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Biomedical subjects

N Cakar

Publications and source records attributed to N Cakar.

At least 37 records · Page 2Linked to original sources
PubMed2000

In vitro differentiation of human endometrial stromal cells: effect of transforming growth factor beta 1 on prolactin secretion.

OBJECTIVE: To investigate the role of Transforming Growth Factor beta 1 on differentiation of human endometrial stromal cells. STUDY DESIGN: A prospective study. MATERIAL AND METHODS: Human endometrial cells obtained from 9 women were cultured in DMEM-HAMs F12 media to adequate cell confluence and then the flasks were cultured in the presence and absence of TGF b 1. The influence of TGF beta 1 were measured by prolactin production expressed as nanograms of prolactin/mg of total DNA in cells measured by diphenylamine reaction. RESULTS: The levels of prolactin in the culture medium with and without TGF beta 1 were 0.16 +/- 0.27 ng/microgram DNA/day and 0.24 +/- 0.41 ng/microgram DNA/day respectively. There was no significant difference between groups. CONCLUSION: There is no direct effect of TGF beta 1 on differentiation of human endometrial stromal cells. However it may involve in more complex relationship in this process.

Adult↗
PubMed2000

[Percutaneous endoscopic gastrostomy in the ICU].

Aspiration pneumonia due to gastroesophageal reflux is a frequent complication in ICU. The most commonly chosen method for long-term enteral access is gastrostomy and this method also reduces the risk of aspiration and shortens the hospital stay. We evaluated 31 patients in whom PEG was performed between 1997-98 in our unit. Indication of PEG was long-term ICU stay and coma which necessitate long term enteral nutrition. Mean age of our patients were 60.5((19.4). We evaluated the aspiration by clinical inspection. Aspiration and interruption of feeding was observed 1.57 ((1.43) times before PEG and 0.67 ((0.73) times after PEG. Further more positive tracheal aspirate culture were seen 3.14 ((1.95) times before PEG and 1.52 ((1.47) times after PEG.

Critical Care↗
PubMed1999

Organ growth and lung maturation in rabbit fetuses.

The rabbit fetus is one of the most commonly used animal models in experimental studies investigating fetal organ development. However, there is no detailed information about normal growth of organs of rabbit fetuses in English language literature. Fetal rabbits were studied in the second half of gestation between 18th and 30th days. Amniotic fluid volume, body mass (BM), lung, heart and liver masses (LM, HM, LiM), lung and thorax volumes (LV, TV) were determined and LM/BM, HM/BM, LiM/BM, TV/BM and LV/TV ratios were calculated. Additionally fetal lungs were evaluated histologically, BM, LM, HM, LiM and LV were increased until 27th gestational day and then remained unchanged. TV was always increased between 18th gestational day and term. The lung maturation was almost completed in the 27th-28th gestational days. Therefore, BM, LM, HM, LiM and LV are the parameters that can be used to evaluate normal fetal growth between 18th and 27th gestational days. TV seems to be the predictive parameter for evaluation of normal fetal growth during the second half of gestation in rabbit fetuses; 20th and 27th days of gestation are more appropriate for experiments to evaluate lung maturation.

Amniotic Fluid↗
PubMed1999

Blood pressure nomograms for children and adolescents in Turkey.

In order to obtain data on blood pressure (BP) distribution in Turkish children, a total of 5,599 Turkish children from birth to 18 years were studied. BP rises with age, and both systolic and diastolic BP showed a positive correlation with height and weight in both sexes. As the sampling was representative of Turkish children at different ages, the mean systolic and diastolic BP levels were compared for each age with the results reported in the study of the Second Task Force. The mean systolic and diastolic BP of Turkish children and the increase with growth and development were different from the Second Task Force study. Genetic, ethnic, and environmental factors were suggested to be responsible for this variation. In conclusion, normal BP curves should be applied with caution in childhood, and every population should use their own normal standards to define a measured BP level in children.

Adolescent↗
PubMed1999

Familial Mediterranean fever and acute rheumatic fever: a pathogenetic relationship?

