The relationship between serum uric acid level and concentration of proangiogenic mononuclear progenitor cells in patients with chronic heart failure
Alexander E Berezin, Alexander A Kremzer
J Clin Exp Invest 2014;5(4):511-520.
https://doi.org/10.5799/ahinjs.01.2014.04.0449
Research Article
[Abstract]
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ABSTRACT
Objective: Serum uric acid (UA) is considered as a marker of natural progression of chronic heart failure (CHF). Progression of CHF associates with declining of circulating mononuclear progenitor cells (MPCs) in the blood. The objective of this study was to evaluate the interrelationship between SUA concentrations and proangiogenic MPCs in ischemic CHF patients.
Methods: The study was structured retrospectively after determining the coronary artery disease (CAD) by contrast-enhanced spiral computed tomography angiography in 126 subjects (54 male), aged 48 to 62 years, with CHF. Serum UA level was measured by enzymatic method and N-terminal proBNP (NT-pro-BNP) level was examined by immunoelectrochemiluminesence method. All biomarkers were measured at baseline.
Results: Concentrations of SUA were distributed by quartiles (Me; IQR): QI=20.11 (19.06; 22.33) mmol/l; QII=27.53 (23.2; 31.10) mmol/l; QIII=35.80 (32.0; 39.0) mmol/l; and QIV=44.9 (40.00; 49.60) mmol/l. Cox proportional adjusted Odds Ratios analyses for CD14+CD309+ and CD14+CD309+Tie2+ MPCs by SUA Quartiles (Q) has showed that high Q (Q3 and Q4) of SUA versus low Q (Q1 and Q2) associated with increased risk of depletion of both CD14+CD309+ and CD14+CD309+Tie2+ MPCs. The ROC analysis has been showed that there was the cut-off point for the SUA level with the best prognostic potential on the risk of decreasing MPCs in both models equal 31.5 mmol/l.
Conclusion: Circulated level of proangiogenic MPCs is declined progressively depended on quartiles of serum UA level in CHF subjects. We suggest that mild elevation of serum UA might be considered as a predictor of low proangiogenic MPCs in CHF patients.
Keywords: Chronic heart failure, serum uric acid, circulating mononuclear progenitor cells, predictive value
The effectiveness of Nigella sativa, methotrexate and their combination in the treatment of moderate to severe psoriasis
Jawad Hassan Ahmed, Sheima Nadim Kadhim, Khalil Ismael Al-Hamdi
J Clin Exp Invest 2014;5(4):521-528.
https://doi.org/10.5799/ahinjs.01.2014.04.0450
Research Article
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ABSTRACT
Objective: Methotrexate (MTX) is a commonly prescribed drug for patients with psoriasis. Nigella sativa (NS) has been shown beneficial in vitiligo and in eczema. Recently, NS has shown activity in modifying psoriatic lesions. The aim of this study was to evaluate the effect of the combination (NS+MTX) on psoriasis and to compare that with NS or MTX monotherapy.
Methods: Sixty patients with moderate to severe plaque, palmoplantar and guttate psoriasis were enrolled for 12 weeks study. The patients were divided into 3 groups; 20 patients in each. Group 1 was treated with NS ointment (20% w/w) 2 times daily + 500 mg NS capsule 3 times daily. Group 2 received MTX tablets 15 mg weekly and group 3 received MTX + NS (topical + oral).
Results: Marked response was achieved in 60%, 80%, and 90% of patients on NS, MTX, and (NS + MTX) respectively. The respective relapse rate was 33.3%, 56.3%, and 27.8%. Serum malondialdehyde (sMDA), a parameter of oxidative stress was decreased from 4.39 ± 0.81 to 2.31 ± 0.72 µmol/L with NS treatment while a small increase in sMDA was observed with MTX. NS + MTX treatment reduced sMDA from 4.39 ± 0.67 to 3.49 ± 0.65 µmol/L after 12 weeks treatment. All treatments did not change liver enzymes or complete blood count. NS was well tolerated and showed ability in ameliorating gastric upset of MTX.
Conclusion: NS augments antipsoriatic effect of MTX. Topical and oral use of NS is effective and safe in moderate to severe psoriasis.
Keywords: Psoriasis, methotrexate, Nigella sativa
Coerced anal sex against spouses in Turkey
Ramazan Karanfil, Alper Keten, Cem Zeren, Bekir Karaarslan
J Clin Exp Invest 2014;5(4):529-533.
https://doi.org/10.5799/ahinjs.01.2014.04.0451
Research Article
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ABSTRACT
Objective: The aim of this study was to investigate medicolegal aspects of sexual assaults involving anal penetration against females by their partners.
Methods: This study includes 34 females claimed to be exposed to anal sexual assaults and referred to the Department of Forensic Medicine, Kahramanmaraş Sütçü İmam University between January 2007 and June 2012. Data were obtained from physical examination records and a face to face applied questionnaire composed of questions about socio-demographic features.
Results: Sexual assaults involving anal penetration were committed against females in all 34 cases included in the study. The mean age of the victims was 23.2±5.2 years. Twenty-four women (70.6%) had a history of physical violence, but 10 (29.4%) did not. Out of all, only four women were presented to hospital because of assault. The rest were noticed to be transferred with conditions other than assaults but they were found out to be exposed to anal assaults on examinations. Most of the cases were young, female and a housewife and were exposed to anal assault.
