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Biomedical subjects

S Unal

Publications and source records attributed to S Unal.

At least 73 records · Page 4Linked to original sources
PubMed1998

Efficacy of transurethral electrovaporization of the prostate with respect to standard transurethral resection.

Transurethral electrovaporization of the prostate (TVP) has been introduced as an alternative to standard transurethral resection of the prostate (TURP) with lesser morbidity. However, the efficacy of this new technique has not been well known. To compare the results of standard TURP and TVP, 76 patients with symptomatic benign prostatic hyperplasia (BFH) were divided into two groups in a randomized clinical trial. Preoperative assessment included AUA Symptom score, maximum flow rates (Qmax), digital rectal examination, serum prostate specific antigen, and transrectal ultrasonography, with biopsy if the patient was randomized to vaporization. Transrectal temperature measurements and the hemoglobin concentration of the irrigation fluid were investigated in all the patients during the procedure. Although the transrectal temperature was higher in the TVP group (0.53-1.27 degrees C; mean 0.83 degrees C), no associated complication were determined. However, blood loss was significantly lesser than with TURP (340 mL v 60 mL). Two patients in the TURP group required blood transfusions, and one had sphincteric incontinence, whereas one postoperative retention, one reoperation with bladder perforation, and one sphincteric incontinence were seen in the TVP group. On the other hand, 12-month follow-up demonstrated that the uroflow rates improved in a similar manner. The Qmax increased in the TURP and TVP groups from 8.8 and 8.3 mL/sec to 19.6 and 17.2 mL/sec, respectively. The mean AUA Symptom Score decreased from 13.7 to 7.9 and 6.1 at 6 and 12 months, respectively. In the TVP group and from 14.6 to 7.3 and 7.0 at 6 and 12 months, respectively, in the TURP group. There were significant differences in the mean catheterization time (P < 0.0001) and hospital stay (P < 0.0001) in favor of TVP. Our results suggest that TVP is a safe and effective alternative treatment for symptomatic BPH.

Aged↗
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↗
PubMed1998

Thallium-201, technetium-99m-tetrofosmin and iodine-131 in detecting differentiated thyroid carcinoma metastases.

UNLABELLED: The purpose of this study was to asses the detectability of differentiated thyroid carcinoma (DTC) metastases by 99mTc-tetrofosmin and to compare the results of 99mTc-tetrofosmin with 131I and 201Tl. The reliability of 201Tl and 99mTc-tetrofosmin scanning during suppression therapy also has been studied. METHODS: A prospective study was performed on 41 patients (30 females, 11 males) with DTC (30 papillary, 11 follicular) who had undergone total thyroidectomy and received an average dose of 117 mCi (4329 MBq) of radioiodine for ablation of postsurgical residual thyroid tissue. All patients (n = 41) had 201Tl, 99mTc-tetrofosmin or 131I whole-body imaging after discontinuation of thyroid hormone replacement (thyroxine-off group). Eight of 14 patients with distant metastases also were imaged when they were on thyroxine therapy both with 201Tl and 99mTc-tetrofosmin (thyroxine on-and-off group). Radiologic studies (chest radiography, CT and MRI), serum thyroglobulin assays and histopathologic examinations were performed to clarify the presence of metastases with positive uptake on any of three radionuclide studies. RESULTS: In 26 of 41 patients all three scans were negative. These patients also clinically didn't show any evidence of metastases. Fourteen patients were considered to have distant metastases on the basis of clinical, radiologic and histopathologic findings. The sensitivities of 201Tl, 99mTc-tetrofosmin and 131I in diagnosing distant metastases were comparable (0.85, 0.85 and 0.78, respectively). Iodine-131 was much more sensitive than 201Tl and 99mTc-tetrofosmin for demonstrating residual thyroid tissue after surgery (1.00, 0.33 and 0.33, respectively). The only false-positive case involved radioiodine uptake in a tuberculoma. Thyroxine-on images of 8 patients with distant metastases showed no difference from their thyroxine-off images regarding the site, number and uptake of metastases. CONCLUSION: Technetium-99m-tetrofosmin and 201Tl imaging are highly sensitive for detecting differentiated thyroid carcinoma metastases and do not require prior withdrawal of thyroid hormone suppressive therapy.

Adenocarcinoma, Follicular↗
PubMed1997

Septic shock as a predictor of mortality in bacteremia caused by coagulase-negative staphylococci.

