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Biomedical subjects

T Yilmaz

Publications and source records attributed to T Yilmaz.

At least 19 recordsLinked to original sources
PubMed2006

Efficacy of right anterior sector drainage reconstruction in right-lobe live-donor transplantation.

BACKGROUND: Without including the middle hepatic vein (MHV) into right-lobe grafts, venous drainage of the anterior segment (AS) has always been a concern. The efficacy and the necessity of additional venous reconstruction in the AS for graft viability and function are still controversial. METHODS: Since February 2002, 57 right-lobe grafts were implanted into adult recipients. The mean graft to ideal recipient weight ratio (GRWR) was 1.3% (minimum: 0.8%, maximum 2.1%). All minor venous tributaries to the MHV less than 5 mm in diameter were ligated. The management of MHV tributaries was categorized into three groups: (A) no major tributaries (n = 33); (B) major tributaries ligated (n = 11); and (C) major tributaries reconstructed (n = 13). Reconstructions were established using vascular grafts (PTF, n = 8; cadaveric, n = 2) or joining with right hepatic vein orifice (n = 6). The groups were homogenous in age, gender, MELD (17 +/- 6, 16 +/- 4, 18 +/- 7), graft weight (817 +/- 181, 838 +/- 152, and 855 +/- 159 g), and graft/ideal liver weight ratio (0.54 +/- 0.12, 0.57 +/- 0.13, and 0.57 +/- 0.1, respectively). We investigated the volume of ascites, serum bilirubin, albumin, and liver enzyme levels and INR on postoperative day 4 (POD4) and POD21. RESULTS: Two patients died of MRSA sepsis on POD18 and POD23 (MELD: 24 and 28) after initial graft function. Their graft weights were 800 g and 980 g, and their volumes were 47% (group B) and 62% (group A) of the ideal liver mass of the recipients, respectively. One PTF and another cadaveric vascular graft were found occluded 4 and 7 days after implantation without any negative consequence. At 6-month follow-up, the remaining 55 patients were alive with primary liver grafts. Vascular reconstructions were patent except for 2 early occlusions. Among the 3 groups, no significant difference was found on POD4. Three weeks after transplantation, the mean AST level in the major ligation group (46.7 +/- 8.14) was significantly higher than in the minor ligatation group (29.6 +/- 8.6) but not in the major reconstruction group (33.7 +/- 3.7; P = .03 and P = .29). The mean albumin level was highest after minor ligation (3.2 +/- 0.18), which was significantly better than the major reconstruction (2.7 +/- 0.1) but not the major ligation (3.1 +/- 0.14) cohorts (P = .02 and P = .13). CONCLUSIONS: In this study of a limited number of cases, right-lobe liver grafts with GRWR of > or =1.1% displayed optimal graft function without additional venous reconstruction to the AS.

Adult↗
PubMed2006

Brief intervention on maternal smoking: a randomized controlled trial.

OBJECTIVES: To determine if mothers receiving a smoking cessation intervention emphasizing health risks of environmental tobacco smoke (ETS) for their children have a higher quit rate than mothers who received routine smoking cessation advice, which focused on their own health, or a control group of mothers. SETTING: Tertiary referral centre. METHODS: Randomized control trial. A total of 363 mothers were randomly assigned to a smoking cessation intervention either aimed at their children's health (n = 111) or their own health (n = 131), or to a control group receiving no smoking cessation advice (n = 121). RESULTS: Provision to mothers of both groups of health risks of tobacco smoke resulted in significantly higher rate of cessation of smoking and smoking location change than those of the control group, with child intervention group having significantly higher rate of cessation of smoking and smoking location change than those of the maternal intervention group (P < 0.05). Post-intervention knowledge scores differed significantly for all groups; however, child intervention group was the only significantly better group than the others (P < 0.05). According to the multivariate analysis results, intervention grouping and presence of smoking friends were independent factors determining smoking cessation (P < 0.05). Intervention grouping, post-intervention knowledge, presence of other household members who smoked and family income were independent factors determining smoking location change (P < 0.05). Family income, intervention grouping and presence of smoking friends were significant independent factors influencing post-intervention knowledge (P < 0.05). CONCLUSION: Discussion during short paediatric visits on effects of smoking on child's or maternal health may result in a significant smoking cessation, smoking location change rate or knowledge change. Those who cannot give up smoking usually change their location of smoking. Provision of information on effects of smoking on child's health, rather than maternal, may result in more significant changes in behaviour or knowledge. Maternal education on smoking should include information on effects of smoking on both child's and maternal health, but should be especially focused on child's health.

