1
|
Akgun-Unal N, Ozyildirim S, Unal O, Baltaci SB, Mogulkoc R, Baltaci AK. The effects of resveratrol and melatonin on cardiac dysfunction in diabetic elderly female rats. Physiol Res 2023; 72:187-198. [PMID: 37159853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
We aimed to investigate the effects of melatonin and resveratrol on diabetes-related papillary muscle dysfunction and structural heart disorders. The protective effect of resveratrol and melatonin supplementation on cardiac functions was investigated in a diabetic elderly female rat model. 16-month-old rats (n=48) were allocated into 8 groups. Group1: Control, Group2: Resveratrol Control, Group3: Melatonin Control, Group4: Resveratrol and Melatonin Control, Group5: Diabetes, Group6: Diabetes Resveratrol, Group7: Diabetes Melatonin, Group8: Diabetes Resveratrol and Melatonin. Streptozotocin was injected intraperitoneally to the rats for experimental diabetes induction. Thereafter, resveratrol (intraperitoneal) and melatonin (subcutaneous) were administered for 4 weeks. Resveratrol and melatonin had a protective effect on the contractile parameters and structural properties of the papillary muscle, which was impaired by diabetes. it has been presented that diabetes impairs the contractile function of the papillary muscle for each stimulus frequency tested and the responses obtained as a result of Ca+2 uptake and release mechanisms from the Sarcoplasmic reticulum, and it has been observed that these effects are improved with resveratrol and melatonin injection. The decrease in myocardial papillary muscle strength in the diabetic elderly female rat can be reversed with the combination of resveratrol, melatonin and resveratrol+melatonin. Melatonin+resveratrol supplementation is no different from melatonin and/or resveratrol supplementation. Resveratrol and melatonin supplementation may have a protective effect on cardiac functions in a diabetic elderly female rat model.
Collapse
Affiliation(s)
- N Akgun-Unal
- Department of Biophysics, Medicine Faculty, Ondokuz Mayis University, Samsun, Turkey.
| | | | | | | | | | | |
Collapse
|
2
|
Buhur A, Unal O. Management of ectopic pregnancy in a tertiary hospital: a retrospective cohort study. Eur Rev Med Pharmacol Sci 2023; 27:3500-3507. [PMID: 37140299 DOI: 10.26355/eurrev_202304_32122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The goal of this study was to manage the treatment modalities of ectopic pregnancy. PATIENTS AND METHODS This retrospective study included 1,103 women diagnosed and treated for ectopic pregnancy at Kanuni Sultan Suleyman Training and Research Hospital between January 1, 2017, and December 31, 2020. Serial beta-human chorionic gonadotropin (β-Hcg) measurements and transvaginal ultrasound (TV USG) findings were used to establish the diagnosis of an ectopic pregnancy. They were divided into four groups: expectant treatment, single-dose methotrexate, multidose methotrexate, and surgical treatment. All data analyses were performed using SPSS version 24.0. A receiver operating characteristic (ROC) analysis was used to determine the cut-off for change in beta-human chorionic gonadotropin (β-hCG) levels between the first and fourth day. RESULTS There were significant differences between groups in terms of gestational age and β-hCG changes (p < 0.001). In patients receiving expectant treatment, the decrease in β-hCG values on the fourth day was 35.19%, while patients receiving single-dose methotrexate treatment showed a decrease of 24%. The most common risk factor for ectopic pregnancy was the absence of risk factors. Comparison of the surgical treatment group with the other groups revealed significant differences in terms of the presence of free fluid in the abdomen, the average diameter of the ectopic pregnancy mass, and the presence of fetal cardiac activity. A single dose of methotrexate was effective in patients with β-hCG levels lower than 1,227.5 mIU/ml, with a 68.5% sensitivity and 69.1% specificity. CONCLUSIONS An increase in gestational age also leads to an increase in β-hCG values and the diameter of the ectopic focus. As the diagnosis period progresses, the need for surgical intervention increases.
Collapse
Affiliation(s)
- A Buhur
- Department of Gynecology and Obstetrics, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
| | | |
Collapse
|
3
|
Unal O, Kaya O, Ozturk T, Cetin ES, Gonen I, Temel EN, Akcam FZ. Evaluation of combination therapies with colistin in an experimental mouse pneumonia model induced by carbapenem-resistant Acinetobacter baumannii strain. Fundam Clin Pharmacol 2023. [PMID: 36905104 DOI: 10.1111/fcp.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023]
Abstract
The treatment options are limited in Acinetobacter baumannii infections. In this study, the effectiveness of colistin monotherapy and combinations of colistin with different antibiotics were investigated in an experimental pneumonia model induced by carbapenem-resistant A. baumannii strain. Mice in the study were divided into five groups as control (no treatment), colistin monotherapy, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline combinations. The modified experimental surgical pneumonia model of Esposito and Pennington was applied to all groups. The presence of bacteria in blood and lung samples was investigated. Results were compared. In blood cultures, while there was no difference between the control and colistin groups, there was a statistical difference between the control and the combination groups (P = 0.029). When the groups were compared in terms of lung tissue culture positivity, there was a statistical difference between the control group and all treatment groups (colistin, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline) (P = 0.026, P < 0.001, P < 0.001, and P = 0.002, respectively). The number of microorganisms that grew in the lung tissue was found to be statistically significantly lower in all treatment groups in comparison with the control group (P = 0.001). Both monotherapy and combination therapies of colistin were found to be effective in the treatment of carbapenem-resistant A. baumannii pneumonia, but the superiority of combination therapies over colistin monotherapy has not been demonstrated.
Collapse
Affiliation(s)
- Onur Unal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University, Isparta, Turkey
| | - Onur Kaya
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University, Isparta, Turkey
| | - Tuba Ozturk
- Laboratory of Medical Microbiology, Isparta City Hospital, Isparta, Turkey
| | - Emel Sesli Cetin
- Faculty of Medicine, Department of Medical Microbiology, Suleyman Demirel University, Isparta, Turkey
| | - Ibak Gonen
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Aydin University, Istanbul, Turkey
| | - Esra Nurlu Temel
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University, Isparta, Turkey
| | - Fusun Zeynep Akcam
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University, Isparta, Turkey
| |
Collapse
|
4
|
Akcam FZ, Bacanak BN, Turk O, Yilmaz GR, Pekbay B, Yirmibes EOB, Temel EN, Unal O, Akın SE, Ozcan MS, Kaya O, Yurekli VA. A rare side effect due to voriconazole: myasthenia gravis. Eur J Clin Pharmacol 2022; 78:1357-1359. [PMID: 35657415 DOI: 10.1007/s00228-022-03349-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Fusun Zeynep Akcam
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey.
| | - Betul Nur Bacanak
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | - Ozge Turk
- Department of Neurology, Suleyman Demirel University, Isparta, Turkey
| | - Gul Ruhsar Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | - Begum Pekbay
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | | | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | - Onur Unal
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | | | | | - Onur Kaya
- Department of Infectious Diseases and Clinical Microbiology, Suleyman Demirel University Education and Research Hospital, East Campus, Cunur, 32040, Isparta, Turkey
| | - Vedat Ali Yurekli
- Department of Neurology, Suleyman Demirel University, Isparta, Turkey
| |
Collapse
|
5
|
Rodoplu O, Yildiz C, Oztas D, Beyaz M, Ulukan M, Unal O. The efficacy of rotational pharmaco-mechanical thrombectomy in patients with acute iliofemoral deep vein thrombosis: is the standard treatment of deep vein thrombosis changing? J Vasc Surg Venous Lymphat Disord 2021. [DOI: 10.1016/j.jvsv.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Kanatli U, Unal O, Ataoglu MB, Ayanoglu T, Ozer M, Cetinkaya M. Effect of Metatarsal Head Shape on the Development of Hallux Valgus Deformity: 10 Years of Natural Follow-up. J Am Podiatr Med Assoc 2020; 110:441594. [PMID: 32730599 DOI: 10.7547/16-090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND We investigated the role of first metatarsal head shape in the etiology of hallux valgus. By pedobarographic analysis, we evaluated whether first metatarsal head shape causes an alteration in plantar pressure values that would result in metatarsalgia. METHODS Referrals to our clinic for metatarsalgia, plantar fasciitis, and calcaneal spur were scanned retrospectively. Patients with severe hallux valgus, pes planus, gastrocnemius stiffness, generalized joint laxity, neuromuscular disease, or a history of lower-extremity orthopedic surgery were excluded. Sixty-two patients with plantar pressure assessment and radiographic evaluation were included. These patients were invited for reassessment after 10 years. Feet were divided into three groups by metatarsal head shape: round, square, and chevron. On anteroposterior radiographs, the hallux valgus and intermetatarsal angles, relative first metatarsal length, lateral sesamoid subluxation, and presence of bipartite sesamoid were noted. Plantar pressure was assessed with pedobarography. RESULTS Feet with round-shaped first metatarsal heads had a statistically significantly greater progression in hallux valgus angle than the other shapes. Plantar pressures under the first, second and third, and fourth and fifth metatarsals increased with time. This can explain the mechanism of transfer metatarsalgia and painful callosities under the first metatarsal in hallux valgus. There was no correlation between hallux valgus angle, relative metatarsal length, and lateral sesamoid subluxation. CONCLUSIONS We found a strong relation between round-shaped first metatarsal head and hallux valgus angle progression. No patients had a risk factor responsible for hallux valgus. In other words, this study gives approximately 10-year natural history results in nearly normal feet.
