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Mustafa Yilmaz

Publications and source records attributed to Mustafa Yilmaz.

82 records · Page 5Linked to original sources
PubMed2002

Risk factors associated with changes in oxygenation and pulse rate during colonoscopy.

BACKGROUND/AIMS: Although hypoxemia is a relatively common complication of colonoscoy, the possible predictive factors of oxygen desaturation and tachycardia in patients undergoing this procedure are not well known. In this study, the possible predictive factors of severe oxygen desaturation (SaO2<90%) and tachycardia in patients with undergoing colonoscopy were investigated. METHODS: A total of 79 consecutive patients were evaluated in the study (46 men and 33 women). Significant oxygen desaturation was considered to be a reduction of arterial oxygen saturation (SaO2) to less than 90%. Tachycardia was defined as a heart rate above 100/min. Patients with inadequate colonoscopy were excluded from the study. The incidence of arterial hemoglobin oxygen desaturation and changes of heart rate during colonoscopy were evaluated and clinical factors in relation to these findings were assessed. RESULTS: The SaO2 during colonoscopy fell below 90% in 19 of the 79 patients (24.1%). The risk factors for desaturation were advanced (>60yr) age (OR: 6.03; 95% CI, 1.35-26.99), receiving sedation (OR: 11.42; 95% CI, 2.05-63.49), chronic lung disease (OR: 4.54; 95% CI and 1.40-11.68), and obesity (OR: 8.95; 95% CI, 1.17-68.55). The presence of hypertension and anemia, a history of cigarette smoking and duration of the colonoscopy had no significant effect on arterial oxygen desaturation (p>0.05). The pulse rate was raised above 100/min during colonoscopy in 26 of 79 patients (32.9%). lncrease in heart rate was found to be related to arterial oxygen desaturation (OR: 13.72; 95% CI, 2.67-70.32), anemia (OR:6.17; 95% CI, 1.15-32.91) and advanced (>60 yr) age (OR: 6.08; 95% CI, 1.62-22.81). Gender, sedation, obesity, hypertension, chronic lung disease and smoking did not affect the heart rate (p>0.05). Two patients had transitional bradyarrythmia, which had no relationship with the parameters studied. There was no incidence of significant hypoxia or change in heart rate which might have caused termination of the procedure. CONCLUSIONS: Benign and transient arterial oxygen desaturation and tachycardia may occur during colonoscopy procedure. Sedation, obesity, advanced age and chronic lung disease might contribute to these adverse events.

Journal Article↗
PubMedDate not supplied

Question mark ear deformity and a modified surgical correction method: a case report.

Question mark ear (Cosman ear) deformity, a rare congenital malformation, is characterized by a cleft between the helix and the ear lobe and marked prominence of the auricles. Although the features of question mark ear deformity are well described in the literature, there is no definitive surgical technique for repair of this deformity, Several surgical methods have been introduced for the correction of the deformity. These techniques mainly provide for repair of the cleft between the helix and ear lobe. However, marked prominence of the upper auricle usually is also present with the cleft. We modified the surgical technique to correct the cleft and the upper prominence at the same time. With this procedure, the cleft is exposed by raising a vertical cutaneous flap based on the cleft on the posterior side of the ear, After anterior scoring to form the antihelix and cleft repair using an ipsilateral conchal cartilage graft, the cutaneous flap is used to cover the cartilage graft and the flap donor site is closed primarily to facilitate restoration of the antihelix. The authors report on a patient with Cosman ear and introduce their modified technique that can be used for repair of the cleft between the helix and ear lobe and the prominence of the upper helix in the same procedure.

Child, Preschool↗
PubMedDate not supplied

Hodgkin's disease and autoimmune hemolytic anemia: a case report.

OBJECTIVE: To report a case of Hodgkin's disease presenting with immune hemolytic anemia. CLINICAL PRESENTATION AND INTERVENTION: A 47-year-old man was admitted to hospital because of weight loss, fever, and inguinal lymph node adenopathy. Biopsy of the inguinal lymph node revealed mixed-cellularity Hodgkin's disease. Three days after starting combined chemotherapy, the patient showed evidence of autoimmune hemolytic anemia, which responded well to prednisolone. CONCLUSION: This case shows that clinicians should be aware of the possibility of autoimmune hemolytic anemia in patients with Hodgkin's disease presenting with anemia, and distinguish it from the anemia of chronic disease.

