Eine präliminäre Studie über die Wirkungen von warmen vorbereitenden Lösungen auf den oxidativen ... more Eine präliminäre Studie über die Wirkungen von warmen vorbereitenden Lösungen auf den oxidativen Stress und postoperatives Vorhofflimmern in der Chirurgie am offenen Herzen Zusammenfassung Grundlagen Ein wichtiger Grund für die Entstehung einer Ischämie, eines Reperfusionsschadens und von oxidativem Stress ist die plötzliche und rasche Änderung der Körpertemperatur während der Einleitung eines kardiopulmonalen Bypasses. Ziel unserer Studie ist es, die Wirkungen von warmen vorbereitenden Lösungen auf oxidativen Stress und Vorhofflimmern zu untersuchen. Methodik Es handelt sich um eine präliminäre, prospektive Studie an 40 Patienten, die einer elektiven Koronararterien-Bypass-Operation mit kardiopulmonalem Bypass unterzogen wurden. Die Patienten wurden in 2 Gruppen von jeweils 20 randomisiert: die eine wurde anfangs mit einer 20 °C Lösung, die andere mit einer 36 °C Lösung für den kardiopulmonalen Bypass vorbereitet. Präoperativ und in der 15. und in der 60. Min nach der Aortenklemmung, sowie 24 h postoperativ wurden von beiden Gruppen Blutproben abgenommen. Die Serumkonzentrationen von Malondialdehyd, sowie der Karbonyl-Protein-Gehalt und der gesamte antioxidative Status wurden bestimmt. Das Auftreten von postoperativem Vorhofflimmern wurde kontrolliert. Ergebnisse Malondialdehyd-Konzentrationen und der Karbonyl-Protein-Gehalt waren in der 15. und 60. Min bei den Patienten mit kalter Vorbereitung signifikant höher. Zugleich war der Gesamt-antioxidative Status signifikant erniedrigt. Diese Veränderungen normalisierten sich bis zur 24 h postoperativ. Bei den Patienten mit der kalten Vorbereitung trat Vorhofflimmern in der postoperativen Phase signifikant häufiger als bei den Patienten mit der körperwarmen Vorbereitung auf. Schlussfolgerung Obwohl die Studie nur an relativ wenigen Patienten durchgeführt wurde, könnte sie doch einen Hinweis auf mögliche präventive Wirkungen einer 36 °C warmen vorbereitenden Lösung im Bezug auf die Entstehung von oxidativen Stress und postoperativem Vorhofflimmern geben.
Familial Mediterranean fever (FMF) is an autosomal recessive disease of unknown origin. A less co... more Familial Mediterranean fever (FMF) is an autosomal recessive disease of unknown origin. A less common manifestation of joint involvement in FMF is spondylartropathy, which is almost always HLA B27 negative. In these patients, along with sacroiliitis, inflammatory neck and back pain is also present producing minimal or no radiographic changes on plain films of lumbar and cervical spine. In this report, we presented a patient with FMF whom had been diagnosed to be ankylosing spondilitis (AS) in the light of some clinical and radiological findings.
Aim: We have conducted this study to seek and observe visual clues through immunohistochemical st... more Aim: We have conducted this study to seek and observe visual clues through immunohistochemical staining for differences in Et-1/2/3 expression and the free-flow capacity measuring the blood flow through grafts, in the left internal mammary artery grafts prepared either with clipped or nonclipped techniques. Methods: A total of 40 consecutive patients with a diagnosis of coronary artery disease who would benefit from elective coronary artery bypass graft surgery were randomised into two groups consisting 20 patients each. Left internal mammary artery was harvested by a traditional clipped (control group) and a modified nonclipped (study group) technique in each of the groups. All harvested arterial segments were evaluated for luminal endothelial integrity through hematoxylin&eosin and immunohistochemical staining. Results: The free-flow capacity of left internal mammary artery grafts were significantly higher in nonclipped arteries when compared with that of clipped ones (P=0.001). The arterial lumen of the nonclipped segments were visibly more dilated than the clipped ones. Nonclipped segments presented a lighter immunostaining for Et-1/2/3 when compared with the clipped ones (P<0.001). Conclusion: We believe that lesser endothelial damage caused by the lower intraluminal pressure in modifiedly harvested left internal mammary artery segments has positive implications on intraoperative and postoperative cardiac events related to graft vasospasm, especially related with endothelins. We recommend modified left internal mammary artery harvesting in patients going under coronary artery bypass graft operation.