Collapse
|
7
|
Akcam FZ, Unal O, Kaya O, Erkilic G, Yilmaz GR, Baspinar S. Lymphoma Erysipeloides. IDCases 2020; 20:e00756. [PMID: 32337157 PMCID: PMC7176943 DOI: 10.1016/j.idcr.2020.e00756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/27/2020] [Accepted: 03/21/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- Fusun Zeynep Akcam
- Suleyman Demirel Universty Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Onur Unal
- Suleyman Demirel Universty Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Onur Kaya
- Suleyman Demirel Universty Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Gamze Erkilic
- Suleyman Demirel Universty Medical School Department of Pathology, Turkey
| | - Gul Ruhsar Yilmaz
- Suleyman Demirel Universty Medical School Department of Infectious Diseases and Clinical Microbiology, Turkey
| | - Sirin Baspinar
- Suleyman Demirel Universty Medical School Department of Pathology, Turkey
| |
Collapse
|
8
|
Celik N, Celik O, Sevinc C, Unal O. Hepatitis C Prevalence in Hemodialysis Patients and the Results of New Antiviral Therapy. Turk J Nephrol 2019. [DOI: 10.5152/turkjnephrol.2019.3311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
9
|
Akcam FZ, Kaya O, Temel EN, Buyuktuna SA, Unal O, Yurekli VA. An investigation of the effectiveness against bacteriuria of silver-coated catheters in short-term urinary catheter applications: A randomized controlled study. J Infect Chemother 2019; 25:797-800. [PMID: 31030965 DOI: 10.1016/j.jiac.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/03/2019] [Accepted: 04/11/2019] [Indexed: 01/02/2023]
Abstract
AIM The aim of this study was to investigate the effectiveness of antimicrobial-coated catheters against bacteriuria and urinary tract infection in patients who have urinary catheterization. METHODS Twenty eight and twenty six people similar in terms of demographic characteristics and primary and underlying diseases were randomly selected from patients undergoing short-time urinary catheterization in the intensive care unit. Silver-coated slicone foley catheters and normal slicone foley catheters were used for uninary catheterization in the first and second group of the patients respectively. Urine specimens were collected from patients at 2-day intervals and assessed in terms of bacteriuria. RESULTS Bacteriuria was found in 12 (46.2%) of the patients using normal catheters and 13 (46.4%) of those using silver-coated catheters throughout the monitoring period. No significant relationship was determined between use of different catheter types and bacteriuria (p = 0.98). The most common microorganism was identified as E. coli in the normal catheter group while microorganism other than E. coli was identified in the silver-coated catheter group. The prevalence of bacteriuria was statistically significantly higher in patients with a history of hospitalization in the previous 3 months (p = 0.028). CONCLUSION The use of silver-coated silicone catheters was not shown to have a protective effect against bacteriuria in this study. Further well-designed studies with larger case numbers are now needed to confirm whether history of hospitalization, which emerged as a statistically significant factor in this study, increases the prevalence of catheter-related bacteriuria.
Collapse
Affiliation(s)
- Fusun Zeynep Akcam
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Onur Kaya
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Esra Nurlu Temel
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Seyit Ali Buyuktuna
- Cumhuriyet University, Department of Infectious Diseases and Clinical Microbiology, Sivas, Turkey.
| | - Onur Unal
- Suleyman Demirel University, Department of Infectious Diseases and Clinical Microbiology, Isparta, Turkey.
| | - Vedat Ali Yurekli
- Suleyman Demirel University, Department of Neurology, Isparta, Turkey.
| |
Collapse
|
10
|
Karasahin O, Yildiz Z, Unal O, Arslan U. A rare cause of healthcare-associated infective endocarditis: Enterobacter cloacae. IDCases 2018; 12:18-20. [PMID: 29560314 PMCID: PMC5857739 DOI: 10.1016/j.idcr.2018.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/03/2018] [Accepted: 03/03/2018] [Indexed: 11/27/2022] Open
Abstract
We report a case of infective endocarditis secondary to healthcare-associated bloodstream infection caused by an uncommon etiologic agent, multidrug-resistant Enterobacter cloacae. The patient was treated with a combination of antimicrobial therapy and surgery, but could not be saved. With this case, we discuss the prevalence, risk factors, treatment options, and outcomes of the rarely encountered Enterobacter cloacae-associated infective endocarditis.
Collapse
Affiliation(s)
- Omer Karasahin
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Zıya Yildiz
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Onur Unal
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| | - Umit Arslan
- Erzurum Regional Education and Research Hospital, Erzurum, Turkey
| |
Collapse
|
11
|
Karatepe O, Eken I, Acet E, Unal O, Mert M, Koc B, Karahan S, Filizcan U, Ugurlucan M, Aksoy M. Vacuum Assisted Closure Improves the Quality of Life in Patients with Diabetic Foot. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2011.11680757] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- O. Karatepe
- Department of General Surgery, Istanbul University, Faculty of Medicine
| | - I. Eken
- Department of General Surgery, Istanbul University, Faculty of Medicine
| | - E. Acet
- Department of General Surgery, Istanbul University, Faculty of Medicine
| | - O. Unal
- Department of Vascular Surgery, Istanbul University, Faculty of Medicine
| | - M. Mert
- Department of Endocrinology, Istanbul University, Faculty of Medicine
| | - B. Koc
- Department of General Surgery, Istanbul University, Faculty of Medicine
| | - S. Karahan
- Department of General Surgery, Istanbul University, Faculty of Medicine
| | - U. Filizcan
- Okmeydani Training and Research Hospital; Department of Cardiovascular Surgery, Istanbul University, Faculty of Medicine
| | - M. Ugurlucan
- Maltepe University Medical Faculty; Department of Cardiovascular Surgery, Istanbul University, Faculty of Medicine
| | - M. Aksoy
- Duzce Ataturk State Hospital; Department of General Surgery, Istanbul University, Faculty of Medicine
| |
Collapse
|
12
|
Akil A, Api O, Bektas Y, Yilmaz AO, Yalti S, Unal O. Paracetamol vs dexketoprofen for perineal pain relief after episiotomy or perineal tear. J OBSTET GYNAECOL 2014; 34:25-8. [PMID: 24359044 DOI: 10.3109/01443615.2013.828026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A randomised controlled trial was conducted to investigate efficacy of paracetamol and dexketoprofen trometamol for perineal pain relief after perineal repair. Subjects were randomly assigned to receive two doses of either 50 mg of intravenous dexketoprofen trometamol via slow i.v. infusion (Group I, n = 49) or 1,000 mg of paracetamol via intravenous infusion (Group II, n = 46). The main outcome measure was a VAS (visual analogue scale) for pain recorded at 1 h (VAS 1). A total of 82 patients were included in the final analysis (Group I, n = 41; Group II, n = 41). There was no difference among groups in terms of pain scores at the beginning (VAS 0). The pain was decreased in 70% of the patients in Group I and in 62% of the patients in Group II (p = 0.502). Both paracetamol and dexketoprofen are effective in perineal pain relief after episiotomy or perineal tear repair.