Adolescent↗
PubMed2006

Alexithymia in diabetes mellitus.

BACKGROUND: Diabetes mellitus is a chronic, progressive disease with complex therapy protocols requiring major coping efforts from patients to achieve and maintain glycaemic control in order to reduce risk of diabetic complications. Disease coping strategies including good knowledge of diabetes and high ability of self-care have been reported to be impaired by alexithymic features. Alexithymia is a psychological construct characterised by inability to express emotions verbally, poor imagination and operational thinking, leading to failure in psychological self-regulation. OBJECTIVE: To compare prevalence of alexithymia and mean Toronto Alexithymia Scale-26 (TAS-26) scores in diabetic patients with non-diabetic controls; to investigate the association of alexithymia with glycemic control in diabetes. METHOD: In this cross- sectional study, TAS-26 scores of 193 diabetic patients and 49 non-diabetic controls were compared. Disease related factors were obtained from patient records. Alexithymia was used as a continuous (mean TAS-26 scores) and semi-quantitative (dichotomised into non-alexithymic 11>TAS-26 scores>11 and alexithymic individuals) variable. Descriptive data are presented as mean +/- SD, median (range) or %. Differences in means were compared via Independent-Samples T Test and One-Way ANOVA. Proportions were analysed with chi-square test and odds ratios (OR) were calculated via cross tabulation with a confidence interval (CI) of 95%. P<0.05 was considered statistically significant. RESULTS: The control group was similar with respect to age, gender and education with the diabetic group. In the diabetic study population (n=193, male/female: 42/58%, age 54.2 +/- 14.0 years, median diabetes duration 7 years (1-32 years), postprandial blood glucose (PBG) 243 +/- 110 mg/dl HbA1 c 7.3 +/- 3.6%) prevalence of alexithymia was significantly higher than in the control group (65 % in diabetics vs. 45 % in controls, p=0.011; mean TAS-26 score 12.3 +/- 3.7 vs. 10.6 +/- 3.6, p=0.004, respectively). Poor postprandial glycaemic control (p=0.002), female gender (p=0.026), combination therapy (p=0.037) and poor educational level (p=0.005) were positively associated with TAS-26 scores in diabetic individuals. Alexithymic diabetic patients were less educated (OR=1.2, p=0.046) and under worse glycaemic control (OR=2.4, p=0.005) compared to their non-alexithymic counterparts.

Adult↗
PubMed2004

Glucose evaluation trial for remission (GETREM) in type 1 diabetes: a European multicentre study.

OBJECTIVE: Strict metabolic control during the 1st year of type 1 diabetes is thought to be a key factor for achieving clinical remission. The aims of this study were two-fold: (i) to evaluate the frequency and duration of spontaneous remission (defined according to the parameters issued by the International Diabetic Immunotherapy Group (IDIG)) in a European population of consecutive recent onset type 1 diabetes patients (aged 5-35 years), followed-up for a period of 36 months with a common protocol of intensive insulin therapy and without adjunct immune-intervention; and (ii) to identify the predictive factors for clinical remission. RESEARCH DESIGN AND METHOD: A total of 189 consecutive patients with newly diagnosed type 1 diabetes according to ADA criteria were recruited in participating centres (Belgium, Czech Republic, Estonia, France, Germany, Hungary, Italy, Poland, Romania, Sweden and Turkey) and followed-up for a period of up to 36 months. In all patients, intensive insulin therapy was implemented consisting of three or four injections of regular insulin daily with NPH insulin at bedtime. Adjustment of insulin dose was made according to a common protocol. Various clinical characteristics (age, gender, severity of presentation, etc.), history (presence of diabetic siblings in the family, etc.) and integrated parameters of metabolic control (HbA(1c), blood glucose, the total insulin dose at hospital discharge adjusted for body weight) were collected. RESULTS: Twenty-two patients (11.6%) experienced remission. The median duration of remission was 9.6 months and the range was 31 months. There was a wide variation among centres. Logistic regression analysis focused on the centre as the main variable in achieving remission. CONCLUSION: Remission was shown to be very heterogeneous between centres depending on 'other factors' such as patient care and family awareness of the disease rather than on 'measurable factors' such as sex, age, HbA(1c) and severity of presentation at diagnosis. Using intensive insulin therapy and optimisation of metabolic control, remission occurred in nearly one out of eight patients.

