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Biomedical subjects

S G Aktan

Publications and source records attributed to S G Aktan.

9 recordsLinked to original sources

Sequence analysis and homology modeling suggest that primary congenital glaucoma on 2p21 results from mutations disrupting either the hinge region or the conserved core structures of cytochrome P4501B1.

We recently reported three truncating mutations of the cytochrome P4501B1 gene (CYP1B1) in five families with primary congenital glaucoma (PCG) linked to the GLC3A locus on chromosome 2p21. This could be the first direct evidence supporting the hypothesis that members of the cytochrome P450 superfamily may control the processes of growth and differentiation. We present a comprehensive sequence analysis of the translated regions of the CYP1B1 gene in 22 PCG families and 100 randomly selected normal individuals. Sixteen mutations and six polymorphisms were identified, illustrating an extensive allelic heterogeneity. The positions affected by these changes were evaluated by building a three-dimensional homology model of the conserved C-terminal half of CYP1B1. These mutations may interfere with heme incorporation, by affecting the hinge region and/or the conserved core structures (CCS) that determine the proper folding and heme-binding ability of P450 molecules. In contrast, all polymorphic sites were poorly conserved and located outside the CCS. Northern hybridization analysis showed strong expression of CYP1B1 in the anterior uveal tract, which is involved in secretion of the aqueous humor and in regulation of outflow facility, processes that could contribute to the elevated intraocular pressure characteristic of PCG.

Amino Acid Sequence↗

Problems of chorioretinal venous anastomosis by laser for treatment of nonischemic central retinal vein occlusion.

OBJECTIVES: Evaluate the efficacy of chorioretinal venous anastomosis in patients with nonischemic retinal vein occlusions with progressive visual loss and to concentrate on complications. DESIGN: Case series of 6 patients, retrospective study. Six patients with nonischemic central retinal vein occlusions and progressive visual loss. Laser photocoagulation was performed to create a chorioretinal venous anastomosis to be able to supply venous blood to the choroid, bypassing the occlusion. Visual acuity, funduscopic appearance and fluorescein angiographic appearance were determined. RESULTS: Two patients showed a chorioretinal anastomosis (33%), whereas in the other 4 patients the anastomosis could not be created. Yet 1 patient consequently had a neovascular tuft under the laser site. These new vessels caused minor vitreous hemorrhage and a tractional membrane which regressed after 10 months. CONCLUSION: The utilization of a chorioretinal venous anastomosis by laser as a therapeutic modality should be further questioned and thoroughly evaluated and caution must be exercised to avoid vision-threatening complications.

Adult↗

Krypton laser suture lysis.

BACKGROUND AND OBJECTIVES: Traditionally, the argon laser has been used with suture lysis. The authors evaluate the krypton laser and define the parameters for the successful use of the laser with this procedure. PATIENTS AND METHODS: Five consecutive patients undergoing combined cataract and trabeculectomy surgery who were considered candidates for this procedure underwent krypton laser suture lysis. Three laser suture lysis contact lenses were used during this procedure. None of the patients underwent adjuvant chemotherapy in the form of either 5-fluorouracil or mitomycin-C. RESULTS: All five patients were successfully treated with the krypton laser. In all cases, the 10-0 nylon sutures were cut. No complications were observed in any patients. The only side effect observed was occasional mild pain noted by the first few patients during the procedure. As the krypton laser settings were adjusted, this problem was corrected. CONCLUSION: The krypton laser can be successfully used to cut 10-0 nylon sutures following trabeculectomy surgery.

Aged↗

A second locus (GLC3B) for primary congenital glaucoma (Buphthalmos) maps to the 1p36 region.

Primary congenital glaucoma (gene symbol: GLC3) is an ocular disorder that occurs for 0.01-0.04% of blind people. In the majority of familial cases reported so far, this condition is inherited as an autosomal recessive trait. We have recently used a group of 17 GLC3 families with a minimum of two affected offspring and consanguinity in most of the parental generation and mapped the first GLC3 locus (GLC3A) to the 2p21 region. Six families did not show any linkage to the GLC3A locus and thus provided evidence for genetic heterogeneity of this disorder. A total of eight families unlinked to the 2p21 region were used to search for the chromosomal location of the second GLC3 locus. Herein, we describe mapping of a new locus (designated GLC3B) for primary congenital glaucoma to the short arm of chromosome 1 (1p36.2-36.1) that is situated centromeric to the neuroblastoma and Charcot-Marie-Tooth type 2A (CMT2A) loci. A total of 17 DNA markers were genotyped from this region of chromosome 1. Four families showed no recombination with the two markers D1S2834 and D1S402 with a maximum lod score of 4.510 and 4.157 respectively. Pairwise and multipoint linkage analysis and inspection of the haplotypes revealed that the remaining four families are not linked to this part of chromosome 1, thus providing further evidence that at least one more locus for the autosomal recessive form of GLC3 must exist in the genome. Based on the recombination events, the overall linkage map of this region is: tel-D1S1192-D1S1635-D1S1193 - (D1S1597/-D1S489/D1S228)- [GLC3B/D1S2834/D1S402] - (D1S1176/D1S507/D1S407) - D1S2728-(MFAP2/D1S170) - D1S1368 - D1S436-D1S1592-cen.

