Biomedical subjects

S Köse

Publications and source records attributed to S Köse.

15 recordsLinked to original sources

PubMed2001

An approach to the surgical management of total oculomotor nerve palsy.

The goal of the procedure was to keep the eyes of patients with total oculomotor palsy in the straight ahead position by means of surgery on the horizontal and inferior rectus muscles in one session, without involving the superior oblique muscles. Six patients underwent surgery for total oculomotor nerve palsy. All of the surgical procedures were carried out on the muscles of the paralytic eye. We performed hemi-hangback recession of the lateral rectus and resection of the medial rectus for exotropia in all patients. Depending on the magnitude of vertical deviation, the insertions of the horizontal rectus muscles were moved upward, alone or in combination with hemi-hangback recession of the inferior rectus. The mean preoperative horizontal deviation was 66.6 PD. Two years after the operation, the horizontal deviation was measured to be 11.6 PD. Similarly, the mean preoperative vertical deviation of 16 PD decreased to 6.6 PD in two years. This procedure did not disturb normally functioning superior oblique and lateral rectus muscles. Subjectively, all of the patients were satisfied with their alignment two years after the operation. We are of the opinion that this technique is a safe, simple and effective procedure and can be regarded as a first-choice operation in total oculomotor palsy. If one fails to maintain the eye position with this procedure, one can still perform a second operation on the superior oblique muscle, which remains untouched in our procedure.

Adolescent↗

PubMed2000

Late hemorrhagic disease of the newborn.

BACKGROUND: Late hemorrhagic disease of the newborn (HDN) may occur without an underlying disorder or as a secondary manifestation of an underlying disorder. It may be seen in fully breast-fed infants without a routine supplementation of vitamin K. In contrast, idiopathic late HDN is defined as HDN without the presence of any risk factor, such as gastroenteritis or use of antibiotics. Severe hemorrhagic symptoms frequently occur. METHODS: Between March 1987 and May 1997, we evaluated 15 infants with idiopathic late HDN, who were diagnosed by detailed history, physical examination and laboratory findings. RESULTS: The age (mean +/- SD) at onset of symptoms was 62.4 +/- 33.9 days. All children were breast-fed infants and were born at term from healthy mothers. The delivery histories were uneventful. There was no history of vitamin K administration at birth. Signs and symptoms of the patients were convulsions (47%), feeding intolerance and poor sucking (47%), irritability (33%) and pallor (20%). In physical examination; there was bulging or full fontanel in 10 patients (67%), diminished or absent neonatal reflexes in nine patients (60%) and ecchymosis in three patients (20%). Before administration of vitamin K, prothrombin time (PT) was 76.1 +/- 43.0 s and partial thromboplastin time (PTT) was 123.4 +/- 68.8 s. Six to 12 h after administration of vitamin K, PT was 15.6 +/- 1.8 s and PTT was 33.4 +/- 1.0 s. Neurologic, gastrointestinal and skin hemorrhagic findings were found in 11 (73%), three (20%) and three patients (20%), respectively. There were both neurologic and skin bleeding symptoms in two patients. The mortality in the present study was 33%. CONCLUSIONS: Late HDN results in severe hemorrhage, especially hemorrhage in the central nervous system. Administration of vitamin K (1 mg, i.m.) at the birth can reduce these severe complications.

Age of Onset↗

PubMed2000

High throughput genetic screening for the detection of hereditary non-polyposis colon cancer (HNPCC) using capillary electrophoresis.

