Showing papers by "Istanbul University published in 1993"

Lumbar Spinal Stenosis: Clinical/Radiologic Therapeutic Evaluation in 145 Patients-Conservative Treatment or Surgical Intervention?

Abstract: In this prospective study, 145 patients with lumbar spinal stenosis were evaluated for clinical signs and radiologic findings and conservative treatment results. Clinical parameters such as pain on motion, lumbar range of motion, straight leg raising test, deep tendon reflexes, dermatomal sensations, motor functions and neurogenic claudication distances were assessed at admission and were compared after a conservative treatment program was completed. A conservative treatment program consisted of physical therapy (infrared heating, ultrasonic diathermy and active lumbar exercises) and salmon calcitonin. Pain on motion (100%), restriction of extension (77%), limited straight leg raising test (23%), neurogenic claudication (100%), dermatomal sensory impairment (47%), motor deficit (29%), and reflex deficit (40%) were observed in the patients. All aforementioned disturbances except reflex deficits improved by the conservative treatment and results were statistically significant. The authors conclude that this conservative treatment should be the treatment of choice in elderly patients and in those patients without clinical surgical indications.

Intratracheal perfluorocarbon administration as an aid in the ventilatory management of respiratory distress syndrome

Abstract: BACKGROUND Respiratory distress syndrome carries a high morbidity and mortality when treated with mechanical ventilation with positive end-expiratory pressure. Perfluorocarbon liquids are employed in liquid ventilation due to low surface tension and high gas solubility. To assess whether intratracheal administration of the perfluorocarbon, perflubron, in combination with conventional mechanical ventilation could be of therapeutic benefit in respiratory distress syndrome, the authors tested the effects of different doses of intratracheal perflubron administration on gas exchange and lung mechanics in adult animals with respiratory failure during a 6-h observation period. METHODS Respiratory failure was induced in 30 rabbits by saline lung lavage (arterial oxygen tension < 100 mmHg at 100% oxygen with the following ventilator settings: tidal volume, 12 ml.kg-1; respiratory frequency, 30 per min; inspiratory/expiratory ratio, 1:2; and positive end-expiratory pressure of 6 cm H2O). Twenty-four rabbits were treated with different perfluorocarbon doses (3, 6, 9, and 12 ml.kg-1), and the remaining six served as controls while mechanical ventilation was continued with the aforementioned settings. Additionally, in ten healthy rabbits who were used as healthy controls, the lungs were mechanically ventilated either alone or in combination with intratracheal perfluorocarbon administration (3 ml.kg-1) for 6 h. RESULTS In all treatment groups, arterial oxygen pressure increased significantly (P < 0.0001) in a dose-related fashion (193 +/- 40, 320 +/- 70, 353 +/- 125, and 410 +/- 45 mmHg at 15 min), and peak airway pressures decreased significantly (range, 18-23%; P < 0.0001) from pretreatment values. These findings were in contrast to those for the control group. The improvements were time-dependent in all four tested perfluorocarbon doses. However, the improvements in pulmonary parameters could be extended to 6 h only in groups treated with 9 ml.kg-1 and 12 ml.kg-1 perflubron. At the end of the 6-h period, the data for these two groups showed significantly higher arterial oxygen pressure (230 +/- 84 and 197 +/- 130 mmHg, respectively; P < 0.05) and lower inflation pressures than the pretreatment data for these groups and the data for the control group at 6 h. There were no clinically significant changes in pulmonary parameters in healthy animals due either to mechanical ventilation alone or mechanical ventilation in combination with intratracheal perfluorocarbon administration for 6 h. CONCLUSIONS The results of this study imply that there is no association between the lung mechanics and gas exchange parameters for mechanical ventilation in combination with intratracheal perfluorocarbon administration. The data suggest that this type of perfluorocarbon administration with conventional mechanical ventilation offers a simple, alternative treatment of respiratory distress syndrome. With this technique, adequate pulmonary gas exchange can be maintained at relatively low airway pressures with high perfluorocarbon doses for several hours.