Collapse
Affiliation(s)
- A Akil
- Bodrum Acıbadem Hospital , Bodrum , Mugla
| | | | | | | | | | | |
Collapse
|
13
|
Ipek A, Cay N, Unal O, Idilman İ, Balaban M. PP-245 Atrioventricular Septal Defect Diagnosed By Fetal Ultrasonography. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Affiliation(s)
- O. Unal
- Department of Mechanical EngineeringFaculty of Engineering, Bartin University 74100, Bartin, Turkey
| | - R. Varol
- Department of Mechanical EngineeringFaculty of Engineering, Suleyman Demirel University 32260, Isparta, Turkey
| | - A. Erdogan
- Department of Metallurgical and Materials Engineering, Bartin University, 74100, Bartin, Turkey
| | - M. S. Gok
- Department of Metallurgical and Materials Engineering, Bartin University, 74100, Bartin, Turkey
| |
Collapse
|
15
|
Kaya O, Akcam FZ, Gonen I, Unal O, Ceylan T. Risk factors for bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli in a Turkish hospital. J Infect Dev Ctries 2013; 7:507-12. [PMID: 23857384 DOI: 10.3855/jidc.2788] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 09/17/2012] [Accepted: 09/19/2012] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Bloodstream infection caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens has become a serious concern worldwide. The purpose of this study was to identify risk factors for bacteremia due to ESBL-producing Escherichia coli in a Turkish hospital. METHODOLOGY We retrospectively reviewed the medical records of patients with E. coli bacteremia in a tertiary care centre from January 2007 to October 2011. Data from patients such as demographic features, underlying conditions, and antibiotic exposure were analysed. RESULTS A total of 113 patients with bacteremia due to E. coli were included and data from patients with ESBL-producing E. coli (case patients) were compared to those with non-ESBL-producing E. coli (control patients). The frequency of ESBL producers was 38.9% (44/113). Exposure to fluoroquinolones and cephalosporins, history of intra-abdominal surgery intervention, and presence of central venous catheteter and urinary catheteter were more frequently detected among case patients (P < 0.05). Independent risk factors for bacteremia due to ESBL-producing E. coli were exposure to fluoroquinolones (OR 13.39, 95% CI 1.28-140.03) and cephalosporins (OR 3.48, 95% CI 1.03-11.74). CONCLUSIONS Previous use of fluoroquinolone and cephalosporin in patients with bacteremia caused by E. coli increased the risk for ESBL-producing strains.
Collapse
Affiliation(s)
- Onur Kaya
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | | | | | | | | |
Collapse
|
16
|
Unal O, Citgez B, Cipe G, Toydemir T, Karatepe O. Conservative treatment of arterial pseudoaneurism in patients with behcet disease. Georgian Med News 2013:28-32. [PMID: 23482359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Behcet's Disease (BD) is a rare disease, of unknown origin that generally causes an inflammation in the subcutaneous tissue, eyes and brain vessels, and related with the immune system, predominantly seen in male patients and the mean age at onset is mainly in the third decade. The aim of the study was to present our experiences with the cases of arterial pseudoaneurysms that we treated conservatively without surgical or radiological intervention. Eleven patients with Behcet's disease who developed arterial pseudoaneuryms and responsed to the medical treatment are included in the study. The operation requirement, the complication rates, and factors that influence morbidity and mortality are evaluated. The mean age of the patients was 29,5 (18-35) years. Nine of the patients were male and 2 were female. The mean period of hospitalization was 18 (11-34) days. Six patients redeveloped aneurysm during their follow-up. Three of these patients were treated with surgery. Five patients had no complication during an average of 20 months of follow-up period. Arterial pseudoaneurysm is a rare complication of Behcet's disease. Despite the good response to conservative treatment at the beginning period, the patients should be closely followed up and redevelopment of the aneurysm should be kept in mind.
Collapse
Affiliation(s)
- O Unal
- Bakirkoy research Hospital, Department of Vasculary Surgery, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
17
|
Gokce M, Unal O, Hismi B, Gumruk F, Coskun T, Balta G, Unal S, Cetin M, Kalkanoglu-Sivri HS, Dursun A, Tokatlı A. Secondary hemophagocytosis in 3 patients with organic acidemia involving propionate metabolism. Pediatr Hematol Oncol 2012; 29:92-8. [PMID: 21970506 DOI: 10.3109/08880018.2011.601402] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) may develop secondary to infections, malignancies, immune deficiency syndromes, and rheumatologic and metabolic disorders. Associations between HLH and inborn errors of metabolism, including lysinuric protein intolerance, multiple sulfatase deficiency, galactosemia, Gaucher disease, Pearson syndrome, and galactosialidosis, have previously been reported in the literature. In this report the authors present 3 children with disorders of propionate metabolism--1 with methylmalonic acidemia and 2 with propionic acidemia--who developed secondary HLH during their metabolic attacks. All patients fulfilled the 5 HLH criteria of the Histiocyte Society. Familial HLH was ruled out by molecular analysis. Plasma exchange was performed for 2 of them. Unfortunately 1 died of multiorgan failure despite intensive therapy. This is the first report of such an association.
Collapse
Affiliation(s)
- M Gokce
- Department of Pediatric Hematology, Hacettepe Medical Faculty, Ankara, Turkey.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Karatepe O, Eken I, Acet E, Unal O, Mert M, Koc B, Karahan S, Filizcan U, Ugurlucan M, Aksoy M. Vacuum assisted closure improves the quality of life in patients with diabetic foot. Acta Chir Belg 2011; 111:298-302. [PMID: 22191131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Diabetes Mellitus (DM) is the most common endocrine disease worldwide. One of the most important chronic complications of this disease is the development of diabetic foot. The management of diabetic foot wounds is quite important with respect to public health. AIMS To determine the effect of Vacuum Assisted Closure (VAC) therapy on the quality of life in the treatment of diabetic foot ulcers and compare it with standart wound care. METHODS Between May 2007 to December 2008, 67 consecutive patients with diabetic foot ulcers were randomly assigned to VAC therapy (Group 1, n : 30) or standart wound care (Group 2, n : 37). The SF-36 questionnaire was administered the day before and in the month following wound healing. Global analyses of the 8 domains and 2 comprehensive indexes of SF-36, Physical Component Summary (PCS) and Mental Component Summary (MCS) were performed. Clinical measures included standard antidiabetic treatment, daily wound care including antiseptic bath, debridement, toe removal for gangrene when necessary, and wound care with conventional methods or VAC. Healing time was calculated as the time from hospital admission to the time of re-epithelization. RESULTS There were no differences in the mean age, ulcer size and pulse status of the patients in both groups. Healing time in the VAC group was significantly reduced (p < 0.05). All 8 domains of SF-36 and MCS and PCS scores improved remarkably after VAC therapy. CONCLUSION Vacuum Assisted Closure therapy was found to be effective in the treatment of chronic diabetic ulcers. The improvement of quality of life demonstrates a clear-cut indication in this particular group of patients.
Collapse
Affiliation(s)
- O Karatepe
- Department of General Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Besiroglu L, Sozen M, Ozbebit O, Avcu S, Selvi Y, Bora A, Atli A, Unal O, Bulut MD. The involvement of distinct neural systems in patients with obsessive-compulsive disorder with autogenous and reactive obsessions. Acta Psychiatr Scand 2011; 124:141-51. [PMID: 21627621 DOI: 10.1111/j.1600-0447.2011.01726.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the regional metabolite abnormalities and changes after treatment in patients with OCD with autogenous and reactive obsessions. METHOD We assessed right anterior cingulate cortex (ACC) and amygdala-hippocampal region (Am + Hpp) N-acetyl-aspartate (NAA), choline (Cho) and creatine (Cr) concentrations and NAA/Cr and Cho/Cr ratios using single-voxel proton magnetic resonance spectroscopy in 15 patients with autogenous obsessions (OCD-A), 15 patients with reactive obsessions (OCD-R) and 15 healthy controls (HC). Measurements were repeated after 16 weeks of fluoxetine treatment. RESULTS Baseline ACC NAA/Cr ratios of both OCD groups were significantly lower than HC. OCD-A group had significantly lower baseline NAA/Cr ratios in the Am + Hpp than other groups. These differences were more likely to be explained by higher Cr levels in ACC. We found no significant differences and changes for Cho levels and Cho/Cr ratios between groups and within groups. Significant increase in NAA/Cr ratios of OCD-A group found in the Am + Hpp was more likely to be explained by increased NAA levels. No significant changes were found in ACC NAA/Cr ratios. CONCLUSION While disturbed energy metabolism in ACC might reflect a common pathology in patients with OCD regardless of symptom dimension, alterations in mesiotemporal lobe are more likely for autogenous obsessions.
