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Biomedical subjects

S Tuncer

Publications and source records attributed to S Tuncer.

At least 37 records · Page 2Linked to original sources
PubMed2000

Compliance with bladder management in spinal cord injury patients.

STUDY DESIGN: Retrospective analysis of medical records on spinal cord injury (SCI) patients with neuropathic bladder. OBJECTIVE: To determine SCI patients' compliance with the method of bladder management they used on discharge from inpatient rehabilitation. SETTING: Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Spinal Cord Injury Unit, which treats patients referred from throughout Turkey. METHODS: The bladder management method of 50 new SCI patients was noted at admission, discharge and follow-up. Reasons for changing the initial method were documented. For analysis, patients were grouped by gender, level and completeness of injury. Compliance with bladder management method was compared between these groups by chi-square test. RESULTS: The method of bladder management at admission was indwelling catheter (IC) for 86% of the patients. Most were switched to clean intermittent catheterisation (CIC) by rehabilitation discharge. Of 38 patients (76%) on CIC at discharge, 20 (52%) discontinued this method and reverted to IC during follow-up. Compliance with CIC was lower for women, for tetraplegics, and for those with complete injury. Dependence on care givers, severe spasticity interfering with catheterisation, incontinence despite anticholinergic agents, and lack of availability of external collective devices for female patients were the main reasons for low compliance with CIC. CONCLUSION: The bladder management method of SCI patients should be selected so as to be suitable to the patients' life style. Besides reducing morbidity, it also has to enhance the quality of life.

Activities of Daily Living↗
PubMed2000

Nasal reconstruction using both cranial bone and ear cartilage.

In this article, an anatomic reconstruction is described using cranial bone graft for the bony part of the nose while reconstructing the cartilaginous part with ear cartilage. This modification provides protection of the nose from the traumatic forces creating a flexible nasal tip. A modification is described and compared with the nasal reconstruction by calvarial bone itself.

Adult↗
PubMed1999

Familial Mediterranean fever. No role of Mycobacterium tuberculosis in ten patients.

BACKGROUND: Tuberculosis (TB) and Familial mediterranean fever (FMF) are two common diseases in our region, Turkey. Both share some properties in common: Both cause AA type amyloidosis and have association with some immunological abnormalities. Upon incidentally observing Mycobacterium tuberculosis in bone marrow biopsies of three patients with FMF in a previous study, we intended to elucidate this association prospectively. MATERIAL AND METHODS: In this study, we examined prospectively 10 FMF patients, 5 male and 5 female, with a median duration of 31 years disease activity. All were under colchicine therapy. They had no sign of renal involvement. The bone marrow biopsies of these patients were examined for the presence of M. tuberculosis by Polymerase chain reaction (PCR), BACTEC culture and pathological stains. Pathological examination was performed for the existence of granuloma and amyloid deposition by hematoxylin-eosin, Crystal Violet and Congo red stains. RESULTS: The examination of all bone marrow specimens by the mentioned methods suggest that Mycobacterium tuberculosis has no role in the ethiopathogenesis of FMF. Although the patients had a positive family history of 60% for tuberculosis and in 80% of them with positive tuberculin skin test. CONCLUSIONS: We concluded that although there seemed to be a kind of association between both diseases, this relationship is not via the direct existence of bacteria itself. Considering high family history and skin test positivity, one should look for the presence of autoimmune mechanisms under this suspicious relationship between tuberculosis and FMF. Also, this is the first study examined the state of amyloidosis in the bone marrow at an earlier stage of FMF without overt renal findings.

Adult↗
PubMed1999

Trace element and magnesium levels and superoxide dismutase activity in rheumatoid arthritis.

It has been suggested that reactive oxygen metabolites and trace elements play some role in the etiology and pathogenesis of rheumatoid arthritis (RA). Superoxide dismutase (SOD) is believed to exert an important protective role against oxygen toxicity. The aim of the study was to investigate the probable changes in the levels of trace elements and SOD activity in RA. Plasma and erythrocyte copper, zinc, and magnesium levels and erythrocyte SOD activity were measured in groups of controls and RA cases. Significantly increased erythrocyte SOD activity was found in RA patients in comparison with controls (p < 0.0001). A rise in erythrocyte Zn level (p < 0.0001) and plasma Cu level (p < 0.0001) and a decrease in erythrocyte Cu level (p < 0.05) and plasma Zn level (p < 0.05) were obtained in RA patients when compared to controls. Plasma and erythrocyte Mg levels of the RA patients showed slight and statistically insignificant reductions when compared to controls (p > 0.05). In RA patients, there were positive correlations between erythrocyte SOD activity and Mg level (r = 0.4345, p < 0.01) and between erythrocyte Zn level and plasma Cu level (r = 0.4132, p < 0.01). There were negative correlations between erythrocyte SOD activity and plasma Zn level (r = -0.3605, p < 0.05) and between plasma Zn level and erythrocyte Cu level (r = -0.4578, p < 0.01) in RA patients.

