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Biomedical subjects

N Yildirim

Publications and source records attributed to N Yildirim.

At least 19 recordsLinked to original sources

sICAM-1 as a serum marker in the diagnosis and follow-up of treatment of pulmonary tuberculosis.

OBJECTIVE: To detect the value of sICAM-1 in the diagnosis and follow-up of treatment of tuberculosis. DESIGN: sICAM-1 levels were evaluated before and after treatment in 30 patients with pulmonary tuberculosis, only before treatment in five patients with pneumonia, five with lung cancer, and five with bronchiectasis, and in 10 healthy volunteers. RESULTS: sICAM-1 levels were as follows: 436.2 +/- 194.4 ng/ml in patients with pulmonary tuberculosis, 274 +/- 32.1 ng/ml in lung cancer patients, 268 +/- 41.9 ng/ml in bronchiectasis patients, 199.6 +/- 43.1 ng/ml in pneumonia patients, and 146.5 +/- 20.2 ng/ml in healthy individuals. sICAM-1 levels of tuberculosis cases before treatment were higher than in both the healthy group and in all the other groups. The levels in the healthy group were lower than in all other groups. CONCLUSION: The cut-off point (298 ng/ml) obtained by adding the standard deviation to the mean sICAM-1 value of patients without tuberculosis had 83.3% sensitivity, 86.6% specificity and 84.4% accuracy in differentiating pulmonary tuberculosis from other pulmonary diseases. sICAM-1 can be used as an auxiliary marker in the diagnosis of pulmonary tuberculosis.

Adult↗

Histopathologic features of the temporal bone in patients with cystic fibrosis.

OBJECTIVES: To investigate the lower than expected incidence of otitis media in patients with cystic fibrosis (CF) through histopathologic evaluation of temporal bones and to document pathologic findings in the inner ears of patients with CF who received long-term administration of antibacterial and diuretic agents. DESIGN: Clinical records of patients who died of CF were reviewed. Their temporal bones were sectioned, stained with hematoxylin-eosin, and examined histologically. Additional sections were stained with Alcian blue and periodic acid-Schiff for comparison of goblet cell densities from middle ears and auditory tubes of patients with CF with those of control temporal bones. Results were analyzed using the t test. SUBJECTS: Twenty-one temporal bones from 11 patients with CF and 13 bones from 8 age-matched patients without CF were selected. RESULTS: All temporal bones with CF had well-pneumatized mastoids. Temporal bones from 2 patients (3 ears) revealed histological findings of chronic otitis media with effusion. There was a statistically significant reduction in the density of goblet cells in the medial (P = .002) and lateral (P = .05) walls in patients with CF who had no otitis media histologically compared with control temporal bones. Two patients with CF who had otitis media had increased densities of goblet cells. Inner ear damage, due to ototoxic drugs, was seen in most of the temporal bones from patients with CF. CONCLUSION: Low densities of goblet cells in temporal bones with CF may contribute reduced amounts of viscous mucus, which can lead to a low incidence of otitis media.

Adolescent↗

Role of increased arterial inflow in arm edema after modified radical mastectomy.

Chronic arm edema is a common finding after modified radical mastectomy and its pathophysiology is unclear. In a prospective study the value of increased arterial inflow and venous abnormalities after mastectomy was evaluated. Arterial and venous blood flow in axillary vessels of 39 patients with arm swelling and 16 patients without swelling were investigated by Doppler ultrasound. In patients with arm edema the arterial flow on the surgical treated side was 689.73+/-44.6 (mean+/-sem) ml/min and 427.73+/-30.8 ml/min on the contralateral side (p<0.05). In those without swelling the flow was 447.75+/-37.8 ml/min on the treated side and 354.95+/-28.7 ml/min on the contralateral side (p>0.05). The difference between arterial flow measurements on the treated sides of the patients with and without arm swelling was statistically significant. There was no significant difference between the measurements on the contralateral sides of both groups. Venous abnormalities were not detected in both groups of patients. We, therefore, conclude that modified radical mastectomy causes increased inflow in ipsilateral arm and it may play an important role in the etiology of arm swelling in breast cancer patients.

Adult↗

[Effect of levodopa therapy on visual evoked potentials and visual acuity in amblyopia].

