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Biomedical subjects

S Kaynak

Publications and source records attributed to S Kaynak.

At least 19 recordsLinked to original sources

[Meningococcal carriers in high school students and possible risk factors].

From August 2004 to January 2005 a cluster of 7 cases of serogroup B meningococcal disease occurred in the state of Saxony-Anhalt in the town of Sangerhausen and the surrounding area. This led to an investigation of meningococcal carriage in 816 high school students (grades 9 to 13). The students were also asked to fill out a questionnaire regarding possible risk factors for carriage. The goal of the study was the evaluation of a possibly persistently increased risk for further cases in the region. Results of the study were to be used for a comprehensive and targeted education of the public. The percentage of students found harbouring N. meningitidis in the nasopharynx in Sangerhausen (9.0 %) was not elevated compared to that found in the two control regions of Kelbra, County of Sangerhausen (8.2 %) and Jessen, County of Wittenberg (9.9 %). The serogroup B fine type responsible for the cluster (P1.7-2,16:F3-3:PorB3-24) was found only in one student each in Sangerhausen and Kelbra. Thus, there was no evidence of an increased risk for further cases at the time of the study at the end of January, 2005. This may have been due to intensive contact tracing and provision of chemoprophylaxis in Sangerhausen. Visiting a disco or bar and smoking were identified as risk factors for meningococcal carriage. However, these factors were associated with carriage only in boys but not in girls. This may be explained by sex-specific differences in physical interaction with others. Efforts to prevent further cases during clusters of meningococcal disease should consider sex-specific risk behaviour.

Adolescent↗

Management of free floating iris cysts in the anterior chamber: a case report.

PURPOSE: To present a case with free iris cysts in the anterior chamber and its management with YAG laser. CASE REPORT: A 14-year-old boy presenting with the complaint of seeing a small ball-like moving mass in his left eye. RESULTS: Slit-lamp examination revealed a pair of free-floating iris cysts located inferiorly in the anterior chamber. After YAG laser application both the cysts collapsed. CONCLUSIONS: This is the first report of a case with multiple free iris cysts in the anterior chamber. Considering the possibility of endothelial damage in the long-term, it is worth noting the favorable response to YAG laser treatment.

Adolescent↗

Unilateral Purtscher-like retinopathy after weight-lifting.

PURPOSE: To report a case of Purtscher-like retinopathy after weightlifting. METHODS: A 17-year-old man presented with a sudden visual loss in his left eye after weightlifting two weeks ago. Fundus examination of the left eye showed cotton-wool spots and scattered retinal hemorrhages in the posterior pole. Fluorescein angiography and indocyanine green angiography with a scanning laser ophthalmoscope were performed. RESULTS: Angiography showed hypofluorescent areas adjacent to the optic disc and in the posterior pole and partial filling insufficiency in the inferior and inferotemporal branch retinal veins. Complete venous filling was noted in late phases of angiography. CONCLUSIONS: The pathogenesis of weightlifting suggests the Purtscher-like changes as a result of Valsalva maneuver in our case. To our knowledge, this is the first reported case of Purtscher-like retinopathy associated with weightlifting.

Adolescent↗

Prevention of posterior capsule opacification by retinoic acid and mitomycin.

BACKGROUND: Our aim was to evaluate the effect of an intraoperative single dose of retinoic acid (RA) or mitomycin C (MMC) in preventing posterior capsule opacification (PCO). METHODS: Twenty-seven rabbits were divided randomly into three groups. RA (250 microg/ml) and MMC (0.04 mg/ml) were given 0.1 ml by hydrosection and 0.9 ml into the capsular bag after phacoemulsification. The third group served as a control group. Three months after intervention PCO was graded clinically. Furthermore, proliferation of lens epithelial cells was evaluated histologically. RESULTS: Two eyes developed corneal edema in the MMC group. On clinical assessment, RA and MMC were significantly effective in preventing PCO compared with controls (P<0.005). On histological analysis, there was significantly reduced proliferative activity on posterior capsules in the treatment groups, in contrast to multilayer cells in the control group. CONCLUSION: Intraoperative single-dose administration of RA and MMC significantly prevented the development of PCO in rabbit eyes. The optimal biocompatible dosage must be carefully determined by further investigation.

Animals↗

Tilt and decentration after primary and secondary transsclerally sutured posterior chamber intraocular lens implantation.