Adult↗
PubMed1999

Human papillomavirus associated with bladder carcinoma? Analysis by polymerase chain reaction.

BACKGROUND: The aim of the present study was to assess the possible etiologic role of human papillomaviruses (HPV) in bladder tumors. METHODS: Forty-two fresh biopsy specimens from different grades and stages of bladder tumor cases and 10 normal bladder mucosa biopsies were studied. Specimens were analyzed by polymerase chain reaction (PCR) with HPV-specific general primer set for the detection of viral DNA. Polymerase chain reaction-positive samples were also tested with HPV 16- and 18-specific primers by the same method. RESULTS: We found two samples (4.8%) containing HPV DNA among the TaG1 bladder tumors. All other specimens, including the control group, were found to be negative by PCR. Neither of the two HPV-positive patients had immune deficiency and/or genital wars. Human papillomavirus 16 was detected by type-specific primers in one sample, but the other HPV-positive sample could not be typed. CONCLUSIONS: The low prevalence of HPV in this and many previous studies does not support an etiologic role of HPV in bladder carcinogenesis. We detected the virus in two early stage tumors, but none was detected in the high-grade samples. However, to clarify the positivity of HPV in these occasional cases, future studies must be designed by using in situ PCR techniques, including samples from tumors and normal bladder mucosa from the same patient.

Biopsy↗
PubMed1999

Disability in ankylosing spondylitis.

PURPOSE: This study was designed to examine the functional loss in ankylosing spondylitis and explore the relationship between disability and various factors such as age, disease duration, disease activity, spinal mobility, chest expansion, peripheral joint involvement, radiological changes, and psychosocial well-being. METHOD: Forty-two patients were included in this cross-sectional study. RESULTS: The results showed that 37 patients had mild to moderate disability, two patients had severe disability, and three patients did not report any functional loss. Spearman correlation analyses showed that disability was strongly correlated with spinal mobility measures, disease activity measures, and disease duration. Also, patients with peripheral joint involvement had greater disability. When the predictive effect of five independent variables was studied by multiple regression analysis, it was found that the most powerful predictors of functional loss in AS patients were cervical rotation, modified Schober's test, and pain. CONCLUSIONS: These data suggest that functional consequences of AS are constituted by multiple impairments and each needs to be managed by an integrated physiatric approach.

Activities of Daily Living↗
PubMed1999

Modifications in endoscopic facelifts.

Since 1996, 72 patients (66 women and 6 men) have undergone endoscopic upper and midface rejuvenation. Sixteen of these patients had concomitant lower face rejuvenation at the same time. The patients were operated using a personal endoscopic technique, including biplanar endoscopic dissection (subgaleal and subcutaneous) at the forehead and temporal regions, excision of a galeal strip approximately 1 cm in thickness (to achieve a stable forehead lift), and a lower blepharoplasty incision for midface lifting and fixation of the malar fat pad. This approach helps to prevent midface widening-a concern of most surgeons. Regarding patient satisfaction, 51 patients had excellent results, 16 patients had good results, and 5 patients had an improved appearance of the mid and upper face. Complications included 11 incidences of temporary numbness in different regions of the upper and mid face, three incidences of temporary lower lid retraction (which did not require additional revision), three relapses of eyebrow elevation (which were reoperated), and unbalanced eyebrows in 2 patients (which were corrected during secondary revisional procedures).

Adult↗
PubMed1999

Splitting advancement genioplasty: a new genioplasty technique.

A new genioplasty technique has been described and performed on 16 patients since 1995. The technique has been developed to avoid some undesired results of the current osseous genioplasty techniques and to achieve a more natural appearance in advancement genioplasty. According to the authors' technique, a rectangular part of the outer table of the mentum is split away from the mandible, and is advanced and fixated to the mandible. This technique can be used for advancement cases but not for reduction genioplasty. This technique was performed on 16 patients with only minor complications, including one case of wound dehiscence, one hematoma, and one case of osteomyelitis, which was managed with systemic antibiotic therapy. Aesthetic results were found to be satisfactory according to an evaluation by the authors. When the results were evaluated using pre- and postoperative photos, lip position and projection of the mentum were found to be natural in shape appearance. During the late postoperative period, the new bone formation between the advanced segment and the mandible was demonstrated radiographically. Advantages of the technique include having more contact surfaces for bony healing, a natural position of the lower lip, more natural projection of the mentum, tridimensional movement of the mentum, and improvement in the soft tissue of the neck. The disadvantages of the technique are the potential risk of infection due to dead space from the advancement, manipulation problems during surgery, and possible mental nerve injury. Splitting advancement genioplasty was found to be a useful technique for advancement genioplasty. Splitting advancement genioplasty is a more physiological osteotomy technique than most of osseous genioplasty techniques.