Conclusion: Anal sexual assault against females by their partners is a serious problem in our region. Therefore, screening studies on women should be conducted to determine the frequency of the condition and to provide solutions for the problem.
Keywords: Sexual assaults, anal assaults, intimate partner violence
Vitalitec International, The Sternal Closure Device: A novel closure technique for sternal dehiscence
Aydın Tunçay, Yiğit Fevzi Akçalı, Rıfat Özmen, Özer Gazioğlu, Faruk Serhatlıoğlu
J Clin Exp Invest 2014;5(4):534-538.
https://doi.org/10.5799/ahinjs.01.2014.04.0452
Research Article
[Abstract]
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ABSTRACT
Objective: Impaired sternal wound healing remains problematic after median sternotomy and can cause to significant morbidity after cardiac surgical procedures. Although some reconstruction systems exist for sternal closure, their use is limited by expense and practicality, and simple wire closure remains the most common technique to close the sternum. In this study, we aim to discuss the results of 6 cases that underwent surgery for sternal dehiscence(SD).
Methods: We reviewed six patients with sternal dehiscence who underwent surgery in our department between April 2013 and May 2014. We have used a novel closure technique in six patients with sternal dehiscence and evaluated early-term results of sternal clips plus rewiring following failed sternal closure.
Results: The mean age was 63 (range, 55 to 79 years). All patients were male. We have used a novel closure technique with sternal clips plus rewiring in all patients. We evaluated six patients with non-infectious SD. Sternal reconstruction using rigid fixation with clips improve bone healing and reduce early postoperative pain. All cases were discharged with successful treatment.
Conclusions: We believe that this method of sternal closure guarantees better clinical outcomes rather than sternal wire closure. Additionally, SCD(sternal closure device) clips proved to be cost effective in cardiac surgery.
Keywords: Sternal dehiscence, closure technique, cardiac surgery
Emergency service visits of fibromyalgia patients
Sadiye Yolcu, Özlem Balbaloğlu, Nesrin Gökben Beceren, Önder Tomruk
J Clin Exp Invest 2014;5(4):539-543.
https://doi.org/10.5799/ahinjs.01.2014.04.0453
Research Article
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ABSTRACT
Objective: We aimed to evaluate the emergency service admission frequencies of fibromyalgia patients with their sociodemographic properties.
Methods: A questionnaire form was applied to 136 fibromyalgia patients who admitted to our Physical Treatment and Rehabilitation Clinic and a control group of 132 non-fibromyalgia adult volunteers.
Results: Last emergency service admission complaints (p<0.05), last emergency service admission time (p<0.05), satisfaction of last emergency visits (p<0.05) of the groups were significantly different but result of last emergency admissions (p>0.05) were not different.
In the fibromyalgia group, status of working is negatively correlated with satisfaction of last emergency visit (p<0.05,r = -0.170). Number of persons at home is positively correlated with frequency of emergency visit (p<0.05, r = 0.255), frequency of outpatient clinic admission (p<0.05,r = -0,204) and result of last emergency admission (p<0.05,r = 0,224).
Conclusion: Detailed evaluation of fibromyalgia patients’ symptoms and sociodemographic properties and appropriate treatment of these patients may be beneficial for decreasing their emergency service admission rates.
Keywords: Fibromyalgia, emergency service, sociodemographic properties
Outcomes of modified deep scleral trabeculectomy surgery under anterior chamber maintainer
Özcan Rasim Kayıkçıoğlu, Sinan Bilgin
J Clin Exp Invest 2014;5(4):544-547.
https://doi.org/10.5799/ahinjs.01.2014.04.0454
Research Article
[Abstract]
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ABSTRACT
Objective: To evaluate patients monitored for glaucoma and operated with trabeculectomy combined with deep sclerectomy under an anterior chamber maintainer.
Methods: In this retrospective study, fifteen eyes of 15 patients diagnosed with primary open angle glaucoma (POAG) who show up regularly for follow-up examinations between April 2006 and May 2010 were included in this study. Pre-operative/post-operative intraocular pressure (IOP) and the number of antiglaucomatous medications were evaluated.
Results: The mean age was 64.6 ± 11.4 (33-80) years and the mean follow-up period was 22.4 ± 16.2 months (6-55). The mean pre-operative IOP was 24.6 ± 8.0 (12-40 mmHg), and the mean cup/disc (c/d) ratio was 0.71 ± 0. 25. According to the Hodapp classification, the mean damage in the visual field was 2.1 ± 0.9. Mean post-operative IOP at months 1, 12, and 24 was 13.2 ± 3.4, 13.6 ± 4.6 and 13.8 ± 2.8 mmHg, respectively. The average number of pre-operative antiglaucomatous medications was 3.1 whereas the average numbers of post-operative antiglaucomatous medications were 1.8, 0.6 and 0.8 respectively.
Conclusion: Modified trabeculectomy has low rates of complication and results in a significant decrease in postoperative IOP, as well as the number of antiglaucomatous medications used.
Keywords: Anterior chamber maintainer, deep sclerectomy, trabeculectomy
The largest reference range study for hematological parameters from Turkey: A case control study
Nilgun Tekkeşin, Huseyin Bekoz, Faruk Tukenmez
J Clin Exp Invest 2014;5(4):548-552.
https://doi.org/10.5799/ahinjs.01.2014.04.0455
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Objectives: Accurate, reliable laboratory reference ranges are essential for effective clinical evaluation and monitoring. We present robust reference ranges established for hematology parameters using the Sysmex XT2000i analyzer.