Collapse
Affiliation(s)
- L Besiroglu
- Department of Psychiatry, Yuzuncu Yil University, Van, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Oven Ustaalioglu BB, Bilici A, Kefeli U, Seker M, Salepci T, Unal O, Gumus M. A retrospective analysis of women's chances to become pregnant after completion of chemotherapy: a single center experience. J BUON 2011; 16:349-352. [PMID: 21766510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE With the improvement in anticancer therapies, the survival of women with malignancies has increased and infertility may affect the quality of life of premenopausal women, who experience temporary or permanent amenorrhea due to chemotherapy. The aim of this study was to review the rate of pregnancies among women with malignancy previously treated with chemotherapy. METHODS We retrospectively recorded 317 women younger than 40 years of age who were treated with chemotherapy (and a number of them with additional radiotherapy/RT) due to several malignancies between 2007-2010. The patients who got pregnant after stopping chemotherapy and during followup were analyzed. RESULTS Among women with breast cancer (n=116), malignant lymphoma (n=85), ovarian cancer (n=26) and colon cancer (n=90), 20 got pregnant after a median 22.9 months (range 10.7-96.5) from the end of chemotherapy. Childbearing was uneventful and newborns were healthy. CONCLUSION Women who had previously received chemotherapy for malignancy can get pregnant and deliver healthy newborns.
Collapse
Affiliation(s)
- B B Oven Ustaalioglu
- Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
21
|
Pirimoglu ZM, Arslan C, Buyukbayrak EE, Kars B, Karsidag YK, Unal O, Turan MC. Glucose tolerance of premenopausal women after menopause due to surgical removal of ovaries. Climacteric 2011; 14:453-7. [PMID: 21271939 DOI: 10.3109/13697137.2010.539723] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the influence of the abrupt withdrawal of ovarian function on glucose tolerance by studying premenopausal women before and after oophorectomy. METHODS Thirty premenopausal women who needed hysterectomy for benign reasons volunteered for the study in our hospital in Istanbul, Turkey. An oral glucose tolerance test (OGTT) was performed before surgery and 3, 6 and 12 months after surgery. Fasting glucose, fasting insulin levels and insulin/glucose indexes, HOMA indexes, insulin and glucose levels were measured during OGTT. RESULTS The mean fasting and 2-h glucose levels of the women did not change significantly during the 12 months of follow-up. However, the glucose levels during the glucose tolerance tests changed significantly after surgery (p<0.05). Insulin responses to the glucose tolerance test also increased significantly (p<0.005). Insulin/glucose indexes were significantly higher after surgery (p<0.005). Type 2 diabetes mellitus was detected in five women and impaired glucose tolerance was detected in 12 of the 30 patients after surgery in the 12-month period. CONCLUSION The impairment of carbohydrate metabolism due to an abrupt decrease in natural estrogen levels should be considered before removing the ovaries during hysterectomy in premenopausal patients.
Collapse
Affiliation(s)
- Z M Pirimoglu
- Obstetrics and Gynecology Department of Dr. Lutfi Kirdar Kartal Education and Research Hospital, Kartal, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
22
|
Avcu S, Koseoglu MN, Ceylan K, Bulut MD, Dbulutand M, Unal O. The value of diffusion-weighted MRI in the diagnosis of malignant and benign urinary bladder lesions. Br J Radiol 2011; 84:875-82. [PMID: 21224296 DOI: 10.1259/bjr/30591350] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the role of diffusion-weighted MRI (DWI) in the diagnosis of urinary bladder (UB) tumours by means of measuring apparent diffusion coefficient (ADC) values. METHODS A total of 83 people aged between 18 and 86 years were included in the study: 63 patients with UB pathology (46 malignant, 17 benign) constituted the case group; 20 individuals without any UB pathology constituted the control group. DWI was applied to all individuals. The ADC values were measured based on the tissue of the UB mass entities and normal UB wall in the control group. RESULTS The mean ADC value in the UB carcinoma group was significantly lower than that in the control group: 1.0684 ± 0.26 × 10(-3) mm(2) s(-1) and 2.010 ± 0.11 × 10(-3) mm(2) s(-1), respectively (p<0.01). There was a significant difference among the mean ADC values of different grades of malignant tumours, corresponding to 0.9185 ± 0.20 mm(2) s(-1) and 1.281 ± 0.18 mm(2) s(-1) in high-grade and low-grade malignant UB carcinomas, respectively (p<0.01). The ADC value in the carcinoma group was significantly lower than that in the benign lesion group: 1.0684 ± 0.26 × 10(-3) mm(2) s(-1) and 1.803 ± 0.19 × 10(-3) mm(2) s(-1), respectively (p<0.01). All 46 malignant lesions displayed a restriction in diffusion; 4 of the 17 benign lesions displayed a mild restriction in diffusion. The sensitivity, specificity and accuracy of DWI in the diagnosis of malignant UB lesions was 100%, 76.5% and 93.65%, respectively. CONCLUSION DWI can be beneficial in the differentiation of benign and malignant UB lesions, as well as of high-grade and low-grade UB carcinomas, using quantitative ADC measurements.
Collapse
Affiliation(s)
- S Avcu
- Department of Radiology, School of Medicine, Yuzuncu Yil University, Van, Turkey.
| | | | | | | | | | | |
Collapse
|
23
|
Buyukbayrak EE, Kaymaz O, Kars B, Karsidag AYK, Bektas E, Unal O, Turan C. Caesarean delivery or vaginal birth: Preference of Turkish pregnant women and influencing factors. J OBSTET GYNAECOL 2010; 30:155-8. [DOI: 10.3109/01443610903461436] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
24
|
Pirimoglu ZM, Guzelmeric K, Alpay B, Balcik O, Unal O, Turan MC. Psychological factors of hyperemesis gravidarum by using the SCL-90-R questionnaire. CLIN EXP OBSTET GYN 2010; 37:56-59. [PMID: 20420284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Hyperemesis gravidarum is known as a complex disease with interaction of biological, psychological and sociocultural factors. Our study was an attempt to understand the psychological effects on hyperemesis gravidarum by using an objective scale. METHODS Thirty-four pregnant women with hyperemesis gravidarum who were hospitalized in the Obstetrics and Gynecology Department of Dr. Lutfi Kirdar Kartal Education and Research Hospital in Istanbul, Turkey comprised the patient group and asymptomatic pregnant women who came for routine antenatal visits to our clinic were enrolled in this study as the control group between March 1, 2007 and October 15, 2008. Women in both groups filled in the Symptom Check List (SCL-90-R) questionnaire. The data collected from both groups were analyzed by using the Student's t-test (SPSS 13.00). Frequencies of high SCL scores between groups were analyzed by chi-square tests. RESULTS The patients with hyperemesis gravidarum had higher distress scores than those in the control group. The mean value of global severity index (GSI) was 1.03 in the patient group and 0.64 in the control group. The difference was statistically significant (p < 0.005). The most significant difference between the two groups was in somatization subscales (p < 0.0001). CONCLUSION Hyperemesis gravidarum is a complex disorder with psychological aspects. Considering this fact can help us deal with the disorder.
Collapse
Affiliation(s)
- Z M Pirimoglu
- Obstetrics and Gynecology Department, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Kartal, Istanbul, Turkey.
| | | | | | | | | | | |
Collapse
|
25
|
Avcu S, Unal O, Turan A, Kiriş M, Yuca K. Retropharyngeal abscess presenting with acute respiratory distress in a case of cervical spondylodiscitis. B-ENT 2010; 6:63-65. [PMID: 20420084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
We treated a 41-year-old man who presented with dysphagia, fever and respiratory distress. Magnetic resonance imaging (MRI) showed a large retropharyngeal abscess (RPA) extending to the C5-6 level, C5-6 spondylodiscitis and a spinal epidural abscess. The RPA was drained surgically under emergency conditions. Because the tuberculin skin test was positive, the patient underwent a triple anti-tuberculous drugs regimen. After six months of drug therapy, the epidural abscess was completely resolved. One of the most important aetiologies of RPA is thought to be tuberculous spondylodiscitis, and cervical vertebrae should be scanned thoroughly with pre-operative MRI.