Helicobacter pylori (H. pylori) enfeksiyonu insanlarda sık görülen kronik bakteriyel enfeksiyondu... more Helicobacter pylori (H. pylori) enfeksiyonu insanlarda sık görülen kronik bakteriyel enfeksiyondur (1, 2). Dünya nüfusunun %60'ının bu bakteri ile kolonize olduğu tahmin edilmektedir. Sıklığı ve sebep olduğu hastalıklar açısından H. pylori ciddi bir halk sağlığı sorunudur (1, 3). H. pylori tedavisinde pek çok tedavi rejimi önerilmekle birlikte halen optimal tedavi rejimi tanımlanmamıştır (4). H. pylori tedavisinde iki antibiyotik ile beraber proton pompa inhibitörü (PPI) (omeprazol, lan
Background/aims: Celiac disease is a condition related to the small intestine's intolerance to gl... more Background/aims: Celiac disease is a condition related to the small intestine's intolerance to gluten. In epidemiologic studies the prevalence is highly variable. The diagnosis can be difficult due to the wide spectrum of signs and symptoms. As the risk for intestinal lymphoma is higher in these patients, early diagnosis has its privileges. The higher prevalence of recurrent aphthous stomatitis in celiac disease led us to investigate the celiac disease prevalence in patients with recurrent aphthous stomatitis, which might assist in diagnosis of asymptomatic celiac disease patients. The aim of this study was to determine the prevalence of celiac disease in patients presenting with recurrent aphthous stomatitis. Methods: The study group consisted of patients having a history of recurrent aphthous stomatitis. The control group included patients not having aphthous stomatitis. Antibodies to gliadin IgG and IgA and antibodies to endomysium were determined from the serum samples of all patients. Biopsies were obtained from the distal part of the duodenum. Results: Biopsies of two patients (4.8%) out of 41 belonging to the study group were diagnosed as celiac disease. In serum samples of both, antibodies to gliadin IgA and antibodies to endomysium were found to be positive. Antibodies to gliadin IgG antibody were positive in only one of these two patients. None of the 49 patients in the control group was diagnosed as celiac disease. Conclusion: Further evaluation of recurrent aphthous stomatitis patients for celiac disease must be performed. As the endoscopic procedures are invasive and costly, evaluation of recurrent aphthous stomatitis patients for celiac disease must include serologic markers at the beginning. If any positivity is determined in markers, then endoscopic procedures including biopsies of the duodenum must be considered as the second-step intervention.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2004
Klinik ve pratik hematolojide, demir eksikliği aneminin en sık nedenidir. Demir eksikliğinin geli... more Klinik ve pratik hematolojide, demir eksikliği aneminin en sık nedenidir. Demir eksikliğinin gelişiminde; azalmış demir alımı, artmış demir kaybı ve artmış demir ihtiyacı rol alır. 1,2 Hastalarda gastrointestinal sistemden (GĐS) belirgin kan kaybına yönelik bulgu olmasa da, açıklanamayan demir eksikliği anemisi (DEA) olan vakalarda endoskopik inceleme yapılmasının önemini vurgulayan çalışmalar mevcuttur. 3-5 Erkeklerde ve postmenopozal kadınlarda, DEA gastrointestinal sistemden kan kaybı ile ilişkili olarak düşünülmesine rağmen, yapılan çalışmalarda bu hastaların endoskopik ve kolonoskopik ORĐJĐNAL ARAŞTIRMA / ORIGINAL RESEARCH.
The left internal mammary artery is the conduit of choice for coronary artery bypass grafting. In... more The left internal mammary artery is the conduit of choice for coronary artery bypass grafting. In the traditional ("clipped-artery") harvesting technique, this artery is prepared as a pedicle; the distal part is clipped, cut, and covered with a papaverine-soaked cloth until anastomosis is performed. In modified ("nonclipped-artery") harvesting, the prepared artery is kept in situ and left connected to the systemic circulation until anastomosis. Better outcomes from use of the nonclip technique have been reported. In order to determine comparative endothelial integrity and endothelial nitric oxide synthase activity, we performed an immunohistochemical study of arterial graft segments that were procured by each technique. This cross-sectional study involved 40 patients who underwent elective coronary artery bypass grafting. The patients were randomized into 2 groups of 20. One group underwent traditional clipped-artery harvesting; the other group, modified nonclipped-artery harvesting. By immunohistochemical methods, we examined redundant segments taken from bifurcation levels of the arteries. The tunica media was thinner in the clipped arterial segments, a phenomenon that we attribute to high luminal pressure. Endothelial nitric oxide synthase immunostaining was absent in regions of denudation in the luminal endothelia of the clipped arteries; in contrast, pronounced immunostaining occurred in the endothelia of the nonclipped segments. We found that traditional harvesting disrupted the integrity of the luminal endothelia of the clipped arteries. In addition, the traditional procedure decreased nitric oxide production, as was revealed by immunostaining.
