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Biomedical subjects

Mustafa Yilmaz

Publications and source records attributed to Mustafa Yilmaz.

At least 73 records · Page 4Linked to original sources
PubMed2003

Serum IL-1, IL-2, TNFalpha and INFgamma levels of patients with type 1 diabetes mellitus and their siblings.

Type 1 diabetes mellitus (DM) develops as a result of autoimmune destruction of the pancreatic beta-cells. The aim of this study was to explore possible associations between serum levels of cytokines, IL-1, IL-2, TNFalpha and INFgamma and metabolic parameters in children with type 1 DM and their non-diabetic siblings to determine whether these cytokines could be indicators of disordered immune regulation. The study population consisted of 41 children with type 1 DM, 32 non-diabetic siblings, and 28 healthy controls. Children with DM were divided into three subgroups: 1) newly diagnosed patients with diabetic ketoacidosis (ND + DKA), 2) newly diagnosed patients without DKA (ND - DKA), and 3) previously diagnosed patients (PD). The highest serum IL-1alpha level was found in the ND - DKA group, which was significant compared to both the ND + DKA (p < 0.05) and the siblings (S) (p < 0.005). IL-2 levels were similar among all groups. The highest TNFalpha level was observed in the ND + DKA group, which was significant against the ND - DKA (p < 0.05), PD (p < 0.001), S (p < 0.05), and control (C) (p < 0.005) groups. TNFalpha concentration in the PD group was significantly lower than those of S (p< 0.005) and C (p < 0.001) groups. The ND - DKA group had the highest INFgamma and this was statistically significant when compared with the S (p < 0.005) and C (p < 0.05) groups. Both the newly diabetics and all diabetics as a group had statistically significantly higher INFgamma levels than both the S (p < 0.01 for both) and C (p < 0.05 for both) groups. In the diabetics as a whole group, TNFalpha showed correlations with INFgamma (r = 0.370, p < 0.05). IL-1 showed correlation with TNFalpha (r = 0.368, p < 0.05) INFgamma (r = 0.796, p < 0.001) and IL-2 (r = 0.862, p < 0.001) in the all diabetics group. IL-2 was correlated with TNFalpha (r = 0.320, p < 0.05) and INFgamma (r = 0.754, p < 0.01) in the all diabetics group. In conclusion, our results suggest that proinflammatory cytokines TNFalpha, INFgamma, IL-1alpha and IL-2 may play important roles alone or in combination in the pathogenesis of type 1 diabetes mellitus.

Adolescent↗
PubMed2003

Hydrogen ion-selective poly(vinyl chloride) membrane electrode based on a calix[4]arene.

A hydrogen ion-selective poly(vinyl chloride) membrane electrode was constructed using 5,11,17,23-tetra-tert-butyl-25,26,27,28-tetracyanomethoxycalix[4]arene as a neutral carrier. The electrode showed an apparent Nernstian response in the 2-11.5 pH range with a slope of 54.0 +/- 0.2 mV/pH at 20 +/- degrees C. This electrode showed a rapid response of the emf to changes in the pH, high ion selectivity with respect to lithium, sodium and potassium, and characteristics similar to those reported for the conventional pH glass membrane electrode. It can be used as a potentiometric indicator electrode in hydrofluoric acid solutions. The effects of iodide, thiocyanate, perchlorate and bromide on the characteristics of the electrode were also considered.

Calixarenes↗
PubMed2003

Vascular anomalies causing tracheoesophageal compression: a 20-year experience in diagnosis and management.

BACKGROUND: Vascular rings and other congenital aortic arch anomalies may be major causes of tracheoesophageal obstruction in children. In this report, our diagnostic approach, surgical treatment, and early and late results for 30 patients are reported. METHODS: During a 20-year period (1982-2002), 30 children underwent surgery for tracheoesophageal compression caused by aortic arch anomalies. The median age at operation was 8 months (range, 36 days to 94 months), and the median patient weight was 8 kg (range, 2.4-16 kg). At 53.3% of cases, double aortic arch was by far the most common encountered cause of compression. Patients were admitted with respiratory distress, stridor, apnea, dysphagia, or recurrent respiratory tract infections. Diagnosis was established by barium esophagogram, computed tomography, magnetic resonance imaging, and angiography. The operative approaches were through a left thoracotomy or a median sternotomy. RESULTS: Operative mortality rate was 3.3%. Follow-up data from 2 months to 10 years (mean follow-up, 34 weeks) were available for all 30 patients. Twenty-six patients (86.7%) were essentially free of symptoms, 3 patients (10%) had residual respiratory problems, and 1 patient (3.3 %) had a gastroesophageal reflux problem. CONCLUSION: These results suggest that surgical correction of symptomatic vascular rings can be performed with low mortality and morbidity rates.

