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Biomedical subjects

S Kavukçu

Publications and source records attributed to S Kavukçu.

At least 19 recordsLinked to original sources
PubMed2006

Effect of obesity and overweight on cyclosporine blood levels and renal functions in renal adolescent recipients.

INTRODUCTION: The impact of obesity, a frequent problem after renal transplantation, which has been associated with poor graft and patient survival, was evaluated on renal function and cyclosporine (CsA) blood levels. PATIENTS: We retrospectively evaluated the data of adolescent renal recipients between 1994 and 2004. Patients with serum creatinine > or = 2.5 mg/dL were excluded. We grouped the data with regard to the body mass index (BMI) percentiles as group I (BMI > 95th), group II (BMI < 95th), group III (BMI > 85th), group IV (BMI < 85th). We compared the clinical and laboratory findings between groups I and II and between groups III and IV. RESULTS: We evaluated 778 visits of 27 patients (M/F: 19/8). There were 30 visits in the obesity period (group I) and 72 visits after the overweight periods were added (group III). Serum creatinine levels were significantly higher and glomerular filtration rate levels significantly lower among obese and/or overweight than lean periods (P < .05). Proteinuria levels were similar in groups I and II, but significantly higher in group III than group IV (P = .356 and .000, respectively). CsA(mg/bw), CsA(mg/bmi), and CsA(mg/bsa) levels were significantly lower in group I than group II and in group III than group IV (P < .05), while C0 and C2 levels were similar (P > .05). CONCLUSION: Weight gain is associated with worse renal functions but not greater proteinuria in our patients. Smaller CsA doses were sufficient to maintain C0 and C2 levels similar to the lean patients, results that were parallel to those of adult renal recipients.

Adolescent↗
PubMed2006

Correlation of C0 and C2 levels with lipid profiles in adolescent renal transplant recipients in the early and late posttransplant periods.

Hyperlipidemia is a frequent complication after renal transplantation. Cyclosporine therapy is an important cause of hyperlipidemia. It is still controversial whether C0 or C2 is the most effective way to monitor blood cyclosporine concentrations to guide dosages. We sought to evaluate the relationship of C0 or C2 to serum lipid levels in the early and late posttransplant periods among adolescent renal transplant recipients. The posttransplantation charts of 26 adolescent renal transplant recipients were evaluated retrospectively. Serum C0 and C2 levels and serum lipid (triglyceride and total cholesterol) levels were analyzed both in the early (first 6 months) and the late (thereafter) posttransplant periods. Hypertriglyceridemia and hypercholesterolemia were defined as levels above the 95th percentile adjusted for age and gender. To evaluate the influence of C0 and C2 levels on serum lipids, we excluded one patient with familial hyperlipidemia. In addition, serum lipid levels of the remaining 25 patients were excluded in acute rejection periods and when the serum creatinine levels were above 2.5 mg/dL, representing chronic allograft nephropathy. Concurrently recorded serum C0 and C2 levels were present for only 21 patients. Overall, we evaluated the records of 245 visits for these 21 patients. The incidence of hyperlipidemia decreased in the late posttransplant period, being significant for hypercholesterolemia. C2 had strong negative correlation with serum lipids; it was significant for total cholesterol in the early posttransplant period (r=-0.542, P=.005), but weaker in the late posttransplant and whole posttransplant periods. Thus correlation of C2 with serum lipids showed differences during posttransplant follow-up. C0, on the other hand, was positively correlated with total cholesterol levels in all periods, being significant for the whole posttransplant period (r=0.293, P=.000) and for the late posttransplant period (r=0.196, P=.025). Although not statistically significant, C0 levels were higher among hypertriglyceridemic or hypercholesterolemic episodes both in the early and the late posttransplant periods. When only the C0 levels of all 25 patients were analyzed (789 visits), C0 and serum cholesterol levels were positively correlated both in the early and the late posttransplant periods (P=.013, r=0.198 and P=.000, r=0.177, respectively). We concluded that C0 has a more predictable correlation with serum cholesterol levels after renal transplantation in adolescent patients.

Adolescent↗
PubMed2005

Significance of ligature technique on the formation of pulmonary artery stump thrombosis in a canine model.

