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Biomedical subjects

N Gürses

Publications and source records attributed to N Gürses.

At least 19 recordsLinked to original sources

Expression of VLA-integrins and their related basement membrane ligands in gingiva from patients of various periodontitis categories.

Periodontitis is characterized by destruction of dento-gingival fibers and apical migration of the junctional epithelium. Tissue destruction may be associated with altered interactions between epithelium and connective tissue mediated by integrins localized in the basement membrane zone. We examined the expression of alpha2beta1, alpha3beta1, alpha4/alpha5/beta1, alpha6beta4 and their related extracellular matrix (ECM) ligands: laminin-1, laminin-5, and collagen type IV in untreated periodontitis sites of various categories. The expression and location of ECM proteins along the basement membrane were found to be similar between clinically healthy and periodontitis affected tissues. However, ECM proteins were more diffusely distributed in connective tissue (CT) of periodontitis tissues as streak-like/ fibrillar/granular stainings, particularly beneath the pocket epithelium (PE) and around the blood vessels. This may reflect an increase in inflammatory cell migration. The more widespread distribution of integrins alpha2beta1, alpha3beta1 in PE of periodontitis specimens may be related to disease activity and increased rate of keratinocyte proliferation and migration. Moreover, the weaker expression of alpha6beta4 in junctional epithelium (JE) of periodontitis affected tissues may be related to the epithelial detachment from the tooth surface. Clarification of expressions of integrins and their ligands in relation to known clinical disease susceptibility factors may provide information on the onset and progression mechanisms of periodontal disease destruction.

Adolescent↗

Unilateral inguinal ectopic scrotum and imperforate anus: a case report.

A case of an ectopic scrotum located in the right inguinal area is described. The left hemiscrotum was in normal location, and each hemiscrotum contained testis. The boy also had an infralevator-type anorectal malformation. Initially, anoplasty was performed, and scrotal reconstruction was carried out 1 month later. The authors also reviewed the embryological explanation of ectopic scrotum in the literature.

Abnormalities, Multiple↗

A pseudoexstrophy with penile anomaly.

Although classical exstrophy of the bladder is not a rare anomaly, variants of exstrophy are extremely uncommon. We report a male pseudoexstrophy case with appearance of a low set umbilicus associated with umbilical hernia and penile anomaly. Although this mild exstrophy variant does not normally require surgical management, penile reconstruction was necessary in our patient.

Abnormalities, Multiple↗

Congenital lumbar hernia associated with the lumbocostovertebral syndrome: two cases.

Congenital hernias in the lumbar region are very uncommon. Two cases with congenital lumbar hernia associated with the lumbocostovertebral syndrome are presented. The first case of a 14-month-old girl presented with the type of a superior lumbar triangle hernia. The second case was a 2-year-old girl presenting with diffuse lumbar hernia. The anatomy, embryology and treatment of this congenital abnormality are discussed.

Child, Preschool↗

Postpneumonic empyema in children treated by early decortication.

We performed early decortication in 32 cases of postpneumonic empyema during the period of February 1991 to December 1995. Twenty of them were male and 12 of them were female. We evaluated these cases retrospectively. Decortication was saved for the patients where antimicrobial therapy and closed-tube drainage had failed to achieve a cure and was performed on the 10-15th day after the diagnosis was established. Indications for the decortication were persistent fever (9), pulmonary air leakage (7), localized effusion (7), persistent respiratory distress (5) and pleural thickening without resolution (28). Decortication was performed through the standard posterolateral thoracotomy. Patients were discharged on the 8th postoperative day with minimal morbidity and no mortality. Because of the simplicity of the procedure (short hospitalization periods, low mortality and morbidity rates) good results were achieved with early decortication.

Adolescent↗

Multifocal eosinophilic granuloma with sequential periodontitis-like lesions.

Eosinophilic granuloma (EG) is the localized and mildest form of the triad commonly known as Langerhans cell histiocytosis. This report describes a case manifesting itself as a periodontal problem with the localized osseous lesions in jawbones which was first diagnosed as early-onset periodontitis. Later on, the diagnosis of EG was established, relying on histopathological and immunohistochemical evaluations. Immunohistochemical findings confirm that a minor component of cell aggregates is phenotypically related to Langerhans cells among the sheet-like accumulations of histiocytes and eosinophils. The aetiology of the disease remains largely unknown. Although surgical curettage of lesions is usually effective in treatment of EG of bone, corticosteroids might be used as an adjunctive. This multifocal case of EG stresses the importance of clinical follow-up examinations, since the sequential lesions appear with irregular intervals, and this may cause diagnostic problems as well as a delay in starting the treatment regimen.

Adrenal Cortex Hormones↗

The value of immunoglobulin and complement levels in the early diagnosis of neonatal sepsis.

Serum IgG, IgG1, G2, G3, G4, IgM, C3c and C4 concentrations were measured in 24 term neonates with sepsis and 17 healthy normal neonates of similar age, sex and weight (control group). The serum IgG, IgG1, G2, G3, G4, IgM, C3c, and C4 levels were similar in the patients with sepsis and the control group (p > 0.05). In the neonates with sepsis, serum IgG, G1, G2, IgM and C4 levels were not significantly different between the 1st and 10th days, while there were significant differences for IgG3, G4 and C3c (p < 0.05). We conclude that the serum levels of IgG, IgG1, G2, G3, G4, IgM, C3c and C4 concentrations are of no value for the early diagnosis of neonatal sepsis.

Bacteremia↗

Predictive value of a 24 hour tuberculin skin test evaluation.