Amblyopia represents the most common form of visual impairment in children, affecting approximately 2% of the population. To determine the efficacy of the dopamine agonist levodopa for childhood amblyopia, a double-masked, placebo-controlled randomised study was performed on 32 amblyopic children with central fixation between 4 and 17 years. Subjects received 2 mg/kg levodopa benzeraside or placebo 3 times per day over a 1 week period. Estimates of visual acuity for each eye (Snellen visual acuity) were obtained, and pattern-shift visually evoked potentials (VEP) were examined by an opthalmologist and a neurologist. At the end of dosing regimens, the levodopa group was significantly improved in visual acuity by 1.4 lines and pattern VEP amplitudes. No changes could be detected after placebo administration. One week after the termination of the treatment, Snellen line acuity and pattern VEP amplitude were decreased to pretreatment levels. The transient effect of levodopa points to a long-term treatment with the substance. Our results should therefore encourage further long-term clinical trials investigating the therapeutic potential of levodopa in amblyopia.

Adolescent↗

Determination of the etiological organism during acute exacerbations of COPD and efficacy of azithromycin, ampicillin-sulbactam, ciprofloxacin and cefaclor. Turkish Thoracic Society COPD Working Group.

Acute exacerbations, most of which are due to lower respiratory tract infections, cause great morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD) and most of these are due to lower respiratory tract infections. The aim of this study was to determine the causative organism and the effects of azithromycin, ampicillin sulbactam (sultamicillin), ciprofloxacin and cefaclor monohydrate therapy in COPD. One hundred and six patients with COPD in acute exacerbation were randomized into four groups for empiric antibiotic treatment following lung function tests and sputum examination. The most common strains isolated from sputum were Haemophilus influenzae (30.8%), Streptoccocus pneumoniae (12%) and Moraxella catarrhalis (7.7%). Azithromycin, sultamicillin, ciprofloxacin and cefaclor monohydrate were found to be effective in treating COPD exacerbations.

Ampicillin↗

CT findings of hydatid cyst with unusual location: infratemporal fossa.

Hydatid disease has a high incidence in the countries of the temperate zones such as Turkey. Only few cases in the head and neck region have been reported in the literature. Our case, an unusual localization of hydatidosis, i.e. hydatid disease of the infratemporal fossa of a 9-year-old male patient suffering from a swelling of the left maxillary region which was diagnosed by CT, is presented. The lesion visualized on CT images was compressing the neighbouring structures. The possible diagnosis was made based on the images obtained from CT examination.

Child↗

[Military pharmacology education outside the imperial school of medicine].

In 1870, just after starting medical education in Turkish at the Imperial School of Medicine (Mekeb-i Tibbiye-i Sahani) favor in the pharmacology and surgery courses decreased; and even pharmacology graduates continued their education to be physicians. This change gave rise to the shortage of pharmacists and surgeons in the army, and consquently in 1873 the branch of surgery and in 1876 pharmacology were inaugurated at the Haydarpasa Military Hospital. Those who had studied at this Hospital for three years were given a diploma for pharmacy practice (ameliyat eczaciligi sehadetnamesi) and were appointed to the army and to military hospitals. The years of education was raised to four years in 1888, and it was reduced to three years again in 1891. According to Charles Bonkowski, the chemist of Sultan Abdulhamid II, the instruction of military pharmacology was independent from the School of Medicine; he suggested the foundation of a higher school of pharmacy in Istanbul on the standards of the Paris Higher School of Pharmacology (Ecole Superieur de Pharmacie de Paris) where he had studied and graduated in 1865. Unfortunately this advice was not realised; but a department of pharmacology was opened within the Military High School for Veterinarians (Baytar Rustiye-i Askeriyesi) in Eyup in order to educate the students properly. This institution, renamed as the Military High School for Veterinarians and Pharmacists (Baytar ve Eczact Mekteb-i Rustiye-i Askeriyesi), had sent its graduates to the Imperial School of Medicine for many years. Since this process had proved to be useful, the Pharmacology Branch at the Haydarpasa Military Hospital was closed in 1892. In 1895, another military school which was called Eczaci ve Timarci Sibyan Mektebi started instruction on the Naval Hospital. Graduates of this school were appointed to the naval offices for minor operations.

Education, Pharmacy↗

[Nahabed Roussignan, the first professor of deontology at the Royal School of Medicine].

