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Biomedical subjects

O Oymak

Publications and source records attributed to O Oymak.

At least 19 recordsLinked to original sources
PubMed2005

Effect of cyclosporine A on total homocysteine level in a rabbit model.

BACKGROUND: Moderate hyperhomocysteinemia is an independent risk factor for cardiovascular disease. Cyclosporine (CsA) has been suggested to interfere with folate-assisted remethylation of homocysteine, thus causing hyperhomocysteinemia. But, this issue is controversial. In this experimental study, we attempted to determine the association between CsA administration and total homocysteine levels. Working with rabbits that have normal creatinine levels, we obviated the misleading effects of renal functional variations, which are the most important confounding factors affecting total homocysteine level. METHODS: Male New Zealand rabbits fed a standard quantity of diet received 10 days of subcutaneous injections of 10 mg/kg per day CsA. After these loading doses, CsA (20 mg/kg) was administered subcutaneously three times a week for 20 days. After first 30 days, the rabbits were followed for another 30 days without CsA therapy. Plasma creatinine, BUN, and total homocysteine levels were measured on days 0, 10, 30, and 60. RESULTS: There were no significant changes in BUN results on days 0, 10, 30, and 60 (P > .05). There was a slight, but significant, increase in mean creatinine levels during CsA administration (P < .01). However, the mean creatinine levels remained in the normal ranges during the 60 days of study. No significant changes were observed in total homocysteine levels (P > .05) compared to baseline, 10-, 30-, and 60-day values. CONCLUSION: Our experimental research minimized confounding factors. It showed that CsA does not increase total homocysteine levels, confirming clinical studies that reported no association between CsA and total homocysteine.

Animals↗
PubMed2005

Obstructive icterus directly related to visceral artery aneurysm in a CAPD patient.

Visceral artery aneurysms (VAA) are uncommon pathologies. We report a case of the first CAPD patient with obstructive jaundice directly related to VAA. A 25-year-old man with a four-year history of hemodialysis followed by two years of CAPD was admitted due to jaundice. He had two episodes of peritonitis. An abdominal ultrasonogram and a selective common hepatic arteriogram confirmed the presence of a 5 cm saccular aneurysm supplied from the gastroduodenal artery and a 4 cm fusiform aneurysm supplied from the proximal part of the common hepatic artery. The gastroduodenal artery was responsible for the impression of the common bile duct. In the operation, the gastroduodenal artery aneurysm was completely excised after its proximal and distal ends were ligated. The proximal and distal ends of the hepatic artery were also ligated. A prosthetic graft (PTFE), which extended from the splenic artery to the distal portion of the hepatic artery, was placed. In this way, the arterial blood flow of the liver was re-established. Patients with VAAs present with a constellation of symptoms including abdominal pain, jaundice and shock (due to rupture of aneurysm). Pancreatitis, and atherosclerosis have been reported to be the most common causes of VAAs. In conclusion, when CAPD patients present with jaundice or hemorrhagic shock with abdominal pain, VAA should be considered in differential diagnosis, especially if patients have a history of frequent pancreatitis episodes, and severe risk factors for atherosclerosis.

Adult↗
PubMed2004

Effects of azithromycin on cyclosporine-induced gingival hyperplasia in renal transplant patients.

BACKGROUND: Gingival hyperplasia is a well-known complication of cyclosporine therapy, affecting 21% to 35% of renal transplant patients. Metronidazole, clarithromycin, and azithromycin, all azalid antimicrobial agents derived from the macrolide antibiotic erythromycin, have been used for treatment. Marked improvements in gingival hyperplasia have been recorded in particular with azithromycin. The aim of the present study was to investigate histopathological features of cyclosporine-induced gingival hyperplasia and to evaluate the quantitative efficacy of short-term azithromycin therapy. METHODS: Eighteen renal transplant patients with cyclosporine-induced gingival hyperplasia were included in the study. All patients received azithromycin with a dose of 500 mg/d for 3 consecutive days. Changes in gingival hyperplasia were evaluated by measuring the gingival sulcus depth to the cementum-enamel junction of every tooth in each of the four quadrants on days 0, 7, 30, 90, 180. Gum biopsies were obtained on days 0 and 30; the degree of inflammation was classified as "mild," "intermediate," and "severe". RESULTS: Gingival hyperplasia was reduced in all treated patients throughout the study. The degree of improvement was more significant between 0 to 7 and 7 to 30 days than at other times (respectively, P < .0001 and P < .002). Histopathologically, eight patients had severe and one patient moderate chronic inflammation at the beginning of therapy. Three other biopsies were reported as papilloma, mucosal hyperplasia, and normal gingival tissue biopsy. CONCLUSIONS: Azithromycin appears to be useful to treat cyclosporine-induced gingival hyperplasia in renal transplant patients. Treatment is inexpensive and free from known adverse effects.