Poisoning by toxic honey in turkey

Abstract: One of the food intoxications encountered in Turkey is the case caused by toxic honey made by bees fromRhododendron species.R.luteum andR.ponticum are the two species which grow in the north regions of Turkey. Grayanotoxins, mainly Grayanotoxin I (Andromedotoxin) occurring only in Ericaceae plants, are the compounds responsible for poisoning. In this investigation, the diagnosis and treatment of 11 cases of poisoning admitted to Kartal Occupational Diseases Hospital between 1983 and 1988 are presented. The results of the light microscopic and chemical analysis of toxic honey samples are compared with those of the ordinary honey samples and the extract ofRhododendron leaves.

Comparative study of the skin pathergy test with blunt and sharp needles in Behçet's disease: confirmed specificity but decreased sensitivity with sharp needles.

Abstract: OBJECTIVE--To compare the specificity and sensitivity of the skin pathergy test performed with blunt and sharp needles in patients with Behcet's disease. METHODS--The skin pathergy test was performed using the simultaneous four needle prick method with blunt and sharp, thick and thin needles in 92 patients with Behcet's disease, 64 healthy controls, and 128 patients without Behcet's disease. The test was evaluated at 48 hours. RESULTS--No positive skin pathergy test was found in healthy controls and patients without Behcet's disease. The frequency and intensity of the positive skin pathergy test with blunt needles were significantly higher than those with sharp needles. CONCLUSION--This study reconfirmed the specificity of a positive skin pathergy test for Behcet's disease using blunt and sharp needles and showed a decreased sensitivity and intensity of the reaction with sharp needles.

Ileosigmoid knotting in Turkey : review of 68 cases

Abstract: PURPOSE: The high mortality associated with ileosigmoid knotting prompted us to review the collected experiences of three university hospitals in order to establish a more rational approach to the problem. METHOD: The clinical records of 68 patients with ileosigmoid knotting from 1970 to 1990 were reviewed with respect to incidence, etiopathogenesis, clinical features, treatment, and clinical outcome. RESULTS: The most common type of ileosigmoid knotting was Type IA (48.5 percent), in which the active ileum encircled the passive sigmoid in a clockwise manner. Fifty (73.5 percent) patients developed a gangrenous bowel whereas 18 patients did not show any definite evidence of impairment of bowel viability.En bloc removal of gangrenous knot and reestablishment of intestinal continuity by enteroenteric or enterocolic anastomosis combined with the Hartmann procedure, which was employed in 20 (42.6 percent) cases, constituted the most frequently preferred operation. The mortality rate in this series was 30.9 percent (21/68) and toxic shock, which ultimately resulted in multiple organ failure, was the major cause of death. It was remarkable to note that there was an inverse correlation between the duration of symptoms and the mortality rate reflecting the dramatic rapidity and severity of symptoms due to tightness of the knot which led to early and extensive gangrene, thus inevitably urged the patients to seek medical help without delay. CONCLUSION: The performance of prompt, individualized surgical treatment in conjunction with the use of advanced measures of critical care to combat the disastrous consequences of multiple organ failure would contribute greatly to improve survival rate in victims of this dreadful entity.

On the realization of OTA‐C filters

Abstract: A synthesis procedure based on the signal flow graph is given for generating second-order active filters using a minimum number of operational transconductance amplifiers and grounded capacitors. the pole quality factor and pole frequency sensitivities are studied for the proposed filters. Furthermore, the limitations on input signal amplitude are studied and a simple formula is derived for the input signal amplitude not causing clipping and slew-rate-limiting problems.

In situ Esterification of Rice Bran Oil with Methanol and Ethanol

Abstract: In situ esterifications of high-acidity rice bran oil with methanol and ethanol and with sulfuric acid as catalyst were investigated In the esterification with methanol, all free fatty acids (FFA) dissolved in methanol were interesterified within 15 min, and it was possible to obtain nearly pure methyl esters The amount of methyl esters obtained from a given rice bran was dependent on the FFA content of the rice bran oil In the esterification with ethanol, it was not possible to obtain pure esters as in methanol esterification, because the solubilities of oil components in ethanol were much higher than those in methanol

Fructosamine as a Possible Monitoring Parameter in Non-Insulin Dependent Diabetes Mellitus Patients With Periodontal Disease

Abstract: Fructosamine assay is a new test used in the diagnosis and monitoring of diabetic patients. This assay may be of interest to the periodontist for, while the traditional plasma glucose value would give a general view and information about diabetic control at a certain point, the fructosamine concentration gives an indication of the plasma glucose level over a considerable period of time, such as 1 to 3 weeks. We investigated whether there was any relation between the diseased state of the periodontal tissues and plasma fructosamine and the plasma glucose values in non-insulin dependent diabetes mellitus (NIDDM) patients. We found that fructosamine correlated with the degree of gingival bleeding, however serum glucose levels had little or no correlation.

