Showing papers by "Trakya University published in 2003"

Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder

Abstract: Over the last 15 years, an increasing body of evidence has suggested a causal relationship between depression and the immunological activation and hypersecretion of pro-inflammatory cytokines, such as interleukin-1, interleukin-6 and tumor necrosis factor-alpha (TNF-α). However, little is known about the probable relationship of serum TNF-α with major depressive disorder (MDD). To assess whether serum TNF-α levels could be associated with the clinical course of MDD. TNF-α and C-reactive protein (CRP) serum concentrations, erythrocyte sedimentation rate, and leukocyte count were measured in 26 MDD patients and in 17 controls. The measurements were repeated following 6 weeks of antidepressant treatment with selective serotonin re-uptake inhibitors. Psychopathological improvement and the severity of depression were evaluated with the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI). On admission, serum TNF-α and leukocyte count were significantly higher in MDD patients compared to controls (P<0.001 and P=0.005, respectively). With the antidepressant treatment, both HAMD and BDI scores decreased significantly (P<0.001 for both). Comparison of pre- and post-treatment measurements revealed that TNF-α, CRP, and leukocyte count decreased to levels comparable with those of the control subjects (P<0.001, P=0.01, and P=0.01, respectively). The results emphasized that some immunological parameters, such as CRP, leukocyte count and TNF-α, are significantly involved in the clinical course and treatment response in MDD. TNF-α in particular could be considered as a potential state marker in MDD.

Efficacy of Low Level Laser Therapy in Myofascial Pain Syndrome: An Algometric and Thermographic Evaluation

Abstract: Background and objectives: The efficacy of low level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. Our aim was to clarify the effect of LLLT in MPS by using algometry and thermography. Study Design/Materials and Methods: Sixty-two patients with MPS having an active trigger point in the neck or upper back region were randomly divided into two equal groups according to therapy applied (group 1: LLLT þ stretching exercises, group 2: stretching exercises alone). The outcome measures were pain measured with visual analogue scale (VAS), algometry on the trigger point, algometric difference, thermographic difference, and thermal asymmetry. Comparison was made within and between the groups pre- and post-therapeutically and 3 weeks after therapy. Results: Mean pain values decreased more significantly in group 1 from baseline to 3 weeks follow up (7.54–3.06) while these values were 7.03–5.19 in group 2 (P < 0.05). Group comparisons revealed significant favorable differences in group 1 patients in terms of all other parameters at the first and the second evaluation post therapeutically (P < 0.05). Conclusions: LLLT seemed to be beneficial for pain in MPS by using algometry and thermography. Lasers Surg. Med. 33:339–343, 2003. 2003 Wiley-Liss, Inc.

An investigation of export performance variations related to corporate export market orientation

Abstract: This research explores the nature and dimensions of market orientation in an international context by using empirical data from a sample of companies to rigorously test hypotheses regarding market orientation as applied to export operations in the context of the Turkish clothing industry. This aim was fulfilled by reliably and validly measuring the key constructs of export market orientation and finding statistically significant relationships between dependent (export marketing orientation) and independent variables (primarily export strategy and export performance). The results of this study draw conclusions showing that the hypothesised relationship between export market orientation and export performance does exist, and in the case of Turkish clothing exporters, improving an export market orientation level is a significant contributor to the company’s export performance. The results of this study also show the dimension of export market orientation that has the strongest relation with each dimension of export performance, and identifying the other export market orientation dimensions that make a significant contribution to the explanation of export performance.

Serum lipid levels in psoriasis.

Abstract: A predisposition to occlusive vascular diseases has been reported in patients with psoriasis and it has been suggested that some of these patients have some disorders of lipid metabolism. In this study, serum lipid levels were investigated in psoriatic patients to explore to the knowledge of this relationship. One hundred psoriatic patients and 100 non- psoriatic controls were included in the study. Total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), and very low-density lipoprotein-cholesterol (VLDL-cholesterol) levels were measured. In patients with psoriasis, total cholesterol and LDL-cholesterol levels were found to be significantly higher than those of controls. No significant differences were found in the other parameters. We concluded that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and obstructive vascular diseases.