Adult↗
PubMed2003

Relationship between different body size indicators and hernia development in CAPD patients.

AIMS: A small body size may increase the risk for hernia development in patients on continuous ambulatory peritoneal dialysis (CAPD). The present study investigates whether there is a relationship between body size and hernia development in CAPD patients. MATERIAL AND METHODS: The records of 78 patients on CAPD were reviewed retrospectively. Body mass index (BMI), body surface area (BSA) and total body water (TBW) were calculated in all patients. Correlations between different body size indicators (BMI, BSA and TBW) and hernia development were assessed using analysis of covariance in which we adjusted for sex. RESULTS: A total of 14 patients (17.9%) with no physical evidence of hernia before catheter insertion developed hernias. Body size was significantly lower in CAPD patients with hernias than those without hernias when adjusted for sex. CONCLUSIONS: We conclude that patients with small body size tend to have an increased risk for hernia development. A simple estimation of patients' height, weight, body surface area and total body water would be helpful to predict development of hernias or other complications related to increased intraperitoneal pressure in CAPD patients.

Adult↗
PubMed2001

Improvement of thyroid hormone profile and thyrotrophin (TSH) surge alterations in hemodialysis patients on erythropoietin treatment.

BACKGROUND, MATERIAL AND METHODS: This study was performed in 20 patients with end-stage chronic renal failure (CRF) and 10 healthy volunteers. All of the patients were on regular hemodialysis treatment (RHD), 10 of whom were on recombinant human erythropoietin (rHuEPO) therapy. Hematocrit levels of the patients with CRF on rHuEPO were between 0.30 to 0.33 and not on rHuEPO were below 0.24. Baseline serum T3, T4, fT3, fT4 and TSH levels were measured and TRH stimulation test was performed in patients and control subjects. Serum TSH levels were measured hourly during the afternoon (2 to 5 p.m.) and at night (10 p.m. to 2 a.m.) to determine the nocturnal rhythm of TSH. RESULTS: The mean T3 in rHuEPO, not rHuEPO and control groups were 98.01 +/- 5.54, 70.55 +/- 7.09, 98.29 +/- 4.2 ng/dl; T4 6.47 +/- 0.68, 6.39 +/- 0.59, 8.35 +/- 0.46 ng/dl; fT3 2.24 +/- 0.19, 1.52 +/- 0.24, 2.29 +/- 0.17 pg/ml and fT4 0.88 +/- 0. 14, 0.75 +/- 0.14, 0.97 +/- 0.10 ng/dl, respectively. These values were significantly lower in patients not on rHuEPO compared to controls (p < 0.05). In patients on rHuEPO only T4 values were lower than in the controls (p < 0.05). In patients not on rHuEPO the T3, and fT3 were significantly lower than the values of patients on rHuEPO treatment (p < 0.05). Normal in 8 (80%), blunted in 1 (10%), no TSH response in 1 (10%) to TRH stimulation were obtained in rHuEPO group. TSH response was normal in 1 (10%), and delayed in 9 (90%) patients not on rHuEPO. The circadian nocturnal rhythm of TSH was abnormal in 8 (80%) patients not on rHuEPO, in 2 (20%) patients on rHuEPO. As a result, CRF and RHD distorts the circadian TSH rhythm and substantially change the thyroid hormone profile probably by affecting hypothalamic-pituitary-thyroid axis. Distortion of the circadian rhythm of TSH and TSH response to TRH points to a defect at the level of hypothalamus and pituitary gland. CONCLUSION: rHuEPO treatment has some beneficial effects on hypothalamo-pituitary-thyroid axis in the patients on RHD.