Airway Obstruction↗
PubMed2003

Role of free radicals in peptic ulcer and gastritis.

BACKGROUND/AIMS: It has been suggested that the free radicals are closely related with peptic ulcer disease and gastritis. Although many studies have been undertaken to clarify the role of oxygen-derived free radicals, most of them were carried out in animal models. The aim of this study was to assess the reactive oxygen species activity and the damage in Helicobacter pylori-infected gastric mucosa in humans. METHODS: In a total group of 42, there were fifteen cases of peptic ulcer, 14 cases of gastritis and 12 control subjects. Measurement of gastric mucosal malondialdehyde concentrations, which is the end - product of lipid peroxidation, was used to assess oxidative damage to membranes in patients with peptic ulcer and gastritis. Mucosal reduced glutathione glutathione concentrations were also measured in order to study whether reactive oxygen species generation affects levels of the antioxidant peptide. malondialdehyde and glutathione content was then measured in biopsies taken from the gastric antrum. RESULTS: Tissue levels of glutathione were significantly (p<0.001) and malondialdehyde was higher (p<0.001) in patients with peptic ulcer compared to controls. In patients with gastritis, glutathione was also lower (p<0.001) and malondialdehyde higher (p<0.01). CONCLUSIONS: Depletion of gastric mucosal glutathione in cases with H.pylori positive peptic ulcer and gastritis may be caused by accumulation of free radicals that can initiate membrane damage by lipid peroxidation.

Biomarkers↗
PubMed2002

Serum cytokine levels in Bell's palsy.

OBJECTIVE: To assess the significance of the serum levels of the cytokines (interleukine (IL-6, IL-8, IL-1b, IL-2r, and tumor necrosis factor alpha (TNF - alpha)) in the patients with Bell's palsy. STUDY DESIGN: A clinical and laboratory study in which serum cytokine levels were compared between the patients who had Bell's palsy and healthy controls. METHODS: Twenty-three patients with Bell's palsy and 30 healthy volunteers were included in the study. The blood samples of the patients and controls were obtained, and serum IL-1b, IL-2r, IL-6, IL-8, and TNF- alpha levels determined with chemiluminescence enzyme immunometric assay on an Immulite Immunoassay. The serum of the patients was taken between 2 days and 1 month after the disease. The assay was not in vitro lymphocyte stimulation. RESULTS: The IL-6, IL-8 and TNF- alpha levels were significantly higher in Bell's palsy than in controls (p < 0.05). The IL-1b and IL-2r levels were similar in both groups (p > 0.05). The levels of cytokine IL-6, IL-8, TNF- alpha, IL-1b, IL-2r did not correlate with the degree of recovery (p > 0.05). CONCLUSION: An alteration in the concentration of the cytokines is expected not only in many inflammatory and infectious diseases but also in Bell's palsy. Cytokines are not stored or preformed within cells. Therefore, high cytokine levels (IL-6 and IL-8, and TNF- alpha) should represent their production in response to underlying pathology in Bell's palsy, or these cytokines may be pathogenetic factors in Bell's palsy. However, serum levels of these cytokines do not help determine the prognosis in Bell's palsy as far as the results of this study are concerned.

Adult↗
PubMed2002

Reconstruction of soft tissue defects following total knee arthroplasty.

Soft tissue defects following total knee arthroplasty can represent serious problems for the patient and the surgeon. Perioperative soft tissue complications can result in loss of the prosthesis or limb. In this study, we present 17 cases with complex wounds following total knee arthroplasty who had surgery between May-1994 and July-2001. Patient-related factors, wound factors, surgical operation, secondary procedures, and duration of follow-up have been analysed for each patient. After local wound care and debridement, soft tissue defects have been covered with either a fasciocutaneous or gastrocnemius myocutaneous flap. All the knees (100%) have been salvaged although in 1 patient (6%) replacement of the prosthesis was necessary. In 5 patients (30%) secondary surgical procedures have been performed. Even though there is no consensus in the management of soft tissue defects following total knee arthroplasty, adequate wound care, including identification of infection, debridement, and early appropriate defect coverage should be the main points to consider.

Adult↗
PubMed2002

Correlation of serum IL-2, IL-6 and IL-10 levels with International Prognostic Index in patients with aggressive non-Hodgkin's lymphoma.

