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Biomedical subjects

S Akalin

Publications and source records attributed to S Akalin.

34 records · Page 2Linked to original sources
PubMed1994

Cotrel-Dubousset instrumentation in the treatment of unstable thoracic and lumbar spine fractures.

The use of computed tomography and developments in spinal biomechanics have led to a better understanding of vertebral fractures. The disappointing results achieved with conservative treatment have led to an increasing popularity of surgical treatment in the last 15 years. The results of 20 unstable thoracic or lumbar spine fractures treated surgically with Cotrel-Dubousset instrumentation at the First Clinic of Orthopaedics and Traumatology of the Ankara Social Security Hospital between December 1988 and June 1991 were evaluated in this study. The mean follow-up was 31.9 months. The mean sagittal index angle was 23.7 degrees +/- 6.8 degrees preoperatively and was corrected by 67.1 +/- 29.9%, and the thoracolumbar junction angle was brought within physiological limits in 65% of the cases. Postoperatively, the neurological status improved in 15% of the patients and remained unchanged in the rest. It was concluded that the Cotrel-Dubousset instrumentation established vertebral stability in unstable vertebral fractures by forming a rigid frame and restored physiological thoracic and lumbar postural contours due to its highly corrective effect in the sagittal plane.

Adolescent↗
PubMed1994

Morphological assessment in pinealectomy and foetal pineal gland transplantation in rats: Part I.

The effects of pineal gland, an endocrine organ known to affect the physiology of various organs and systems including the hypothalamo-hypophyseal axis, on the morphological characteristics of target organs were investigated in rats after pinealectomy and foetal pineal gland transplantation to a subpial cortical area close to the pinealectomized region. It was demonstrated that weight gain was significantly slower in pinealectomized male rats (p < 0.01); pituitary gland weight was lower in the pinealectomized group (p < 0.01) and transplantation had no effect on the weight of this organ; weight of adrenal gland and testis were lower after pinealectomy (p < 0.01) but restored back to control levels after transplantation; the mitotic activity in seminiferous tubules increased with pinealectomy and returned back to control indexes after transplantation. Research on hypothalamic catecholaminergic content revealed a diminished histofluorescence in pinealectomized rats which showed a potentiated restoration after transplantation. The innervation of the pineal gland was studied by anterograde and retrograde injections of Wheat Germ Agglutinin Horse Radish Peroxidase from superior cervical ganglion and pineal gland, respectively. It was demonstrated that cell bodies were traced both at the transplanted tissue and hypothalamus. In view of these data, the multifunctional and a probable high level homeostatic harmony regulator essence of pineal gland is discussed.

Adrenal Glands↗
PubMed1994

Cerebellar ataxia associated with hypogonadotropic hypogonadism and chorioretinopathy: a poorly recognized association.

We report a male with cerebellar ataxia, hypogonadism and chorioretinopathy. The age of onset was 12. The parents were first cousins. Endocrinologic studies demonstrated hypogonadotropic hypogonadism due to pituitary dysfunction. The ocular disorder involved the choriocapillaris and the retina. The association may represent a separate syndrome, seldom recognized in the past.

Adult↗
PubMed1993

Scintigraphic evaluation of functional renal reserve using angiotensin-converting enzyme inhibition in patients with type II diabetes mellitus.

Acute effects of 20 mg oral enalapril (E), and angiotensin-converting enzyme inhibitor, on renal function and the renin-angiotensin-aldosterone system were investigated in 13 patients with type II diabetes mellitus (8 female, 5 male) and 10 hypertensive controls using a radionuclide method. Plasma glucose control was evaluated with fructosamine (F) determinations. After intravenous administration of 370 MBq 99mTc-DTPA, sequential images were recorded. Glomerular filtration rate (GFR), perfusion index (PI), time to maximum activity and reno index values of the kidneys were calculated. Two days later, renal scintigraphy was repeated after oral administration of E. Plasma levels of renin, angiotensin II and aldosterone were analyzed using RIA. Basal GFR values (mean: 92.6 ml/min) correlated with F (r = 0.364; p < 0.05). In the diabetic group, 5 patients had a decrease in GFR and an increase in PI after oral E. The mean percent change of GFR was 12 +/- 32 for patients and 20 +/- 12 for controls, respectively. Percent change of GFR had a slightly negative correlation with F values (r = -0.51; p < 0.05) and with PI (r = -0.65; p < 0.001). The patients with good metabolic control had an increase in GFR and a decrease in PI indicating an increase in renal blood flow and glomerular filtration. In patients with proteinuria and poorly controlled diabetes, in response to E-induced efferent arteriolar dilation, there is a decrease in GFR and an increase in PI which indicates a fall in filtration and renal blood flow. This glomerular hemodynamic pathology precedes morphological changes due to diabetes.