Background: Vascular endothelial growth factor (VEGF), basic-fibroblast growth factor (b-FGF), an... more Background: Vascular endothelial growth factor (VEGF), basic-fibroblast growth factor (b-FGF), and endothelial nitric oxide synthase (eNOS) are factors that take part in placental angiogenesis. They are highly expressed during embryonic and fetal development, especially in the first trimester. In this study, we aimed to investigate the role of placental angiogenesis in the development of intrauterine growth restriction (IUGR) by comparing the levels of expression of VEGF-A, b-FGF, and eNOS in normal-term pregnancy and IUGR placentas. Methods: The expression of VEGF-A, b-FGF, and eNOS was studied using the avidin-biotin-peroxidase method in placental tissues diagnosed as normal (n = 55) and IUGR (n = 55). Results were evaluated in a semi-quantitative manner. Results: The expression of all the markers was significantly higher (p < 0.001) in cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, vascular smooth muscle cells, chorionic villous stromal cells, and villous vascular endothelial cells of the IUGR placentas when compared with those collected from normal-term pregnancies. Conclusion: Increased expression of VEGF-A, b-FGF, and eNOS may be the result of inadequate uteroplacental perfusion, supporting the proposal that abnormal angiogenesis plays a role in the pathophysiology of IUGR.
Many studies have defined human body parts and their proportions to each other morphometrically [... more Many studies have defined human body parts and their proportions to each other morphometrically [1À3,6,7,10]. These studies are important because they enable accurate definitions for morphometric properties of different body parts in different human populations. In this context, both of the ears play a vital role in producing a natural and harmonious look and an aesthetically fine facial appearance [1,2,6]. They also are helpful in defining population standards, congenital malformations, and the ergonomic design of hearing aids [6,7,9,11,12]. This study aimed to establish morphometric properties for the ears, a determining feature of the human face, in a group of Turkish children.
The present study aimed to investigate whether electrocautery caused any thermal injury to the fo... more The present study aimed to investigate whether electrocautery caused any thermal injury to the forearm nerves or not. We compared the neurological outcome of two different radial artery harvesting techniques through neuroelectrophysiological studies. Preoperative values and postoperative conduction changes after one month were compared in two groups of patients. Each of the groups consisted of 20 patients. Radial arteries were harvested using scissors in Group 1 and with a low dose diathermy technique in Group 2. The mean amplitude of sensory action potentials of radial nerves was significantly reduced postoperatively at the end of the first month in both groups (P = 0.01, P = 0.001). But there were no significant differences between groups with respect to the sensory action potentials of ulnar and median nerves postoperatively. There were no significant differences between groups with respect to radial, ulnar and median nerve motor conduction recordings. Low dose electrocautery does not cause excessive nerve injury compared with the scissors technique in radial artery harvesting. Electrocautery may be used safely for RA harvesting in the forearm.
Our aim was to determine the effects of cardiopulmonary bypass procedures on the optic nerve by r... more Our aim was to determine the effects of cardiopulmonary bypass procedures on the optic nerve by retinal nerve fiber layer thickness measurements. Retinal nerve fiber layer thickness was measured using the GDx Nerve Fiber Analyser, 1 day before the surgery and on postoperative days 1, 5 and 30 in 20 patients undergoing coronary artery bypass grafting surgery. Postoperative mean values for retinal nerve fiber layer thickness, except symmetry on the first day and except symmetry and superior nasal ratio on the fifth day, were statsitically decreased. Only the value for the inferior ratio was significantly lower at the end of the first month. Cardiopulmonary bypass procedures cause a temporary decrease in retinal nerve fiber layer thickness.
Objectives: Adenosine and adenosine A 1 receptor agonists exert protective effects against reperf... more Objectives: Adenosine and adenosine A 1 receptor agonists exert protective effects against reperfusion injury in different tissues by mediating preconditioning. The aim of the present study was to examine the effects of adenosine A 1 /A 2 receptor activation on reperfusion-induced small intestinal injury in rat. Methods: Animals were randomized into four groups each including eight as following: sham control, ischemia-reperfusion control, 5’-N-ethylcarboxamidoadenosine (NECA) (non-selective A 1 /A 2 agonist, 0.1 mg/kg, i.v.)-treated I/R, and theophylline (non-selective A 1 /A 2 antagonist, 20 mg/kg, i.v.)-treated I/R groups. The treatments were administered 5 min before inducing ischemia in which superior mesenteric artery was clamped for 30 min followed by 180 min of reperfusion period. Myeloperoxidase, malondialdehyde, and reduced glutathione contents of terminal ileum samples were measured besides recording contractile responses to KCl, carbachol and substance P. Results: Ischemic insult significantly increased neutrophil infiltration and lipid peroxidation while decreasing the reduced glutathione. Contractile responses were seriously reduced in I/R group compared to that of the sham control group. NECA pretreatment alleviated the tissue content of reduced glutathione remarkably besides providing partial amelioration of I/R-reduced contractile response, while theophylline pretreatment had no any protective effect. Conclusion: We offer additional evidence that activation of A 1 /A 2 adenosine receptors provides partial protection against ischemia-induced intestinal contractile dysfunction possibly through maintaining reduced glutathione content at physiological levels.