Methods: Blood samples were taken from 17409 healthy adults (19 to 49 years, 51.4% men and 48.6% women) and routine hematology analysis performed. Patients were assessed as healthy on the basis of a medical history and routine medical examinations. Serum hematinic assays (vitamin B12, folate, iron and ferritin) were also analyzed in order to exclude the potential anemia existence.
Results: There was a statistically significant difference (p<0.001) between men and women, with the former showing higher CBC values, except WBC, neutrophil and platelet counts compared to females. Several differences were observed when compared to previously established values from Turkey, most notably in leucocytes and platelets. Our findings for CBC parameters, except leucocyte count and MCV are in general agreement with previously published data from more limited trials undertaken in other countries.
Conclusions: In spite of the uncontrolled factors influencing hematological values, this study permitted to establish the new hematological reference values in Turkey, especially living near sea level. In the absence of previously detailed investigated hematological reference values in Turkey, we offered to use these results for clinical management of Turkish patients and interpretations of laboratory data for research purpose.
Keywords: Complete blood count, hematology, reference range
The evaluation of Recombinant Immunoblot assay (RIBA) and HCV-RNA test results in patients with low titer Anti-HCV positivity
Berrin Karaayak Uzun, Hakan Er, Serdar Güngör, Aslı Gamze Şener, Selçuk Kaya
J Clin Exp Invest 2014;5(4):553-556.
https://doi.org/10.5799/ahinjs.01.2014.04.0456
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ABSTRACT
Objectives: Laboratory diagnosis of hepatitis C virus (HCV) infection is based on the detection of anti-HCV antibodies by enzyme immunoassay (EIA) or chemiluminescence immunoassay (CIA) techniques. However, a consensus related to the problem of low titer (Serum/Cut-off; S/C= 1.0) anti-HCV antibodies is still lacking. The study attempts to evaluate the clinical status of the patients with low titer anti-HCV antibodies detected by third generation anti-HCV tests during February 2013- May 2014 retrospectively.
Methods: Serum samples were studied by Advia Centaur XP autoanalyser (Bayer-Siemens, Germany) for anti-HCV, and line immunoassay (Inno-LIATM HCV Score, İnnogenetics, Belgium) for anti-HCV confirmatory test, Cobas AmpliPre/Cobas AMPLICOR HCV Test (Roche diagnostics, Switzerland) for HCV RNA.
Results: A total of 55.631 serum samples were studied, and 55 of them were anti-HCV positive of which with low antibody levels (sample/cutoff [S/CO]). S/CO values ranged from 1.15 to 6.15. Seventeen (31%) of patients who have low antibody levels were defined as positive and 2 (4%) patients were intermittent and 36 (65%) patients were negative with line immunoassay. HCV-RNA was not detected in any of the samples.
Conclusions: It is thought that antibody positivity must be verified in cases of recurrent reactivity when considering the cost-effectiveness of molecular tests. In the study was concluded that the use of molecular tests would be appropriate diagnosis, and the effectiveness of treatment if necessary after evaluation of patients with biochemical analysis.
Keywords: Anti-HCV, HCV RNA, Hepatitis C virus, S/C ratio, RIBA
Combination of Wells clinical score and high D-dimer levels in the diagnosis of pulmonary embolism
Süreyya Yılmaz, Füsun Topçu, Hadice Selimoğlu Şen, Özlem Abakay, Zülfükar Yılmaz
J Clin Exp Invest 2014;5(4):557-562.
https://doi.org/10.5799/ahinjs.01.2014.04.0457
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ABSTRACT
Objectives: Pulmonary embolism is a preventable disease that is sometime difficult to diagnosed, can be recurrent and has a high morbidity and mortality. The aim of our study is to investigate the contribution of d-dimer, which is noninvasive, fast, cheap and easy obtainable laboratory parameter and Wells clinical prediction scoring combination to the diagnosis of PE.
Methods: In this study, PE positive 46 and negative 24 in the total 70 patients were evaluated prospectively. Initially clinical scoring system was calculated Wells and d-dimer levels were measured. The levels of d-dimer were over the normal level in all patients. Patients with PE were divided into 3 groups as massive, submassive and non-massive. All patients were performed shooting with computed tomographic pulmonary angiography.
Results: Among Low-moderate, low-high and moderate-high probabilities the mean value of d-dimer did not differ significantly in the PE (+) patients. In patients with PE (-) moderate and high clinical probability were compared and the d-dimer (p = 0.036) mean value was significantly higher in the high clinical probability. In massive group the mean values levels of d-dimer were significantly higher than the non-massive group (p=0.02).
Conclusion: In all cases D-dimer levels were above normal values. Nevertheless, when we compare our results with the literature did not detect significant differences. Therefore, we want to emphasize that new larger studies needed for the determination of new cut-off values of D-dimer test.
Keywords: Pulmonary embolism, D-dimer, clinical probablitiy
The prevalence of incidental neuroendocrine tumours in the appendectomy materials: Ten-year s archive search
Sezen Koçarslan, Muhammet Emin Güldür, Turan Ekinci, Rabia Aparı, Yusuf Yücel, Turgay Ulaş
J Clin Exp Invest 2014;5(4):563-566.
https://doi.org/10.5799/ahinjs.01.2014.04.0458
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ABSTRACT
Objective: Aimed to investigate the incidence of neuroendocrine tumors (NET) in the appendectomy specimens of the patients who underwent appendectomy for various indications.