Collapse
Affiliation(s)
- S Avcu
- Department of Radiology, Yüzüncü Yil University Medical Faculty Van, Turkey.
| | | | | | | | | |
Collapse
|
26
|
Turan C, Koc N, Dansuk R, Cengizoglu B, Mericeli DS, Unal O. Misoprostol administration in first-trimester pregnancies with embryonic demise reduces uterine arterial blood flow. J Matern Fetal Neonatal Med 2009; 14:226-8. [PMID: 14738166 DOI: 10.1080/jmf.14.4.226.228] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study was designed to evaluate the effect of misoprostol on the blood flow in uterine arteries of pregnant women with first-trimester embryonic demise. METHODS Transvaginal ultrasonographic Doppler examinations (resistance index, pulsatility index, systolic/diastolic ratio) of the uterine arteries in 61 pregnant women were performed before misoprostol administration and 90 min later. Following baseline Doppler measurements, each woman received 200 microg misoprostol intravaginally and 200 microg misoprostol orally. RESULTS AND CONCLUSION All Doppler indices increased significantly after misoprostol administration (p < 0.0001), suggesting an increase in flow resistance.
Collapse
Affiliation(s)
- C Turan
- Department of Obstetrics and Gynecology, Kartal Education and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
27
|
Avcu S, Akgun C, Temel H, Arslan S, Akbayram S, Unal O. Report of a girl with vacterl syndrome and right pulmonary agenesis. Genet Couns 2009; 20:379-383. [PMID: 20162874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Report of a girl with VACTERL syndrome and right pulmonary agenesis: VACTERL syndrome is a combination of vertebral anomalies (V), anal atresia (A), congenital heart defects (C), tracheo-esophageal fistula (T), esophageal atresia (E), abnormalities of kidneys (renal anomalies, R) and limbs (L). In the present patient right pulmonary agenesis is co-occurring with VACTERL syndrome. We report on this case because the association of right pulmonary agenesis and VACTERL syndrome is rare.
Collapse
Affiliation(s)
- S Avcu
- Department of Radiology, University of Yuziancl Yil, School of Medicine, Van, Turkey
| | | | | | | | | | | |
Collapse
|
28
|
Abstract
OBJECTIVE To determine the efficacy of intravenous (i.v.) paracetamol for decreasing pain associated with fractional curettage. MATERIALS AND METHODS This double-blind, randomised, placebo-controlled trial included 70 women who underwent fractional curettage. Patients were randomly assigned to receive i.v. infusion of either 1000 mg paracetamol (n = 36) or 0.9% normal saline as placebo (n = 34) prior to the procedure. The main outcome measure was the intensity of pain assessed by a 10-cm visual analogue scale. Pain scoring was performed at t(1) = prior to the procedure, t(2) = during the procedure and t(3) = 30 min after the procedure. Statistical analysis was performed using the Student's t-test, chi-squared and Pearson's correlation analysis. RESULTS The pain scores at t(2) and t(3) were significantly higher than the score at t(1) in both groups. There was no statistically significant difference between the pain scores at t(1), t(2) and t(3) among the two groups. Menopausal status had no effect on the pain scores and on the treatment outcome. The pain scores prior to the procedure were significantly higher in women with a history of endometrial curettage when compared with women who have no history. CONCLUSIONS Fractional curettage is associated with mild pain. We were unable to detect a significant difference in pain scores in patients undergoing fractional curettage when comparing the use of i.v. paracetamol with placebo. History of prior endometrial curettage seems to be a predictor of the basal pain scores at admission although it does not affect the pain intensity related to the procedure.
Collapse
Affiliation(s)
- O Api
- Department of Obstetrics & Gynecology, Dr Lutfi Kirdar Kartal Teaching and Research Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
29
|
Api O, Emeksiz MB, Api M, Ugurel V, Unal O. Modified myocardial performance index for evaluation of fetal cardiac function in pre-eclampsia. Ultrasound Obstet Gynecol 2009; 33:51-57. [PMID: 19086000 DOI: 10.1002/uog.6272] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess cardiac function by means of the modified myocardial performance index (Mod-MPI) in fetuses of pre-eclamptic mothers without intrauterine growth restriction and to compare this with values from normal controls. METHODS A cross-sectional study was conducted including a total of 72 fetuses at between 26 and 40 weeks' gestation. Forty fetuses of healthy mothers were assigned as the control group (Group I) while 15 fetuses of mildly pre-eclamptic mothers constituted Group II and 17 fetuses of severely pre-eclamptic mothers constituted Group III. Two-dimensional gray-scale and Doppler fetal echocardiography was used to exclude cardiac anomalies and calculate the Mod-MPI. RESULTS The mean+/-SD Mod-MPI values of Groups I, II and III were 0.43+/-0.045, 0.44+/-0.064 and 0.44+/-0.064, respectively (P=0.680). The mean aortic peak systolic velocity (PSV), the mean mitral valve early ventricular filling (E-wave) and active atrial filling (A-wave) peak velocities were significantly lower in fetuses of severely pre-eclamptic mothers than in fetuses of mildly pre-eclamptic mothers and control fetuses. CONCLUSION The fetal global myocardial function assessed by Mod-MPI does not seem to change in mild or severe pre-eclampsia. The lower mitral E-wave and A-wave peak velocities and the lower aortic PSV seem to reflect the increased cardiac afterload against which the fetal heart has to work, rather than systolic or diastolic cardiac dysfunction, in the fetuses of severely pre-eclamptic mothers.
Collapse
Affiliation(s)
- O Api
- Department of Obstetrics & Gynecology, Dr Lutfi Kirdar Kartal Teaching and Research Hospital Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
30
|
Karagoz T, Pazarli P, Mocin OY, Duman D, Duman G, Salturk C, Unal O. Evaluation of drug resistance in pulmonary tuberculosis patients at Sureyyapasa Chest Diseases Hospital, Istanbul, Turkey. Int J Tuberc Lung Dis 2008; 12:631-635. [PMID: 18492329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
SETTING Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey. OBJECTIVE To determine levels of Mycobacterium tuberculosis resistance to first-line drugs in patients with pulmonary tuberculosis (PTB). DESIGN Between 1 January and 31 December 2005, all hospitalised PTB patients with culture-positive M. tuberculosis specimens and corresponding drug susceptibility tests (DST) for isoniazid (INH), rifampicin (RMP), streptomycin (SM) and ethambutol, routinely performed for every tuberculosis (TB) case at our centre, were included. RESULTS Of a total of 1513 cases, 1277 (84.4%) were new and 236 (15.6%) were previously treated cases. Of the 1513 isolates, 290 (19%) isolates were resistant to at least one of the drugs tested. Resistance among new and previously treated cases was respectively 16.3% (209 of 1277) and 34.3% (81/236). Any SM resistance and any INH resistance were the most common drug resistance in new cases, while any RMP resistance was the most common drug resistance in previously treated cases. Multidrug resistance was detected in 3.2% (n = 41) of new cases and in 13.5% (n = 32) of previously treated cases. CONCLUSION Planning for TB control requires an assessment of the number and distribution of drug-resistant cases, with laboratories providing accurate and reliable results.