The frequency of acute rheumatic fever (ARF) in patients with familial Mediterranean fever (FMF) was documented and the effects of preceding streptococcal infections on the exacerbation of FMF were determined. In the first part of the study, 162 individuals with FMF were investigated for a history of ARF in a retrospective study. In the second part of the study, antistreptolysin-O (ASO) titres were measured in 130 individuals with FMF. Thirty-six patients had an arthritic attack (group A1), 55 patients had a typical FMF attack without arthritis (group A2) and 39 patients were in the attack-free interval (group B) during the investigation. Nine patients with FMF (5.5%) were considered to have ARF and three of them (1.85%) also had rheumatic heart disease. This prevalence of rheumatic heart disease in FMF is higher than that of the normal population (0.65%) reported in Turkey. Elevated ASO titres were found in 75%, 42% and 38% of the patients in groups A1, A2 and B, respectively. These percentages were found to be significantly higher in group A1 than in both groups A2 (p<0.01) and B (p<0.01). We concluded that patients with FMF might be more prone to the late complications of streptococcal infections.

Acute Disease↗
PubMed1999

The preventive effect of heparin on stricture formation after caustic esophageal burns.

BACKGROUND/PURPOSE: Preventing thrombus formation after caustic esophageal ingestion has been proposed to have beneficial effects. Therefore, an experimental study was carried out to investigate the effects of heparin on the esophagus after caustic burns. METHODS: Caustic esophageal burns were produced in rats by irrigation with 50% NaOH as described by Liu. Rats were divided into four groups as follows: group A, animals with esophageal burns, received placebo and underwent autopsy 48 hours after caustic injury; group B, animals with esophageal burns, received subcutaneous heparin treatment and underwent autopsy 48 hours after caustic injury; group C, animals with esophageal burns, received placebo and underwent autopsy 28 days after caustic injury; group D, animals with esophageal burns, received subcutaneous heparin treatment for 7 days and underwent autopsy 28 days after caustic injury. Histopathologic evaluation was performed in all groups, and collagen content of esophageal sections was analyzed by determination of hydroxyproline levels. RESULTS: Submucosal vascular thrombosis was encountered in all group A animals but the submucosal venules and arterioles were patent in most of group B animals. Esophageal strictures did not develop in any of group D animals, although varying degree of esophageal stenoses were encountered in all animals of group C. The circumferences of the burned segment have been narrowed to 3+/-1 mm in group C rats. There was obvious collagen deposition in submucosa, and epithelial regeneration was not complete in group C rats. Submucosa and epithelial integrity seemed normal in group D animals. Hydroxyproline contents in group D were significantly lower compared with group C (P < .05). CONCLUSIONS: Heparin has ameliorating effects on stricture formation after caustic esophageal burn. Those effects may occur through possible anticoagulant, antithrombotic, and endothelial protective effects, and modifying effects of heparin on wound healing.

Animals↗
PubMed1999

Familial Mediterranean fever--renal involvement by diseases other than amyloid.

BACKGROUND: In patients with familial Mediterranean fever (FMF) renal involvement is usually in the form of AA amyloidosis. There is increasing evidence that renal involvement may be due to diseases other than amyloid as well. METHODS: Amongst 302 children with FMF we observed and followed 28 with typical clinical and laboratory features of vasculitis. The diagnosis of FMF was established according to the Tel Hashomer criteria. RESULTS: Polyarteritis nodosa, protracted febrile attacks and Henoch-Schönlein purpura were diagnosed in 4, 13, and 11 patients, respectively. The presentation was often difficult to distinguish from FMF attacks, but protracted febrile attacks lasting several weeks, hypertension, thrombocytosis, and dramatic responses to corticosteroid therapy that were observed in many cases were different from what is observed in classical FMF. CONCLUSIONS: We suggest that FMF, perhaps as a consequence of impaired control of inflammatory responses, predisposes to vasculitis with renal involvement.

Child↗
PubMed1997

Cardiac involvement in childhood polyarteritis nodosa.