Cytokines play important roles in the pathogenesis of lymphomas. The aim of this study was to determine the relations between serum levels of interleukin-2 (IL-2), IL-6, and IL-10 and parameters of International Prognostic Index (IPI). Serum levels of IL-2, IL-6, and IL-10 were measured using a sensitive enzyme-linked immunosorbent assay in the pretreatment frozen sera from 43 patients with non-Hodgkin's lymphoma. The patients we included in the study were divided into two groups, one with high risk and the other with low risk according to the IPI in regard to their ages, stages, performance status, extranodal involvements, and serum levels of lactate dehydrogenase. In the high-risk group, serum levels of IL-2 (0.852 +/- 0.268 ng/ml), IL-6 (0.461 +/- 0.206 ng/ml), and IL-10 (0.816 +/- 0.240 ng/ml) were found to be higher than serum levels of IL-2 (0.667 +/- 0.170 ng/ml), IL-6 (0.355 +/- 0.075 ng/ml), and IL-10 (0.643+0.177 ng/ml) in the low-risk group ( < 0.05). There was a correlation between the patients with high risk according to the IPI criteria and high levels of serum cytokines (IL-2, IL-6, IL-10). Knowledge of the serum levels of these cytokines in patients with newly diagnosed aggressive non-Hodgkin's lymphoma may help us to have some information about the possible prognosis, the activation of disease, and to decide on appropriate therapeutic approaches for individual patients.

Biomarkers↗
PubMed2002

Effects of nerve growth factor on the neurotization of denervated muscles.

Studies on surgical repair techniques of the peripheral nerve are still trying to improve the outcome. There are many studies on the effects of various neurotrophic factors on the transected peripheral nerve. Muscular neurotization, which is the direct implantation of the nerve to the target denervated skeletal muscle, is one of the techniques used when the primary repair of the peripheral nerves is not possible. The effects of nerve growth factor (NGF), which is one of the primary neurotrophic factors, on the reinnervation of denervated muscles by neurotization is investigated in this experimental study. The denervated soleus muscle was neurotized via peroneal nerve implantation (group 1), and NGF was administered to the neurotized muscle (group 2). All animals were evaluated at weeks 8, 10, and 12 using electromyography. Muscle contractility, muscle weight, and histological morphometric tests were performed at week 12. The experimental groups were compared with each other and normal control values. Electromyographically, group 2 (direct nerve implantation + NGF) demonstrated better reinnervation in all evaluations. The study of muscle weight showed that the muscle mass was 75% of the normal soleus muscle in group 1 and was 85% of the normal side in group 2 at the end of week 12. In group 1, the twitch force was 56% of the normal soleus muscle and was 71% in group 2. Tetanic force was 53% of the normal soleus muscle in group 1 and 68% in group 2. Histological morphometric studies revealed that there was a decrease in the density of the motor end plates in group 1, but there was no statistically significant difference between the normal soleus muscles and the NGF applied to group 2. The positive effects of NGF on the neurotization of denervated muscles seen in this study suggest that it may be useful for treating some difficult reconstructions caused by denervation.

Animals↗
PubMed2002

Reverse temporalis muscle flap for the reconstruction of orbital exenteration defects.

Orbital exenteration is a surgical procedure that results in devastating functional and aesthetic losses. Many reconstructive techniques, ranging from spontaneous epithelialization to free flaps, have been described for orbital exenteration defects. The temporalis muscle flap is one of the most frequently used flaps to obliterate the orbital cavity, but only a small portion of the muscle can be used for this purpose because most of the muscle is used as the pedicle. The reverse temporalis muscle flap based on the superficial temporal vessels is a versatile flap by which the entire temporalis muscle can be elevated and carried to defects beyond the midline. The authors have used this flap for orbital reconstruction after exenteration in 6 patients with successful results. This flap enables placement of highly vascularized tissue that provides the reconstructive goals of primary healing, obliterates dead space with separation of the orbit from the nasal cavity or sinuses, provides the potential for early postoperative radiotherapy, and offers possible flaps that can be used in combination for complex, wide defects.

Aged↗
PubMed2002

Treatment options in extravasation injury: an experimental study in rats.