Adolescent↗
PubMed2004

Evaluation of gustatory function after third molar removal.

The aim of this study was to determine the severity of taste changes after surgical removal of all four third molars in one session. Taste function in 27 patients was measured before and at 1 month and 6 months after surgery. In every patient all four third molars were removed using local anesthesia and sedation with midazolam and fentanyl. For testing gustatory function, two tests were administered: a whole-mouth, above threshold test and a spatial (localized) taste test. For this purpose, sucrose, NaCl, citric acid and quinine hydrochloride solutions were used. Taste intensity of quinine hydrochloride of the palate was significantly reduced 1 month after surgery (P < 0.05) but recovered and reach to preoperative values 6 months after surgery. The results showed that there were no significant changes in gustatory function after third molar surgery.

Adolescent↗
PubMed2003

Evaluation of gustatory function in postmenopausal women.

OBJECTIVE: The aim of this study is to evaluate the gustatory function in postmenopausal women. SUBJECTS AND METHODS: Whole mouth taste test and spatial taste test were administered to 20 postmenopausal women (Group 1) and 20 age-matched male subjects (Group 2). Further investigations were carried out for subjective assessment of taste alteration and nutritional differences between premenopausal and postmenopausal periods. RESULTS: There was a significant reduction in sucrose perception and in palatal sensitivity in postmenopausal women (p<0.05). Only 7(35%) of the female patients noticed alteration in taste perception during the postmenopausal period. Alteration in dietary habits after menopause was reported by 9 (45%) patients. CONCLUSION: This study demonstrates that taste perception of the tongue does not change, but that there is a disorder in palatal perception in postmenopausal women. Furthermore, there is tendency to preference of sweeter foods during menopause.

Age Factors↗
PubMed2002

The use of waterworks sludge for the treatment of dye wastes.

Water treatment works using coagulation/flocculation in the process stream will generate a waste sludge. The works in Adana, Turkey uses ferric chloride. The potential for using this sludge for the treatment of reactive, direct, disperse, acidic, and basic dyestuffs by coagulation and sorption has been investigated. The sludge acted as a coagulant and removed colour with excellent removal efficiencies being obtained for basic, disperse and direct dyes. The optimum conditions were a pH value of 5 and a sludge dose of 2000 mg l(-1). Mediocre results were obtained for acidic and reactive dyes. The efficiency of the sludge was also compared with alum and ferric chloride for the same group of dyes. The sludge was also used as a coagulant to treat the wastewater from a textile factory. At doses of 2000-4000 mg l(-1), the sludge was as effective as ferric chloride and alum at removing COD. Sorption tests showed that the disperse and reactive dyes did not bind to the sludge. Langmuir and Freundlich constants were determined for the other three types of dye. Rate constants for the adsorption were determined using the Lagergren equation.

Adsorption↗
PubMed2001

The effect of carnitine on random-pattern flap survival in rats.

Carnitine is an endogenous cofactor involved in the transport of long-chain fatty acids into the mitochondria where they undergo beta-oxidation. Through another reaction, carnitine produces free coenzyme A and reduces the ratio of acetyl-coenzyme A to coenzyme A, thereby enhancing oxidative use of glucose, augmenting adenosine triphosphate synthesis, and reducing lactate production and acidosis. Because of its regulatory action on the energy flow from the different oxidative sources, especially under ischemic conditions, carnitine has been used in cardiovascular diseases such as coronary heart disease, congestive heart failure, peripheral vascular disease, dyslipidemia, diabetes, and chronic renal diseases with satisfactory results. A flap is also a relatively ischemic tissue and may obtain benefit from carnitine. To investigate this, 30 rats were divided into three groups of 10 animals: a control group and two carnitine-treated groups. Random dorsal skin flaps were elevated on the rats. In the control group, no pharmacologic agents were used. Of the two treated groups, group 1 was treated with 50 mg/kg/day carnitine for 1 week and group 2 was treated with 100 mg/kg/day carnitine for 1 week. The areas of flap necrosis were measured in each group. The median areas of flap necrosis of the groups were 12.55, 9.23, and 4.9 cm2, respectively. There was a statistically significant improvement of flap necrosis in carnitine-treated groups compared with the control group (group 2, p = 0.001; group 3, p = 0.000). Furthermore, there was less necrosis in the high-dose carnitine-treated group than the low-dose carnitine-treated group. As a conclusion, carnitine may have a dose-dependent effect to increase flap survival in random skin flaps.