Chromosome Mapping↗

Assignment of a locus (GLC3A) for primary congenital glaucoma (Buphthalmos) to 2p21 and evidence for genetic heterogeneity.

Primary congenital glaucoma (GLC3) is an inherited eye disorder that accounts for 0.01-0.04% of total blindness. Although a large number of chromosomal abnormalities have already been reported in patients with congenital glaucoma, the precise location and pathogenesis of this condition remain elusive. By using a group of 17 GLC3 families and a combination of both candidate regional and general positional mapping strategies, we have mapped a locus for GLC3 to the short arm of chromosome 2. Eleven families showed no recombination with 3 tightly linked markers of D2S177 (Z = 9.40), D2S1346 (Z = 8.83), and D2S1348 (Z = 8.90) with a combined haplotype lod score of 11.50. Haplotype and multipoint linkage analyses of 14 DNA markers from 2p indicated that the disease gene is located in the 2p21 region and is flanked by DNA markers D2S1788/D2S1325 (theta = 0.03; Z = 5.42) and D2S1356 (theta = 0.05; Z = 4.69). Inspection of haplotype and heterogeneity analysis confirmed that 6 families are not linked to the 2p21 region, thus providing the first proof of genetic heterogeneity for this phenotype. We therefore designated the locus on 2p21 GLC3A and positioned it in the overall linkage map of Tel-D2S405-D2S367-(D2S1788/D2S1325)-[(GLC3A++ +, D2S177)/(D2S1346/D2S1348)]-D2S1356-D2S119- D2S1761-D2S1248-D2S1352-D2S406- D2S441-Cen. Of the seven genes mapping to the 2p21 region, CAD, CALM2, and LHCGR are centromeric to D2S119 and can be excluded as a candidate for GLC3A, but mutations in PRKR, TIK, SOS1, or SPTBN1 may still be accountable for this phenotype. As human 2p21 shows homology with mouse chromosomes 11 and 17, the homolog of GLC3A is expected to reside on one of these two chromosomes.

Animals↗

Gonioscopic evaluation of glaucoma patients after trabeculectomy.

Seventy-three eyes of 65 patients with various types of glaucoma have been evaluated before and after trabeculectomy. These cases have been examined gonioscopically preoperatively and in the 1st, 3rd, and 6th months. The status of the trabeculectomy defect, and synechiae related to the area, factors predisposing to the development of synechiae, have been looked at. Peripheral anterior synechia formation was more pronounced in chronic angle closure glaucoma, exfoliative glaucoma and secondary glaucoma. The relationship between synechiae and intraocular pressure has been defined. The eyes with total peripheral anterior synechia had a lesser degree of success in lowering the intraocular pressure.

Adult↗

Therapeutical and genetical aspects of congenital glaucomas.

Therapy for congenital glaucoma is primarily surgical. We have investigated 249 cases who have undergone trabeculectomy. There was a 79% success rate as regards to control of the IOP. Vision could be saved among the patients who had applied relatively early. At the end of the follow up which was 5 years IOP remained normal in the successful group. All the patients and their families were analysed genetically by their pedigrees and caryotypes. An autosomal recessive pattern with variable penetrance was found. The majority of the patients came from families with consanguineous marriages giving a rate of 66.6%. It was suggested that the course of the disease is highly affected by and related to parental consanguinity. An early age of onset and an accelerated clinical course could be well correlated.

Adolescent↗

Ophthalmic screening of school children in Ankara.

Ophthalmic screening was done on 23,810 children visited at schools in different regions of Ankara. Children with below normal visual acuity were invited to the outpatient department and had a full routine ocular examination. Thirty-nine nursery and primary schools were selected, ten of them private, eleven average state schools, seven good state schools and eleven village schools. Among the 23,810 children, 3095 (13%) had various pathology; 1516 were girls, 1579 boys. Refractive errors were found in 85% of the children (2630). This equals 11% of the total screened population. Refractive errors were myopia 32%, hypermetropia 21%, astigmatism 47%. Strabismic children were 2.5%, and amblyopia was found in 1.1%. The purpose of the study was to assess the place of an ocular screening program in primary school children and to discuss the differences encountered in different urban areas.

Age Distribution↗