Approximately 5-10% of all colorectal carcinomas arise from cancer predisposition syndromes caused by heterozygote germline mutations in post-replicative DNA mismatch repair (MMR) genes. In contrast to gastrointestinal polyposis syndromes, carcinomas in these patients do not occur on the background of increased numbers of polyps and hence are refered to as hereditary non-polyposis colorectal cancers (HNPCC). Six different MMR genes, MSH2, MSH3, MSH6, MLH1, MLH3 and PMS2, have been identified in the human genome. In the majority of HNPCC patients, heterozygote germline mutations are present in the MSH2 or MLH1 gene. Detection of mutations by conventional sequencing technology is expensive and labor intensive due to the complex intron and/or exon structures. In this study, we therefore have explored whether capillary electrophoresis-based single strand conformation polymorphism (SSCP-CE) provides a reliable means for mutation screening. We have tested different MLH1 mutations in exons 9 and 16 and find that SSCP-CE produces reliable electrophoretic patterns that allow recognition of wild-type alleles, microdeletions and point mutations. In summary, SSCP-CE provides a rapid, automated, and cost-effective technology for MSH2 and MLH1 mutation screening and will facilitate genetic diagnostics for HNPCC patients.

Colonic Neoplasms↗

PubMed2000

An unusual central retinal dystrophy associated with ichthyosis vulgaris.

A number of ichthyosis syndromes may have retinal abnormalities such as the retinitis pigmentosa-like diffuse rod-cone dystrophy in Refsum's syndrome and the maculopathy in Sjögren-Larsson syndrome. We present two sisters who have an unusual, almost identical, bilaterally symmetric central retinal dystrophy associated with ichthyosis vulgaris in the absence of other systemic disorders. We believe that this dystrophy has not been previously described in patients with any of the known varieties of ichthyosis.

Adolescent↗

PubMed1998

Assessing the cause of T wave inversion in precordial leads with ECG mapping.

Inversion of the T wave in precordial leads in patients with angina pectoris is a predictor of coronary disease; however, it may also be seen in normal adults. The aim of this study was to assess the cause of T wave inversion by carrying out precordial electrocardiographic (ECG) mapping in 51 patients, who also underwent echocardiography and coronary angiography. The 37 patients in group A had atypical symptoms. They included 11 patients who showed M pattern mapping, of whom 7 had noncoronary cardiac disease and 4 were normal. In 23 other group A patients, whose mappings were in the N pattern, the angiography was normal. In the remaining three patients of this group, mappings were in the I pattern, with angiography revealing coronary disease in two of them and no disease in the third. The 14 group B patients all had typical angina; mappings were in the I pattern in 8 of the patients and in the N pattern in the remaining 6. Angiography revealed coronary artery disease in all patients with the I pattern mapping, while all those with the N pattern were found to be normal. Sensitivity, specificity, and positive predictive value for detecting normal subjects were all 100% for N pattern mapping; for detecting coronary disease, they were 100%, 90%, and 90% for I pattern mapping, respectively. It is concluded that precordial ECG mapping is an accurate method for the assessment of T wave inversion in precordial leads.

Adult↗

PubMed1998

Butterfly-like pattern dystrophy and unilateral choroidal neovascularization.

PURPOSE: To report a case with butterfly-like pattern dystrophy and unilateral subretinal neovascular membrane. RESULTS: We examined a 62-year-old woman with occult subretinal neovascular membrane in the right eye and butterfly-like yellowish figure in the retina confined to the posterior pole in the left eye. Electro-oculogram was subnormal bilaterally. Her 32-year-old daughter also had hypopigmented bilateral macular changes with subnormal electro-oculogram. CONCLUSION: This case demonstrates a rare complication of subretinal neovascular membrane formation in butterfly-like pattern dystrophy.

Choroidal Neovascularization↗

PubMed1998

Effects of octreotide in patients with hypertrophic obstructive cardiomyopathy.

Hypertrophic obstructive cardiomyopathy (HOCM), the cause of which is unknown, is a heart disease characterized by obstruction of the left ventricular outflow tract and an increase in interventricular septum thickness. Octreotide, a synthetic analogue of somatostatin, was administered subcutaneously to 15 patients for 6 months in order to determine its efficacy in HOCM. Echocardiographic examination was performed in each patient before we had initiated treatment and after treatment. Interventricular septum thickness, interventricular septum thickness/left ventricular posterior wall thickness, and subaortic gradient decreased significantly at the end of treatment. The ratio of the mitral valve E to A waves increased significantly. We observed that octreotide treatment caused a significant decrease in interventricular septum thickness and subaortic pressure gradient. Before and after therapy left ventricular enddiastolic diameter, left ventricular endsystolic diameter, ejection fraction and fractional shortening were not changed. No adverse effect was observed during the therapy. According to our results, octreotide has some beneficial effects on HOCM and it seems to be a new therapeutic approach for HOCM.