In this report, we evaluated the cardiac findings of 15 children with polyarteritis nodosa. The age range of the patients was 4-14 years; with a mean of 10 years. All have had systemic involvement of the disease. The most common findings in cardiac evaluation were diminished left ventricular systolic functions and mild mitral and/or tricuspid valve regurgitation. One patient had pericardial thickening with no effusion. One had sinus tachycardia. There were no signs of myocardial infarction or ischemia clinically or electro-cardiographically. In conclusion, we did not find cardiac complications, such as pericarditis or myocardial infarction, to be as frequent as in previous reports. However, even in asymptomatic patients, systolic dysfunction or valvular involvement were common findings in patients with polyarteritis nodosa, which were not reported previously. These findings may be due to the histological changes of the myocardium or atrioventricular valves. Although these were not severe and fatal lesions, long-term follow-up of these patients with echocardiography may help to determine the course of cardiac involvement.

Adolescent↗
PubMed1997

Pharmacokinetics of recombinant human erythropoietin in children with chronic renal failure.

Basal erythropoietin (Epo) levels and single dose-pharmacokinetics of recombinant human erythropoietin (rhuEpo) were investigated in 8 predialysis (PD) patients (mean age 11.6 +/- 1.4 years) and in 8 patients on continuous ambulatory peritoneal dialysis (CAPD) (mean age 12.7 +/- 0.6 years). Basal Epo levels were found to be 1.0 +/- 0.0 mu/ml in PD group, 1.6 +/- 0.7 mu/ml in CAPD group and 8.5 +/- 1.8 mu/ml in control group. Following administration of 50 mu/kg rhuEpo (s.c.) serum Epo concentration (Cmax) was 23.2 +/- 2.5 mu/ml in 18.5 +/- 2.6 hours (tmax) in PD patients and 9.9 +/- 0.8 mu/ml in 26.8 +/- 7.7 hours in CAPD patients. Mean elimination half-lives (t1/2) were 13.3 +/- 1.9 hours and 13.5 +/- 3.0 hours in PD patients and CAPD patients, respectively. The volume of distribution (Vd) was 840.0 +/- 100.0 ml/kg; the clearance (Epo Cl) was 37.0 +/- 5.5 ml/kg/hour in PD patients. These values were significantly lower in PD patients than in CAPD patients (p < 0.05) (Vd; 1500 +/- 240.0 ml/kg; Epo Cl 110 +/- 30.0 ml/kg/hour). During the course of CAPD, more efficient clearance of uraemic toxins that inhibit erythropoiesis and more rapid extraction of erythropoietin by erythroid precursors may cause higher Vd in CAPD patients than in PD patients.

Adolescent↗
PubMed1997

Low-dose erythropoietin is effective and safe in children on continuous ambulatory peritoneal dialysis.

Hypertension is one of the most important complications of erythropoietin (rHuEPO) therapy in dialysis patients. In this study, the effect of two different dosage regiments of subcutaneous rHuEPO on blood pressure [BP] was evaluated in 20 anemic children on continuous ambulatory peritoneal dialysis (CAPD). Patients were randomized to receive rHuEPO 50 U/kg, either once a week (group 1, 50 U/kg per week) or three times a week (group 2, 150 U/kg per week). At the beginning of the study, 8 patients in group 1 and 8 patients in group 2 were on antihypertensive therapy. In group 1, the hematocrit increased gradually and significantly from 18.98% +/- 1.79% to 30.1% +/- 1.62% after 6 months, while in group 2 it rapidly increased from 19.53% +/- 1.86% to 32.4% +/- 1.11% after 3 months. A significant increase in the mean arterial BP was observed in group 2. Antihypertensive therapy had to be increased in all of the 8 previously hypertensive patients and had to be initiated in 1 of the 2 originally normotensive patients in the same group. None of the patients in group 1 required a change in antihypertensive medication. We conclude that during treatment with rHuEPO pre-existing hypertension and the dose of rHuEPO are the most important risk factors for the development or worsening of hypertension in children on CAPD, and gradual elevation of hematocrit by low-dose rHuEPO avoids the development of severe hypertension.

Adolescent↗
PubMed1997

Histological evidence of decreased contralateral testicular blood flow during ipsilateral testicular torsion.