Adult↗
PubMed2001

Patient to patient transmission of hepatitis C virus in hemodialysis units.

AIMS: In dialysis patients, blood transfusions and long-term dialysis are well known risk factors for transmission of hepatitis C virus. In this study the impact of use of dedicated hemodialysis (HD) units on the anti-HCV conversion rates was studied in patients of two different hemodialysis units in a city, Kayseri, between October 1995, and March 1999. MATERIALS AND METHODS: In the HD Unit of Erciyes University (HUEU), anti-HCV-positive and -negative patients were dialyzed on the dedicated machines in the same big room and seropositive patients for HBsAg in isolated rooms. In the HD Unit of Kayseri State Government Hospital (HUSH) only seronegative for anti-HCV and hepatitis B patients were treated. If a patient became positive, the patient was transferred to HUEU. Seventy-five patients have been receiving hemodialysis therapy in HUEU. Thirteen HBsAg-positive and 62 HBsAg-negative patients were dialyzed in separate rooms. Of 62 HBsAg-negative patients, 22 (35.5%) were already positive for HCV antibody when they started dialysis or before the study period. Forty seronegative patients (64.5%) for anti-HCV (23 males, 17 females) were treated with 22 anti-HCV-positive patients in the same room in HUEU. The mean duration of dialysis treatment was 24.7 +/- 21.0 months (range 4 to 96 months). Of the 40 patients, 28 (70%) became positive during the study period. Of 28 patients who became seropositive, 10 (35.7%) had a history of blood transfusion. Fifty-four patients (21 males, 33 females) were treated in HUSH during the study period. The mean duration of dialysis treatment was 19.3 +/- 9.6 months (range 5 41). Eight patients (14.8%) became anti-HCV-positive. Of these, 7 had received blood transfusion (88%). RESULTS: The seroconversion rate of patients in HUEU was higher than that of HUSH (odds ratio 3) (p < 0.05). Data derived from our patients showed that contamination appeared to be both transfusional and nosocomial and that there is a possibility of transmitting HCV infection in hemodialyzed patients never submitted to blood or blood products transfusion. Nosocomial spread of HCV in HD units which both seropositive and seronegative patients treated together was higher than that of dedicated unit. This is true even though we separated anti-HCV-positive dialysis machine.

Adult↗
PubMed2001

Horner's syndrome secondary to internal jugular catheterization.

We present three cases of people who developed Horner's syndrome following repeated attempts for catheterization of the internal jugular vein for hemodialysis. Any other neurologic finding or evidence of mass lesions in the neck or pulmonary apex could not be determined. Horner's syndrome should be considered a possible complication of percutaneous internal jugular vein catheterization for hemodialysis.

Adult↗
PubMed2001

Case report. Successfully treated subcutaneous infection with Sporothrix schenckii in Turkey.

Sporotrichosis is rare in Turkey. We report a 48-year-old man who had subcutaneous sporotrichosis caused by Sporothrix schenckii that was successfully treated with short-term itraconazole and potassium iodide. The isolate was susceptible to itraconazole also in vitro. Short-term itraconazole and potassium iodide should be agents of choice for treatment of subcutaneous sporotrichosis. However, treatment is controversial both in choice of agent used and in duration of therapy.

Antifungal Agents↗
PubMed2000

Acute renal failure in Central Anatolia.