PURPOSE: To evaluate tilt and decentration after primary and secondary implantation of transsclerally sutured posterior chamber intraocular lenses (PC IOLs). SETTING: Dokuz Eylül University Medical School, Department of Ophthalmology, Izmir, Turkey. METHODS: Fifty-six consecutive eyes of 53 patients who had implantation of transsclerally sutured PC IOLs were prospectively included in the study. Intraocular lens tilt and decentration after primary (14 eyes) and secondary (42 eyes) implantation were compared quantitatively using Purkinje images. RESULTS: The mean IOL tilt was 6.09 degrees +/- 3.80 (SD) in all eyes, 5.71 +/- 3.41 degrees in the primary implantation group, and 6.22 +/- 3.94 degrees in the secondary implantation group. The mean IOL decentration was 0.67 +/- 0.43 mm (range 0 to 2.5 mm), 0.59 +/- 0.38 mm, and 0.69 +/- 0.45 mm, respectively. There were no statistically significant differences between the primary and secondary implantation groups in decentration or tilt. Decentration greater than 1.0 mm was present in 7 eyes (16.7%) after secondary implantation and in 1 eye (7.1%) after primary implantation. Tilting of more than 10 degrees was present in 7 eyes (16.7%) and 2 eyes (14.2%), respectively. There were no statistically significant differences between the 2 groups in decentration greater than 1.0 mm (chi square = 0.194, P =.834) or in tilting greater than 10 degrees (chi square = 0.834, P =.659). CONCLUSIONS: Clinically significant IOL tilt or decentration was rare after transscleral implantation. There were no differences in tilt or decentration between primary and secondary implantation.

Aged↗

Prevention of posterior capsule opacification by intraoperative single-dose pharmacologic agents.

PURPOSE: To determine whether an intraoperative single dose of dexamethasone, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDTA and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Celal Bayar University, School of Medicine, Manisa, and Department of Pathology, Dokur Eylül University, School of Medicine, Izmir, Turkey. METHODS: Fifty-four rabbits were randomly divided into 6 groups. Dexamethasone (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDTA and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hydrodissection and 0.9 cc into the capsular bag after phacoemulsification. The sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evaluated histologically. RESULTS: The drugs were significantly effective in preventing PCO compared with the control (P <.005). Dexamethasone had a weaker effect than the other drugs. In histological analysis, although monolayer LECs in the dexamethasone and diclofenac groups were observed, there was no proliferative activity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in contrast to the multilayer cells in the control. CONCLUSIONS: Intraoperative single-dose application of EDTA, EDTA+RGD peptide combination, and MMC significantly prevented the development of PCO in rabbit eyes. Diclofenac was less effective but also reduced PCO. Although dexamethasone did not prevent the proliferation of LECs, it decreased PCO clinically.

Animals↗

Pseudoexfoliation and glaucoma in eyes with retinal vein occlusion.

PURPOSE: To evaluate pseudoexfoliation (PE) and pre-existent glaucoma in eyes with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). METHODS: Consecutive eyes with a diagnosis of BRVO (73 eyes of 70 patients) and CRVO (53 eyes of 49 patients) examined between July and December 1998 comprised the study eyes. Age-matched control group consisted of 384 eyes of 192 outpatients. The prevalence of PE and glaucoma were determined and appropriate statistical tests were performed. RESULTS: PE was present in six of 73 eyes with BRVO (8.2%), 11 of 53 eyes with CRVO (20.8%) and 20 of 384 control eyes (5.2%). Two of 73 eyes with BRVO (2.7%) and 10 of 53 eyes with CRVO (18.9%) had glaucoma. Compared with the control eyes, PE was significantly more common in eyes with CRVO and coexistent glaucoma was significantly more common both in eyes with CRVO and in eyes with BRVO. CONCLUSION: While glaucoma seems to be a risk factor both for BRVO and CRVO, PE is a likely risk factor for CRVO.

Adult↗

Retinal breaks and rhegmatogenous retinal detachment in association with branch retinal vein occlusion.

BACKGROUND AND OBJECTIVE: To report the incidence and clinical characteristics of retinal breaks and/or rhegmatogenous retinal detachment (RRD) in patients with branch retinal vein occlusion (BRVO). PATIENTS AND METHODS: We reviewed the clinical records of 230 eyes of 214 patients with BRVO and identified eyes with retinal breaks and/or RRD. Patients had at least 6 months of follow-up. RESULTS: Seven of 230 eyes (3%) had retinal breaks and 3 eyes (1.3%) had RRD. One of the eyes with RRD had subclinical retinal detachment. All 7 eyes had ischemic disease documented by fluorescein angiography. Two of 7 eyes had concurrent retinal neovascularization. Four eyes with breaks, but without RRD, and the eye with subclinical RRD were managed by argon green laser. Two eyes with RRD were managed successfully with scleral buckling surgery and postoperative supplemental argon green laser. The mean follow-up period was 14.8 +/- 8.3 months. CONCLUSIONS: Patients with BRVO should be monitored closely for possible retinal break formation and RRD development.

Aged↗

Pars plana vitrectomy with pars plana tube implantation in eyes with intractable glaucoma.