Caudal ropivacaine and neostigmine in pediatric surgery.

Abstract: BACKGROUND Neostigmine has been added to local anesthetics for different nerve blocks This study was conducted to evaluate effects of neostigmine when added to ropivacaine for caudal anesthesia METHODS We studied children, aged 1-5 yr, undergoing inguinal hernia and hypospadias surgery After standard induction of anesthesia, Group I received 02% ropivacaine 05 ml/kg and Group II received 02% ropivacaine 05 ml/kg with 2 microg/kg neostigmine via the caudal route Heart rate, mean arterial pressure, and pulse oximetry were recorded before induction, after induction, and then every 10 min after caudal anesthesia Hemodynamic, Toddler-Preschooler Postoperative Pain Scale pain score, and sedation score values were recorded 30 min after extubation and at hours 2, 4, 6, 12, and 24 A pain score greater than 3/10 resulted in administration of rectal paracetamol RESULTS There were no differences between the groups in demographic and hemodynamic data, duration of surgery and anesthesia, time to extubation, or sedation scores The pain scores were significantly lower in Group II at 6 and 12 h (P < 005) Time to first analgesic requirement was statistically prolonged in Group II (192 +/- 55h) when compared with Group I (71 +/- 57 h) (P < 005) Total analgesic consumption was statistically larger in Group I (174 +/- 96 mg) when compared with Group II (80 +/- 855 mg) (P < 005) The incidence of vomiting (3 patients in Group II and 1 patient in Group I) was not statistically significantly different CONCLUSIONS The authors found that a single caudal injection of neostigmine when added to ropivacaine offers an advantage over ropivacaine alone for postoperative pain relief in children undergoing genitourinary surgery

Revalidation of description of constipation in terms of recall bias and visual scale analog questionnaire

Abstract: Background and Aim: The present study was designed to identify a cut-off value to define subjective and relatively objective criteria of constipation using the visual scale analog questionnaire (VSAQ) in healthy subjects. In addition, the importance of recall bias when evaluating constipation was investigated by repeating the questionnaire and ensuring the subjects maintained diaries. Methods: Seven hundred and sixty healthy hospital personnel were questioned by means of a standard questionnaire. Subjects were initially asked if they were constipated (self-reported) and their daily defecation frequencies. Severity of the parameters of constipation, the consistency of defecation in the form of hard stools, straining and incomplete evacuation were also investigated using a VSAQ (0–10). Subjects were asked to complete a standard form about their daily bowel habits in the subsequent 7 days (diary). At the end of this series, the questionnaire forms completed at the beginning were readministered. Using the criteria of functional constipation, the prevalence of self-reported, symptom-based (≥2 criteria) and diary-based (≥2 criteria in the diary) were defined. Results: Of the subjects, 48.5% (369/760) completed diaries regarding their bowel habits and completed the questionnaire for the second time (198 female, 171 male; mean age 31.6 ± 7.1 years). According to only interrogation, 29.8% of subjects reported that they were constipated; however, this number increased to 39.6% when symptom-based constipation (≥2 criteria) was considered. Significant agreement was observed between the results of self-reported constipation in form I and II, and symptom-based and diary-based constipation (concordance = 77.7–98.6%, k = 0.47–0.97). Furthermore, 98.1% of the subjects who reported that they were not constipated scored 3 on the VSAQ; conversely, 91.8% who accepted being constipated scored >3 for the same question. A total of 76.1% subjects who had symptom-based constipation scored 3 on the VSAQ, 97.3% of those who had 3 on the VSAQ. Also, 91.8% of those with three criteria and 100% of those with four criteria had a score >3 on the VSAQ for the same question. Conclusions: The prevalence of constipation in the questionnaire form based on self-reported, symptom-based and diary-based criteria were highly compatible with the result obtained on readministration. Recall bias was negligibly low. Also, the present results suggest that the diagnosis of constipation is more accurate when >2 criteria are present. In addition, the VSAQ seems to be sensitive enough to differentiate subjects with constipation from those without, when a score of 3 has been chosen as the cut-off value for discrimination. However, this sensitivity was less in the group who stated they were constipated.