Adult↗
PubMed1998

Comparison of cytochemical staining, immunofluorescence and PCR for diagnosis of pneumocystis carinii on sputum samples.

Detection of P. carinii has increased with the use of polymerase chain reaction (PCR), particularly in sputum samples. In this study, sputum samples obtained from 30 immunosuppressed patients with respiratory symptoms (12 HIV-infected) were tested by standard cytochemical staining (Giemsa and methenamine silver), immunofluorescence (IF) staining and PCR for detection of P. carinii and the results were compared. Pneumocystis carinii was detected in 4, 8 and 13 sputum samples by cytological staining, IF test and PCR, respectively. Specific amplification bands were obtained in all sputum samples that were positive by both other tests. All tests gave negative results in sputum samples obtained from 5 HIV-infected asymptomatic patients and 22 non-immunosuppressed tuberculosis patients. Our observations suggest that PCR results were well correlated with P. carinii pneumonia (PCP), especially in non-HIV-infected patients. However, PCR positivity obtained in HIV-infected patients could be misleading in the diagnosis of PCP without careful clinical evaluation. Positive results obtained by Giemsa staining or IF test confirm diagnosis of PCP authoritatively. As a result, we suggest testing sputum samples by both PCR and IF techniques for detection of P. carinii.

AIDS-Related Opportunistic Infections↗
PubMed1998

Anti-Kp 90 IgA antibodies in the diagnosis of active tuberculosis.

BACKGROUND: Accurate diagnosis of active tuberculosis (TB) has been difficult historically, yet a great demand persists for a rapid and reliable diagnostic method. Detection of Mycobacterium tuberculosis anti-Kp 90 IgA antibodies is one of the more novel techniques. STUDY OBJECTIVES: To evaluate the diagnostic value of a recently developed enzyme-linked immunosorbent assay (ELISA) test, which detects IgA antibodies against M tuberculosis Kp 90 antigen, and to compare the results with conventional diagnosis and the polymerase chain reaction (PCR) method. PARTICIPANTS: Serum, ethylenediaminetetraacetic acid (EDTA)-blood, and body fluid samples were obtained from 51 patients with active TB and 71 control subjects. The clinical diagnosis of TB was supported by a positive culture (n = 6), detection of acid-fast bacilli on smear (n = 35), or both (n = 10). MEASUREMENTS AND RESULTS: IgA antibodies were detected in sera and/or body fluid samples from 82% of patients with TB and 10% of controls. M tuberculosis DNA was detected in body fluid sample of 96% and blood sample of 49% of patients with TB by PCR. None of the blood and 5.6% of the body fluid specimens from controls were PCR-positive. CONCLUSIONS: Anti-Kp 90 IgA antibodies were detected using ELISA in 78% of serum and 69% of body fluids from patients with TB, therefore, this test is promising for the diagnosis of active TB and appears to be more reliable, particularly for body fluid samples.

Adolescent↗
PubMed1997

Detection of bacillus Calmette-Guerin in the blood by the polymerase chain reaction method of treated bladder cancer patients.

PURPOSE: Following intravesical bacillus Calmette-Guerin (BCG) instillation, we attempted to detect BCG in the blood using the polymerase chain reaction (PCR) method and correlate these findings with the occurrence of major complications due to this treatment. MATERIALS AND METHODS: Intravesical BCG immunotherapy was given to 22 consecutive patients with superficial bladder tumors. In 2 patients the BCG instillation had to be discontinued due to serious side effects of therapy. Blood samples (252 aliquots) were obtained from 126 BCG courses in 22 cases, and 2 additional samples (4 aliquots) were obtained from 1 patient 1 and 3 months after cessation of therapy. All blood samples were analyzed by the PCR technique for detection of deoxyribonucleic acid tuberculosis Mycobacterium tuberculosis. RESULTS: Of the 126 blood samples 9 (7.1%) were PCR positive for M. tuberculosis. These 9 positive samples belonged to 3 patients, all of whom were among those 4 patients who had major clinical side effects. CONCLUSIONS: We demonstrated that rapid and sensitive detection of mycobacteremia by PCR correlated with the clinical course of these patients. We also demonstrated that PCR can be used to monitor BCG in the blood after antituberculous therapy. The early, fast and accurate diagnosis of BCG in the blood by PCR may alter the serious clinical course of these patients by initiation of specific treatment early. However, further extensive studies are needed to validate these results.