Local skin necrosis after extravasation of doxorubicin hydrochloride (Adriamycin), a widely used chemotherapeutic agent, is a common problem in cancer patients. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. The aim of this study was to compare the efficacy of saline infiltration, vitamin C infiltration, suction technique, and early surgical excision as a treatment in a rat extravasation model. The authors planned their study in two stages. In stage 1, the lowest effective dose of doxorubicin at which a homogeneous skin necrosis was formed and the method of administration were investigated. Intradermal and subpannicular injections were made for six rats, using six different concentrations of doxorubicin (0.33, 0.5, 0.66, 1.0, 1.33, and 1.5 mg/ml). In stage 1, the intradermal injection produced homogeneous and uniform tissue necrosis. In stage 2, the efficacy of saline infiltration (group 1), vitamin C infiltration (group 2), suction (group 3), suction and saline washout (group 4), suction and vitamin C washout (group 5), and early surgical excision (group 6) was compared. The treatment options were applied 2 hours after doxorubicin injection. At the end of the seventh day, the presence and size of ulcers at the injection site were calculated. Fourteen days after injection, a histopathologic examination was performed for each treatment and control group. In groups 1 and 3, there was no statistically significant difference in the size of necrosis compared with the control groups. In groups 2, 4, and 5, the size of necrosis was smaller compared with the control groups, and this was statistically significant. Furthermore, in group 4 (suction and saline washout) and group 5 (suction and vitamin C washout), the calculated area of necrosis was smaller compared with other treatment groups, and this was statistically significant. The findings supported the assertion that suction and saline or vitamin C washout reduce necrotic tissue size in extravasation injury.

Animals↗
PubMed2002

Effects of extracorporeal circulation on thrombinantithrombin III and prothrombin fragment 1+2 levels.

Cardiopulmonary bypass may alter the factors responsible for normal hemostasis by exposing blood to nonendothelial surfaces, for example, extracorporeal circuits. To evaluate the probable effect of extracorporeal circulation on hemostasis, we measured thrombin-antithrombin III complex (TAT) and prothrombin fragment 1+2 (PF 1.2) plasma levels, which are the biologic markers of in vivo coagulation, in 20 patients who underwent coronary artery bypass grafting (CABG). Postoperative PF 1.2 levels were higher in comparison to the preoperative concentrations of the parameter. Preoperative and postoperative TAT concentrations showed no statistically significant difference. The increment in the PF 1.2 levels in CABG patients might suggest ongoing subclinical hemostatic activation associated with CABG. Further investigations are needed to clarify the exact relationship between increased PF 1.2 levels and thrombotic complications observed in CABG patients. Hemostatis in CABG is still an enigma and remains to be eluciated.

Adult↗
PubMed2002

Effect of haemodialysis on left atrial mechanical function in patients with chronic renal failure.

OBJECTIVE: The aim of this study was to investigate the potential effects of haemodialysis on left atrial (LA) mechanical functions in patients with chronic renal failure. METHODS: Thirty-two patients with chronic renal failure (mean age 42.8 +/- 19.6 years) were included in this study. LA volumes were determined echocardiographically at the time of mitral valve opening (maximal,Vmax), at the onset of atrial systole (p wave at the electrocardiography = Vp) and at the mitral valve closure (minimal, Vmin) according to the biplane area-length method in apical 4-chamber and 2-chamber view. All volumes were corrected to the body surface area, and the following left atrial emptying functions were calculated. LA passive emptying volume = Vmax - Vp, LA passive emptying fraction = LA passive emptying volume/Vmax. Conduit volume = LV stroke volume-(Vmax - Vmin), LA active emptying volume = Vp Vmin. LA active emptying fraction = LA active emptying volume/Vp, LA total emptying volume = (Vmax - Vmin), LA total emptying fraction = LA total emptying volume/Vmax. RESULTS: Mean fluid removal was 1,875 +/- 812 milliliter. There was no difference between in the LA passive emptying volume before and after dialysis (10.83 +/- 7.44 vs. 11.47 +/- 7.73 cm3/m2, p > 0.05). Conduit volume (from 15.30 +/- 10.68 to 10.31 +/- 6.83 cm3/m2, p < 0.05), LA active emptying volume (from 12.61 +/- 6.39 to 9.25 +/- 4.40 cm3/m2, p < 0.005), LA total emptying volume (from 23.44 +/- 8.52 to 20.72 +/- 8.58 cm3/m2, p < 0.05), LA maximal volume (from 39.44 +/- 14.07 to 28.89 +/- 11.80 cm3/m2, p < 0.001), LA minimal volume (from 15.99 +/- 9.70 to 8.17 +/- 4.52 cm3/m2, p < 0.001), and the volume at the onset of atrial systole (from 28.61 +/- 10.36 to 17.42 +/- 7.20 cm3/m2, p < 0.001) decreased significantly after the haemodialysis session, whereas LA passive emptying fraction (from 0.27 +/- 0.14 to 0.38 +/- 0.14%, p < 0.001), LA active emptying fraction (from 0.46 +/- 0.18 to 0.53 +/- 0.17%, p < 0.05), LA total emptying fraction (from 0.61 +/- 0.14 to 0.72 +/- 0.09%, p < 0.001) increased significantly after haemodialysis. CONCLUSION: The results of this study suggest that left atrial mechanical functions improve after haemodialysis in patients with chronic renal failure.