BACKGROUND: Thrombo-embolism following pulmonary resection is a serious complication with a fatal outcome. We have tried to clarify the role of ligature techniques used in pulmonary resection on the formation of pulmonary artery stump thrombosis, which may lead to a subsequent pulmonary thrombo-embolism. MATERIAL AND METHODS: Two groups of 10 mongrel dogs underwent a standard left pneumonectomy under anesthesia. The transfixation, or the continuous ligature technique, was applied to close the pulmonary artery stump in each group. Morphological evaluation of the ligated pulmonary artery was carried out, including the macroscopic thrombus formation and microscopic findings. RESULTS: The transfixation ligature technique showed a significantly greater incidence of macroscopic thrombosis in the pulmonary artery stump when compared with the continuous ligature technique (p = 0.033). This was confirmed by microscopic changes (p = 0.020). CONCLUSION: Thrombus formation in the pulmonary artery stump is more likely to occur following the closure of the stump with the transfixation ligature technique compared with the continuous ligature technique.

Animals↗
PubMed2003

Female and male differences in the survival of patients undergoing resection for lung cancer.

OBJECTIVE: In recent years much attention has been focused on the rapidly increasing incidence of primary lung cancer in women. The aim of this study was to determine gender differences in patients treated surgically for lung cancer. METHODS: We performed a retrospective review of patients who had lung resection for primary lung cancer from January 1994 to December 1998. RESULTS: There were 530 men and 42 women. Women were younger than men (55.6 +/- 10 versus 57 +/- 9.9). The difference was not statistically significant (p = 0.9). The mean cigarette consumption was greater in men than in women (p < 0.001). We observed a higher operative morbidity and mortality rate in men compared to women (p < 0.05). Men had more squamous cell carcinoma (61.7%). In female patients, squamous cell cancer and adenocarcinoma were found with almost the same incidence (35.7% versus 33.3%). There was a significant difference in the distribution of cell types (p < 0.001). Pathologic stages for women were; I = 38.2%, II = 21.4%, IIIa = 21.4%, IIIb = 9.5%, IV = 9.5% and for men; I = 40.4%, II = 26.6%, IIIa = 24%, IIIb = 6%, IV = 3%. There was no significant difference in the stage distribution between genders (p = 0.2). Median survival for female and male patients were 38 +/- 9.2 and 35 +/- 3.2 months. Female patients' survival was longer than male patients but the difference was not statistically significant (p > 0.05). CONCLUSIONS: This study emphasizes sex differences in cigarette consumption, operative mortality and the distribution of cell types of patients with primary lung cancer. These initial results should strongly encourage additional studies in different countries on the interaction between sex and lung cancer characteristics to improve clarity.

Adenocarcinoma↗
PubMed2002

Giant ancient schwannoma of the posterior mediastinum cytologically misdiagnosed as a malignant tumour. A case report.

We report a case of a 45-year old woman who was found to have a giant mediastinal tumour with radiological degenerative changes. She underwent thoracotomy to remove the mass, which was eventually diagnosed histologically as an ancient schwannoma, whereas cytological interpretation of the accompanying pleural fluid was malignant. Ancient schwannoma is a rare variant of schwannoma, histologically showing atypical features that may result in erroneous diagnosis of a malignant tumour. Clinical and radiological findings are important aids for further consideration of surgical removal of these potentially resectable tumours.

Female↗
PubMed2001

The effect of vitamin A on the course of renal ablation nephropathy.

Renal scarring due to pyelonephritis was shown to improve in rats given vitamin A. We evaluated the effect of vitamin A in a renal ablation nephropathy model. Four groups, each including 7 rats with 5/6 nephrectomy, were formed: group I (no vitamin A), group II (60 kIU vitamin A), group III (120 kIU vitamin A), and group IV (180 kIU vitamin A). Four sham-operated rats comprised the control group. After 6 weeks of 5/6 nephrectomy, the rats were sacrificed and serum creatinine, vitamin A, and beta-carotene levels were determined in addition to histopathological evaluation of the remnant kidneys. The tubulointerstitial and glomerular changes were graded as "0-3" and "0-5" respectively, in accordance with the severity of the lesions. Tubulointerstitial score (TIS), mean glomerulosclerosis score (MGS, arithmetical mean of the sclerosis scores of 100 glomeruli), and severity of glomerulosclerosis index (SGI, ratio of the number of glomeruli with grade > or = 3 sclerosis to the total number of glomeruli examined) were calculated for each rat. Serum creatinine levels were higher in the study groups than the control rats (P < 0.05), but there was no significant difference between the study groups (although the levels increased as the dose of vitamin A increased). Serum vitamin A levels were significantly higher in the groups given vitamin A than the control rats and group I (P < 0.05). In addition, serum vitamin A levels increased significantly in parallel to increasing doses of vitamin A (P < 0.05). Serum beta-carotene levels did not differ between the groups, except for group II, which had lower levels than controls (P = 0.01). MGS and SGI were significantly higher in the study groups than control rats (P < 0.05), but did not differ between the study groups. Study and control rats were not different with respect to TIS, but there was a difference between the control group and group III (P = 0.04). Group II had the lowest MGS, SGI, and TIS scores among the study groups. When all the rats were considered together, vitamin A levels did not correlate with the MGS and SGI, but correlated positively with the TIS (r = 0.391, P = 0.027). beta-Carotene levels also did not correlate with the MGS, SGI, and TIS. In conclusion, vitamin A administration did not significantly affect the clinical and pathological course of renal ablation nephropathy in rats. Furthermore, higher doses of vitamin A might even damage renal tissue.