The predictive value of induration 24 hours after administration of purified protein derivative (PPD) was examined. Altogether 1082 healthy schoolchildren were tested using 5 tuberculin units of PPD. Induration was measured at 24, 48, and 72 hours. At 24 hours, induration of any size had a relatively low positive predictive value (63%), although indurations > 5 mm had a higher (86%) positive predictive value.

Adolescent↗

A case of ectopic anus localized on the right gluteus.

A case of a gluteus-localized ectopic anus on the right side is described. A 5-month-old boy had a severe sacral anomaly with atrophy of the right lower extremity and a pes equinus deformity. Transcutaneous muscle stimulation showed a well-developed muscle complex, and parasagittal muscle fibers have been localized obliquely. Although he has severe sacral anomalies, the posterior sagittal anorectoplasty procedure could be performed. This unique case provides a good demonstration of not only the ectopically localized anus but also the ectopically localized muscle complex.

Abnormalities, Multiple↗

Numerical chromosomal changes in high-grade prostatic intraepithelial neoplasia (PIN) and concomitant invasive carcinoma.

Prostatic intraepithelial neoplasia (PIN) is regarded as a precursor lesion of at least some prostatic cancers. Using interphase cytogenetics, an in situ hybridization technique with chromosome specific probes, we investigated 15 prostatectomy specimens containing both invasive carcinoma and PIN for the presence of numerical changes of chromosomes 7, 8, 10, 17 and X. The results were correlated with tumor stage and Gleason grade as well as with morphological features of PIN. Of the 15 carcinomas, four were disomic, five displayed at least focal chromosomal gains and six were found to be aneusomic. A non-disomic chromosomal status correlated well with a higher tumor stage and grade. Although the majority of PIN glands showed an eusomy, focal chromosomal gains within single glands or parts of a gland could be observed in 12 of the 15 cases. All but one specimen with non-disomic carcinomas also harboured areas of PIN with numerical chromosomal aberrations, often laying directly adjacent to tumorous glands. Additionally, focal non-disomies of PIN could also be detected in two cases with eusomic cancer. With regard to numerical changes in PIN and cancer, no significant preponderance could be observed for the five chromosomes tested. We conclude that numerical chromosomal aberrations are a frequent, but mostly focal event in PIN. This karyotypic instability is further evidence for the premalignant nature of this lesion.

Adenocarcinoma↗

Failure of acyclovir sodium therapy in herpes simplex encephalitis.

Herpes simplex encephalitis is an important disease characterized by focal haemorrhagic necrosis of the temporal and frontal lobes of the brain. The mortality rate may be as high as 70% of untreated cases. Isolation of the virus from brain tissue is the most reliable means of diagnosis. Although some non-invasive diagnostic modalities have been investigated, none is as reliable as brain tissue sampling. Despite acceptance that acyclovir sodium is the most effective drug for treatment, there is not a consensus on the dosage and duration of the antiviral therapy because some patients fail to respond and sometimes there is recurrence following therapy. We report a case of encephalitis in a previously normal host who died after a 13-day course of acyclovir therapy with isolation of HSV-type 1 from the brain post mortem.

Acyclovir↗

Cefuroxime axetil in the treatment of acute sinusitis in childhood.

A study of the efficacy of cefuroxime axetil was conducted for the treatment of acute sinusitis in childhood. Thirty-nine patients aged 5-14 years were given cefuroxime axetil 20 mg/kg/day divided into two doses for seven days. The diagnosis of acute sinusitis was based on history, physical examination, and radiological findings. The results of throat cultures before treatment were 17 patients with group A beta-haemolytic streptococci, seven patients with pneumococci, and two patients with Staphylococcus aureus; in the remainder of the patients only normal throat flora were isolated. In 36 patients (92%) a satisfactory improvement was reported at the end of the treatment. It was found that cefuroxime axetil was efficaceous for the treatment of sinusitis in childhood.

Adolescent↗

The incidence and significance of increased backscatter in myocardial ultrasonography of patients on hemodialysis.

Ultrasonic backscatter is substantially modified by pathologic changes in myocardium. To define the incidence and significance of increased backscatter in myocardial ultrasonography of patients on chronic hemodialysis, 41 patients (aged 9-63 years) and 20 healthy controls were studied with conventional two-dimensional and M-mode echocardiography and with analysis of integrated backscatter. Increased histogram values were found in all patients especially in those whose two-dimensional echocardiographic examinations revealed mitral annular calcification (n = 3), aortic valve calcification (n = 2) and aortic plus mitral annular calcification (n = 1). It was concluded that ultrasonographic-integrated backscatter may be a useful method for early identification of cardiac calcification in uremic patients.

Adolescent↗

Significance of pleural fluid cholesterol and beta-2 microglobulin levels for the differentiation of pleural effusions in childhood.

We studied 60 children, ages 3-15 years, with pleural effusions to determine the usefulness of different criteria for the separation of transudates from exudates. Twenty of these effusions were classified as transudates and 40 as exudates. Pleural cholesterol (P chol), pleural/serum cholesterol ratio (P/S chol), and pleural/serum beta 2 microglobulin (P/S beta 2 m) were determined to characterize pleural effusions and were compared with Light's criteria (pleural/serum protein ratio, pleural LDH, pleural/serum LDH ratio). With a threshold of 0.3, the sensitivity and specificity of P/S chol for diagnosis of exudates were 95 and 90%, respectively. With a threshold of 1.3, the sensitivity of P/S beta 2 m was 77.5%, and its specificity was 95%. Our findings indicate that determination of P chol and P/S chol, as well as Light's criteria, is of value for characterizing pleural effusions in childhood, but the measurement of P/S beta 2 m is less sensitive in distinguishing transudates from exudates and it should not be used routinely.

Adolescent↗