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Biomedical subjects

N Güler

Publications and source records attributed to N Güler.

At least 37 records · Page 2Linked to original sources
PubMed2001

[The effects of sildenafil citrate on the isolated rat aorta: comparative in vitro study].

OBJECTIVE: Sildenafil, an inhibitor of cGMP-specific phosphodiesterase 5 (PDE5), is currently being used as oral therapy for penile erectile dysfunction. The aim of this study was to investigate the relaxing effect of sildenafil on vascular tissue and compare it with the known vasodilatator agents, sodium nitroprusside and acetylcholine. METHOD: Rat thoracic aorta samples were cut into rings, mounted on steel hooks, and immersed in aerated Krebs solution maintained at 37 degree C. Isometric responses were recorded by strain gauge transducers connected to a polygraph. Graded relaxations were induced using increasing concentrations of acetylcholine sodium nitroprusside and sildenafil. RESULTS: The agents all does-dependently relaxed rat aorta strips. The relaxing potential of sildenafil was found to be similar to sodium nitroprusside, but higher than acetylcholine. CONCLUSIONS: In the absence of regulatory mechanisms, sildenafil citrate has noticeable vasodilatatory effect in vitro.

Acetylcholine↗
PubMed2000

Sonographic assessment of ceftriaxone-associated biliary pseudolithiasis in children.

PURPOSE: Ceftriaxone is a widely used third-generation cephalosporin. In this prospective study, we used sonography to investigate the incidence and outcome of biliary complications in children receiving ceftriaxone therapy. METHODS: Ceftriaxone was administered intravenously at a dosage of 100 mg/kg/day for 1-3 weeks to 118 children hospitalized for severe infection. Serial gallbladder sonograms were obtained on days 1, 5-7, and 10-14 of therapy and the day after therapy ended if it had lasted more than 2 weeks. When sonographic abnormalities were found, additional sonograms were obtained every 3 days until the abnormalities had completely resolved. RESULTS: Twenty patients (17%), all asymptomatic, demonstrated sonographic abnormalities: 8 had gallbladder sludge, defined as echogenic material without associated acoustic shadowing, and 12 had pseudolithiasis, defined as echogenic material with acoustic shadowing. These abnormalities spontaneously resolved within 2 weeks of stopping the ceftriaxone (mean time to disappearance, 8.2 +/- 3.4 days). No significant differences were found between patients with normal versus abnormal sonographic findings in sex, age, duration of treatment, or other risk factors for drug precipitation. CONCLUSIONS: Ceftriaxone-associated biliary pseudolithiasis is usually asymptomatic and was rapidly reversible after cessation of therapy in this group of Turkish children.

Adolescent↗
PubMed2000

A case of arrhythmogenic right ventricular cardiomyopathy in sinus rhythm associated with thrombus in the right atrium.

We describe a patient with arrhythmogenic right ventricular cardiomyopathy (ARCV) in sinus rhythm associated with thrombus in the right atrium. The occurrence of a right heart thrombus in ARCV is extremely rare and, to our knowledge, has been previously reported only in the right ventricle. In our case, ARCV most probably led to right atrial spontaneous echo contrast, and later, right atrial thrombus formation by blood stasis caused by right ventricular systolic dysfunction. In conclusion, our case suggests that right atrial thrombus may occur in ARCV, even in sinus rhythm.

Adult↗
PubMed2000

Brucellosis in a mother and her young infant: probable transmission by breast milk.

Brucellosis, although primarily a zoonotic infection, is also a threat for human health. Infection can be transmitted to humans through direct contact with infected animals, products of conception, or animal discharges, and through consumption of potentially infected milk, milk products, or meat. Human-to-human transmission is rare. There have been case reports of transmission via blood transfusion and bone marrow transplantation from infected donors. Sexual intercourse is a possible means of transmission. Neonatal infection can be acquired transplacentally or during delivery. This report describes a mother with brucellosis who probably transmitted the infection to her 3-month-old baby by breast milk.

Adult↗
PubMed2000

Transesophageal echocardiography assessment of left atrial appendage function in untreated systemic hypertensive patients in sinus rhythm.