Cakmak Ozlu F, Aktunc E, Yilmaz H, Karadeniz EI-Effectiveness of three different types of educati... more Cakmak Ozlu F, Aktunc E, Yilmaz H, Karadeniz EI-Effectiveness of three different types of educational methods on implementation of proper oral hygiene behaviour prior to orthodontic treatment 2 ABSTRACT Objective: The aim of this study was to compare three teaching methods' time and personnel requirements, and their effects on plaque and gingival indices. Methods: This study was a single-blind randomized controlled trial on fixed orthodontic appliance candidates (n = 90), assigned into a control group (n = 30) and two different study groups (n = 30 each). The control group received standard printed educational material and was assisted with verbal information. The study groups either received video-assisted or hands-on training about fixed orthodontic appliance and oral hygiene. The time requirements for all three educational interventions was recorded during the initial visit. The adequacy of oral hygiene was documented through plaque and gingival indices during the initial visit and eighth week of the treatment. The continuous variables were analyzed using 1-way ANOVA. Tukey HSD and Student t-tests were used for post-hoc comparisons (α = 0.05). Also, a chi-square test was used for the analysis of categorical variables. Results: Standard education failed to maintain the plaque and gingival indices at the eighth week of the treatment. Although both video-assisted and hands-on training took a considerable amount of time, they served well in preserving both of the indices at the eighth week. The longer the educational intervention was, the better the preservation of the plaque and gingival indices. Conclusion: Educational intervention, either with video-assisted or hands-on programs, provided better results in oral hygiene depending on the time and personnel constraints of the orthodontist.
Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan ... more Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan olgularda ikinci tedavi ile eradikasyon daha zordur. H. pylori eradikasyon başarısızlıklarında uygulanacak tedavi kombinasyonları kesin belirlenmemiştir. Bu çalışmada lansoprazol, amoksisilin ve klaritromisin (LAK) ile yapılan standart üçlü tedavi ile H. pylori eradikasyonu sağlanamayan olgularda lansoprazol, ranitidin bizmut sitrat, tetrasiklin ve metronidazolden (LBTM) oluşan dörtlü tedavinin etkinliğini araştırdık. Gereç ve yöntem: Peptik ülser hastalığı veya nonülser dispepsi nedeniyle standart üçlü LAK tedavisi verilen ve H. pylori eradikasyonu sağlanamayan toplam 36 olgu çalışmaya alındı. Bu olgulara lansoprazol (2x30 mg), ranitidin bizmut sitrat (2x400 mg), tetrasiklin (4x500 mg) ve metronidazolden (3x500 mg) oluşan dörtlü tedavi 14 gün verildi. Tedavinin bitiminden iki ay sonra endoskopik biyopsi ile H. pylori eradikasyonu değerlendirildi. Bulgular: Olgulardan beşi tedavi bitimin...
Objective: Coagulation anomalies in patients with thyroid dysfunction may vary from subclinical d... more Objective: Coagulation anomalies in patients with thyroid dysfunction may vary from subclinical disorders in laboratory tests to life threatening thrombotic events or bleeding. We aimed to determine the effect of thyroid dysfunction on thrombophilia in patients with acute and subacute deep vein thrombosis (DVT). Materials and Methods: A number of 30 patients with the diagnosis of DVT between November 2015 and June 2016 included in this case - control study. The patients divided into two groups as provoked (with known ethiology, n = 13) and unprovoked (with un-known ethiology, n = 17) patients. Provoked patients group divided as the patients with acquired risk factors (predisposition) and/or the patients with genetic risk factors. Results: The difference of the rate of the thyroid dysfunction between the provoked and unprovoked groups was not significant (p=0.844). The PAI – 1 gene mutation was detected in 70% of the study cohort and none of the patients had prothrombin gene mutation...
... Hematüri, piyüri ve bakteriüri kız çocuklarda erkeklerden anlamlı derecede daha fazla görülme... more ... Hematüri, piyüri ve bakteriüri kız çocuklarda erkeklerden anlamlı derecede daha fazla görülmek-te iken, idrar kristalleri erkek çocuklarda kızlardan anlamlı derecede fazla ... Murat Ünalacak 1, Ferah Armutcu 2, Fatma Demirel 3, Ahmet Gürel 2, Nejat Demircan 1, Erol Aktunç 1 ...
Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the fi... more Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20 degrees C and 36 degrees C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15(th) and 60(th) minutes of aortic cross-clamping and the 24(th) hour following surgery. Serum pre-albumin, alpha-1 antitrypsin, and tumor necrosis factor-alpha levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontaneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.