Adult↗

PubMed1993

[Histopathological examinations of skin biopsy specimens from patients with acute HAV and HBV infections].

Punch skin biopsy is performed from 35 patients who are hospitalized with the diagnosis of acute viral hepatitis (AVH) at clinical examination and to 13 control groups. Thirteen of the 35 patients (37.4%) are diagnosed as Hepatitis A (HAV) infection, and 22 (62.6%) of them are diagnosed as Hepatitis B (HBV) infection. The histopathological examination of the skin biopsy specimens under light microscope leukocytoclastic vasculitis is found only in one case in the group of HBV infection.

Acute Disease↗

PubMed1993

[Chlamydia trachomatis in conjunctival specimens].

One hundred two patients with signs and symptoms of conjunctivitis and 45 asymptomatic subjects were screened for Chlamydia trachomatis using a direct fluorescent antibody test. 26.5% of the symptomatic and 6.6% of the asymptomatic patients were positive for C.trachomatis. The follicular response rate was significantly higher (p < 0.05) in the symptomatic group than in the asymptomatic population (48.1% and 29.3% respectively). This finding correlated well with chlamydial conjunctivitis.

Chlamydia trachomatis↗

PubMedDate not supplied

Coexistence of intraocular eyelashes and anterior chamber cyst after penetrating eye injury: a case presentation.

We herein describe a patient in whom two intraocular eyelashes and an anterior chamber cyst embedded into the anterior surface of the iris was detected following penetrating eye injury. After a one year asymptomatic period, the patient was hospitalized because of uveitic reaction in the anterior chamber which may be due to cyst development. The lashes and cyst were removed surgically, and examined pathologically. There was no complication in one year follow-up period.

Adolescent↗

PubMedDate not supplied

Two-day induction with thymoglobulin in kidney transplantation: risks and benefits.

INTRODUCTION: The aim of this study was to develop an induction protocol to reduce allograft rejection with fewer posttransplant infections and malignancies. METHODS: In this prospective randomized study, a T- and B-cell depletion protocol, consisting of IV thymoglobulin (ATG 5 mg/kg/d) plus methylprednisolone (500 mg/d) plus azathiopurine (2 mg/kg/d), was on days 0 and 1 after renal transplantation. CyA was introduced at day 3.39 among patients undergoing either primary living related (n = 16) or cadaveric (n = 23) transplants excluding recipients of full-HLA-matched sibling, or five- and six-HLA-matched cadaveric donor kidneys. The adequacy of immunosuppression was evaluated by flow cytometric analysis for total, CD3+ (T-cell), and CD19+ (B-cell) lymphocytes. RESULTS: The acute rejection rate was 6% and 37/39 patients are alive with functioning grafts at an average follow-up of 14.5 months. The overall patient and graft survival rate was 95%. Their mean creatinine value was 1.27 mg/dL. Six patients (16%) required hospitalization due to serious infections. The two deaths were attributed to septicemia and brain abcess caused by unusual agents, namely, Rhodococcus equi and Sporobolomyces. One patient presented with a cutaneous Kaposi sarcoma in the 11th month posttransplant. CONCLUSION: A Two-day induction protocol with thymoglobulin yields acceptable acute rejection rates among renal transplants. However, caution is necessary for adverse events, particularly atypical bacterial and fungal infections.

Adolescent↗

PubMedDate not supplied

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region.