Methods: 2252 cases, that were performed appendectomy at Harran University Faculty of Medicine and examined histopathologically in Pathology department between January 2004 and May 2014, were analyzed retrospectively.
Results: In the study, it was reported NET in only 3 (0.13%) of these patients. All of the patients with NET were women and mean age ± SD was 58,33 ± 18.14 years. All of the patients had been operated for acute appendicitis and the tumor was detected incidentally during microscopic examination. The tumor was localized to the distal portion of the appendix in all cases, the tumor sizes were 1.4cm, 1cm, 0.7cm (mean: 1,03 ± 0,35), respectively. Although, muscular layer and periappendicular fatty tissue involvement was present in each case, cellular atypia was minimal. Mitotic activity was calculated as 1-2 in 10 high power field. Immunohistochemical staining was performed in all cases and tumor cells showed positive staining with pancytokeratin, synaptophysin and chromogranin in all. Ki-67 proliferative indices were found 1-2%. In all cases, the presence of acute appendicitis had been reported in the peritumoral appendix.
Conclusion: On histopathological examination of the excised appendiceal materials, NET should be constantly kept in mind in differential diagnosis and should be evaluated by an appropriate sampling.
Keywords: Appendix, histopathology, neuroendocrine tumor
The impact of obesity on clinical, metabolic and hormonal features in patients with polycystic ovary syndrome
Serap Baydur Şahin, Fatih Sümer, Hacer Sezgin, Teslime Ayaz, Osman Zikrullah Şahin, Kadir İlkkılıç, Emine Uslu Gür, Ekrem Algün
J Clin Exp Invest 2014;5(4):567-571.
https://doi.org/10.5799/ahinjs.01.2014.04.0459
Research Article
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ABSTRACT
Objectives: Our aim was to compare the clinical, hormonal and metabolic features between overweight and obese patients with PCOS and normal weight women with polycystic ovary syndrome (PCOS).
Methods: 119 patients with PCOS (15-39 years) were included in the study. We evaluated anthropometric, hormonal and metabolic parameters in all patients.
Results: Ferriman- Gallwey hirsutism score was similar in overweight or obese patients with PCOS (n=78) and normal weight patients with PCOS (n=41) (p=0.373). While 71.8% of the obese group had irregular menses, this ratio was 60.9% in normal weight group (p=0.160). HOMA-IR values were higher in the obese group (1.7±0.7 vs 3.3±1.7, p<0.001). Serum triglyceride (87.2±49.8 vs. 123.4±65.3 mg/dl) and LDL-cholesterol levels (104.5±29.4 vs 121.7±32.9 mg/dl) were higher in obese group than the normal weight group (p=0.002, p=0.006). HDL-cholesterol levels were lower in obese group (46.5±11 vs 56.7±11.7 mg/dl, p<0.001). Free testosterone levels were 3.54±2.5 pg/ml in overweight and obese group and 2.36 ± 1.2 pg/ml in normal weight group (p = 0.016). While BMI was positively correlated with age (r=0.210), waist circumference (r=0.916), systolic (r=0.238) and diastolic blood pressure (r=0.181), insulin (r=0.635), HOMA-IR (r=0.650), total-C ( r=0.242), LDL-C (r=0.295), triglyceride (r=0.424) and total testosterone (r=0.230), it was negatively correlated with HDL-C (r=-0.476).
Conclusion: Obesity did not influence hirsutism and menstruel regularity in patients with PCOS in this study, however obesity deteriorated insulin sensitivity and lipid profile.
Keywords: Polycystic ovary syndrome; obesity; hirsutism; menstruel regularity; HOMA-IR
Relationship between adiponectin and adiponectin receptor 1 gene polymorphisms with colorectal cancer
Badel Arslan Mamur, Etem Akbaş, Tahsin Çolak, Mehmet Özgür Türkmenoğlu, Hakan Seyit, Mehmet Ali Sungur
J Clin Exp Invest 2014;5(4):572-576.
https://doi.org/10.5799/ahinjs.01.2014.04.0460
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Objectives: Adiponectin is a protein synthesized from adipose tissue and it is also an endogeneous insulin sensitizer. Adiponectin seems to act in preneoplastic colonic lesions to regulate cell growth by activating, altering, or interacting with several pathways including the leptin and the NFkB pathways. This study aims to investigate the relationship of T/G rs2241766ADIPOQ exon 2 (+45,codon 15) and A/G rs2275738ADIPOR1 intron 1 (-106) polymorphisms with CRC risk.
Methods: The studying group consist of total 266 person which 129 of them are colorectal cancer cases who were diagnosed at the Mersin University Medical Faculty Hospital and 137 controls participating. Genotypes were determined using PCR/RFLP methods.
Results: It was found that there is no relationship between T/G rs2241766ADIPOQ exon 2 (+45, codon 15) and A/G rs2275738ADIPOR1 intron 1 (-106) polymorphisms and the risk of developing colorectal cancer. It was determined an increasing risk of colorectal cancer with male subjects and old age groups.
Conclusion: In conclusion, it was found that rs2241766 and rs2275738 polymorphisms may not be related to the progression of colorectal cancer.