Collapse
Affiliation(s)
- T Karagoz
- Pulmonary Diseases Clinic, Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
31
|
Fox TE, Houck KL, O'Neill SM, Nagarajan M, Stover TC, Pomianowski PT, Unal O, Yun JK, Naides SJ, Kester M. Ceramide recruits and activates protein kinase C zeta (PKC zeta) within structured membrane microdomains. J Biol Chem 2007; 282:12450-7. [PMID: 17308302 DOI: 10.1074/jbc.m700082200] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We have previously demonstrated that hexanoyl-D-erythro-sphingosine (C(6)-ceramide), an anti-mitogenic cell-permeable lipid metabolite, limited vascular smooth muscle growth by abrogating trauma-induced Akt activity in a stretch injury model of neointimal hyperplasia. Furthermore, ceramide selectively and directly activated protein kinase C zeta (PKC zeta) to suppress Akt-dependent mitogenesis. To further analyze the interaction between ceramide and PKC zeta, the ability of ceramide to localize within highly structured lipid microdomains (rafts) and activate PKC zeta was investigated. Using rat aorta vascular smooth muscle cells (A7r5), we now demonstrate that C(6)-ceramide treatment results in an increased localization and phosphorylation of PKC zeta within caveolin-enriched lipid microdomians to inactivate Akt. In addition, ceramide specifically reduced the association of PKC zeta with 14-3-3, a scaffold protein localized to less structured regions within membranes. Pharmacological disruption of highly structured lipid microdomains resulted in abrogation of ceramide-activated, PKC zeta-dependent Akt inactivation, whereas molecular strategies suggest that ceramide-dependent PKC zeta phosphorylation of Akt3 at Ser(34) was necessary for ceramide-induced vascular smooth muscle cell growth arrest. Taken together, these data demonstrate that structured membrane microdomains are necessary for ceramide-induced activation of PKC zeta and resultant diminished Akt activity, leading to vascular smooth muscle cell growth arrest.
Collapse
Affiliation(s)
- Todd E Fox
- Department of Pharmacology College of Medicine, Pennsylvania State University, Hershey, Pennsylvania 17033, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Api O, Unal O, Api M, Ergin B, Alkan N, Kars B, Turan C. Ultrasonographic appearance of cervical pregnancy following successful treatment with methotrexate. Ultrasound Obstet Gynecol 2006; 28:845-7. [PMID: 17063447 DOI: 10.1002/uog.3846] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We report a case of cervical ectopic pregnancy successfully treated with systemic methotrexate. Conservative management with single-dose methotrexate was undertaken, but owing to the failure of human chorionic gonadotropin (hCG) levels to fall by 15% by day 7 and the persistence of fetal cardiac activity, two further doses of methotrexate were required. The patient's hCG levels were monitored, and repeat transvaginal ultrasonography was performed until complete resolution of the pregnancy by spontaneous miscarriage. We describe the ultrasonographic findings, which showed that the sac size increased despite treatment.
Collapse
Affiliation(s)
- O Api
- Kartal Dr Lutfi Kirdar Education and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
33
|
|
34
|
O'Neill SM, Nagarajan M, Fox T, Houck K, Stover T, Unal O, Yun J, Naides S, Kester M. Ceramide Recruits and Activates PKCzeta Within Structured Microdomains. FASEB J 2006. [DOI: 10.1096/fasebj.20.5.a1121-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - M. Nagarajan
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - T. Fox
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - K. Houck
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - T. Stover
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - O. Unal
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - J. Yun
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - S. Naides
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| | - M. Kester
- PharmacologyPenn State College of Medicine500 University DrHersheyPA17033
| |
Collapse
|
35
|
Ozkan G, Gokturk RS, Unal O, Celik S. Determination of the volatile constituents and total phenolic contents of some endemic Stachys taxa from Turkey. Chem Nat Compd 2006. [DOI: 10.1007/s10600-006-0070-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
36
|
Delazar A, Celik S, Göktürk RS, Unal O, Nahar L, Sarker SD. Two acylated flavonoid glycosides from Stachys bombycina, and their free radical scavenging activity. Pharmazie 2005; 60:878-80. [PMID: 16320954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Preparative reversed-phase HPLC analysis of the methanol extract of the aerial parts of Stachys bombycina (Lamiaceae) afforded two acylated flavonoids glycosides, chrysoeriol 7-O-[6-O-acetyl-beta-D-allopyranosyl]-(1 --> 2)-beta-D-glucopyranoside (1) and apigenin 7-O-beta-D-(6-p-coumaroyl)-glucopyranoside (2), the former being a new natural product. The structures of these compounds were elucidated unambiguously by UV spectroscopic analyses using shift reagents, ESIMS, and 1D and 2D NMR spectroscopic techniques. The free radical scavenging activity of 1 and 2 compounds were assessed by DPPH assay, and the RC50 values were 1.25 x 10(-2) and 7.69 x 10(-4) mg/mL, respectively.
Collapse
Affiliation(s)
- A Delazar
- School of Pharmacy and Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | | | | | | |
Collapse
|
37
|
Taşdemir T, Aydemir H, Inan U, Unal O. Canal preparation with Hero 642 rotary Ni-Ti instruments compared with stainless steel hand K-file assessed using computed tomography. Int Endod J 2005; 38:402-8. [PMID: 15910476 DOI: 10.1111/j.1365-2591.2005.00961.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To compare ex vivo root canal preparation with conventional stainless steel K-files and Hero 642 rotary Ni-Ti instruments. METHODOLOGY Mesiobuccal canals of 20 maxillary first molars (with angles of curvature between 25 degrees and 35 degrees ) were used. After preparation with Hero 642 rotary instruments and stainless steel K-files, the amount of transportation that occurred was assessed using computed tomography. The teeth were scanned by computed tomography before instrumentation. One millimetre thick slices were prepared from the apical end point to the pulp chamber. The first two sections were 3 mm from the apical end of the root (apical level) and 3 mm below the orifice (coronal level). A further section (mid-root level) was recorded, dividing the distance between the sections of apical and coronal levels into two equal lengths. Ten teeth were instrumented using Hero 642 rotary instruments and another 10 teeth were instrumented using stainless steel K-files. Following the completion of the instrumentation, the teeth were again scanned and compared with the cross-sectional images taken prior to canal preparation. Amount of transportation and centreing ability was assessed. Student's t-test was used for statistical analysis. RESULTS Less transportation occurred with Hero 642 rotary instruments than stainless steel K-files at the mid-root and coronal levels (mid-root: P < 0.05 and coronal: P < 0.001). Hero 642 rotary instruments had better centreing ability than K-files at all three levels (apical: P < 0.05, mid-root: P < 0.05 and coronal: P < 0.001). CONCLUSIONS Hero 642 rotary instruments transported canals less, especially at the middle and coronal thirds of the root canals than stainless steel K-files. Hero 642 instruments had better centreing ability.
Collapse
Affiliation(s)
- T Taşdemir
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
| | | | | | | |
Collapse
|
38
|
Yuca K, Unal O, Bayram I, Cankaya H, Kiris M. Papillary thyroid carcinoma presenting as a giant cervical mass: a case report. B-ENT 2005; 1:101-5. [PMID: 16044743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
Papillary thyroid carcinoma (PTC) is a relatively uncommon malignancy. The prognosis is generally good and the mortality rate is low. PTC is more common in younger patients; incidence is two to three times higher in women and in individuals with radiation exposure to the neck. We report on a 75-year-old woman with PTC admitted to our clinic for a giant mass in the neck dating back ten years. A hyperintense huge cystic lesion and hypo-intense central solid component were seen on T1- and T2-weighted magnetic resonance imaging. No distant metastasis was present. The PTC was treated surgically and radioiodine (131I) treatment was applied postoperatively. No recurrence was observed one year later.
Collapse
Affiliation(s)
- K Yuca
- Department of Otorhinolaryngology, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
| | | | | | | | | |
Collapse
|
39
|
Guzelmeric K, Seker N, Unal O, Turan C. High serum prostate-specific antigen concentrations in hirsute women do not decrease with treatment by the combination of spironolactone and the contraceptive pill. Gynecol Endocrinol 2004; 19:190-5. [PMID: 15724801 DOI: 10.1080/09513590400012069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Using an ultrasensitive assay, prostate-specific antigen (PSA) has been detected in female serum and has been proposed as a potential marker of androgen excess in hirsute women. Measurement of PSA levels in serum may play a role in monitoring hirsutism during antiandrogen therapy. We investigated the role of PSA as a marker of androgen activity in hirsute patients taking spironolactone together with oral contraceptive pills containing ethinyl estradiol and gestodene. Twenty-eight hirsute patients were included in the study. Clinical and biochemical variables including serum levels of PSA (using an ultrasensitive chemiluminscent immunoassay), dehydroepiandrosterone sulfate, total testosterone, free testosterone and 17-hydroxyprogesterone concentrations were recorded at baseline and after six cycles of treatment. Fifteen healthy women were included in the study as controls. Serum PSA levels in hirsute women were clearly higher than in the control group (0.023 +/- 0.004 vs. 0.006 +/- 0.003 ng/ml, p < 0.001) and correlated with baseline serum free testosterone concentrations (r = 0.518, p = 0.005). After 6 months, serum PSA concentrations as compared with baseline values did not change significantly in patients who were given spironolactone plus contraceptive pills (p = 0.4) despite a marked decrease in total testosterone, free testosterone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate and hirsutism score (p < 0.05). Thus, serum PSA levels in hirsute women were higher than in non-hirsute healthy controls. A 6-month course of treatment with spironolactone combined with contraceptive pills containing ethinylestradiol and gestodene did not reduce high serum PSA levels in these subjects. In conclusion, the serum PSA level is not a convenient biochemical marker with the available assays for the management of hirsute women treated with the combination of spironolactone and oral contraceptives.