Azathioprine in combination with steroids in the treatment of autoimmune inner-ear disease

Abstract: A total of twelve patients with a relatively uncommon form of progressive sensorineural deafness (autoimmune inner-ear disease) were treated orally with 1 mg/kg azathioprine, once daily, and with 30 mg prednisolone, every other day, for 4 weeks. Statistically significant increases in the ability to hear pure tones or in discrimination on audiometry took place in 10/12 patients. This condition was initially described as 'sensorineural hearing loss', but it is now clear that the term 'autoimmune inner-ear disease' is more appropriate since the vestibular compartment as well as the cochlear compartment is involved. This relatively uncommon disease is one of the few forms of sensorineural deafness that can be successfully treated.

Right atrial thrombus mimicking myxoma and bilateral pulmonary artery aneurysms in a patient with Behçet's disease--a case report.

Abstract: A case of Behcet's disease, in which superior vena cava syndrome was the presenting feature is reported. Magnetic resonance imaging and echocardiography revealed a mass lesion in the right atrium. This patient developed bilateral pulmonary artery aneurysms postoperatively and represents one of the bizarre manifestations of Behcet's disease.

Polyaminocarboxylic acids–Ce(IV) redox systems as an initiator in acrylamide polymerization

Abstract: Acrylamide polymerization by Ce(IV)-polyaminocarboxylic acids, i.e., EDTA, DTPA, EGTA, and NTA, which have strong chelating properties, have been studied at different [H+], initiator concentration, and reaction time. Initiation of polymerization proceeds through the formation of the free radical after decarboxylation of the carboxyl group of polyaminocarboxylic acid. Results also indicate that the termination of the polymerization reaction is mainly mutual termination. Decrease of the rate of disappearance of the cerium(IV) is in the order of DTPA ≥ EDTA > NTA > EGTA. © 1993 John Wiley & Sons, Inc.

Investigation on the compressive strength of several gypsum products dried by microwave oven with different programs

Abstract: Different programs in a microwave oven were selected to dry several gypsum products. A type III dental stone (Moldano), a type IV high-strength dental stone (Glastone) and a type III partial denture casting investment (Multi-vest) were selected. Specimens of the products were dried by microwave radiation set at the lowest and highest power levels for 5 and 15 minutes. The dried specimens were tested at intervals of 2, 4, 24, and 48 hours for compressive strength. Specimens dried in ambient room air were used as the control group. A statistical analysis of the test results was performed with Student's t-test at p < or = 0.05 level. Microwave radiation at the highest power level resulted in a decrease in the compressive strength of type IV dental stone (Glastone), whereas the values of the other gypsum products did not differ at any time interval from values attained for the air-dried specimens. The 2-hour low power test of the investment (Multi-vest) had a higher compressive strength than the air-dried specimens after 24 hours.

The role of lipid peroxidation and calcium in galactosamine induced toxicity in the rat liver.

Abstract: Liver homogenate and subcellular fractional levels of lipid peroxides, homogenate glutathione (GSH) and calcium contents and hepatic plasma membrane Ca 2+ -ATPase activity were determined in rats, 12, 18, 24 and 48 hours after treatment with a single dose of 1 g/kg galactosamine. Lipid peroxides and calcium levels in liver homogenate and subcellular fractions were found to increase, but hepatic GSH content and Ca 2+ -ATPase activity were observed to decrease reversibly

Serum thyroid hormones and pituitary response to thyrotropin-releasing hormone in epileptic children receiving anti-epileptic medication

Abstract: Thyroid hormones and pituitary function were assessed in 49 children with epilepsy who were receiving either a single medication of carbamazepine, phenobarbital and valproate or a combination of carbamazepine with phenobarbital or valproate. All therapeutic regimens except valproate monotherapy were associated with low levels of circulating thyroxine, free tri-iodothyronine and free thyroxine. Carbamazepine with valproate was associated with the lowest serum concentration of thyroid hormones. It seems probable that accelerated hormone metabolism is responsible for these hormonal changes. However, all drug regimens also had effects on the function of the hypothalamic pituitary axis. Because of these findings, thyroid hormones should be checked frequently during anti-epileptic drug treatment, although clinical hypothyroidism was not seen in our patients.