Eine präliminäre Studie über die Wirkungen von warmen vorbereitenden Lösungen auf den oxidativen ... more Eine präliminäre Studie über die Wirkungen von warmen vorbereitenden Lösungen auf den oxidativen Stress und postoperatives Vorhofflimmern in der Chirurgie am offenen Herzen Zusammenfassung Grundlagen Ein wichtiger Grund für die Entstehung einer Ischämie, eines Reperfusionsschadens und von oxidativem Stress ist die plötzliche und rasche Änderung der Körpertemperatur während der Einleitung eines kardiopulmonalen Bypasses. Ziel unserer Studie ist es, die Wirkungen von warmen vorbereitenden Lösungen auf oxidativen Stress und Vorhofflimmern zu untersuchen. Methodik Es handelt sich um eine präliminäre, prospektive Studie an 40 Patienten, die einer elektiven Koronararterien-Bypass-Operation mit kardiopulmonalem Bypass unterzogen wurden. Die Patienten wurden in 2 Gruppen von jeweils 20 randomisiert: die eine wurde anfangs mit einer 20 °C Lösung, die andere mit einer 36 °C Lösung für den kardiopulmonalen Bypass vorbereitet. Präoperativ und in der 15. und in der 60. Min nach der Aortenklemmung, sowie 24 h postoperativ wurden von beiden Gruppen Blutproben abgenommen. Die Serumkonzentrationen von Malondialdehyd, sowie der Karbonyl-Protein-Gehalt und der gesamte antioxidative Status wurden bestimmt. Das Auftreten von postoperativem Vorhofflimmern wurde kontrolliert. Ergebnisse Malondialdehyd-Konzentrationen und der Karbonyl-Protein-Gehalt waren in der 15. und 60. Min bei den Patienten mit kalter Vorbereitung signifikant höher. Zugleich war der Gesamt-antioxidative Status signifikant erniedrigt. Diese Veränderungen normalisierten sich bis zur 24 h postoperativ. Bei den Patienten mit der kalten Vorbereitung trat Vorhofflimmern in der postoperativen Phase signifikant häufiger als bei den Patienten mit der körperwarmen Vorbereitung auf. Schlussfolgerung Obwohl die Studie nur an relativ wenigen Patienten durchgeführt wurde, könnte sie doch einen Hinweis auf mögliche präventive Wirkungen einer 36 °C warmen vorbereitenden Lösung im Bezug auf die Entstehung von oxidativen Stress und postoperativem Vorhofflimmern geben.
Familial Mediterranean fever (FMF) is an autosomal recessive disease of unknown origin. A less co... more Familial Mediterranean fever (FMF) is an autosomal recessive disease of unknown origin. A less common manifestation of joint involvement in FMF is spondylartropathy, which is almost always HLA B27 negative. In these patients, along with sacroiliitis, inflammatory neck and back pain is also present producing minimal or no radiographic changes on plain films of lumbar and cervical spine. In this report, we presented a patient with FMF whom had been diagnosed to be ankylosing spondilitis (AS) in the light of some clinical and radiological findings.
Aim: We have conducted this study to seek and observe visual clues through immunohistochemical st... more Aim: We have conducted this study to seek and observe visual clues through immunohistochemical staining for differences in Et-1/2/3 expression and the free-flow capacity measuring the blood flow through grafts, in the left internal mammary artery grafts prepared either with clipped or nonclipped techniques. Methods: A total of 40 consecutive patients with a diagnosis of coronary artery disease who would benefit from elective coronary artery bypass graft surgery were randomised into two groups consisting 20 patients each. Left internal mammary artery was harvested by a traditional clipped (control group) and a modified nonclipped (study group) technique in each of the groups. All harvested arterial segments were evaluated for luminal endothelial integrity through hematoxylin&eosin and immunohistochemical staining. Results: The free-flow capacity of left internal mammary artery grafts were significantly higher in nonclipped arteries when compared with that of clipped ones (P=0.001). The arterial lumen of the nonclipped segments were visibly more dilated than the clipped ones. Nonclipped segments presented a lighter immunostaining for Et-1/2/3 when compared with the clipped ones (P<0.001). Conclusion: We believe that lesser endothelial damage caused by the lower intraluminal pressure in modifiedly harvested left internal mammary artery segments has positive implications on intraoperative and postoperative cardiac events related to graft vasospasm, especially related with endothelins. We recommend modified left internal mammary artery harvesting in patients going under coronary artery bypass graft operation.