Animals↗
PubMed2001

Posterior leukoencephalopathy syndrome in poststreptococcal acute glomerulonephritis.

Reversible posterior leukoencephalopathy syndrome is an increasingly recognized brain disorder most commonly associated with hypertension, toxemia of pregnancy, or the use of immunosuppressive agents. Its clinical features include headache, decreased alertness, mental abnormalities, such as confusion, diminished spontaneity of speech, changed behavior ranging from drowsiness to stupor, seizures, vomiting, and abnormalities of visual perception like cortical blindness. Magnetic resonance imaging shows edematous lesions primarily involving the posterior supratentorial white matter and corticomedullary junction. We describe a 7-year-old uremic girl who developed neurological symptoms of posterior leukoencephalophaty syndrome during the course of acute poststreptococcal glomerulonephritis. Since the symptoms first appeared 24 h after a hypertensive crisis and the patient was uremic at the time of symptoms, we decided to report this patient to discuss the differential diagnosis of neurological symptoms developing during the course of acute poststreptococcal glomerulonephritis.

Acute Disease↗
PubMed2001

Management of esophageal perforation.

Despite recent advances in thoracic surgery, the management of esophageal perforation remains problematical and controversial. Thirty-one patients were treated for an esophageal perforation between 1986 and 1998. The esophageal perforation was iatrogenic in 25 cases, spontaneous in 2, traumatic in 2, and caused by a tumor and tuberculous lymphadenitis in 2 patients. There were 10 cervical, 19 thoracic, and 2 abdominal perforations. The interval from perforation to operation was less than 24h in 12 patients and more than 24h in 19 patients. The surgical procedures included a primary repair in 12 patients, a resection in 8, and conservative treatment with minor surgical approaches in 11. The mortality rate was 20% (4/20 patients) in the surgical treatment group and 45.5% (5/11 patients) in the conservative treatment with minor surgery group. The overall mortality was 29% (9/31 patients). The prognosis is thus concluded to depend on the cause and location of the perforation, the presence of underlying esophageal diseases, and the surgical procedure chosen.

Adolescent↗
PubMed2001

Proximal bronchial extension with special reference to tumor localization in non-small cell lung cancer.

OBJECTIVE: Surgery is the optimal treatment in patients with non-small cell lung cancer (NSCLC) and tumor-negative bronchial resection margins should be maintained for a curative resection. The epidemiology of NSCLC, including the aspects of tumor localization, has been changing during the recent decades. The aim of this study was to evaluate microscopic proximal bronchial extension with special reference to the site of the tumor. METHODS: Surgical specimens of 70 NSCLC cases were examined histologically for proximal bronchial extension of the tumor. The entire bronchial tree with the tumor was extracted from the specimen and serially cut at a thickness of 5 mm in the transverse plane of the bronchus. Microscopic proximal extension of the tumor was classified as either endobronchial or peribronchial. RESULTS: Thirty-three (47.1%) tumors had central and 37 (52.9%) had peripheral localization. Among the central and peripheral tumors, 10 (30.3%) and seven (18.9%) had microscopic proximal extension, respectively. In total, the mean length of proximal extension was 10.94 +/- 7.07 mm. The mean length of extension for peripheral tumors was 15.71 +/- 8.38 mm, significantly greater than that of central tumors, which was 7.60 +/- 3.47 mm (P = 0.026). Peripheral tumors showed a significant peribronchial extension (P = 0.024). CONCLUSIONS: A greater percentage of central tumors show microscopic proximal bronchial extension, whereas the length of microscopic proximal bronchial extension is significantly greater in peripheral tumors. Peripheral tumors preferentially have a peribronchial extension pattern.

Adenocarcinoma↗
PubMed2001

Implantation metastasis caused by fine needle aspiration biopsy following curative resection of stage IB non-small cell lung cancer.