Collapse
Affiliation(s)
- K Guzelmeric
- Department of Obstetrics and Gynecology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey
| | | | | | | |
Collapse
|
40
|
Harman M, Etlik O, Unal O. Direct percutaneous embolization of a carotid body tumor with n-butyl cyanoacrylate: an alternative method to endovascular embolization. Acta Radiol 2004; 45:646-8. [PMID: 15587423 DOI: 10.1080/02841850410006759] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report ultrasound-guided direct percutaneous injection of n-butyl cyanoacrylate for preoperative embolization of carotid body tumor in a 50-year-old patient. Angiographic road map assistance was used for protection of parent arteries during the injection. After embolization, complete devascularization of the tumor was achieved without complications. The tumor was removed surgically with minimal blood loss. This procedure is effective and promising for preoperative embolization of carotid body tumors.
Collapse
Affiliation(s)
- M Harman
- Department of Radiology, University of Yüzüncü Yil Faculty of Medicine, Van, Turkey.
| | | | | |
Collapse
|
41
|
Buyukbayrak EE, Turan C, Unal O, Dansuk R, Cengizoğlu B. Diagnostic power of the vaginal washing-fluid prolactin assay as an alternative method for the diagnosis of premature rupture of membranes. J Matern Fetal Neonatal Med 2004; 15:120-5. [PMID: 15209120 DOI: 10.1080/14767050410001659842] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the reliability of the vaginal washing-fluid prolactin assay for the diagnosis of premature rupture of membranes (PROM) and to determine a diagnostic cut-off value. STUDY DESIGN Seventy pregnant women between 11 and 40 weeks of gestation who were admitted with vaginal fluid leakage were included in the study group, and were then further subdivided into two subgroups according to amniotic fluid pooling and nitrazine paper test results. Group 1 was the 'confirmed PROM group', positive for both pooling and nitrazine (38 patients). Group 2 was the 'suspected but unconfirmed PROM group' which had possible pooling and/or nitrazine (32 patients). Seventy pregnant women between 11 and 40 weeks of gestation without any complaint and complication were included in the control group (group 3). All patients underwent vaginal washing-fluid sampling and prolactin level determination. For the statistical analysis one-way analysis of variance, Tukey multiple comparison test, chi2 test and receiver operating characteristic (ROC) curve analysis were used. RESULTS Geometric mean values of vaginal washing-fluid prolactin levels were 616.59 microIU/ml for group 1, 23.98 microIU/ml for group 2 and 10 microIU/ml for group 3 (p < 0.0001). The optimal diagnostic cut-off value was found to be 30 microIU/ml with 95% sensitivity, 78% specificity, 84% positive predictive value, 93% negative predictive value, 87% accuracy and 11.30 relative risk. CONCLUSIONS We recommend vaginal washing-fluid prolactin level determination as an alternative diagnostic method for PROM.
Collapse
Affiliation(s)
- E E Buyukbayrak
- Department of Obstetrics and Gynecology, Kartal Education and Research Hospital, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
42
|
Etlik O, Arslan H, Bay A, Sakarya ME, Harman M, Temizoz O, Kayan M, Bakan V, Unal O. Abdominal hydatid disease: long-term results of percutaneous treatment. Acta Radiol 2004; 45:383-9. [PMID: 15323389 DOI: 10.1080/02841850410005651] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the effectiveness of percutaneous treatment under sonographic guidance in abdominal hydatid cysts. MATERIAL AND METHODS Fifty-two hydatid cysts in 33 patients were treated using a percutaneous approach under sonographic guidance. Forty-five cysts were located in the liver, 6 in the spleen, and 1 in the pancreas. Forty-nine cysts were type I, and 3 were type II. Thirty-one cysts in 15 patients were treated with puncture and aspiration of the contents, injection of hypertonic saline solution, and respiration (PAIR); 15 cysts in 14 patients were treated with puncture, aspiration of cyst contents, injection of hypertonic saline solution, drainage, and injection of sclerosing agent (PAIDS); and 6 cysts in 4 patients were treated with puncture, aspiration of cyst contents, injection of sclerosing agent, and re-aspiration (mPAIDS). Hypertonic saline or alcohol was used as a scolicidal agent. The follow-up period was between 17 and 53 months. RESULTS A decrease in the dimensions of the cysts, solidification of the contents, and irregularity in the walls of cysts, all of which were considered signs of cure, were found in all patients. Recurrence was observed in one case and anaphylaxis in one. CONCLUSION Percutaneous treatment of abdominal hydatid cysts is a safe, easily applicable, well-tolerated, and effective method.
Collapse
Affiliation(s)
- O Etlik
- Department of Radiology, Yuzuncu Yil University Faculty of Medicine, Van, Turkey.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Dansuk R, Unal O, Karageyim Y, Esim E, Turan C. Evaluation of the effect of tibolone and transdermal estradiol on triglyceride level in hypertriglyceridemic and normotriglyceridemic postmenopausal women. Gynecol Endocrinol 2004; 18:233-9. [PMID: 15346658 DOI: 10.1080/09513590410001715199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
The objective of the present study was to quantify the magnitude of the association between the change in triglycerides and high-density lipoprotein (HDL) cholesterol levels with the use of tibolone and transdermal estrogen in postmenopausal women with hypertriglyceridemia and normotriglyceridemia. This prospective randomized study enrolled 140 postmenopausal women who had all been hysterectomized for almost a year or more. All subjects completed the 3-month follow-up. The 140 patients were divided into two groups: 70 were given transdermal 17beta-estradiol 0.05 mg/day, and 70 were given tibolone 2.5 mg/day. We compared the effects of tibolone and transdermal 17beta-estradiol on lipids and dimacteric symptoms of the patients. To evaluate the effects of tibolone and transdermal estrogens on triglycerides and HDL cholesterol in postmenopausal women with normotriglyceridemia and hypertriglyceridemia, the women were assigned to five groups according to triglyceride levels (0-100, 101-200, 201-300, 301-400 and > or = 401 mg/dl). We compared changes in the triglyceride and HDL cholesterol levels of each group after treatment. All 140 postmenopausal women completed the trial. No significant differences were found in baseline characteristics of the patients. The tibolone group showed a 22.6% decrease whereas the transdermal estrogen group had a 10.9% decrease in the mean triglyceride levels after 3 months of treatment. The mean decrease of triglyceride level with transdermal estradiol was approximately 11% in normotriglyceridemic and hypertriglyceridemic postmenopausal women. The mean decrease of triglyceride level was 17% in the normotriglyceridemic group and 22-30% in the hypertriglyceridemic groups with tibolone. While the mean HDL cholesterol level increased in the transdermal estrogen group (3.6%), it decreased in the tibolone group (9.3%). We found that tibolone decreased triglyceride levels much more than did transdermal estradiol. However, HDL cholesterol was decreased by tibolone and increased by transdermal estradiol. Tibolone had a more marked decreasing effect in postmenopausal women who had higher initial triglyceride levels. It is suggested that the beneficial effect of tibolone on the cardiovascular system might be greater in women with a high level of triglycerides.