Helicobacter pylori (H. pylori) enfeksiyonu insanlarda sık görülen kronik bakteriyel enfeksiyondu... more Helicobacter pylori (H. pylori) enfeksiyonu insanlarda sık görülen kronik bakteriyel enfeksiyondur (1, 2). Dünya nüfusunun %60'ının bu bakteri ile kolonize olduğu tahmin edilmektedir. Sıklığı ve sebep olduğu hastalıklar açısından H. pylori ciddi bir halk sağlığı sorunudur (1, 3). H. pylori tedavisinde pek çok tedavi rejimi önerilmekle birlikte halen optimal tedavi rejimi tanımlanmamıştır (4). H. pylori tedavisinde iki antibiyotik ile beraber proton pompa inhibitörü (PPI) (omeprazol, lan
Background/aims: Celiac disease is a condition related to the small intestine's intolerance to gl... more Background/aims: Celiac disease is a condition related to the small intestine's intolerance to gluten. In epidemiologic studies the prevalence is highly variable. The diagnosis can be difficult due to the wide spectrum of signs and symptoms. As the risk for intestinal lymphoma is higher in these patients, early diagnosis has its privileges. The higher prevalence of recurrent aphthous stomatitis in celiac disease led us to investigate the celiac disease prevalence in patients with recurrent aphthous stomatitis, which might assist in diagnosis of asymptomatic celiac disease patients. The aim of this study was to determine the prevalence of celiac disease in patients presenting with recurrent aphthous stomatitis. Methods: The study group consisted of patients having a history of recurrent aphthous stomatitis. The control group included patients not having aphthous stomatitis. Antibodies to gliadin IgG and IgA and antibodies to endomysium were determined from the serum samples of all patients. Biopsies were obtained from the distal part of the duodenum. Results: Biopsies of two patients (4.8%) out of 41 belonging to the study group were diagnosed as celiac disease. In serum samples of both, antibodies to gliadin IgA and antibodies to endomysium were found to be positive. Antibodies to gliadin IgG antibody were positive in only one of these two patients. None of the 49 patients in the control group was diagnosed as celiac disease. Conclusion: Further evaluation of recurrent aphthous stomatitis patients for celiac disease must be performed. As the endoscopic procedures are invasive and costly, evaluation of recurrent aphthous stomatitis patients for celiac disease must include serologic markers at the beginning. If any positivity is determined in markers, then endoscopic procedures including biopsies of the duodenum must be considered as the second-step intervention.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2004
Klinik ve pratik hematolojide, demir eksikliği aneminin en sık nedenidir. Demir eksikliğinin geli... more Klinik ve pratik hematolojide, demir eksikliği aneminin en sık nedenidir. Demir eksikliğinin gelişiminde; azalmış demir alımı, artmış demir kaybı ve artmış demir ihtiyacı rol alır. 1,2 Hastalarda gastrointestinal sistemden (GĐS) belirgin kan kaybına yönelik bulgu olmasa da, açıklanamayan demir eksikliği anemisi (DEA) olan vakalarda endoskopik inceleme yapılmasının önemini vurgulayan çalışmalar mevcuttur. 3-5 Erkeklerde ve postmenopozal kadınlarda, DEA gastrointestinal sistemden kan kaybı ile ilişkili olarak düşünülmesine rağmen, yapılan çalışmalarda bu hastaların endoskopik ve kolonoskopik ORĐJĐNAL ARAŞTIRMA / ORIGINAL RESEARCH.
The left internal mammary artery is the conduit of choice for coronary artery bypass grafting. In... more The left internal mammary artery is the conduit of choice for coronary artery bypass grafting. In the traditional ("clipped-artery") harvesting technique, this artery is prepared as a pedicle; the distal part is clipped, cut, and covered with a papaverine-soaked cloth until anastomosis is performed. In modified ("nonclipped-artery") harvesting, the prepared artery is kept in situ and left connected to the systemic circulation until anastomosis. Better outcomes from use of the nonclip technique have been reported. In order to determine comparative endothelial integrity and endothelial nitric oxide synthase activity, we performed an immunohistochemical study of arterial graft segments that were procured by each technique. This cross-sectional study involved 40 patients who underwent elective coronary artery bypass grafting. The patients were randomized into 2 groups of 20. One group underwent traditional clipped-artery harvesting; the other group, modified nonclipped-artery harvesting. By immunohistochemical methods, we examined redundant segments taken from bifurcation levels of the arteries. The tunica media was thinner in the clipped arterial segments, a phenomenon that we attribute to high luminal pressure. Endothelial nitric oxide synthase immunostaining was absent in regions of denudation in the luminal endothelia of the clipped arteries; in contrast, pronounced immunostaining occurred in the endothelia of the nonclipped segments. We found that traditional harvesting disrupted the integrity of the luminal endothelia of the clipped arteries. In addition, the traditional procedure decreased nitric oxide production, as was revealed by immunostaining.