Prognostic factors in meningococcal disease and a new scoring system.

Abstract: One-hundred-and-forty patients diagnosed as having meningococcal disease have been investigated retrospectively with respect to prognostic factors. The overall mortality was 8.6%, the mortality rate of the infants under 6 months of age being higher than that of the other groups. In cases where there was no meningitis or leucocytosis, the presence of hypotension, disturbed consciousness and diffuse petechiae increased the mortality rate significantly. High fever did not have any effect on mortality. We propose a new practical and reliable scoring system for meningococcal disease for determining the influence of prognostic factors on mortality.

Neonatal suppurative parotitis: a vanishing disease?

Abstract: A case of neonatal suppurative parotitis due to Klebsiella pneumoniae is described. This is the first case reported in the last 20 years. Infection with unusual microorganisms should be taken into account when planning antibiotic treatment, especially in hospital acquired infections of the salivary glands in the newborn.

Estimation of annual height velocity based on short- versus long-term measurements.

Abstract: We assessed the relationships between annual height velocity, calculated from two measurements taken at intervals of 6, 12 and 24 months, in 69 healthy prepubertal children (34 male, 35 female) aged 6.5 years (range 6.25–6.75 yrs) who were followed for 2.5 years and measured biannually. Initial height values for age were within normal ranges except for one child with a height SDS of — 2.0. Mean annual velocities also conformed to British norms. Significant differences were observed between consecutive six-monthly velocities and these values failed to predict annual velocities calculated from measurements taken at 12– or 24-month intervals. Seasonal effects were thought to have some impact on the six-monthly velocity differences. Height velocity, based on measurements taken at intervals of 12 months, was essentially similar to two-year velocity values. The results indicate that in estimating annual height velocity, six-month intervals between measurements may be misleading while 12-monthly measurements are as reliable as height velocity values based on measurements taken at two-year intervals.

The free-radical polymerization of acrylamide initiated with ceric sulfate in the presence of amino acids

Abstract: Polymerization of acrylamide initiated with ceric (IV) ion in the presence of methionine, phenylalanine, serine and aspartic acid was investigated in sulfuric acid solution. Maximum yield was obtained at 70°C and sulfuric acid concentration of 0.16 mol/1. Both conductometric titration and FT-IR results showed that the resulting polymers contained carboxy end groups. According to these findings and previous studies in this field, a suitable polymerization mechanism was proposed. Acrylamid wurde mit Ce(IV)-Initiator in Gegenwart von Methionin, Phenylalanin, Serin bzw. Aspartamsaure in verdunnter Schwefelsaure polymerisiert. Bei 70°C und einer Schwefelsaurekonzentration von 0,16 mol/l wurde die groste Ausbeute erzielt. Carboxy-Endgruppen in den Polymeren wurden sowohl durch konduktometrische Titration als auch durch FT-IR-Spektroskopie nachgewiesen. Ein geeigneter Reaktionsmechanismus wird aufgrund dieser Resultate sowie vorangegangener Untersuchungen vorgeschlagen.

Pediculosis capitis in Istanbul.

Abstract: Background. Pediculosis capitis is a worldwide problem. We studied the prevalence of this infestation in Istanbul. Methods. We reviewed the records of the Dermatology Clinic of istanbul University Cerrahpasa Medical Faculty from a 20–year period (1970–1989). Results. The number of cases of pediculosis capitis have gradually increased over this period, with a peak in 1981. Women are more involved than men. There has been a significant increase in cases in children of school and preschool ages. Conclusions. Many factors may have contributed to this increase: poor hygiene and socioeconomic conditions, lack of medical training, and probably some resistance to pediculicide preparations in the lice. The stigma attached to the disease may prevent people from coming forward.