Adult↗
PubMed1993

Comparison of metoclopramide and erythromycin in the treatment of diabetic gastroparesis.

OBJECTIVE: To compare the effects of erythromycin and metoclopramide on gastric emptying and symptoms of gastroparesis in diabetic patients with delayed gastric emptying. RESEARCH DESIGN AND METHODS: The study group consisted of 13 patients with symptoms of severe gastroparesis and delayed gastric emptying. Gastric emptying was evaluated using a radionuclide method, and gastrointestinal symptoms were scored. The patients were given either erythromycin (250 mg 3 times/day) or metoclopramide (10 mg 3 times/day) in random order for 3 wk, and after a washout period of 3 wk they were crossed-over to the other medication for another 3 wk. Parameters of gastric emptying were assessed before treatment and after both erythromycin and metoclopramide administration. RESULTS: The half-time of gastric emptying in diabetic subjects was 110 (77-120) min before treatment. At 60 and 90 min, the median value of residual isotope activity was 66.5 (55-83.5) and 55% (43-74.3), respectively. The half-time decreased to 55 min (28.6-115) after 3 wk of treatment with erythromycin and percentages of meal retention in the stomach at 60 and 90 min were 49.9 (38.4-70) and 40.5% (29.7-60), respectively. After taking metoclopramide, the median value of half-time was 67 min (15-115) and percentages of meal retention at 60 and 90 min were 51 (34.5-93.9) and 42% (24-71.2), respectively. When compared with baseline values a significant difference in gastric emptying parameters was found after both erythromycin and metoclopramide. A significant improvement of the total score for gastrointestinal symptoms was observed with both drugs, but this improvement was more pronounced with erythromycin. CONCLUSIONS: Erythromycin, a macrolide antibiotic and a motilin receptor agonist, appears to stimulate intestinal motility and seems to be an alternative agent for the treatment of gastroparesis caused by diabetic autonomic neuropathy.

Administration, Oral↗
PubMed1992

Epidemiological, clinical and radiological aspects of osteopoikilosis.

Osteopoikilosis is a rare condition showing characteristic sclerotic lesions on radiographic examination, which are diagnostic for the trait. We report four patients presenting with various complaints and 49 members of their families who later were found to have osteopoikilosis. The mean age of all 53 was 27.5 years and the male:female ratio was 33:20. Most had lesions in the small tubular bones. We studied the epidemiological, clinical and radiological features of these patients and from the pedigrees conclude that the disease is inherited as an autosomal dominant.

Adolescent↗
PubMed1992

The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation.

In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty-three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation.

Adult↗
PubMed1991

Effects of ketoconazole in hirsute women.

To determine the efficacy of ketoconazole in the treatment of hirsutism, clinical and hormonal effects of this agent were evaluated with a randomized, placebo-controlled, double-blind cross-over study design. Nine hirsute women were given ketoconazole (600 mg/day) or placebo for 6 months and then crossed over. The severity of hirsutism was assessed according to the scale of Ferriman & Gallwey. Baseline serum testosterone, dehydroepiandrosterone sulphate, progesterone, estradiol, basal and stimulated cortisol and 17-alpha hydroxyprogesterone were measured. Blood was also drawn for FSH and LH levels at 0, 30, 60, and 90 min of a GnRH stimulation test. The same parameters were determined following administration of placebo or ketoconazole for 6 months. The pretreatment (28.3 +/- 0.9) and post-placebo (27.7 +/- 1.4) Ferriman-Gallwey scores were significantly higher than the post-ketoconazole score (16.6 +/- 1.3, p less than or equal to 0.01). Basal and stimulated cortisol levels were not blunted after ketoconazole, but basal and stimulated 17-hydroxyprogesterone levels were significantly higher, indicating sufficient enzymatic inhibition. Serum dehydroepiandrosterone sulphate and testosterone levels were significantly lowered following ketoconazole (p less than or equal to 0.05). Although E2 levels did not change significantly at any time, E2:testosterone ratios were significantly higher after ketoconazole (p less than or equal to 0.01), and the LH:FSH area ratio was also significantly greater than 3 after ketoconazole. It is concluded that ketoconazole significantly alleviates hirsutism by inhibiting steroid synthesis.