OBJECTIVE: To evaluate contralateral testicular blood flow by histological examination of arterioles during ipsilateral testicular torsion. MATERIALS AND METHODS: The study comprised two groups of 20 male albino rats (weight 250-270 g). The control group underwent a sham operation, while in the second group the left testes were twisted clockwise by 720 degrees. All rats underwent bilateral orchidectomy 24 h after the initial intervention. Three slides for each testis (n = 240) were evaluated randomly while unaware of treatment to determine the total number of arterioles, the percentage of collapsed and open arterioles, the diameter of open arterioles and the presence or absence of blood cells in the lumen. Differences were assessed using t-tests for paired and independent samples. RESULTS: Very few arterioles were collapsed in both testes of the control group and in the ipsilateral testes of the torsion group, but half the arterioles in the contralateral testes of the torsion group were collapsed. The difference between the contralateral testes of the two groups and between the ipsilateral and contralateral testes in the torsion group were significant. The diameter of uncollapsed arterioles did not differ significantly among either testes of the control and torsion groups and either testes in each group. Both testes in the torsion group had significantly more arterioles containing blood cells than those in the control group. The difference between the testes in the torsion group was also significant, but was not in the control group. CONCLUSION: There was histological evidence of decreased blood flow in the contralateral testis during unilateral testicular torsion; contralateral testicular damage during unilateral testicular torsion may result from hypoxia caused by decreased blood flow.

Animals↗
PubMed1997

Comparison of pressure- and flow-triggered pressure-support ventilation on weaning parameters in patients recovering from acute respiratory failure.

OBJECTIVE: To compare the effects of pressure- and flow-triggered pressure-support ventilation on weaning parameters during recovery from acute respiratory failure. DESIGN: Prospective, randomized, clinical trial. SETTING: Intensive care unit in a university hospital. PATIENTS: Sixteen orotracheally intubated adult patients recovering from acute respiratory failure of various etiologies, without chronic obstructive pulmonary disease. INTERVENTIONS: Randomized application of pressure- and flow-triggered pressure-support ventilation at 100% and 75% ventilatory support levels in each triggering system. A total of four conditions were applied for 30 mins each in all patients. MEASUREMENTS AND MAIN RESULTS: Ventilatory, respiratory, and hemodynamic data were measured. For the measurement of weaning parameters, pressure and volume signals were directed to a computerized respiratory monitor by means of an esophageal probe and a flow sensor between the "Y" piece of the ventilatory circuit and the endotracheal tube. During both pressure-triggered (trigger sensitivity of -1 cm H2O) and flow-triggered (trigger sensitivity of 0.7 to 2.0 L/min) pressure-support ventilation with a ventilator, peak airway pressures were applied so as to decrease the work of breathing performed by the patient to zero (full ventilatory support). Partial ventilatory support was applied at 75% of the peak airway pressures achieved during full ventilatory support with each triggering system. A total of four experimental conditions were evaluated at identical FiO2 and positive and-expiratory pressure levels during pressure-support ventilation in each patient. Total ventilation volumes, arterial blood gas data, and hemodynamics did not differ among the four experimental conditions. During partial ventilatory support, the work of breathing, rapid shallow breathing index, and esophageal pressure increased significantly with both triggering systems when compared with data obtained at full ventilatory support. The mean data for the weaning parameters during the condition of partial ventilatory support were comparable between pressure- and flow-triggered pressure-support ventilation (i.e., 0.38 +/- 0.24 vs. 0.42 +/- 0.26 joule/L for work of breathing, 2.6 +/- 1.6 vs. 3.3 +/- 1.7 cm H2O for tracheal occlusion pressure, and 40.2 +/- 12.9 vs. 50.4 +/- 18.3 breaths/min/L for rapid shallow breathing index, respectively). CONCLUSIONS: The application of either a pressure- or flow-triggered system during pressure-support ventilation with the ventilator did not significantly affect short-term changes in gas exchange, respiratory mechanics, and inspiratory workload in patients recovering from acute respiratory failure of various etiologies without chronic obstructive pulmonary disease.

APACHE↗