Keywords: Adiponectin, ADIPOQ, adiponectin receptor 1, ADIPOR1, polymorphism, colorectal cancer
Retrospective look to tonsillary lesions and the location of malign lesions in distribution
Ulaş Alabalık, Yahya Avcı, Gül Türkcü, Ayşe Nur Keleş, Mehmet Akdağ, İbrahim İbiloğlu, Uğur Fırat, Vefa Kınış, Hüseyin Büyükbayram
J Clin Exp Invest 2014;5(4):577-579.
https://doi.org/10.5799/ahinjs.01.2014.04.0461
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ABSTRACT
Objective: In this study, we investigate the distribution of malign lesions in all tonsillar lesions and the compatibility with the literature.
Methods: The pathology reports and preparations of 1118 patients whose tonsillectomy and tonsil biopsy materials were assessed in Department of Pathology in Dicle University Medical Faculty between January 2006 and September 2013 are examined retrospectively and included to the study.
Results: Of 1118 patients, the diagnoses were chronic inflammation in 452 (40.43%), lymphoid hyperplasia in 226 (20.21%), chronic inflammation and lymphoid hyperplasia in 411 (36.76%), cyst in 2 (0.18%), squamous papilloma in 2 (0.18%) and malignancy was observed in 25 (2.24%). Of 25 malign cases, the diagnoses were B-cell non-Hodgkin lymphoma in 19 (76%), epidermoid carcinoma in 4 (16%), plasmacytoma in 1 (4%) and malign melanoma in 1 (4%).
Conclusion: Primary tonsillar malignancies constitute 2% of all human malignancies. Epidermoid carcinomas (75%) and lymphomas take the first and second places in frequency respectively. In our study conversely lymphomas account for 76% of all tonsillar malignancies that makes an important portion, while epidermoid carcinomas account for 16% of those. B-cell non-Hodgkin lymphomas constitute the vast majority of lymphomas showing tonsillar involvement. It is reported that the most frequently seen lymphoma type in tonsillar location is diffuse large B-cell lymphoma. Consistent with this information in our study, it is determined that 15 of 19 tonsillar lymphoma cases are diffuse large B-cell lymphoma.
Keywords: Tonsil, lymphoma, epidermoid carcinoma
Lower gastrointestinal endoscopies results
Ahmet Bozdağ, Barış Gültürk, Ali Aksu
J Clin Exp Invest 2014;5(4):580-582.
https://doi.org/10.5799/ahinjs.01.2014.04.0462
Research Article
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ABSTRACT
Objectives: Endoscopic examinations have great potential in early diagnosis of colorectal adenomas and carcinomas with reducing to colorectal cancer incidence and mortality. We aimed to evaluate for diagnostic purposeful lower gastrointestinal endoscopic procedures in the second step state hospital retrospectively
Methods: Between June 2010 and June 2013, we evaluated 278 patients with rectal bleeding, constipation and abdominal pain detected by lower gastrointestinal endoscopic procedures retrospectively.
Results: The mean age of the patients was 54.8 ± 16.8 (15-90) year, respectively. 172 (61.9%) of the patients were male and 106 (38.1%) of the patients were female. 116 (41.7%) of the patients was performed rectosigmoidoscopy and 162 (58.3%) of the patients was performed colonoscopy. 51(18.3%) of our patients were normal. 10 (3.6%) of patients had colorectal cancer, 11(3.9%) of patients had inflammatory bowel disease, 8 (2.9%) of patients had parasitosis, 31(11.1%) of patients had colorectal polyps, 12 (4.3% ), in patients had diverticular disease, 2 (0.7%) patients had rectal ulcer, 25 (9%) patients had anal fissure and 159 (57.2%) of the patients had hemorrhoidal disease.
Conclusion: Lower gastrointestinal endoscopy is a method been the gold standard with a low complication rate and that can be easily applied in the evaluation to pathology of colorectal and anal canal.
Keywords: Colonoscopy, rectosigmoidoscopy, endoscopy
The effects of melatonin on the oxidants and antioxidants in the pancreatic tissue during the aging process
Hakan Yüzüak, Kazime Gonca Akbulut, Sara Yüzüak
J Clin Exp Invest 2014;5(4):583-588.
https://doi.org/10.5799/ahinjs.01.2014.04.0463
Research Article
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ABSTRACT
Objective: To investigate the effect of melatonin on the levels of malondialdehyde (MDA), nitric oxide (NO) and glutathione (GSH) of pancreas tissues at young (4 months) and middle-aged (14 months) rats.
Methods: Young and middle-age male Wistar albino rats were used in this experimental study. Rats were divided into two groups: melatonin applied; young rats , middle-aged rats and melatonin was not applied; young rats and middle-aged rats . Melatonin was administered at a dose of 10 mg/kg/day in 0.2 cc-% 1 ethanol-phosphate buffered saline (PBS) solution via subcutan way for 7 days at 18:00 until surgery. In control group, 0.2 cc-%1 Ethanol-PBS was applied for 7 days at 18:00. At the end of seven days, MDA, NO levels which are indicators of oxidant stress and GSH were detected.
Results: Although there were no significant difference between control and experiment group for the NO and MDA level of melatonin group of young rats, there were significantly difference in the GSH levels of pancreas tissues for melatonin levels. NO levels of the pancreas tissues were significantly reduced and GSH levels were significantly increased in the melatonin group of middle aged rats compared to the control group. The MDA levels of pancreas tissues were significantly increased in the middle aged control group compared to young control group. The MDA levels of pancreas tissues were not significantly different in melatonin group of middle-aged compared to control group. The NO and the GSH levels of the pancreas tissues were not significantly different between the control groups of young and middle aged rats.