Adult↗
PubMed1991

Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease and toxic multinodular goiter.

Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or 131I treatment for hyperthyroid Graves' disease and toxic multinodular goiter. To determine the frequency of this discordance, we reviewed 62 patients with hyperthyroidism. Among 41 Graves' disease patients treated with antithyroid drugs and/or 131I, discordant serum triiodothyronine (T3) and thyroxine (T4) levels occurred in 26.8%. Of these patients 72.8% had a high serum T3 level associated with a normal serum T4 level, whereas in 27.2% a high serum T3 level was associated with a low serum T4 level. Among 21 toxic multinodular goiter patients, 14.3% had discordant T3 and T4 levels. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease and less frequently in toxic multinodular goiter during or after therapy.

Adult↗
PubMed1990

The effect of radioactive iodine treatment on thyroid C cells.

To determine the effect of radioiodine treatment on thyroid C cells, calcitonin (CT) levels were measured by RIA before and after intravenous calcium stimulation (2 mg/kg body-weight elemental calcium) in 22 women treated with 131I for hyperthyroidism. The results were compared with sex, age and weight-matched normal controls. There was a slight but statistically significant decrease in basal CT levels of the patients compared to the control group (mean +/- SE; 0.009 +/- 0.001 vs 0.011 +/- 0.001 pmol/l, P less than 0.05). The mean stimulated CT level of the patient group was significantly lower than that of the controls (0.010 +/- 0.001 vs. 0.018 +/- 0.003 pmol/l, P less than 0.001). The absence or presence of 131I-induced hypothyroidism at the time of the study did not influence basal or stimulated CT levels. Basal and stimulated CT levels were significantly lower in the patients with Graves' disease than in the patients with toxic nodular goitre. We conclude that 131I used to correct hyperthyroidism may cause marked CT deficiency.

Adult↗
PubMed1986

Effects of vitamin D deficiency and repletion on insulin and glucagon secretion in man.

We have studied the effects of vitamin D deficiency on pancreatic A- and B-cell function. Four subjects with vitamin D deficiency and 10 healthy subjects were studied. Pancreatic B-cell function was assessed by the insulin response to an oral glucose tolerance test. An insulin tolerance test was used to evaluate pancreatic A-cell function. The patients were then treated with 2000 U/day of vitamin D3 for 6 months, after which the clinical, metabolic, biochemical and radiological features of vitamin D deficiency resolved, and pancreatic A-and B-cell function was repeated. In the vitamin D-deficient subjects pre-treatment and post-treatment serum calcium levels (mean +/- SEM) were 2.22 +/- 0.01 mmol/l and 2.24 +/- 0.01 mmol/l respectively, and 2.27 +/- 0.02 mmol/l in healthy subjects (NS). The pre-treatment level of 1,25-dihydroxy vitamin D (1,25-(OH)2D) of 29.7 +/- 3.3 pg/ml in the vitamin D deficient subjects rose to 70.3 +/- 10.3 pg/ml after treatment (p less than 0.05). The 1,25-(OH)2D level in the healthy subjects was 50.0 +/- 13.7 pg/ml (p less than 0.05 versus pre- and post-treatment values in the patients). Insulin secretion, calculated by the area under the insulin curve, was significantly lower before vitamin D3 treatment in the patients (9.09 +/- 0.7 mU X min, p less than 0.05) compared with the healthy subjects (11.9 +/- 0.5 mU X min) and post-treatment values of the patients with vitamin D deficiency (13.7 +/- 0.5 mU X min). Similar changes were seen in the insulogenic indices (delta I/delta G).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Intrasellar hydatid cyst. Case report.