BACKGROUND: The aetiological spectrum of acute renal failure (ARF) has changed in developed countries. It was the purpose of the study to evaluate whether similar changes have occurred in this part of the world as well. METHODS: In a prospective study a total of 439 patients with ARF were evaluated. They had been admitted to one hospital during two successive periods, i.e. 1983-1990 and 1991-1997. RESULTS: Of 439 patients with ARF, 116 were admitted in 1983-1990 (first period) and 323 in 1991-1997 (second period). The age of presentation increased from 49.8+/-6.2 years in the first period to 58.8+/-16.4 years in the second. Medical causes were present in 259 cases (59%), surgical causes in 110 cases (25%), and obstetric causes in 70 cases (16%). The frequency of surgical cases decreased from 28.4% in the first period to 23.8% in the second period. The respective figures for obstetric cases were 18.9% and 14.8%. Mortality did not change with time (33.6% in the first and 31.0% in the second period); the overall mortality was 31.7%. The mortality was higher for surgical (45.5%) than for obstetric (27.8%) and medical ARF (24.3%). CONCLUSION: In the mid-1970s, the most common causes of ARF in Turkey were obstetric complications and septic abortion. The aetiological spectrum of ARF has changed and today medical causes predominate. ARF resulting from septic abortion has become rare, possibly because of liberalization of abortion in 1983 in Turkey.

Abortion, Septic↗
PubMed2000

Transformation of hepatitis B virus-related membranous glomerulonephritis to crescentic form.

We report a case of hepatitis B virus-(HBV) related membranous glomerulonephritis which progressed to crescentic transformation after withdrawal of immunosuppressive treatment. Immunosuppressive therapy probably enhanced HBV replication, and its withdrawal led to a return of immune competence resulting in progression of the glomerulonephritis. Prior screening of all patients for hepatitis B surface antigen, before using immunosuppressive therapy may prevent this complication. The usage of immunosuppressive therapy as a first-line choice in HBV-related glomerulonephritis may result in harmful complications.

Adult↗
PubMed1999

Granulomatous interstitial nephritis in extrapulmonary sarcoidosis.

Sarcoidosis is a multisystem disorder in which the lungs or intrathoracic lymph nodes are involved in more than 90% of patients with the disease. It occasionally involves kidneys most commonly due to disordered calcium metabolism. Granulomatous interstitial nephritis is a distinct renal pathology in sarcoidosis. Renal dysfunction due to granulomatous interstitial nephritis is rare. We recently encountered a sarcoidosis patient without hypercalcemia and any evidence of pulmonary involvement which is distinctly unusual.

Biopsy↗
PubMed1996

Effect of extracorporeal shock wave lithotripsy on glomerular and tubular functions.

To evaluate the early and late effects of extracorporeal shock wave lithotripsy on renal function, we prospectively designed a controlled study using a Direx lithotriptor. Twenty-five patients with renal stones and 16 healthy volunteers as the control group were included in the study. Blood and urine samples were collected before and after 24 hours, seven days and 8 months in the patient group. White blood cell count, serum levels of haemoglobin, urea, creatinine, SGOT, SGPT, AP, and LDH were determined. 24-hour urine specimens were collected to be tested for volume, excretion of creatinine, albumin, N-acetyl-beta-glucosaminidase, gamma-glutamyltransferase and beta-2-microglobulin. There were statistically significant increments in the secretion of urinary enzymes and albumin in the early period after ESWL, no longer lasting 8 months after the procedure. At 8 months one patient was hypertensive as judged by the diastolic pressure above 95 mm Hg. The results of this study showed that, although there was a transient glomerular and tubular damage after extracorporeal shock wave lithotripsy, the procedure seems safe and causes no permanent deterioration in renal function.

Adult↗
PubMed1996

The effect of desmopressin on platelet aggregation defect in systemic amyloidosis: a preliminary report.

Systemic amyloidosis may often be complicated with haemorrhagic tendency. The causes of this manifestation are factor deficiencies, hyperfibrinolysis and vasculopathy. In order to investigate the role of platelets, if any, we performed platelet aggregation tests with different aggregants in 10 patients with systemic amyloidosis due to familial Mediterranean fever and 10 healthy controls. Platelet aggregation was defective with different aggregants (ADP, epinephrine, collagen) in patients compared with controls. Platelet aggregation tests repeated after desmopressin (DDAVP) administration were normalized. These findings may suggest a role of a platelet aggregation defect in haemorrhagic diathesis complicating systemic amyloidosis. DDAVP may benefit patients with this disease in case of bleeding and before surgical interventions.

Adenosine Diphosphate↗