Anemia, Hemolytic↗
PubMedDate not supplied

Effects of interferon-alpha-2a on Th3 cytokine response in multiple myeloma patients.

AIMS AND BACKGROUND: Multiple myeloma cells increase Th3 cytokine response by secreting TGF-beta, which causes defective Th1 and Th2 cytokine responses. Therefore, a significant suppression of the immune system is seen in multiple myeloma. Interferon-alpha (IFN-alpha) is used in the treatment of multiple myeloma due to its immunomodulatory and anti-tumoral effects. We attempted to define the characteristics of immune cytokine responses and the effects of IFN-alpha-2a on the immune response in multiple myeloma. METHODS: Fifteen patients with multiple myeloma and 15 healthy controls were enrolled. IFN-alpha-2a, 3 million units/day x 3 times/week, was administered subcutaneously to the patients for 2 weeks. Cytokines (TGF-beta, IL-1, IL-2, IL-4, IL-10, IFN-gamma) were assessed by the ELISA method in sera of the patients in pretreatment and posttreatment periods and in the sera of the controls. RESULTS: IL-2 and IL-4 levels in patients, before IFN-alpha-2a, were lower than the controls, whereas TGF-beta levels were higher than the controls. In other words, Th3 cytokine response was increased and Th1 and Th2 cytokine responses were decreased in patients. A short course of IFN-alpha-2a increased IL-2 levels. CONCLUSIONS: These findings suggest IFN-alpha-2a may enhance nonTh3 cytokine responses in multiple myeloma patients.

Adult↗
PubMedDate not supplied

Early medical treatment is life saving in acute Budd-Chiari due to polycythemia vera.

Here we describe two women with polycythemia vera presented with fulminant hepatic failure due to acute Budd-Chiari syndrome. Both had a history of severe abdominal pain and distention of short duration. Clinical and laboratory findings showed fulminant hepatic failure due to acute Budd-Chiari syndrome. Diagnosis was confirmed with abdominal ultrasonography and Doppler ultrasonography showing ascites, hepatomegaly, portal hypertension and total occlusion of hepatic veins. Complete blood count and other clinical findings were compatible with polycythemia vera in both patients. Patients were treated successfully with early administration of continuous heparin infusion, repeated phlebotomies and hydroxyurea. We emphasize here early diagnosis and effective treatment in such fulminant cases may be life saving.

Acute Disease↗
PubMedDate not supplied

Induction of apoptosis and inhibition of growth of human hepatoma HepG2 cells by heparin.

BACKGROUND/AIMS: Apoptotic and anti-proliferative effects of heparin on a number of cancers have been described. There have been no studies analyzing the effect of heparin on human hepatoma cells. The aim of this study was to investigate the effect of heparin on human hepatoma cell line, HepG2. METHODOLOGY: HepG2 cell line was cultured with different concentrations of heparin. Colony count, viability assay, percentage of the apoptosis and proliferative index were assessed at the end of the 7th day. Trypan blue was used to assess viability. Apoptosis and proliferative indexes were assessed by flow-cytometry. RESULTS: Hepatoma cells were arrested at the G0/G1 phase with heparin incubation and proliferative indexes decreased significantly in 20, 40 and 80 U/mL of heparin concentrations in comparison with the control (36 +/- 1%, 30 +/- 5% and 29 +/- 8% vs. 44 +/- 1%, p < 0.01). Flow cytometry revealed a statistically significant increase in apoptosis in groups incubated with 40 and 80 U/mL of heparin in comparison with the control (39 +/- 26% and 58 +/- 18% vs. 0.83 +/- 1.3%, p < 0.01). Colony counts per well and viable cells per microL decreased significantly in 80 U/mL of heparin. CONCLUSIONS: Heparin leads to a significant anti-proliferative and an apoptotic effect on human hepatoma cells in vitro.

Anticoagulants↗
PubMedDate not supplied

The prevalence of asthma and allergic diseases in children of school age in Adana in southern Turkey.