To assess left atrial appendage (LAA) function in hypertensive patients without treatment, transesophageal echocardiography (TEE) was performed in 46 hypertensive patients in sinus rhythm, aged 40 to 55 years, and in 16 control subjects (group I) without cardiovascular disease, aged 41 to 54 years. The hypertensive patients were divided into 2 groups according to left ventricular (LV) systolic function: group II, the group with normal LV systolic function (ejection fraction 0.63 +/- 0.08), and group III, the group with LV systolic dysfunction (ejection fraction 0.39 +/- 0.05). The LAA late emptying velocities (EVs) were significantly reduced in the hypertensive subgroups compared with the control group (P <.001), but no significant difference in the LAAEV was found between groups II and III. The LAAEV in the hypertensive patients had a significant negative correlation with diastolic blood pressure, systolic blood pressure, and left atrial (LA) diameter. The maximal LAA areas were significantly larger in the hypertensive subgroups than in the control group (P <.05). No significant difference in LAA maximal area existed between groups II and III. The maximal LAA area in the hypertensive patients had a significant positive correlation with diastolic blood pressure, systolic blood pressure, and LA diameter, but a significant negative correlation with LV ejection fraction. With TEE, LA spontaneous echocardiographic contrast (SEC) was present in 6 (43%) of 14 patients in group III (P <.01) and in 7 (22%) of 32 patients in group II (P <.05). No significant difference in the occurrence of LASEC was found between groups II and III. Left atrial appendage thrombi by TEE were observed in 4 (29%) of 14 patients in group III (P <.05) and in 4 (13%) of 32 patients in group II (P = not significant). No significant difference in the occurrence of LAA thrombus existed between groups II and III. In conclusion, in patients with untreated hypertension, marked elevation of afterload imposed on the left atrium may involve both the left atrium and the LAA, resulting in impairment of LAA function. This condition may worsen with subsequent occurrence of SEC and later, thrombus formation. Therefore assessment of LAA function may be important even in the hypertensive patient in sinus rhythm.

Adult↗
PubMed2000

A case of left atrial appendage thrombus with embolic stroke in association with aortic stenosis in sinus rhythm.

Although left atrial appendage (LAA) thrombus formation in the presence of sinus rhythm may potentially be the source for embolic events in various types of heart disease, no cases of LAA thrombus with embolic stroke in association with aortic stenosis in sinus rhythm have been reported. We present a case of valvular aortic stenosis with cerebral embolism in a person who was in sinus rhythm and had an LAA thrombus diagnosed by transesophageal echocardiography.

Aortic Valve Stenosis↗
PubMed2000

Primary breast lymphomas--a retrospective analysis of twelve cases.

This study was undertaken to define the natural history and treatment results of patients with primary breast non-Hodgkin's lymphoma (NHL). Twelve female patients who had been followed at Hacettepe University Hospital between 1973 and 1997 were retrospectively evaluated. All patients presented with breast masses (6 in the right breast and 6 in the left) that had recently enlarged. The most common histologic subtype was diffuse, small cleaved-cell lymphoma. Chemotherapy regimens were employed in 9 patients. Radiotherapy was delivered to the breast and its lymphatics in 8 patients. Lumpectomy, simple or modified radical mastectomy was performed in 5 cases. An objective response was attained with surgery, chemotherapy, or radiotherapy alone in 2, 1, and 1 cases, respectively. Combined modality treatment including either two or three modalities was successful in 7 cases. The median progression-free and overall survival times were 49 and 56 months, respectively. Although primary NHL of the breast is a rare disease compared to carcinoma, it should be considered in the differential diagnosis of breast masses.

Adolescent↗
PubMed2000

Brachial artery blood flow velocity pattern in patients with congestive heart failure: duplex Doppler ultrasonographic assessment.