Sensitization to aeroallergens of Aegean region is not well decumented. In this study we evaluated the epidermal skin prick test results of the patients who applied to allergy outpatient department retrospectively. Epidermal skin prick test of the 5055 patients were evaluated. Of these patients 2638 (52 %) were female, 2417 (48 %) male, 1213 (24 %) adult and 3842 (76 %) pediatric patient, 1163 (23 %) patients were allergic rhinitis, 2477 (49 %) were bronchial asthma, 505 (10 %) were allergic rhinitis with bronchial asthma, 556 (11 %) were chronic urticaria, 253 (5 %) were wheezy infant and 101 (2 %) patients were atopic dermatitis, 2932 (58 %) had atopy history in their first and second degree relatives. Patients were aged between 3.5 months and 79 years (mean 14.1 3.2 years and median 11 years). In epidermal skin prick tests sensitization to house dust mites (D. farinae, D. pteroniyssinus), pollens (grass, cereals and trees), moulds, animal danders, foods (especially in early childhood) and cockroach were evaluated. Our data indicate that allergens that may be the cause of the high prevalence of allergic diseases in Izmir are probably produced by pollens and mites.

Adolescent↗

PubMedDate not supplied

Evaluation of montelukast in 8 to 14 year old children with mild persistent asthma and compared with inhaled corticosteroids.

OBJECTIVES: To determine the clinical effectiveness, tolerability and reliability of montelukast and to compare this drug with inhaled corticosteroids. METHODS: We performed a randomized, 14-week, 2-period, prospective parallel group study. After a 2-week run-in period, patients received treatment for 12 weeks. Sixty-three clinically stable outpatients aged 8 to 14 years with a history of mild persistent asthma for at least 1 year and a forced expiratory volume in one second (FEV1) greater than 80 % of the predicted value were evaluated. RESULTS: Montelukast produced improvement in airway obstruction, daily symptom scores, total daily as-needed beta-agonist use, nocturnal awakenings, percentage of days and percentage of patients with asthma exacerbations, and urinary leukotriene E4 levels. These beneficial effects were similar to those produced by inhaled corticosteroids. There were no significant adverse effects requiring treatment discontinuation. CONCLUSIONS: Montelukast may be a well-tolerated and effective therapeutic option in 8 to 14-year-old patients with mild persistent asthma.

Acetates↗

PubMedDate not supplied

Prevalence of atopy in young healthy population, in Izmir, Turkey.

The aim of this study was to determine the prevalence of atopy especially in young aged group in which allergic diseases are frequently seen. We carried out this study in Izmir which is located on the west coast of Turkey and has all the characteristics of mediterranean climate. However, we evaluated whether geographical characteristics such as climate, dampness, kinds of plant might be affected on prevalence of atopy. Participants were randomly selected and detailed standard questionnaire about if they or their relatives had any allergic symptoms were applied. The skin prick tests (SPT) with standardzied allergen extracts were performed and serum total IgE levels were assayed. The study group consisted of 277 individuals, aged 15-25 years. Based on the questionnaire, 123 (44.4%) participants described positive history of atopy. In 127 of 277 subjects (46%) was found at least one positive skin-test response and the most frequent allergen was house-dust mites. SPT was positive in 68 (55.2%) of 123 subjects who had atopic history and in 59 (38%) of 154 subjects who had negative history of atopy. The subjects who had atopic history showed more frequently positive SPT prevalence than the others (p < 0.01). Geometric mean of total IgE level was 105.5 kU/L in SPT positive 127 subjects and 57.7 kU/L in SPT negative 150 subjects. There was a positive relationship between total IgE level and positive SPT (p < 0.01). History of atopy was correlated with total IgE levels in males (p < 0.01) but not in females. Women more often than men reported atopic history in the absence of true atopy.

Adolescent↗

PubMedDate not supplied

Diabetes insipidus in a pediatric patient with systemic lupus erythematosus. A case report.

In systemic lupus erythematosus (SLE), the central nervous system (CNS) produces numerous and varying clinical disorders. A 14-year-old girl with the features of cerebral involvement in SLE is presented. The development of diabetes insipidus (DI), which responded to desmopressin, was an interesting finding in this case. Therapy consisting of high-dose methylprednisolone combined with cyclophosphamide was effective in improving the symptoms as well as the DI.

Adolescent↗