AIMS: Intractable glaucoma is glaucoma resistant to medical therapy and conventional surgical procedures. In this study, a planned surgical technique is discussed for controlling the increased intraocular pressure in selected cases with intractable glaucoma. METHODS: Total pars plana vitrectomy with pars plana tube implantation was performed in 17 eyes of 17 cases with intractable glaucoma. Patients with neovascular glaucoma were not included in this study. The mean age of these patients (seven men, 10 women) was 44.6 (SD 22.1) years and mean follow up period was 30.3 (15.5) months (range 4-71). Drainage implants with a disc were used in 16 cases, whereas, a tube with scleral buckle (Schocket surgery) was preferred in one case. An intraocular pressure below or equal to 20 mm Hg without any adjunctive medication or with only one type of antiglaucomatous drop was considered as an adequate operative outcome. RESULTS: 16 out of 17 eyes maintained adequate pressure control. Only three out of these 16 eyes required prophylactic antiglaucomatous medications. One patient underwent reoperation for pressure control. The most severe complications observed postoperatively were intravitreal haemorrhage (one case), choroidal detachment (one case), implant failure (one case), total retinal detachment (two cases), and corneal endothelial decompensation (five cases). CONCLUSION: Pars plana placement of drainage tube following pars plana vitrectomy should be considered as an alternative method for controlling increased intraocular pressures in selected patients with intractable glaucoma.

Adolescent↗

Bilateral duplication of the optic canals.

During an autopsy survey of 369 human skulls, one with bilateral (0.27%) and one with unilateral (0.27%) duplication of the optic canal were reported. The anatomical findings in case of this rare anomaly are presented.

Adult↗

Magnetic resonance imaging in the evaluation of eyes treated with silicone oil.

BACKGROUND AND OBJECTIVE: To evaluate the sensitivity of magnetic resonance imaging (MRI) in detecting retinal detachment (RD) in eyes filled with silicone oil, and to determine the MRI characteristics of silicone oil in vivo. PATIENTS AND METHODS: Seven eyes of seven patients with RD and eight eyes of eight patients without RD after silicone oil surgery were included in the study. All of the patients had clear media. MRI was performed in these patients. The results of ophthalmic examinations were compared with MRI findings. RESULTS: MRI detected six of the seven detached retinas. The multiplanar imaging capability of MRI helped in showing the RDs in various locations. The chemical shift artifact exaggerated the retinal thickness and made the detached retina visible. Fat suppressed images showed the silicone oil-corneal contact clearly. CONCLUSION: MRI is an effective technique for demonstrating RD in eyes filled with silicone oil and can be used successfully in eyes with opaque media.

Adult↗

Somatostatin receptors in the orbits.

In-111 pentetreotide has been recommended for the detection of somatostatin receptor (SSR) positive tumors. Sites with increased numbers of activated lymphocytes may also show In-111 pentetreotide with Graves' ophthalmopathy (GO) compared to various other orbital disorders. Five patients with GO, three patients with necrotizing scleritis, and two patients with orbital pseudotumor were imaged at 4 hours, 24 hours, and 48 hours after injection of In-111 pentetreotide. Although planar images did not show considerable uptake, SPECT slices showed marked and persistent uptake in the orbits unilaterally in one patient, and bilaterally in three patients with GO. There was no significant correlation between the In-111 pentetreotide activity and the degree of opthalmopathy determined by Werner's classification. Pseudotumors also showed positive uptake. Early uptake was present in one patient with necrotizing scleritis because of Wegener's granulomatosis, and was completely diminished at 24 hours. Octreotide treatment in three patients with GO did not cause any clinical improvement. Although the presence of SSR, either on the infiltrated lymphocytes or on fibroblasts, implies that octreotide treatment for GO can be considered, the results are not encouraging. Nonspecific binding might be present when uptake patterns of orbits and persistence of activity during octreotide treatment are considered.

Adult↗

Thallium-201 uptake in the orbits.

Thallium-201 uptake patterns in the orbits are not widely known. Diffuse, bilateral orbital localization of TI-201 chloride may be an incidental finding because of orbital muscle or other soft tissue uptake. Differences in orbital blood flow and soft tissue mass may be the cause of the varying uptake intensities in most cases. Focal uptakes, even when bilateral, may indicate specific pathology and should be investigated. Sample cases are presented.

Adult↗

Nd:YAG laser posterior hyaloidotomy in subhyaloid hemorrhage.

Subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because subhyaloid hemorrhage may be associated with permanent macular changes before it spontaneously resolves, posterior Nd:YAG hyaloidotomy may be indicated in selected patients. We performed Q-switched Nd:YAG laser posterior hyaloidotomy via the transcorneal route in two cases of subhyaloid hemorrhage. The hemorrhage instantaneously drained into the vitreous cavity, resulting in a dramatic increase in visual acuity.

Adult↗