Adult↗
PubMed2002

Left atrial mechanical function in patients with essential hypertension.

OBJECTIVE: This study was carried out to assess the left atrial (LA) mechanical function in patients with essential hypertension with two-dimensional echocardiography by means of left atrial volume measurements. METHODS: LA volumes were measured echocardiographically in 36 untreated hypertensive patients and 20 age-sex-matched healthy controls according to biplane area-length method. LA volume measurements were done at the time of mitral valve opening (Vmax), at the onset of atrial systole (p wave at the electrocardiography = Vp) and at closure (Vmin). All volumes were indexed for body surface area, and the following left atrial emptying functions were calculated: LA passive emptying volume = Vmax -Vp, LA passive emptying fraction = LA passive emptying volume /Vmax, conduit volume = left ventricular stroke volume-(Vmax-Vmin), LA active emptying volume = Vp-Vmin, LA active emptying fraction = LA active emptying volume /Vp, LA total emptying volume = (Vmax-Vmin), LA total emptying fraction = LA total emptying volume /Vmax. RESULTS: Vmax (p < 0.01),Vmin (p < 0.005) and Vp (p < 0.001) were significantly greater in hypertensives than in controls. Although LA passive emptying volume (p < 0.001), LA passive emptying fraction (p < 0.001), conduit volume (p < 0.005) and LA total emptying fraction (p < 0.05) were found to be significantly lower in hypertensives than in controls, LA active emptying volume (p < 0.001) and LA active emptying fraction (p < 0.01) were found to be significantly greater in hypertensives than in controls. LA total emptying volume (p > 0.05) was similar in both groups. CONCLUSION: The results of the present study indicate that chronic hypertension is associated with an increased in left atrial volumes, a decrease in left atrial passive emptying function, and an increase systolic pump function. Increased left atrial pump function represents a compensatory mechanism in hypertensive patients with left ventricular hypertrophy.

Adult↗
PubMed2002

Non-valvular isolated pulmonary artery vegetations.

BACKGROUND: One of the serious potential complications of complex congenital heart defect (CHD) is bacterial endocarditis. Right sided endocarditis accounts for 5-10% of all cases of infective endocarditis, with the tricuspid valve more frequently affected than the pulmonary valve. Pulmonary artery involvement in bacterial endocarditis is very rare, but when it exists it is almost always associated with endocarditis of the pulmonary valve: isolated pulmonary artery vegetations have not previously been reported before. CASE REPORT: A 6-year-old boy with atrial septal defect (ASD), ventricular septal defect (VSD), coarctation of the aorta (CA), persistent ductus arteriosus (PDA) and pulmonary hypertension, who had been operated for closure of PDA, correction of CA and pulmonary artery banding, was readmitted with bacterial endocarditis. In surgery, the VSD was closed with a Dacron patch using interrupted pledget buttressed sutures, and the ASD was closed using primary sutures. After debanding, while pulmonary arteriotomy was performed for patch angioplasty, we observed that the entire pulmonary artery trunk, right and left pulmonary artery branches, were filled with a solid mass, which was successfully treated by surgical excision. CONCLUSIONS: With ongoing improvements in diagnostic tools, especially in echocardiography, antibiotic therapy and surgery, CHD can now be treated successfully in early infancy or childhood.

Bacteremia↗
PubMed2002

[Pancreaticoduodenectomy in the management of pancreatic and duodenal injuries].

BACKGROUND: Patients who have undergone pancreaticoduodenectomy because of duodenopancreatic injury are retrospectively evaluated. METHODS: Eight patients have undergone pancreaticoduodenectomy because of trauma in Ege University School of Medicine Department of Surgery. Six of the injuries were penetrating, and two of them were blunt. Six patients were male and two of them were female with a mean age of 29.2 (between 17 and 63). RESULTS: All patients had complicated duodenopancreatic, and associated grade I and grade II liver injuries. Major vessels were injured in three patients. There were also two colonic, one gastric, and one jejunal injury as a coexisting pathology. Two patients were died because of sepsis. One patient had pancreatic, and one had biliary fistula, both healed spontaneously. CONCLUSION: Pancreaticoduodenectomy should be practiced as a life-saving procedure in the management of severe duodenopancreatic trauma. Qualified centers with adequate experience have a higher success rate.

Adolescent↗