Animals↗
PubMed2001

Pulmonary metastasectomy in the treatment of recurrent ameloblastoma of the maxilla and mandible: a case report.

Ameloblastoma is an aggressive benign tumor with frequent local recurrences. Although histologically benign, it occasionally metastasizes to many organs, most commonly to the lungs. The metastasis develops after multiple recurrences and many unsuccessful attempts at removal of the tumor. When distant metastasis occurs, the prognosis is poor and there is no effective treatment. A case of metastatic ameloblastoma of the mandible and maxilla is reported which was treated with pulmonary metastasectomy. The treatment options are discussed in relation to the literature.

Adult↗
PubMed2001

Positive surgical margins in cancer of the larynx.

In order to determine what should be done for laryngeal cancer patients when surgical margins are positive, and to evaluate their prognosis, a retrospective review of 21 laryngeal cancer patients with positive surgical margins out of 714 surgically treated cases (2.9%) was carried out. Nineteen patients were treated with postoperative radiation therapy. Two patients who had had endolaryngeal partial laryngectomy were treated with vertical partial laryngectomy. Two patients were lost to follow-up. Ten patients (10/19; 53%) were recurrence-free. Four patients had local, two had regional, and two had locoregional recurrences. Only one patient with a local recurrence could be salvaged with total laryngectomy and is disease-free. One patient developed liver metastasis. Nineteen patients had a mean and median disease-free survival of 48 and 36 months, respectively. Nine out of fourteen patients (64%) treated curatively were recurrence-free. The patients with positive margins developed significantly more locoregional recurrences than those with free margins (P < 0.05). We conclude that surgical margins must be checked peroperatively with frozen sections to make sure that they are free. The margins of every laryngectomy specimen must be diligently examined. If positive, re-excision, postoperative radiotherapy and chemotherapy are treatment alternatives. They should not just be managed with close follow-up. However, whatever treatment is applied, the prognosis for patients with positive margins is significantly worse than for those with free margins.

Adult↗
PubMed2001

Assessment of whole saliva flow rate in denture wearing patients.

It has been suggested that salivary flow rate decreases with age. As is known, the presence of a thin salivary film layer is essential for the comfort of the mucosa beneath a denture base and for denture retention. The purpose of this study was to determine the flow rates, viscosity and the pH of resting and stimulated whole saliva before and after prosthetic treatment in complete denture wearing patients. Saliva was collected under clinical conditions between 08.00 and 10.00 hours. The flow rates of whole saliva were measured at three stages: (i) resting and stimulated saliva before prosthetic treatment; (ii) immediately after the first wearing of the complete denture; and (iii) resting and stimulated saliva after 2 or 3 months of wearing the complete denture. Saliva production was stimulated by chewing paraffin wax. Flow rate was calculated as collected volume/collection time. It was found that there was a significant difference between resting and stimulated whole salivary flow rates before and after complete denture wearing.

Adult↗
PubMed2001

Alstrom syndrome: a case report.

Alstrom syndrome is a rare disorder characterized by early obesity, loss of central vision, diabetes mellitus, hearing loss and short stature. Previous studies, have reported no information regarding oral findings. This article describes oral findings in two cases of Alstrom syndrome. In both cases, gingivitis was present and also light yellow-brown discolored enamel bands were observed on the anterior teeth. This staining may have resulted from discoloration of the preexisting slight band-like enamel hypoplasia. The gingiva was examined histologically by light and transmission electron microscopy. Irregular thickness of the basal lamina and delamination of the myelin sheath were detected by transmission electron microscopy. There is no information about pathological odontogenesis in Alstrom syndrome in previous reports. Oral present findings may contribute further information about the clinical manifestations of Alstrom syndrome.

Abnormalities, Multiple↗
PubMed2000

Intranasal budesonide spray as an adjunct to oral antibiotic therapy for acute sinusitis in children.