Adjuvants, Immunologic↗
PubMed1997

Solubilizing efficiency of different gutta-percha solvents: a comparative study.

A study was conducted to comparatively evaluate the efficiency of different solvents for dissolving gutta-percha. Halothane, chloroform, xylene, acetone, isopropyl alcohol, turpentine, oil of mela-leuca and eucalyptol were used as solvents for dissolving standardized gutta-percha discs. Halothane, chloroform and xylene were markedly superior solvents of gutta-percha in comparison with the others. There was no significant difference among the three (p > 0.05). Eucalyptol, turpentine and oil of melaleuca were relatively less efficient. Acetone and isopropyl alcohol did not dissolve gutta-percha, being similar in this respect to distilled water.

2-Propanol↗
PubMed1997

PCR on disseminated tuberculosis in bone marrow and liver biopsy specimens: correlation to histopathological and clinical diagnosis.

Disseminated tuberculosis with negative pulmonary findings is a diagnostic problem. Histopathological studies of bone marrow (BM) and liver (LV) biopsies are the most reliable methods for diagnosis in such cases; however, their sensitivity is limited. In this retrospective study, 41 BM and 7 LV paraffin-embedded biopsy specimens from clinically (clinical response to antituberculous treatment after 6 months follow-up) and/or histopathologically diagnosed tuberculosis were analysed for the detection of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). Two different primer sets, one based on the repeated IS6110 sequence of M. tuberculosis and the other based on the mtp40 gene region, were used for amplification. Histopathological and PCR studies were positive for M. tuberculosis in 12/41, and 30/41 in BM and 4/7, and 6/7 in LV biopsy specimens, respectively. As the control group, 17 BM biopsy specimens obtained from patients with a positive Mantoux skin test but no active tuberculosis were analysed. One BM biopsy out of 17 control cases was positive with PCR while none was consistent with TB histopathologically. In conclusion, PCR might be applicable and more reliable than histopathological studies for detection of tuberculosis in BM and LV biopsy specimens.

Adolescent↗
PubMed1996

PCR detected hepatitis C virus genome in the brain of a case with progressive encephalomyelitis with rigidity.

A case of progressive encephalomyelitis with rigidity (PEWR) associated with hepatitis C virus (HCV) is reported. A 58 year-old woman presented with a clinical picture of progressive quadriparesis, sensory loss, sphincter dysfunction, painful muscle spasms in the upper and lower limbs and continuous muscle unit activity in electromyography. She developed hepatitis, pancreatitis and HCV-RNA was detected in the plasma by reverse transcription-polymerase chain reaction (RT-PCR). Postmortem histopathological examination showed encephalomyelitis with perivascular lymphocyte cuffing, infiltration and neuronal loss mainly affecting the brainstem and cervical spinal cord. The RT-PCR analysis of the postmortem brain, brainstem, liver, pancreas, plasma and CSF samples revealed the presence of HCV genome in all specimens except CSF. Clinical features, postmortem histopathology and PCR results and the possible etiopathogenesis of PEWR are briefly discussed.

Brain Stem↗
PubMed1996

A local renin-angiotensin system in the bone marrow.

The renin-angiotensin system has been considered to be a circulating system that controls blood pressure and electrolyte homeostasis. It is now clear, however, that the renin-angiotensin system must also be regarded as a local tissue system within many organs. Renin-angiotensin system peptides are capable of producing the hyperplasia and growth of cells. The haematopoietic bone-marrow system is characterized by turnover, proliferation and differentiation of cells. We propose that there exists a locally active renin-angiotensin system that is intrinsic to bone marrow and that might affect the growth of haematopoietic colonies, and the production, proliferation and differentiation of cells. The local synthesis of a particular protein can be deduced from the presence of the corresponding messenger ribonucleic acid. To prove our hypothesis, we propose that attempts be made to quantitatively analyse messenger ribonucleic acids for components of the renin-angiotensin system in tissues from bone marrow biopsies. Demonstration of an endogenous renin-angiotension system in bone marrow might lead us to a better understanding of the production of haematopoietic cells and of the excessive cell-growth associated with neoplastic diseases of the blood.

Animals↗