Conclusion: Aging may be related with an increase in free radicals and a reduction in the antioxidant capacity of the tissues and exogenous melatonin may play a protective role in aging by means of its action on free radicals.
Keywords: Melatonin, pancreas, malondialdehyde, nitric oxide, glutathione, aging
Non functioning adrenal incidentalomas may be associated with insulin resistance
Sezgin Barutçu, Mazhar Müslüm Tuna, Faruk Kılınç, Zafer Pekkolay, Hikmet Soylu, Alpaslan Tuzcu
J Clin Exp Invest 2014;5(4):589-591.
https://doi.org/10.5799/ahinjs.01.2014.04.0464
Research Article
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Objective: Adrenal incidentaloma are bulks which are stated incidentally by imagining methods or in abdominal laparotomy when there is no suspicion of any disease in adrenal gland. With increase in using abdominal ultrasonography and BT, the frequency of determining adrenal incidentaloma also increases. In this study, we aimed to examine demographical features and insulin resistance in patients with non functioning adrenal incidentaloma (NFAI).
Methods: 30 (20 female–10 male) patients, who followed due to NFAI at Dicle University Medical Faculty Department of Endocrinology between years of 2007-2013, and age, BMI matched 66 healthy subjects were included in the study. Results of physical examination, USG and BT were recorded from patients’ files. All patients were underwent following analyses for excluding a functioning adrenal mass, overnight dexamethasone suppression test, 24 hour urinary metanephrine and normetanephrine, plasma aldosterone/ renin activity ratio. Insulin resistance was calculated in accordance with homeostatic model assessment- insulin resistance formula.
Results: The average of age was 45.9 ± 10.9 years and body mass ındex (BMI) 28.5 ± 5.8. There were no significantly difference in terms of age, gender and BMI between groups. Fasting blood glucose and insulin resistance were significantly higher in patients with non-functional adrenal incidentaloma than control group (p=0.022, p=0.005i respectively). No significant difference was found between groups, in terms of LDL, HDL and triglyceride levels.
Conclusion: patients with NFAI are more prone to have insulin resistance and hyperglycemia. Thus, clinicians should evaluate those patients with NFAI, in terms of metabolic parameters.
Keywords: adrenal incidentaloma, insulin resistance, homeostatic model assessment
The possible protective effect of melatonin on streptozotocin induced experimental diabetes
Hakan Yüzüak, Mehmet Aybak
J Clin Exp Invest 2014;5(4):592-598.
https://doi.org/10.5799/ahinjs.01.2014.04.0465
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ABSTRACT
Objective: This experimental study aims to investigate the protective effect of melatonin on the enzymes’, which regulate glucose metabolism in liver tissue.
Methods: In this experimental study, four-month-old male Wistar albino rats were used. The rats were divided into 4 groups as 7 rats in each group. Rats were grouped as control group, diabetic group, melatonin protecting group, as well as melatonin treatment group. Before the streptozotocin implementation to melatonin protecting group (seven days ago) everyday at 18.00 melatonin was implemented for seven days. On the other hand melatonin was implemented to melatonin treatment group after streptozotocin implementation everyday at 18.00 for seven days. Only a single dose of streptozotocin was implemented to diabetic group. Control group had no intervention throughout the study. In the end of the experiment, blood was taken and rats were sacrificed. Before the sacrifice process rats’ fasting blood pressure was measured. Hexokinases, pyruvate kinase, glucose-6-phosphatase, fructose - 1,6-bisphosphatase, glucose -6 phosphate dehydrogenase levels were measured in the liver samples.
Results: Between control and experimental groups of rats, there are statistically significant differences between control and experimental groups for all parameters. Melatonin protecting group levels of investigated parameters were more close to that of control groups’ values and results are statistically significant. Moreover, melatonin treatment group showed a protective effect. However it is not effective as melatonin protecting group.
Conclusion: It can be suggested that melatonin shows protective effect on enzymes related to glucose metabolism in the liver tissue in a model of streptozotocin-induced experimental diabetes.
Keywords: Melatonin, liver, diabetes, streptozotocin
Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience
Mesut Aydın, Nihat Polat, Murat Yüksel, Necdet Özaydoğdu, Yahya İslamoğlu
J Clin Exp Invest 2014;5(4):599-603.
https://doi.org/10.5799/ahinjs.01.2014.04.0466
Research Article
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ABSTRACT
Objectives: Atrial fibrillation (AF), the most common arrhythmia in clinical practice, is a major cause of stroke. Atrial fibrillation increases morbidity and mortality. Nowadays cryoablation therapy is being performed efficiently and safely worldwide. In this paper the clinical outcomes of the patients whom were treated with cryoablation were discussed.
Methods: Between June 2012 and March 2014, patients with paroxysmal AF who were treated with cryoablation were included in the study. The medical records of the patients were retrospectively reviewed. Patients were called to receive information about the symptom recurrence.
Results: Twelve patients were included in the study. Half of the patients were female. The mean age was 48 ± 15 years. Acute procedural success rate of cryoablation was 100%. In one patient transient right phrenic nerve injury occurred which was returned to normal after discontinuation of cryoablation therapy. One patient developed AF episode for 10 minutes in the 4th month of follow-up period.