Fifty episodes of bacteremia caused by coagulase-negative staphylococci at Hacettepe University Hospital over a five-year period were reviewed to evaluate the factors influencing the prognosis. Overall mortality and mortality due to bacteremia were 36% and 24%, respectively. Septic shock was determined to be the only factor adversely influencing mortality in both univariate and multivariate analyses. Age, sex, duration of hospitalization, origin of infection, underlying disease, presence of central intravascular or urinary catheters, and prior antibiotic therapy were not statistically significant parameters in predicting septic shock.

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

In vitro activity of a new echinocandin, LY303366, compared with those of amphotericin B and fluconazole against clinical yeast isolates.

The in vitro activity of LY303366, a new echinocandin derivative, was evaluated with 191 yeast isolates by a broth microdilution method. The MICs at which 50% of the isolates were inhibited were 0.125 microg/ml for Candida albicans and C. tropicalis, 0.25 microg/ml for C. krusei, C. kefyr, and C. glabrata, and 2.0 microg/ml for C. parapsilosis.

Amphotericin B↗
PubMed1997

Economic analysis of nosocomial infections in a Turkish university hospital.

Nosocomial infections constitute an important health problem with morbidity, and high mortality, prolongation of hospital stay, and increased costs of direct patient care. This study was conducted in Hacettepe University Hospital in order to determine the cost of nosocomial infections and length of hospitalization by matching infected patients with uninfected controls. Data collected from 102 individuals with nosocomial infection (group A) and 102 controls without nosocomial infection (group B) were recorded by using a computer program (dbase IV). Urinary tract infections, surgical wound infections and bacteremias were the most common nosocomial infections. Patients were generally located in Internal Medicine, Neurosurgery, General Surgery Clinics. The mean total length of stay was 35.1 and 14.8 days for group A and group B, respectively (p<0.001). The average hospital cost was US $2280 for group A, and US $698 for group B (p<0.001). Mortality rates were 19.6% for patients with nosocomial infections and 2.9% for uninfected controls (p<0.0001). We conclude that the high economic expense which nosocomial infection represents justifies measures to control this entity.

Bacteremia↗
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↗
PubMed1997

Epidemiology of enuresis in Turkish children.

To establish the prevalence of enuresis in Turkish children and to identify common methods of managing enuresis, a self-administered questionnaire was distributed to parents of 5754 children aged 7-12 years. From a response rate of 96% the overall prevalence of any reported nocturnal enuresis was 11.5% and diurnal enuresis was 0.5%. The prevalence of enuresis was higher in boys than in girls. Turkish parents primarily administered behavioural techniques for the management of enuresis. These results suggest that prevalence rates for nocturnal enuresis in Turkish children are similar to those in previous studies reported from Western Europe, the USA and Australia.

Age Factors↗
PubMed1996

Cloning and characterization of femA and femB from Staphylococcus epidermidis.

A DNA fragment was identified and cloned from Staphylococcus epidermidis (Se) using femA from S. aureus (Sa) as a heterologous hybridization probe. DNA sequence analysis of a portion of this clone revealed two complete ORFs highly related to femA and femB of Sa. The genomic arrangement of the Se femA/B complex was nearly identical to that observed in Sa. Intra- and interspecies relatedness of these genes and conservation of genomic organization were consistent with gene duplication of one of these genes in an ancestral organism. Recombinant FEMA, produced in Escherichia coli (Ec), was purified to near homogeneity. Identity of the purified protein was verified by N-terminal amino acid (aa) sequence analysis.

Amino Acid Sequence↗
PubMed1996

Is general anaesthesia necessary for URS in women?

A total of 65 women with ureteral stone who underwent ureteroscopy were divided randomly into two groups between April 1993 and March 1994. URS was performed under general anaesthesia in the first group (35 patients), and under local anaesthesia with sedation analgesia in the second group (30 patients). Only 2 patients of the second group did not tolerate the operation. The success rate was 88% in the first group and 83.3% in the second. There was no significant difference between the two groups. Since URS under local anaesthesia is time-saving, cost-effective, and highly tolerable in women, it is a good choice for ureteral stones.

Adult↗
PubMed1996

The coexistence of familial Mediterranean fever and polyarteritis nodosa; report of a case.

We describe a 14-year-old boy with a 5-year history of familial Mediterranean fever (FMF), treated with colchicine, who developed polyarteritis nodosa (PAN). He was admitted to our hospital with fever, general weakness, arthritis, and purpura. Five weeks after admission, hypertension was noted. Skin biopsy showed perivascular leukocyte infiltration in the epidermis. An aortography revealed multiple aneurysms of the renal, common hepatic, and intercostal arteries. He was treated with intravenous methylprednisolone, oral cyclophosphamide, and azathioprine. The known rare association of FMF and PAN is discussed.

Adolescent↗