Fine needle aspiration is a useful procedure in the diagnosis of lung cancer, however controversy still remains as to whether it should be employed particularly in patients with operable lung cancer. We report herein a case of metastatic tumor at the site of transthoracic needle biopsy following a curative resection in a patient with stage IB bronchogenic carcinoma. The patient was managed with aggressive chest wall resection and subsequent musculocutaneus flap transposition, however he died 11 months after the initial operation. The tumor implantation risk and the related complications should be considered in patients with operable bronchogenic carcinoma undergoing a tranthoracic needle aspiration biopsy.

Aged↗
PubMed2001

Transthoracic approach in surgical management of Morgagni hernia.

OBJECTIVE: Morgagni hernia is an uncommon type of diaphragmatic hernias. Numerous approaches have been described and, particularly the significance of laparatomy has been emphasized as an operative technique. We present our experience on patients with Morgagni hernia operated on via transthoracic approach in our department. MATERIALS AND METHODS: Between January 1986 and March 2000, 16 patients with Morgagni hernia were operated in our department. Their ages ranged from 16 to 68 years (mean 51.5). Five (31.25%) patients were male, and 11 (68.75%) patients were female. Chest roentgenograms, thorax CT, barium enema roentgenographic studies were used as diagnostic utilities. Right posterolateral thoracotomy was performed in all patients. RESULTS: Hernia sac was present in all cases. Exploration revealed omentum in hernia sac in eight patients (50%), colon and omentum in seven patients (44%), only colon in one patient (%6). Postoperative course was uneventful. The mean follow-up was 5.7 years. There was no recurrence or symptoms related to the operation. CONCLUSIONS: We advocate transthoracic approach for surgical exposure as it provides wide exposure and easy repair of the hernia sac in Morgagni hernia.

Adolescent↗
PubMed2001

Surgical treatment of pulmonary hydatid cysts in children.

PURPOSE: Ten years' experience is analyzed in pediatric patients with pulmonary hydatid cysts. METHODS: Between 1990 and 2000, 33 pediatric patients (2 to 15 years of age) with pulmonary hydatid cysts were operated on in Department of Thoracic Surgery in Ankara University School of Medicine. There were 17 girls and 16 boys. RESULTS: Twenty-three cases presented as a solitary lung cyst, whereas the remaining 10 were found to have multiple cysts in one or both lungs. Cystotomy and capitonnage were performed in 25 patients, cystotomy was done in 6 patients, and only 2 patients underwent the wedge resection. The authors used no scoliocidal agent in our approach. There was no operative mortality. Recurrence after operation was seen in one patient. CONCLUSION: Pulmonary hydatid cysts in children can be treated successfully by cystotomy and capitonnage or only cystotomy. J Pediatr Surg 36:917-920.

Adolescent↗
PubMed2001

Expression of CD44 and major histocompatibility complex class II antigens correlate with renal scarring in primary and systemic renal diseases.

OBJECTIVE: Phenotypical changes in the tubular epithelial cells (TEC) seem to be important in the progression of renal diseases. The present study was designed to identify the relation between the expression of major histocompatibility complex (MHC) class II antigens and CD44 by TEC, with parameters of renal scarring in primary and systemic renal diseases. MATERIAL AND METHODS: Expression of MHC class II and CD44 antigens was determined immunohistochemically in 71 renal biopsies and eight nephrectomy specimens with chronic pyelonephritis (CP). RESULTS: CD44 expression was increased in renal diseases compared with autopsy cases and was strongly correlated with parameters of renal scarring and MHC class II antigen expression in primary and systemic renal diseases. CD44 expression was demonstrated in chronic pyelonephritis, postinfectious glomerulonephritis, diabetic nephropathy and hypertensive nephropathy, as well as other diseases described previously. Similar results were obtained for MHC class II antigen expression by TEC and these results were correlated with serum creatinine values. CONCLUSIONS: CD44 expression by TEC is a common pathway in renal scarring, like MHC class II antigen expression, and both of these may be important in renal scarring in CP cases as well as other primary and systemic renal diseases.

Adolescent↗
PubMed2001

Goldston syndrome: report of a case.

Cerebrohepatorenal malformation is a rare familial disorder characterized by typical renal lesions combined with Dandy-Walker malformation, and congenital hepatic fibrosis. In this case report, a male premie with the diagnosis of cerebrorenal syndrome or so called Goldston syndrome is presented. Besides the rarity of this syndrome, this case is the second reported patient diagnosed prenatally.

Abnormalities, Multiple↗