The prevention of pain from injection of rocuronium by magnesium sulphate, lignocaine, sodium bicarbonate and alfentanil.

Abstract: We compared the efficacy of magnesium sulphate, lignocaine, sodium bicarbonate or alfentanil in minimizing pain due to injection of rocuronium in 250 patients. After tourniquet application on the forearm, the patients were given saline, magnesium sulphate, lignocaine, sodium bicarbonate 8.4% or alfentanil, diluted into a 3 ml solution. The occlusion was released after 20 seconds, and rocuronium was injected over 10 to 15 seconds. The patients were observed and asked immediately if they had pain in the arm and the response was assessed. Reactions such as discomfort and pain, withdrawal of the hand and screaming after the administering of the rocuronium were recorded as side-effects and patients were reassessed at 24 hours postoperatively. We concluded that magnesium sulphate, lignocaine, sodium bicarbonate or alfentanil decreased the level of rocuronium injection pain. Of these drugs, magnesium sulphate, lignocaine and sodium bicarbonate were the most effective while alfentanil was the least effective.

Elevated serum TNF-alpha levels in normal-weight women with polycystic ovaries or the polycystic ovary syndrome.

Abstract: OBJECTIVE To compare the serum tumor necrosis factor-alpha (TNF-alpha) levels in nonobese women with those in women with polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS) and healthy controls. STUDY DESIGN Twenty-one sonographically and biochemically diagnosed women with PCOS, 19 with PCO and 14 healthy women were recruited for the study. Serum TNF-alpha levels were measured in all three groups. Insulin and glucose serum concentrations were analyzed before and after a 75-g oral glucose tolerance test in all samples. The serum TNF-alpha, glucose and insulin levels were compared in PCOS, PCO and controls. RESULTS Serum TNF-alpha levels were similar in the PCOS and PCO groups (23.67 +/- 5.58 and 13.58 +/- 1.34 pg/mL, respectively) and significantly higher than in the control group. Serum TNF-alpha levels did not significantly correlated with body mass index, serum total testosterone, LH, DHEAS, fasting glucose and fasting insulin levels or glucose and insulin area under the curve values in the three groups. CONCLUSION We found similar TNF-alpha levels in patients with PCOS and with PCO; however, there was no correlation between the TNF-alpha and insulin, glucose and androgen levels in the study.

Trans FA in Sunflower Oil at Different Steps of Refining

Abstract: The contents of total trans FA of sunflower oils at different stages of refining processes were determined by capillary GLC. The contents of 18∶1, 18∶2, and 18∶3 trans acids were 0.22±0.03, 2.31±0.23, and 0.03±0.01%, respectively, in physically refined sunflower oils, and 0.05±0.01, 0.69±0.26, and 0.02±0.01%, respectively, in chemically refined sunflower oils. The total trans FA contents drastically increased at the end of the physical refining process. The total trans FA contents of chemically refined sunflower oils were <1%. Because of the high temperature applied in the last stage of physical refining, the content of total trans FA was higher than in chemically refined sunflower oils. The last-stage conditions should be carefully evaluated to reduce the formation of trans FA during physical refining.

Evaluation of tumor angiogenesis with contrast-enhanced dynamic magnetic resonance mammography.