We investigated the clinical value of intranasal budesonide in acute sinusitis in 52 children with acute maxillary sinusitis. We randomly divided them into two groups: group 1 received oral pseudoephedrine (2 x 30 mg) and cefaclor (40 mg/kg) for 10 days, and group 2 received intranasal budesonide (2 x 100 microg) and cefaclor (40 mg/kg) for 10 days. Symptoms of headache, cough, and nasal stuffiness and signs of nasal discharge were graded before and after treatment. The patients whose symptoms and signs completely normalized after treatment were considered to have recovered, and those with persisting symptoms and signs after treatment as having not recovered. The results of the two treatment groups were compared. The recovery rate of the children in group 2 were significantly higher than those in group 1 (P < 0.05). No adverse drug effects were determined during the study period. These findings suggest that topical steroids may be a useful adjunctive agent in the treatment of acute sinusitis of children without apparent side effects and can possibly hasten the resolution of symptoms.

Acute Disease↗
PubMed2000

Influence of insulin resistance on total renin level in normotensive women with polycystic ovary syndrome.

OBJECTIVE: To evaluate the influence of insulin resistance on the plasma total renin level in normotensive women with polycystic ovary syndrome (PCOS). DESIGN: Prospective, controlled study. SETTING: University hospital. PATIENT(S): Twenty-five normotensive women with PCOS were compared with 11 normotensive control women with regular cycles and no features of PCOS. INTERVENTION(S): Clinical, ultrasonographic, and hormonal findings were used to define PCOS. Insulin resistance was estimated by continuous infusion of glucose with model assessment in the early follicular phase. MAIN OUTCOME MEASURE(S): Plasma levels of total renin and angiotensin II and serum levels of gonadotropins, DHEAS, total T, free T, 17 alpha-hydroxyprogesterone, and PRL were determined. RESULT(S): Plasma concentrations of angiotensin II were similar in the PCOS group and the control group. The concentration of total renin in plasma was higher in women with PCOS than in healthy women independent of insulin resistance. The sensitivity and specificity of the plasma total renin level to diagnose women with PCOS were calculated as 80% and 71.4%, respectively. CONCLUSION(S): The plasma total renin level is higher in normotensive women with PCOS than in healthy women independent of insulin resistance.

Adult↗
PubMed2000

Tumor thickness as a predictor of cervical lymph node metastasis in squamous cell carcinoma of the lower lip.

Tumor thickness is a relatively new prognostic factor that has been investigated for lower lip cancer. This study was performed in 27 patients, 13 of whom had histopathologically confirmed cervical metastasis, to investigate whether tumor thickness could be used as a predictor of cervical lymph node metastasis. The mean tumor thickness of those cases with neck metastasis was 5.60 mm (SD = 2.24), and the mean thickness of cases without neck metastasis was 3. 79 mm (SD = 1.68). The difference between tumor thicknesses of both groups was found to be statistically significant (P < 0.05). The tumor thickness of 5 mm was determined as a cutoff point, above which the cervical lymph node metastasis rate was significantly increased. As a conclusion, tumor thickness is an objective histopathologic factor that is easily reproducible; it significantly influences cervical lymph node metastasis in lower lip cancer, and it may be used in the assessment of prognosis.

Carcinoma, Squamous Cell↗
PubMed2000

Comparison of regional recurrence rates of radical and comprehensive neck dissection type 3 in N0 laryngeal cancer.

To determine whether comprehensive neck dissection (CND) type 3 could accomplish regional tumor control as well as radical neck dissection (RND) in clinically N0 laryngeal cancer patients, we compared the regional recurrence rates of 316 N0 laryngeal cancer patients. In the 316 N0 patients, 486 neck dissections were performed. For 170 patients the dissection was bilateral, and for 146 patients it was unilateral. Of these, 193 were type 3 CNDs, and 293 were RNDs. In 30 (15.5%) of 193 type 3 CNDs and in 53 (18.1%) of 293 RNDs, metastatic lymph nodes were determined histopathologically in neck dissection specimens. The difference in cervical lymph node metastasis rates was not statistically significant (P > 0.05). During follow-up, 3 patients who underwent CND type 3 (1.6%) and 12 who underwent RND (4.1%) had regional recurrences. The difference between recurrence rates was not statistically significant (P > 0. 05). A conclusion was reached that CND type 3 safely provided regional cancer control in N0 laryngeal cancer and that it might be performed to decrease the morbidity of RND.

Humans↗