Conclusion: In patients with paroxysmal atrial fibrillation cryoablation effectively decrease symptoms consistent with the literature.
Keywords: Atrial fibrillation, pulmonary vein isolation, cryoballoon ablation
To evaluate the effectiveness of latanoprost and dorsolamide/timolol fixed combination therapy as initial treatment for glaucoma patients with high intraocular pressure
Sinan Bilgin, Özcan Rasim Kayıkçıoğlu, Esin Başer
J Clin Exp Invest 2014;5(4):604-607.
https://doi.org/10.5799/ahinjs.01.2014.04.0467
Research Article
[Abstract]
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ABSTRACT
Objectives: To evaluate the effectiveness of latanoprost and dorsolamide-timolol fixed combination therapy as initial treatment for treatment naïve patients with intraocular pressure (IOP) values over 30 mm Hg.
Methods: Twenty-five eyes of 25 newly diagnosed patients whose IOP measurements were at least 30 mmHg and who did not receive any antiglaucomatous medication previously were included in the study. Sixteen eyes had primary open angle glaucoma and 9 eyes had pseudoexfoliation glaucoma. Visual acuity, iridocorneal angle, intraocular pressure, optic nerve head and computerized visual field test were evaluated in each patient. Patients were evaluated on the first and third months of therapy for IOP reduction and ocular side effects.
Results: The baseline average IOP was 38.4 ± 7.0 mmHg initially, at first month average IOP was 16.3± 3.7mmHg and at third month average IOP was 18.6 ± 4.2 mmHg. IOP reduction from baseline was 22.1 ± 9.0 mmHg (55.7± 14.5 %) for the first month, 19.8 ± 8.9 mmHg (49.6 ± 15.9 %) for the third month (p=0.0001) None of the patients reported any serious side-effects about therapy. Five (20%) had moderate hyperemia, 2 (8%) reported metallic taste.
Conclusion: The combined therapy of latanoprost and dorsolamide/timolol fixed combination as initial treatment for intraocular pressure over 30 mmHg is highly efficient and well tolerated for treatment naive glaucoma.
Keywords: Dorsolamide, latanoprost, timolol, pseudoexfoliation glaucoma, primary open angle glaucoma
Anaesthesia in Poland syndrome: A case report
İlker İnce, Mehmet Aksoy, Ali Ahıskalıoğlu, Mehmet Çömez, Ahmet Kaciroğlu
J Clin Exp Invest 2014;5(4):608-609.
https://doi.org/10.5799/ahinjs.01.2014.04.0468
Case Report
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ABSTRACT
Poland syndrome is a rare congenital anomaly. It includes in different anomalies such as musculo-skeletal system, heart, kidneys and lungs. This syndrome is characterized by thorax deformity most commonly. Ipsilateral hand anomalies are most important features and can be seen as syndactyly or ectrodactyly. Patients may have lung complications due to the use of muscle relaxants, which is used induction and maintenance of general anesthesia. In addition, these patients show increased risk of malignant hyperthermia during general anesthesia. Because of malignant hyperthermia risk, general anesthesia should be provided carefully. In this report, we discuss the anesthetic concerns related to the management of a 23-year-old female patient with right-sided Poland syndrome undergoing breast reconstruction surgery.
Keywords: Poland syndrome, anesthetic management, congenital anomaly
Hypertension and multiple arterial changes in a child with Klippel Trenaunay syndrome
Meral Torun Bayram, Önder Yavaşcan, Aytaç Gülcü, Nejat Aksu, Salih Kavukçu, Alper Soylu
J Clin Exp Invest 2014;5(4):610-613.
https://doi.org/10.5799/ahinjs.01.2014.04.0469
Case Report
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ABSTRACT
Klippel-Trenaunay syndrome (KTS) is an inherited disorder which essentially affects the venous system. Arterial malformations accompanying venous pathologies are extremely rare. We report a 10-year-old boy of KTS patient presented with hypertension and renal atrophy who have also multiple arterial (renal, pulmonary and internal carotid) pathologic features.
Keywords: Hypertension, arterial changes, Klippel-Trenaunay syndrome
Cervical adenoid basal carcinoma: Case report
Ulaş Alabalık, Uğur Fırat, Ayşe Nur Keleş, Gül Türkcü, Zuhat Urakçı, Elif Ağaçayak
J Clin Exp Invest 2014;5(4):614-616.
https://doi.org/10.5799/ahinjs.01.2014.04.0470
Case Report
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ABSTRACT
Adenoid basal carcinomas are rare tumors that accounts for less than 1% of all cervical cancers. Generally they are seen in postmenopausal women. Macroscopically these tumors do not reach large sizes. Microscopically adenoid basal carcinomas are composed of uniform, round, basaloid cells that form nests surrounded by palisade formations. These tumors express CAM 5.2, CK7, EMA, and CEA immunohistochemically. In evaluation of the material referred to our unit, an ulcerated mass lesion that is located on uterine posterior wall is determined. On microscopic examination of sections prepared from the mass, under the surface epithelium accompanied by severe dysplasia, a tumoral formation composed of basaloid cells is observed. It is seen that the tumor demonstrate configurations of nests and islets which comprise generally peripheral palisading. When the tumoral cells are characterized by mild to moderate pleomorphism and atypia, the mitotic index is detected low. In immunohistochemical studies, the tumoral cells are positively stained with CEA and CK7, and negatively stained with HMWCK, vimentin, CD34, and HPV18. Adenoid basal carcinoma cases typically do not manifest with local recurrence or metastasis and have very good prognosis. Our case has filled 48 months after the diagnosis and any local recurrence or metastasis has not been observed.