This study based on researches utilizing the American and Ottoman sources, deals with the claim upon the lectures given by Roussignan (Rusinyan Efendi), especially at the Royal School of Medicine and describes his medical career as follows. Nahabed Roussignan who graduated from Paris School of Medicine in 1849, returned to Istanbul in 1851 and was appointed as the private physician to Fuad Pasha, upon the request of Dr. Serviçen. In the meantime he worked at the Bab-i Seraskeri Hastanesi (the Hospital of the Military Ministry) until 1860 and also started to work at the Military High School as a doctor of medicine. As to the Royal School of Medicine, he taught pathological anatomy between 1864-1872. There are not any records to prove his being a faculty member during this year. He was probably in financial shortage because of unemployment during that year, as stated by Artin Mezbour. The following year he was employed at in the School of Medicine again, through his friends' support. this time he taught logic and French composition between 1874-1876 and instructed deontology for a little while in 1876. He collected his lectures on logic as a Textbook of Philosophy. He passed away in the same week, so this book was published posthumously (Istanbul 1879). Since he died on November 29th 1876, at the end of the year, his name was included in the State Yearbook of 1877, but was misspelled as "Rüsteban". To sum up, deontology as an independant discipline at the Royal School of Medicine began to be lectured for the first time by N. Roussignan in 1876, and succeeding his death these lectures were taken over by Dr. Hovsep Nouridjan (Nurican Efendi). Istepan Arslanian, who was claimed to be the lecturer of these courses after Roussignan, was in Rumelie during 1875-1876 and employed in Austria in 1877; therefore he could never have taught deontology during this period.

Ethics, Professional↗

[Zoeros Pasha's report presented to the Sultinate on his return from Paris].

The Ottoman Empire dispatched a committee consisting of Zoeros Pasha, the president, Dr. Hüseyin remzi and veterinarian Hüseyin Hüsnü, who were members sent to learn how the method of the vaccination of rabies was practiced in Paris in 1886. Zoeros Pasha relates their studies in Paris, as well as his idea on the novelties he observed there and comments on the advantages of them in case of application in the Empire, in his report dated December 29th of 1886, prepared on his return from Paris. Zoeros Pasha and Hüseyin Hsnü Bey learned the vaccination practice, attending Pasteur's laboratory. Zoeros Pasha studied bacteriology for three months and Hüseyin Remzi attended the laboratory of "Jardin des Plantes" in order to do some zoological researches. When Pasteur went on vacation, Zoeros Pasha provided for Hüsnü Bey to attend the Veterinary School of Paris and directed his attention to the anthrax vaccination found by Pasteur. Hüseyin Hsnü Bey and Dr. Hüseyin Remzi Bey composed a book based on their translations on the subject Zoeros Pasha also mentions in his report the following topics on which he says he could report, if desired: 1. New methods of treatment applied for heart and lung diseases. 2. The most effective prophylactic methods and sanitary precautions on the epidemic and infectious diseases. 3. Improvement planned for the Imperial School of Medicine. 4. Use of anatomy in finding out criminals, in order to help the police forces.

Bacteriology↗

Penetration of ciprofloxacin into pleural fluid.

The penetration of oral 1000 mg/day ciprofloxacin into pleural fluid is investigated in 15 patients with exudative pleural effusion. After 4 days of ciprofloxacin therapy ciprofloxacin concentrations were measured in plasma and pleural exudate simultaneously by high-performance liquid chromatography (HPLC). Mean serum ciprofloxacin level was 1.58 +/- 0.91 mg/L and mean pleural exudate concentration was 1.00 +/- 0.59 mg/L. The concentrations achieved were all above the MIC90 of the majority of Gram-positive and Gram-negative pathogens. It is concluded that ciprofloxacin penetrates well into the pleural fluid.

Adolescent↗

Effect of posture and breathing route on genioglossal electromyogram activity in normal subjects and in patients with the sleep apnea/hypopnea syndrome.

Patients with the sleep apnea/hypopnea syndrome (SAHS) often have more apneas supine that sitting. We have shown radiologically that although the retropalatal airway narrows on lying down, the retroglossal airway widens. We have thus investigated the effect of posture on genioglossal EMG activity in 10 normal subjects and 10 patients with SAHS (58 +/- 29 SD apneas + hypopneas/h) using peroral intramuscular EMG electrodes. Data were analyzed by three-way analysis of variance, with diagnosis, posture, and route as factors. Peak inspiratory and tonic expiratory genioglossal EMG were both than sitting, with no significant difference between normal subjects and SAHS higher (p < 0.001) supine patients, although there was a trend (p < 0.09) toward the supine posture having a greater effect on peak inspiratory EMG in the SAHS patients. There was no significant effect of breathing route on either peak inspiratory (p > 0.9) or tonic expiratory (p > 0.8) genioglossal EMG, but there were significant differences between the groups (p < 0.01), the SAHS patients having higher and the normal subjects lower EMG tone with nasal in comparison with oral breathing on both inspiration and expiration. This study therefore shows that both body posture and breathing route are important determinants of genioglossal EMG tone.

Adult↗

[The demographic structure and fertility levels of the population in the new and old slum areas of a "gecekondu" settlement in Antalya Province center].

