) and peak early diastolic (10.99 +/- 3.28 cm/s vs 19.39 +/- 4.3 cm/s) velocities were significantly lower in group II than in group I, as compared with controls ( P << 0.001). Peak early diastolic velocity of tricuspid annulus (10.99 +/- 3.28 cm/s vs 19.39 +/- 4.3 cm/s) was significantly lower in group I than in controls ( P << 0.001); however, late diastolic velocity was significantly lower in group II (15.98 +/- 5.08 cm/s, P << 0.05) than in group I (18.21 +/- 2.63 cm/s, P << 0.05) and in controls (19.02 +/- 5.29 cm/s). The results of this study indicate that tricuspid annular peak systolic and early diastolic velocities are reduced in patients with right ventricular infarction. The velocity of the tricuspid annulus by tissue Doppler imaging is simple and can be used to distinguish whether patients with inferior myocardial infarction have right ventricular infarction.

Aged↗
PubMed2003

Large volume donor plasmapheresis in inherited thrombophilia implicated in arterial thrombosis.

BACKGROUND: Life-threatening complications following apheresis are rare, and include venous thrombosis. Arterial thrombosis following apheresis has not been reported. CASE REPORT: A 48 year old donor had cerebral infarction following large volume plasma donation. The outcome was fatal. He was found to be heterozygous for both methylene tetrahydrofolate reductase (MTHFR) 677C-T mutation and Prothrombin 20210G-A allele. CONCLUSION: This case suggests that large volume plasma donation may trigger arterial thrombotic events in inherited thrombophilia. Therefore, the effects of plasmapheresis on coagulation system should be studied thoroughly.

Arteries↗
PubMed2003

Seroprevalence of rubella in school girls and pregnant women.

Many studies have been assigned to investigate the surveillance of congenital rubella syndrome, acquired rubella and seroprevalence in different countries to determine the new vaccination program and national vaccination schedules. Seroprevalence of rubella in Turkey is still insufficient and national immunization schedules do not include routine rubella vaccination. In this study we aimed to investigate the seroprevalence of rubella at child bearing age in an unvaccinated population in Adana, southern Turkey, to help determine whether routine rubella vaccination is necessary, if so when it should be administered. Ninety-four school girls aged 12-18 years living in Adana were selected for the study and stratified according to the socioeconomic status of their parents and evaluated for rubella antibodies. One hundred pregnant women aged 18-25 years and 100 pregnant women aged 26-35 years were sampled rubella antibodies. Rubella specific IgG antibody was measured qualitatively and quantitatively by using microparticule enzyme immune assay technology. Rubella specific IgG antibody was positive in 87-94 school girls (92.5%). The geometric mean rubella specific IgG antibody value was found be 148.14 IU/ml. No correlation was found between socioeconomic status and rubella seropositivity (p = 0.6521). In all pregnant women rubella specific IgG antibody was found to be positive. In conclusion rubella vaccination should be considered carefully in developing countries. Because of the high seropositivity to rubella in our region we do not recommend rubella vaccination in early childhood. Yet this is a preliminary study and further studies with larger population size are needed to determine the national immunization policy for rubella.

Adolescent↗
PubMed2003

The effects of Medroxyprogesterone acetate on apoptosis of CD34+ cells.

BACKGROUND: Medroxyprogesterone acetate (MPA) is widely used in oncology practice, especially in the treatment of gynecological malignancies and cachexia of cancer. Some studies have demonstrated that high-dose MPA might reduce hematological toxicity in patients receiving chemotherapy for solid tumors. The underlying mechanism of this action is still unknown. We aimed to investigate the in vitro effects of MPA on CD34+ cells. METHODS: We investigated the in vitro effects of two different doses of MPA (10 and 100 ng/ml) on acidic pH-induced apoptosis of CD34+ cells derived from 12 healthy volunteers. RESULTS: Compared with the control group, we found that MPA at the dose of 100 ng/ml has a negative effect on apoptosis (6.7 +/- 3.8 and 12.5 +/- 5.0% apoptosis, respectively; p = 0.038) and a positive effect on the number of CD34+ cells (680 +/- 294 and 350 +/- 131 x 10(3)/ml, respectively; p = 0.009). CONCLUSION: Our results indicate that further studies are needed on larger populations in order to assess the relationship between MPA and its myeloprotective effect.

Antigens, CD34↗
PubMed2003

Dermalipectomy for body contouring after bariatric surgery in Aegean region of Turkey.

BACKGROUND: The only proven effective long-term treatment for morbid obesity is bariatric surgery. After surgery, additional problems may arise such as redundant hanging skin and a poor body image. The patient's quality of life and social acceptance may thus still be hindered. Body contouring operations remain the only hope here. METHODS: Body contouring surgery was performed on 11 patients out of 38 who had had vertical banded gastroplasty. General self-consciousness, social self-consciousness of appearance and sexual and bodily self-consciousness of appearance were measured with a retrospective questionnaire. RESULTS: Timing of body contouring surgery was determined according to the demand of the patient and stabilization of the patient's weight status. On average the first plastic surgery operation was performed after 17 (12-25) months. Mean age was 37.4 (34-65) and mean excess weight loss was 57.6 (37-129). In the 11 patients who underwent plastic procedures, a total of 23 such operations were performed, and 8 complications were encountered in these 23 operations. General self-consciousness and sexual bodily self-consciousness of appearance showed improvement after bariatric surgery and further improvement after the plastic surgery. CONCLUSION: For markedly redundant skin after massive weight loss, dermalipectomy is the only treatment. This improves the patient's general, sexual and bodily self-consciousness.

Adult↗