Keywords: Adenoid basal carcinoma, adenoid cystic carcinoma, uterine cervix
Difficult airway in a patient with H1N1 pneumonia in intensive care unit
Meltem Türkay, Gülistan Aktaş, İsmail Çoşkuner
J Clin Exp Invest 2014;5(4):617-619.
https://doi.org/10.5799/ahinjs.01.2014.04.0471
Case Report
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ABSTRACT
The difficult airway is a frequent problem among adult patients in intensive care unit. All critical patients should initially be evaluated as a potential difficult airway cases. Development of a serious desaturation should be considered since these patients have less physiological reserve compared to those with difficult airway due to elective surgery. Development of respiratory failure with H1N1 associated pneumonia is likely and support of intubation and mechanic ventilator shall be needed. The objective of this report is to present the management of a patient with H1N1 associated pneumonia who required intubation however could not be intubated due to difficult airway.
Keywords: H1N1 pneumonia, difficult airway, intensive care unit
A case of echolalia in a topiramate induced patient with epilepsy
Eşref Akıl, Rezan Alp, Abdullah Atli, Abdullah Acar, Hasan H Özdemir
J Clin Exp Invest 2014;5(4):620-622.
https://doi.org/10.5799/ahinjs.01.2014.04.0472
Case Report
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ABSTRACT
Echolalia are subsets of imitative behavior which repetition of sounds and language. Topiramate is an effective drug for treatment several types of seizures. It is generally tolerated well. We reported the case of a 44-year old man patient who presented with a history of a epilepsy disorder, He had been maintained with 1000 mg/day sodium valproate for seizure episode. But this recently did not control his seizure episode. Then he was placed on topiramate (600mg/day). Following treatment, he had no seizure episode. subsequently He became incoherence, confusion, disorientation, and significant speech impairments including echolalia Thereby, we present a case of echolalia in a rapidly titrated topiramate induced in a epilepsy disorder patient.
Keywords: Echolalia, topiramate, epilepsy
Nonoperative management in a pregnant patient with gunshot injury: Case report
Ahmet Türkoğlu, Metehan Gümüş, Zübeyir Bozdağ, Yılmaz Zengin, Fatih Mehmet Fındık
J Clin Exp Invest 2014;5(4):623-625.
https://doi.org/10.5799/ahinjs.01.2014.04.0473
Case Report
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ABSTRACT
Although the first choice of treatment in thoracoabdominal gunshot injury is surgery, nonoperative treatment has increasingly been raised recently. On the other hand, there isn't clinical experience yet in nonoperative treatment of pregnant patients with gunshot injury. In this study, the management of a pregnant patient with liver damage due to a gunshot injury who treated nonoperatively was presented. An 18-year-old female patient with 20 weeks gestation was admitted to an external center with a gunshot injury and a computed tomography showed a liver injury. When she was admitted to our hospital eight hours after the injury, her vital signs were stable. Therefore, we decided to manage nonoperatively. She was closely monitorized in intensive care unit and followed up by physical examination and ultrasonography. Nonoperative management is a choice of treatment in carefully selected patients and well-defined strategy. Pregnant patients are a patient group that is most likely to benefit from this approach, if well managed.
Keywords: Gunshot injury, pregnant, liver wound, nonoperative treatment
Ovulation induction in polycystic ovary syndrome
Ali İrfan Güzel, Nazlı Aksoy, Aytekin Tokmak, Nafiye Yılmaz
J Clin Exp Invest 2014;5(4):626-631.
https://doi.org/10.5799/ahinjs.01.2014.04.0474
Review
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ABSTRACT
Polycystic ovary syndrome (PCOS) is the most common reason of anovulatory infertility in reproductive age women. To make ovulation in these patients, from simple approach like life style changes to complicated therapies like assisted reproductive techniques are used. In this review, we aimed to emphasize different ovulation induction techniques that can be used in cases with PCOS.
Keywords: Polycystic ovary syndrome, anovulation, infertility, ovulation induction
Cutaneous drug reactions in childhood
Savaş Öztürk, İlker Erden, İlkay Can, Haydar Uçak
J Clin Exp Invest 2014;5(4):632-638.
https://doi.org/10.5799/ahinjs.01.2014.04.0475
Review
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ABSTRACT
Cutaneous Drug reactions (CDR) are adverse admissions or harmful effects of drugs according to the definition by the World Health Organization. One of the early lessons learned in dermatology training is “any drug, any rash.” Drug-related cutaneous reactions can be daunting, even for the experienced dermatologist and pediatrics. There have been more than 25 different patterns described in the literature. The most commonly affected organs are the skin in drug reactions and dermatological examination is very important in the diagnosis for drug reactions. Cutaneous drug reactions should be distinguished from viral exanthema which is the most commonly seen in children, and it often is not easily. In treatment of cutaneous drug reactions, the first step is to immediately discontinue the susceptible drug. In this article, the approach to cutaneous drug reactions in children will be evaluated in accordance with current literature.
Keywords: Cutaneous, drug, reaction, child