Abstract: The goal of this research was to correlate dynamic magnetic resonance (MR) mammographic contrast enhancement and microvessel densities in breast masses. Forty-six female patients with breast masses detected by mammography and/or ultrasonography were included in the study. MR contrast enhancements of the lesions were investigated dynamically using axial three-dimensional fast low-angle shot sequences. After excisional biopsy or mastectomy, immunohistochemical staining with factor VIII-RA was performed, followed by microvessel density measurements. Contrast enhancement patterns in dynamic MR mammography were compared with microvessel density measurements using Student's t-test, Pearson's moment correlation coefficients, and one-way analysis of variance (ANOVA). Malignant lesions exhibited three different enhancement patterns: 1) a peak enhancement within 120 seconds (early phase), followed by a decrease in the delayed phase (25 cases); 2) an increase in the early phase, followed by a plateau in the delayed phase (9 cases); and 3) an increase throughout the examination without any peak (5 cases). In benign lesions, signal intensity did not exhibited a peak in five cases, whereas in two cases enhancement was increased in the early phase and made a plateau in the delayed phase. A significant correlation was found between microvessel density and the percentage of maximal signal increase following paramagnetic contrast administration (r = 0.322, p < 0.05). Dynamic enhancement patterns and rates of maximal signal increase predict microvessel density in breast malignancies and may possibly be used as prognostic indicators.

Epidemiological Features of Ulcerative Colitis in Trakya, Turkey:

Abstract: To determine the epidemiological features of ulcerative colitis in the Trakya region of Turkey, southeast Europe, we conducted a descriptive, cross-sectional, hospital-based study. All subjects were followed, and age, sex, place of residence, family history, educational status, tobacco consumption and use of oral contraceptives were recorded. The study included 49 cases of ulcerative colitis. The incidence of the disease was 0.59 per 100,000 in 1998, 0.89 per 100,000 in 1999, 0.89 per 100,000 in 2000 and 0.69 per 100,000 in 2001. The overall prevalence of the disease was 4.9 per 100,000; it was 2.18 per 100,000 in rural areas and 5.87 per 100,000 in urban areas. As in the Mediterranean countries, both the incidence and the prevalence of ulcerative colitis were found to be low. The incidence was significantly higher in urban areas than in rural areas.

The effect of intravenous pantoprazole and ranitidine for improving preoperative gastric fluid properties in adults undergoing elective surgery.

Abstract: UNLABELLED We studied pantoprazole, a new potent and fast-acting proton pump inhibitor. Its effects on preoperative gastric fluid volume and pH have not yet been determined. In this randomized, controlled trial, we examined the effects of preoperative IV pantoprazole or ranitidine on gastric pH and volume. Ninety patients (ASA status I and II, scheduled for elective surgery) were studied. One hour before surgery, patients in Group I (n = 30) were given IV saline 5 mL, those in Group II (n = 30) were given 40 mg of pantoprazole IV, and those in Group III (n = 30) were given 50 mg of ranitidine IV. A nasogastric tube was inserted immediately after anesthesia induction. Gastric contents were aspirated, and volume and pH were recorded. The pH values determined in Group I were 3.73 +/- 0.82; in Group II, they were 5.30 +/- 1.84; and in Group III, they were 4.80 +/- 1.40. There was no statistical difference between Groups 2 and 3, but there was a significant difference between Group I and Groups 2 and 3 (P < 0.0005). The volume of the gastric contents was 28.67 +/- 10.98 mL in Group I, 15.20 +/- 15.52 mL in Group II, and 7.77 +/- 11.17 mL in Group III. There was no statistical difference between Groups 2 and 3, but there was a statistically significant difference between Group I and Groups 2 and 3 (P < 0.0005). The proportion of patients considered "at risk" of significant lung injury should aspiration occur was 20% of Group I, 10% of Group II, and 3.3% of Group III. When statistically evaluated, there was no difference among groups. We concluded that the administration of IV pantoprazole and ranitidine 1 h before surgery is effective in reducing gastric pH and volume. IMPLICATIONS This randomized, controlled trial examined the effects of preoperative IV pantoprazole or ranitidine on gastric pH and volume. We concluded that IV pantoprazole and ranitidine, given 1 h before surgery, are effective in reducing gastric pH and volume.

Increased immunoglobulin E response in acute coronary syndromes.