Collapse
Affiliation(s)
- R Dansuk
- Department of Obstetrics and Gynecology, Lütfi Kirdar Kartal Research Hospital, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
44
|
Caksen H, Odabas D, Demirtas M, Kiymaz N, Anlar O, Unal O, Ugras S. A case of metastatic spinal Ewing's sarcoma misdiagnosed as brucellosis and transverse myelitis. Neurol Sci 2004; 24:414-6. [PMID: 14767689 DOI: 10.1007/s10072-003-0199-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2003] [Accepted: 11/26/2003] [Indexed: 11/25/2022]
Abstract
An 11-year-old girl was admitted with back pain for 2 months, inability to walk for 15 days, and enuresis and encopresis for 2 days. She had been hospitalized with the diagnosis of brucellosis in another hospital. At presentation, she had paraplegia, sphincter dysfunction, and bilateral sensory loss below the T6 level, and was initially diagnosed with transverse myelitis caused by brucellosis. On the third day of hospitalization, however, agglutination test for brucella was negative, but it was positive for Salmonella. Therefore, transverse myelitis was considered to be due to salmonellosis. Thoracic spine magnetic resonance imaging showed an extradural, paraspinal mass at the level of T6-T7. The mass was totally extracted, and histopathological examination revealed Ewing's sarcoma. During follow-up, no improvement in paraplegia was noted and an enlarged presacral decubital ulcer developed. Aside from supportive care, local radiotherapy was applied. Unfortunately, the patient died from probable infection 9 months after the diagnosis. We emphasize that metastatic spinal Ewing's sarcoma may mimic brucellosis and transverse myelitis in childhood.
Collapse
Affiliation(s)
- H Caksen
- K. Karabekir C. Gölba i 3. S., Erkam sitesi. B. Blok. No. 3/7, Van, Turkey.
| | | | | | | | | | | | | |
Collapse
|
45
|
Harman M, Kiroğlu F, Kösem M, Unal O. Primary Ewing's sarcoma of the paranasal sinus with intracranial extension: imaging features. Dentomaxillofac Radiol 2004; 32:343-6. [PMID: 14709612 DOI: 10.1259/dmfr/17098962] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Extraskeletal Ewing's sarcoma is often described as a tumour involving the soft tissues of the lower extremities and the paravertebral region. Involvement of the paranasal sinus is a very rare entity. We present a case of primary Ewing's sarcoma of the paranasal sinus extending into the middle cranial fossa in a 40-year-old female. CT and MRI findings of this unusual case are discussed. To our knowledge, this case is the first to be reported with CT and MRI documentation.
Collapse
Affiliation(s)
- M Harman
- Department of Radiology, University of Yuzuncu Yil Faculty of Medicine, Van, Turkey.
| | | | | | | |
Collapse
|
46
|
Erol M, Caksen H, Tan O, Atik B, Unal O, Odabaş D. Report of a girl with Klippel-feil syndrome and Poland anomaly. Genet Couns 2004; 15:469-72. [PMID: 15658624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Report of a girl with Klippel-feil syndrome and Poland anomaly: Klippel-Feil syndrome, consisting of the triad of a short neck, low posterior hairline, and limitation of neck movement, is a congenital anomaly characterized by the fusion of cervical vertebrae, Poland anomaly consists of unilateral aplasia of the chest wall muscles and ipsilateral anomalies of upper extremity. We report a 7-year-old girl with typical findings of Klippel-Feil syndrome and Poland anomaly. To the best of our knowledge a case of Klippel-Feil syndrome and Poland anomaly has not been described before, although a combination of Poland, Klippel-Feil and Moebius anomalies has been reported in the literature.
Collapse
Affiliation(s)
- M Erol
- Department of Pediatrics, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey
| | | | | | | | | | | |
Collapse
|
47
|
Caksen H, Tuncer O, Kirimi E, Fryns JP, Uner A, Unal O, Cinal A, Odabaş D. Report of two Turkish infants with Norman-Roberts syndrome. Genet Couns 2004; 15:9-17. [PMID: 15083694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Lissencephaly or agyria refers to a rare disorder that is characterized by the absence of cerebral convolutions and a poorly formed sylvian fissure, giving the appearance of a 3-4 months old fetal brain. At present more than 25 dysmorphology syndromes with lissencephaly or other disorders of neuronal migration have been described. In 1976, Norman et al. reported on two patients with lissencephaly type I and short, sloping forehead, an atypical phenotype for Miller-Dieker syndrome, a more common lissencephaly syndrome. In this article, we report two Turkish female infants whose abnormal findings were consistent with Norman-Roberts syndrome because of their very rare presentation. Both patients had typical cranio-facial abnormalities and abnormal magnetic resonance imaging findings, but no deletion in 17p13.3 for Miller-Dieker syndrome. In addition to the typical findings of Norman-Roberts syndrome, case 1 had atrial septal defect, corpus callosum agenesis, intracranial widespread calcification and case 2 had bilateral macular cherry-red spot, persistent foramen ovale, increased blood level of C6 hexanoylcarnitine, cavum septum pellucidum vergae anomaly and cerebellar atrophy. In conclusion, we would like to emphasize that Norman-Roberts syndrome should also be considered in infants with lissencephaly. A detailed physical examination, chromosomal and fluorescence in situ hybridization (FISH) analysis to exclude a deletion in 17p13.3 should be performed for the definite diagnosis of the syndrome.
Collapse
Affiliation(s)
- H Caksen
- Department of Pediatrics, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Caksen H, Tuncer O, Ataş B, Demirok A, Unal O, Ikbal M, Odabaş D. A Turkish case of subcortical/subependymal heterotopia associated with corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation. Genet Couns 2003; 14:343-8. [PMID: 14577680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The patient is a 12-year-old boy with a history of learning disability, growth retardation, and strabismus. Weight, height and head circumference were below the 3rd percentile. A café-au-lait spot, 1x1 cm a diameter, on the back region and pectus excavatum deformity were diagnosed. He had facial asymmetry, a broad nose, sparse eyebrows and eyelashes, a rudimentary frontal sinus, deviation of the nasal septum, and bilateral small maxillary bones. The left orbital fossa was also mildly rudimentary. On eye examination the movements of the left globe to the upward and lateral side were limited and internal strabismus was noted at this side. Visual acuity was 1/10, bilaterally. Bilateral choroid coloboma, glaucoma, vertical and horizontal nystagmus were diagnosed. Fundoscopic examination revealed bilateral optic atrophy and macular and paramacular granulation tissues on the left side. Intelligence quotient was 46. Electroencephalography revealed bilateral frontal slow-wave activity. Visual evoked potential revealed prolonged p100 wave latencies bilaterally. Magnetic resonance imaging of the brain demonstrated corpus callosum dysgenesis, bilateral subcortical heterotopia in the frontal lobes and subependymal heterotopia in the posterior horn of the left ventricle. Chromosomal analysis revealed a normal male karyotype, 46, XY. Although several cases of heterotopia in association with mental retardation, craniofacial dysmorphism, cerebral, and eye abnormalities have been described the combination of abnormalities diagnosed in our case has not previously been reported. We hypothesize that the combination of subcortical/subependymal heterotopia, corpus callosum dysgenesis, craniofacial dysmorphism, severe eye abnormalities, and growth-mental retardation may be a new syndrome.
Collapse
Affiliation(s)
- H Caksen
- Department of Pediatrics, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey.
| | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
Chorea gravidarum is a rare syndrome in pregnancy. The clinical picture is of extrapyramidal symptoms such as involuntary movements, lack of coordination and slurred speech. Neuroleptics or benzodiazepines can be used for treatment. When antiphospholipid antibodies are shown to be present, corticosteroids, and sometimes aspirin, are added to the treatment. Movement disorders can also be associated with an increased central dopamine level. In this report, we present the case of a patient with chorea gravidarum in whom an etiologic factor has not been observed. We treated the symptoms with dopamine-blocking agents such as haloperidol. We believe that, if chorea gravidarum is not accompanied by other etiologic factors (such as antiphospholipid antibodies), there is no elevated risk for the mother and the fetus.
Collapse
Affiliation(s)
- A Y Karageyim
- Kartal Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
Early diagnosis of brucellar spondylodiscitis is often difficult because of the long latent period. Radiographs of the spine, bone scan, and computed tomography (CT) scan provide insufficient data. Among 25 patients with brucellar spondylodiscitis studied by magnetic resonance imaging (MRI), 9 were in the acute stage and 16 were in the chronic stage. MRI is the investigation method of choice in diagnosing brucellar spondylodiscitis.
Collapse
Affiliation(s)
- M Harman
- Department of Radiology, University Faculty Medicine, Van, Turkey.
| | | | | | | | | |
Collapse
|