Background: Vascular endothelial growth factor (VEGF), basic-fibroblast growth factor (b-FGF), an... more Background: Vascular endothelial growth factor (VEGF), basic-fibroblast growth factor (b-FGF), and endothelial nitric oxide synthase (eNOS) are factors that take part in placental angiogenesis. They are highly expressed during embryonic and fetal development, especially in the first trimester. In this study, we aimed to investigate the role of placental angiogenesis in the development of intrauterine growth restriction (IUGR) by comparing the levels of expression of VEGF-A, b-FGF, and eNOS in normal-term pregnancy and IUGR placentas. Methods: The expression of VEGF-A, b-FGF, and eNOS was studied using the avidin-biotin-peroxidase method in placental tissues diagnosed as normal (n = 55) and IUGR (n = 55). Results were evaluated in a semi-quantitative manner. Results: The expression of all the markers was significantly higher (p < 0.001) in cytotrophoblasts, syncytiotrophoblasts, extravillous trophoblasts, vascular smooth muscle cells, chorionic villous stromal cells, and villous vascular endothelial cells of the IUGR placentas when compared with those collected from normal-term pregnancies. Conclusion: Increased expression of VEGF-A, b-FGF, and eNOS may be the result of inadequate uteroplacental perfusion, supporting the proposal that abnormal angiogenesis plays a role in the pathophysiology of IUGR.
Many studies have defined human body parts and their proportions to each other morphometrically [... more Many studies have defined human body parts and their proportions to each other morphometrically [1À3,6,7,10]. These studies are important because they enable accurate definitions for morphometric properties of different body parts in different human populations. In this context, both of the ears play a vital role in producing a natural and harmonious look and an aesthetically fine facial appearance [1,2,6]. They also are helpful in defining population standards, congenital malformations, and the ergonomic design of hearing aids [6,7,9,11,12]. This study aimed to establish morphometric properties for the ears, a determining feature of the human face, in a group of Turkish children.
The present study aimed to investigate whether electrocautery caused any thermal injury to the fo... more The present study aimed to investigate whether electrocautery caused any thermal injury to the forearm nerves or not. We compared the neurological outcome of two different radial artery harvesting techniques through neuroelectrophysiological studies. Preoperative values and postoperative conduction changes after one month were compared in two groups of patients. Each of the groups consisted of 20 patients. Radial arteries were harvested using scissors in Group 1 and with a low dose diathermy technique in Group 2. The mean amplitude of sensory action potentials of radial nerves was significantly reduced postoperatively at the end of the first month in both groups (P = 0.01, P = 0.001). But there were no significant differences between groups with respect to the sensory action potentials of ulnar and median nerves postoperatively. There were no significant differences between groups with respect to radial, ulnar and median nerve motor conduction recordings. Low dose electrocautery does not cause excessive nerve injury compared with the scissors technique in radial artery harvesting. Electrocautery may be used safely for RA harvesting in the forearm.
Our aim was to determine the effects of cardiopulmonary bypass procedures on the optic nerve by r... more Our aim was to determine the effects of cardiopulmonary bypass procedures on the optic nerve by retinal nerve fiber layer thickness measurements. Retinal nerve fiber layer thickness was measured using the GDx Nerve Fiber Analyser, 1 day before the surgery and on postoperative days 1, 5 and 30 in 20 patients undergoing coronary artery bypass grafting surgery. Postoperative mean values for retinal nerve fiber layer thickness, except symmetry on the first day and except symmetry and superior nasal ratio on the fifth day, were statsitically decreased. Only the value for the inferior ratio was significantly lower at the end of the first month. Cardiopulmonary bypass procedures cause a temporary decrease in retinal nerve fiber layer thickness.
Objectives: Adenosine and adenosine A 1 receptor agonists exert protective effects against reperf... more Objectives: Adenosine and adenosine A 1 receptor agonists exert protective effects against reperfusion injury in different tissues by mediating preconditioning. The aim of the present study was to examine the effects of adenosine A 1 /A 2 receptor activation on reperfusion-induced small intestinal injury in rat. Methods: Animals were randomized into four groups each including eight as following: sham control, ischemia-reperfusion control, 5’-N-ethylcarboxamidoadenosine (NECA) (non-selective A 1 /A 2 agonist, 0.1 mg/kg, i.v.)-treated I/R, and theophylline (non-selective A 1 /A 2 antagonist, 20 mg/kg, i.v.)-treated I/R groups. The treatments were administered 5 min before inducing ischemia in which superior mesenteric artery was clamped for 30 min followed by 180 min of reperfusion period. Myeloperoxidase, malondialdehyde, and reduced glutathione contents of terminal ileum samples were measured besides recording contractile responses to KCl, carbachol and substance P. Results: Ischemic insult significantly increased neutrophil infiltration and lipid peroxidation while decreasing the reduced glutathione. Contractile responses were seriously reduced in I/R group compared to that of the sham control group. NECA pretreatment alleviated the tissue content of reduced glutathione remarkably besides providing partial amelioration of I/R-reduced contractile response, while theophylline pretreatment had no any protective effect. Conclusion: We offer additional evidence that activation of A 1 /A 2 adenosine receptors provides partial protection against ischemia-induced intestinal contractile dysfunction possibly through maintaining reduced glutathione content at physiological levels.