The purpose of this study was to determine whether there are abnormalities in blood flow velocity pattern of the brachial artery in patients with congestive heart failure (CHF). Brachial artery blood flow velocities were measured with duplex Doppler ultrasonography in 12 normal subjects, 31 patients with congestive heart failure (CHF), and 26 patients with coronary artery disease (CAD). None of the patients had clinical evidence of arterial disorders at upper extremities. In both patient groups, the presence of hypertension was correlated with the peak systolic velocity (r=0.48, p<0.05). Patients with heart failure had significantly larger (p<0.0001) peak reverse velocity (20 +/- 6 m/sec) than healthy subjects (5 +/- 4 m/sec) and patients with CAD (7 +/- 3 m/sec). Peak reverse velocity did not differ significantly between normal subjects and CAD group. These data indicate that the blood flow velocity pattern at brachial artery is abnormal in CHF. The simple measurement of brachial artery flow velocity suggests changes in peripheral vasculature related to CHF.

Adult↗
PubMed2000

Acute ECG changes and chest pain induced by neck motion in patients with cervical hernia--a case report.

We report two cases of acute cervical angina and ECG changes induced by anteflexion of the head. Cervical angina is defined as chest pain that resembles true cardiac angina but originates from cervical discopathy with nerve root compression. In these patients, Prinzmetal's angina, valvular heart disease, congenital heart disease, left ventricular aneurysm, and cardiomyopathy were excluded. After all, the patient's chest pain was reproduced by anteflexion of head, at this time, their ECGs showed nonspecific ST-T changes in the inferior and anterior leads different from the basal ECG. ECG changes returned to normal when the patient's neck moved to the neutral position. To our knowledge, these are the first cases of cervical angina associated with acute ECG changes by neck motion.

Adult↗
PubMed2000

Biatrial thrombosis after acute inferior wall myocardial infarction--a case report.

The authors describe a case of biatrial thrombosis after acute inferior wall myocardial infarction (MI) with sinus rhythm. The presence of atrial thrombosis in patients with acute MI has recently been recognized with the aid of echocardiography. However, to the author's knowledge, a case of biatrial thrombosis after acute MI has not been reported previously. In this case, blood stasis, resulting from both left ventricular and right ventricular systolic dysfunction, was the most likely cause of the biatrial thrombi formation. In summary, this case suggests that biatrial thrombosis may occur in acute MI, even in the presence of sinus rhythm.

Aged↗
PubMed2000

Right atrial appendage function in patients with chronic nonvalvular atrial fibrillation.

To assess right atrial appendage (RAA) flow and its possible relationship to left atrial appendage (LAA) flow in chronic nonvalvular atrial fibrillation (AF), transesophageal echocardiography (TEE) was performed in 26 patients with chronic nonvalvular AF (group I). For the purpose of comparison, an additional group of 27 patients with chronic valvular AF due to mitral stenosis (group II) was analyzed. The clinically estimated duration of AF in group I was significantly longer than that of group II (8.7+/-3.4 versus 2.7+/-1.1 years). Although right atrial size and RAA maximal area were larger in group I than those in group II, left atrial size was larger in group II than that in group I. Group II had larger LAA maximal areas than group I, but this difference did not reach statistical significance. The two groups were not different with respect to the RAA or LAA emptying velocities. Significant correlations were observed between echocardiographic parameters of the two atria in patients with nonvalvular AF (r range, 0.4 to 0.7). In contrast, in patients with valvular AF, no correlation was observed between the echocardiographic parameters of the two atria (appendage emptying velocity, r = 0.38, p = 0.051; atrial size, r = -0.03, p = 0.89; maximal appendage area, r = 0.07, p = 0.75, respectively). There were no significant differences in the presence of right and left atrial spontaneous echo contrast and thrombus between the groups. All of the right and left atrial thrombi were confined to their respective appendages and were found in the atria with spontaneous echo contrast. Both RAA and LAA thrombi were present in one patient. In conclusion, our findings suggest that AF could affect both atria equally in nonvalvular AF, in contrast to valvular AF. Therefore, the assessment of RAA function as well as LAA may be important in patients with chronic nonvalvular AF.

Aged↗
PubMed2000

The effect of autonomic nervous system activity on exaggerated blood pressure response to exercise: evaluation by heart rate variability.