"The demographic structure and fertility level of the population in two slum areas [in Turkey's Antalya Province]...were investigated with a cross-sectional study in 1989. It was found that the distribution of population by age groups differed and especially the fertility measurements were high in the new area in relation to various social and demographic characteristics. In order to facilitate and accelerate the transition period of slum communities, it is necessary to provide health education, mother and child health and family planning services." (SUMMARY IN ENG)

Age Distribution↗

Effect of theophylline in chronic obstructive lung disease.

The bronchodilator, respiratory center and respiratory muscle effects of oral sustained release theophylline are investigated with a placebo controlled double-blind study in 34 patients with chronic obstructive lung disease (COLD). The first 3 days were a theophylline washout period and the patients did not receive theophylline and on the 4th day, serum theophylline concentration was negligible. Initial pulmonary function tests were performed. Twenty-four of the patients took 350 mg oral sustained release theophylline twice a day. Ten of the patients were given placebo. On day 7, serum theophylline concentrations of the study group were in therapeutic doses and the tests were repeated. Bronchodilator effect was assessed by spirometry, flow-volume loops and measuring airway resistance (Raw). Respiratory muscle function was assessed by measuring maximal inspiratory (PImax) and expiratory pressures (PEmax) and the effect on respiratory center was evaluated by minute ventilation, mouth occlusion pressure index and inspiratory duty ratio. Forced vital capacity in one second (p less than 0.001), maximal mid expiratory flow rate (p less than 0.05), maximal expiratory flow at 50 percent of vital capacity (p less than 0.001), maximal inspiratory pressure (p less than 0.01) increased, while airway resistance (p less than 0.05) decreased significantly. Mouth occlusion pressure and minute ventilation mouth occlusion pressure index did not change after theophylline therapy. In placebo group, there was no significant change in airway obstruction assessed by spirometry and flow volume loops or in respiratory muscle function assessed by maximal respiratory pressures. It is therefore, concluded that oral sustained release theophylline has a bronchodilator effect in irreversible chronic obstructive lung disease, increases respiratory muscle function, but in therapeutic doses has no effect on respiratory center.

Administration, Oral↗

Venous blood histamine levels and effect of terfenadine in patients with bronchial hyperreactivity.

Twenty-two subjects complaining of cough, chest tightness and/or shortness of breath with normal chest radiograph and normal pulmonary function test results were challenged with methacoline. Venous histamine levels were measured before and just after methacoline challenge. For comparison, a single blood sample was obtained from 10 normal subjects. Blood histamine levels were significantly higher in subjects with respiratory symptoms regardless of methacoline challenge being positive or negative (p less than 0.001). After methacoline challenge, blood histamine increased significantly in methacoline challenge positive group (p less than 0.05). Thereafter, terfenadine, a H1 antagonist, 120 mg/day were given to patients for one month. After terfenadine therapy, there was a subjective improvement of symptoms, methacoline provocation dose (PD20) increased and there was no significant change in blood histamine level. It is concluded that nonspecific challenge increases blood histamine levels and blood histamine levels seems to be a sensitive index of bronchial hyperreactivity in subjects with respiratory symptoms of unknown origin and that terfenadine is effective in the treatment of bronchial hyperreactivity.

Adult↗

The effect of posture on upper airway dimensions in normal subjects and in patients with the sleep apnea/hypopnea syndrome.

The effect of posture on upper airway dimensions was assessed for two reasons. First, some patients with untreated sleep apnea/hypopnea syndrome (SAHS) report they sleep better sitting upright. Second, to allow comparison of the differing techniques used to determine the site of maximal airway narrowing in awake patients with SAHS, as some are carried out in the erect and others in the supine posture. Lateral cephalometry was therefore carried out in 33 nonsnoring normal subjects and in 29 patients with obstructive SAHS (mean apneas plus hypopneas, 46 per hour; range, 17 to 103). In both normal subjects and patients, uvular width was increased (p less than 0.05) in the supine posture, and this was associated with significant narrowing of the retropalatal airway in the patients with SAHS (erect, 5.0 +/- SD 2.6 mm; supine, 3.6 +/- 2.8 mm; p less than 0.01). In both normal subjects and patients, the retroglossal hypopharynx widened (p less than 0.05) in the supine posture (e.g., in patients with SAHS, posterior airway space was: erect, 11.5 +/- 4.5 mm; supine, 13.4 +/- 4.8 mm; p = 0.003). In the supine posture there was anterior movement of the hyoid and neck flexion in both groups. However, a study of the effect of neck flexion in the erect posture showed that neck flexion produced no changes in airway caliber. Thus, posture is an important determinant of upper airway dimensions.

Adult↗