The authors report a case of hypopituitarism due to a cystic lesion in the sella turcica which was revealed by neuroradiological investigations. A hydatid cyst was found and removed by the transsphenoidal route. The transsphenoidal approach avoided intracranial spillage of fertile daughter cyst and scolices.

Adolescent↗
PubMed1980

Effect of acute hypercalcaemia on glucose tolerance and insulin release in human beings.

Insulin secretion in response to an oral glucose challenge during acute hypercalcaemia was studied. Oral glucose tolerance tests (OGTT) were performed in 12 non-diabetic, non-obese human volunteers, aged 20-28 years. Blood samples were collected for calcium, glucose and insulin determination. The next day the same volunteers received a 4 h infusion of calcium gluconate (15 mg/kg/4 h) and were administered glucose 1 h after starting the infusion. Serum calcium, glucose and insulin concentrations were measured again. Infusion of calcium gluconate resulted in an increase in serum calcium concentration of 5 mg/100 ml over 4 h. During these infusions no significant changes in glucose concentrations were noted. On the other hand, the total mean insulin concentration, expressed as the area under the 3 h glucose tolerance curve, and the insulin peak at 30 min were significantly increased during hypercalcaemia (P < 0.001). These data indicate that acute hypercalcaemia does not affect carbohydrate tolerance but increases insulin secretion in human beings.

Adult↗
PubMedDate not supplied

Non-invasive assessment of left ventricular function in diabetics without clinical heart disease.

Left ventrical performance was assessed by systolic and diastolic time intervals measured echocardiographically in 24 diabetic patients without clinical heart disease and in 18 healthy subjects. It was found that diabetics had longer PEP, higher PEP/LVET ratio and longer IVRT (p less than 0.01). The possible pathogenetic explanations of these abnormalities are discussed and it is concluded that the measurement of time intervals is a useful method for detecting this myocardial dysfunction on the preclinical stage.

Adolescent↗
PubMedDate not supplied

Angiotension converting enzyme inhibition and calcium channel blockage improves cyclosporine induced glucose intolerance in rats.

The aim of this study was to evaluate the effects of quinapril, valsartan, and amlodipin on glucose tolerance in cyclosporine (CsA)-toxic rats. Among 40 male Wistar rats 32 were administered cyclosporine (CsA) (15 mg/kg) intraperitoneally for 6 weeks. Quinapril (10 mg/kg per day) (group Q), valsartan (40 mg/kg per day) (group V), and amlodipine (10mg/kg per day) (group A) were administered to individual sets of eight CsA-treated animals via the drinking water with the remaining untreated hosts followed as a control group (group C) and 8 healthy controls (group H). A Glucose-tolerance test was performed by administering oral glucose (2 g/kg) followed by blood samples obtained from the tail vein at baseline as well as 30,60,90, and 120 minutes after the glucose load. Glucose area under the curve (AUC) was calculated according to the trapezoidal rule. CsA levels were determined using an immunofluorescence method. Kruskal Wallis ANOVA test was used for statistical analysis. Median CsA levels were 1968 ng/mL, 1982 ng/mL, 1580 ng/mL, 1600 ng/mL; and glucose AUC, 232.4 +/- 130 mg/min per dL, 63.1 +/- 25 mg/min per dL, 115.0 +/- 90 mg/min per dL, 47.4 +/- 34 mg/min per dL 53.4 +/- 38 mg/min per dL for groups C,Q,V,A and H, respectively. Quinapril-treated and amilodipine-treated rats displayed a lower glucose AUC than group C (P <.01), which had higher glucose levels than healthy controls (P <.001). In summary, CsA treated rats show impaired glucose tolerance, which is improved by quinapril or amlodipine treatment. Angiotensin converting enzymes inhibitors and calcium channel blockers affect beta cell function rather than insulin sensitivity.

Administration, Oral↗