The aim of this study was to determine the prevalence of asthma and other allergic disorders as well as the factors affecting these disorders in school-children in Adana. This cross-sectional population-based study using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was carried out on 3164 school-children aged between 6-18 years during March to June 1997. There were 1521 (48.1%) boys and 1643 (51.9%) girls. The prevalence of asthma, allergic rhinitis and eczema in the 6-18 year-old children was found to be 12.6%, 13.6% and 8.3%, respectively. The prevalence of asthma was highest in 6-10 year-old school-children (14.7%), and lowest (6.0%) in 15-18 year-old children. The prevalence of asthma diagnosed by a doctor was 5.0%. The cumulative and current prevalences of wheezing were found to be 19.0% and 13.5%, respectively. The cumulative prevalence of allergic disorders was found to be 23.4%. The presence of domestic animals at home and dampness of the home were found to be important risk factors for asthma. Family histories of asthma, eczema, and diagnosis made by a doctor, and history of frequent sinusitis were found to be significantly higher in asthmatics. In conclusion, asthma is an important chronic disease of childhood in Adana in southern Turkey.

Adolescent↗
PubMedDate not supplied

Endoscopic injection therapy of bleeding Dieulafoy lesion of the stomach.

BACKGROUND/AIMS: Dieulafoy's lesion is a rare cause of upper gastrointestinal bleeding and is potentially life threatening. The aim of this study is to determine the clinical features of these lesions and the efficacy of the endoscopic injection sclerotherapy in patients with Dieulafoy's lesion. METHODOLOGY: Between January 1994 and December 2001, twenty-eight patients with upper gastrointestinal bleeding due to Dieulafoy's lesion were treated by endoscopic injection sclerotherapy. Efficacy of endoscopic therapy and clinical findings of these cases were analyzed. RESULTS: The study group consisted of 22 male (78.5%) and 6 female (21.5%) patients with a mean age of 57 years (range 22-82 years). Significant comorbidity was present in 22 (78.5%) patients. Hemoglobin values of the patients ranged from 5.4-10.3 g/dL at hospitalization. The median transfusion requirement was 5 (range 0-12) units. Dieulafoy's lesion was observed in the proximal half of stomach in 25 cases (89.3%), in the antrum in 2 cases (7.1%) and in the angulus in 1 case (3.5%). Endoscopic injection sclerotherapy was successful in stopping the bleeding in 26 out of 28 patients (92.8%). CONCLUSIONS: Dieulafoy's lesions mostly affect the proximal stomach and cause serious upper gastrointestinal bleeding. Endoscopic injection sclerotherapy is an effective and a safe therapeutic method for Dieulafoy's lesion.

Adult↗
PubMedDate not supplied

A false negative by planar scintigraphy liver hemangioma, diagnosed by technetium-99m-red blood cells and technetium-99m-sulfur colloid single photon emission tomography scan.

We present a 42-year-old patient who was examined in the Gastroenterology Department of Gaziantep University for chronic abdominal pain, nausea and vomiting. Ultrasonography showed a 4.7 cm solid hepatic mass on the right lateral side of the right lobe of the liver. The patient was then sent to the Nuclear Medicine Department of Gaziantep University for liver scan. After injecting autologous red blood cells labeled with 740 MBq of technetium-99m ((99m)Tc-RBC), early and delayed anterior planar images of the liver showed no significant findings because of the right kidney shine through the liver. Two days later, after injecting again 740 MBq of (99m)Tc-RBC, we performed a single photon emission tomography (SPET) scan but still this scan was nondiagnostic even in the delayed images of the liver. Three days later, after the iv injection of 185 MBq of technetium-99m-sulphur colloid ((99m)Tc-SC), we observed in the delayed SPET images of the liver, a mismatch defect with decreased focal uptake of (99m)Tc-SC at 60 min while the uptake of (99m)Tc-RBC at the same area was normal or slightly increased. The patient was then operated due to bleeding in the abdominal cavity. A cavernous hemangioma was found, confirmed by histology. The absorbed dose from all three diagnostic scanning procedures was: 4 mSv. In conclusion, the mismatch of the SPET delayed images between the (99m)Tc-RBC and the (99m)Tc-SC scans indicated that this procedure was effective for the diagnosis of liver cavernous hemangioma located in this unusual position.

Adult↗