OBJECTIVE: We investigated the effect of autonomic nervous system activity on exaggerated systolic blood pressure (SBP) response to exercise in healthy subjects using heart rate variability (HRV) analysis. METHOD AND RESULTS: We studied 53 healthy volunteer subjects with exercise treadmill test according to the Bruce protocol. Time domain and frequency domain of HRV were measured for each 5-minute segment before (rest) and after exercise (recovery) and during the total exercise period. The mean change in SBP (delta SBP) was 39 +/- 18 mm Hg. The delta SBP above the value of mean (> or = 40 mm Hg) was defined as an exaggerated delta SBP. According to the delta SBP, subjects were classified into two groups. Group I consisted of 32 patients who showed a normal delta SBP, group II consisted of 21 patients who showed exaggerated delta SBP. There were no significant differences in baseline clinical characteristics and exercise duration between the two groups. There were no significant differences in the mean RR intervals, SDNN (standard deviation of all RR intervals), RMSSD (the square root of the mean of the sum of the squares of differences between adjacent RR intervals), and HF (high-frequency power, 0.15 to 0.40 Hz) at rest between the two groups. However, LF (low-frequency power, 0.04 to 0.15 Hz) and LF/HF ratio at rest were significantly higher at rest in group II than in group I. There were no significant differences in the mean RR intervals and HF at exercise between the groups. However, SDNN and RMSSD were significantly lower, LF and the LF/HF ratio were significantly higher at exercise in group II than in group I. No differences in these parameters were observed at recovery between the two groups. CONCLUSIONS: The sympathetic activity was higher at rest and during the total exercise period, parasympathetic activity was lower during the total exercise period in healthy subjects with exaggerated SBP response to exercise than in those with normal SBP response.

Adult↗
PubMed2000

Effects of cigarette smoking on the circadian rhythm of heart rate variability.

BACKGROUND: The effects of cigarette smoking on the circadian rhythm of heart rate variability (HRV) are not known. METHODS: We studied the effects of cigarette smoking on the circadian rhythm of HRV in 24 smoking and 21 non-smoking healthy subjects. Twenty-four hour ambulatory electrocardiograms were recorded and time domain parameters of HRV (SDNN [standard deviation of all R-R intervals], SDANN [standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recording], RMSSD [the square root of the mean of the sum of the squares of differences between adjacent R-R intervals]) were determined for the entire 24-hour period and for each 3-hour period. RESULTS: In total, SDNN and SDANN were significantly lower in smokers than non-smokers (116 +/- 26 vs 136 +/- 27, p < 0.05 for SDNN, 109 +/- 25 vs 121 +/- 24, p < 0.05 for SDANN). However, there were no statistical differences between smokers and non-smokers in heart rate (81 +/- 9 vs 76 +/- 10, p > 0.05) and RMSSD (32 +/- 12 vs 37 +/- 18, p > 0.05). These HRV parameters showed a circadian variation: they increased at night and decreased during the day in both groups. The parameters were lower in smokers than non-smokers during daytime (especially, between 8-14 hours). However, no differences were detected during night-time. CONCLUSIONS: Time domain parameters of HRV (SDNN, SDANN and RMSSD) in both smoking and non-smoking healthy subjects have a circadian rhythm. SDNN and SDANN were lower in smokers than non-smokers during daytime.

Adult↗
PubMed2000

Treatment of advanced soft tissue sarcomas with ifosfamide and doxorubicin combination chemotherapy.

Our objective was to assess the efficacy of a standard dose ifosfamide and doxorubicin containing regimen in the treatment of advanced soft tissue sarcomas. Forty consecutive patients with a median age of 35.5 years were treated. Ifosfamide was administered at a dose of 2.5 g/m(2)/day as 72-hour continuous infusion with mesna at the same dosage and schedule. Doxorubicin was given at the dose of 60 mg/m(2)/day as 2-hour infusion on day 1. Six patients had a complete response (15%), and 9 (22.5%) had a partial response, fourteen patients (35%) stable disease, and 11 (27.5%) did not respond to chemotherapy. The median duration of response was 13 and 5 months for the complete and partial responders, respectively. The median survival was 37 months. Febrile neutropenia was encountered in 9 cases (22.5%). The present ifosfamide and doxorubicin combination is a moderately effective and well-tolerable regimen in the treatment of advanced soft tissue sarcomas.

Adolescent↗