Cakmak Ozlu F, Aktunc E, Yilmaz H, Karadeniz EI-Effectiveness of three different types of educati... more Cakmak Ozlu F, Aktunc E, Yilmaz H, Karadeniz EI-Effectiveness of three different types of educational methods on implementation of proper oral hygiene behaviour prior to orthodontic treatment 2 ABSTRACT Objective: The aim of this study was to compare three teaching methods' time and personnel requirements, and their effects on plaque and gingival indices. Methods: This study was a single-blind randomized controlled trial on fixed orthodontic appliance candidates (n = 90), assigned into a control group (n = 30) and two different study groups (n = 30 each). The control group received standard printed educational material and was assisted with verbal information. The study groups either received video-assisted or hands-on training about fixed orthodontic appliance and oral hygiene. The time requirements for all three educational interventions was recorded during the initial visit. The adequacy of oral hygiene was documented through plaque and gingival indices during the initial visit and eighth week of the treatment. The continuous variables were analyzed using 1-way ANOVA. Tukey HSD and Student t-tests were used for post-hoc comparisons (α = 0.05). Also, a chi-square test was used for the analysis of categorical variables. Results: Standard education failed to maintain the plaque and gingival indices at the eighth week of the treatment. Although both video-assisted and hands-on training took a considerable amount of time, they served well in preserving both of the indices at the eighth week. The longer the educational intervention was, the better the preservation of the plaque and gingival indices. Conclusion: Educational intervention, either with video-assisted or hands-on programs, provided better results in oral hygiene depending on the time and personnel constraints of the orthodontist.
Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan ... more Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan olgularda ikinci tedavi ile eradikasyon daha zordur. H. pylori eradikasyon başarısızlıklarında uygulanacak tedavi kombinasyonları kesin belirlenmemiştir. Bu çalışmada lansoprazol, amoksisilin ve klaritromisin (LAK) ile yapılan standart üçlü tedavi ile H. pylori eradikasyonu sağlanamayan olgularda lansoprazol, ranitidin bizmut sitrat, tetrasiklin ve metronidazolden (LBTM) oluşan dörtlü tedavinin etkinliğini araştırdık. Gereç ve yöntem: Peptik ülser hastalığı veya nonülser dispepsi nedeniyle standart üçlü LAK tedavisi verilen ve H. pylori eradikasyonu sağlanamayan toplam 36 olgu çalışmaya alındı. Bu olgulara lansoprazol (2x30 mg), ranitidin bizmut sitrat (2x400 mg), tetrasiklin (4x500 mg) ve metronidazolden (3x500 mg) oluşan dörtlü tedavi 14 gün verildi. Tedavinin bitiminden iki ay sonra endoskopik biyopsi ile H. pylori eradikasyonu değerlendirildi. Bulgular: Olgulardan beşi tedavi bitimin...
Objective: Coagulation anomalies in patients with thyroid dysfunction may vary from subclinical d... more Objective: Coagulation anomalies in patients with thyroid dysfunction may vary from subclinical disorders in laboratory tests to life threatening thrombotic events or bleeding. We aimed to determine the effect of thyroid dysfunction on thrombophilia in patients with acute and subacute deep vein thrombosis (DVT). Materials and Methods: A number of 30 patients with the diagnosis of DVT between November 2015 and June 2016 included in this case - control study. The patients divided into two groups as provoked (with known ethiology, n = 13) and unprovoked (with un-known ethiology, n = 17) patients. Provoked patients group divided as the patients with acquired risk factors (predisposition) and/or the patients with genetic risk factors. Results: The difference of the rate of the thyroid dysfunction between the provoked and unprovoked groups was not significant (p=0.844). The PAI – 1 gene mutation was detected in 70% of the study cohort and none of the patients had prothrombin gene mutation...
... Hematüri, piyüri ve bakteriüri kız çocuklarda erkeklerden anlamlı derecede daha fazla görülme... more ... Hematüri, piyüri ve bakteriüri kız çocuklarda erkeklerden anlamlı derecede daha fazla görülmek-te iken, idrar kristalleri erkek çocuklarda kızlardan anlamlı derecede fazla ... Murat Ünalacak 1, Ferah Armutcu 2, Fatma Demirel 3, Ahmet Gürel 2, Nejat Demircan 1, Erol Aktunç 1 ...
Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the fi... more Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20 degrees C and 36 degrees C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15(th) and 60(th) minutes of aortic cross-clamping and the 24(th) hour following surgery. Serum pre-albumin, alpha-1 antitrypsin, and tumor necrosis factor-alpha levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontaneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.
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