Abstract: The role of inflammation and mast cell activation has been implicated in atherosclerotic plaque destabilization and rupture. To investigate the role of immunoglobulin E (IgE) in acute coronary syndrome, a prospective clinical study was conducted in patients with acute myocardial infarction (AMI), unstable angina pectoris (UAP), stable angina pectoris (SAP), and healthy controls. IgE levels were serially measured and compared in consecutive patients with AMI (n = 16) and UAP (n = 14) on days 1, 3, 7, 21 after admission and 3 months later and only once in stable angina pectoris (n = 15) and healthy controls (n = 14). In addition, blood eosinophil and basophil levels on admission were measured in all groups and compared. Initial IgE levels determined at admission in patients with AMI, UAP, and SAP were significantly higher than levels in the control group (p = 0.002). Initial high IgE level in AMI on day 1 increased to a peak by day 7 (p = 0.024), then gradually decreased by day 21 and at 3 months (p = 0.052). High IgE level in UAP persisted by day 7 and gradually decreased by day 21 and 3 months (p = 0.037 and p = 0.018, respectively). Blood eosinophil count on admission was significantly higher in UAP than in the control group (p = 0.005). Basophil levels of both AMI and UAP groups on admission were found to be elevated as opposed to control group (p = 0.02 and p = 0.012, respectively). This study demonstrates that the level of IgE significantly increased during the acute phase of acute coronary syndromes and gradually decreased, supporting the role of acute inflammatory response and mast cell involvement in plaque rupture.

Electrocardiographic findings and prognosis in ischemic stroke.

Abstract: Introduction: Electrocardiographic (ECG) changes are observed in patients with acute stroke and are related with the prognosis. Aims: To determine the frequency and significance of ECG changes in patients with acute ischemic stroke. Material and Methods: In a prospective hospital-based study 87 patients with cerebral infarction were observed for ECG changes during their stay in the hospital. All the patients had ischemic stroke for the first time. The ECG changes observed were compared with those of the control group consisting of 87 patients. Results: Of the 87 patients of the study group, 47.1% were females and 52.9% males. The mean age was 65.5 ± 11.9 (range 31–91 yrs). The control group consisted of 50.6% females and 49.4% males. The mean age was 64.5 ± 11.9 (range 31–87 yrs). The frequency of the ECG changes observed in patients with cerebral infarct was 62.1% while it was 29.9% in the control group (P<0.0001). ECG changes observed were mostly related to myocardial ischemia. The six-month mortality rate in the patients with ECG changes was 38.9% whereas it was 15.2% in those with normal ECG (P<0.05). Conclusions: The observations of this study suggest that cardiac evaluation in patients with acute ischemic stroke is of prognostic importance.

Epithelial-myoepithelial carcinoma of the lung. A case report and review of the literature.

Abstract: Primary lung tumors mimicking the salivary gland–type neoplasms are extremely rare. These types of tumors originate from submucosal bronchial glands. Epithelial-myoepithelial carcinoma is an uncommon tumor in this group, and only 7 cases have been reported. It is considered to be a low-grade malignant neoplasm. We report a case of epithelial-myoepithelial carcinoma of bronchial gland origin in a 73-year-old man who presented with coughing and dyspnea. The bronchus of the left lower lobe contained a tumor mass that had a polypoid growth pattern. The tumor also extended into the pulmonary parenchyma, forming a well-circumscribed mass with a pushing margin. The tumor consisted of epithelial and myoepithelial cells. The epithelial cells were positive for cytokeratins and epithelial membrane antigen, while the myoepithelial cells were positive for S100 protein and muscle-specific actin. According to these findings, we diagnosed epithelial-myoepithelial carcinoma. After undergoing pneumonectomy, the pa...

The epidemiology of hepatitis a virus infection in children, in Edirne, Turkey.

Abstract: Turkey is a middle endemic area with respect to Hepatitis A virus (HAV) infection. However, the frequency of this infection varies due to socio-economic differences in various regions. The aim of this study was to detect the most likely age of exposure to HAV and factors affecting infection rates among children living in Edirne. A sample of 645 children between the ages of 0–19 living in Edirne were tested for total anti-HAV levels using ELISA method. A questionnaire on socio-economic status (SES), possible risk factors, and place of residence was completed for each child. Anti-HAV seropositivity was found to be 4.4, 25, 37.3 and 43.2%, in 2–5, 6–10, 11–14 and 15–19 age groups, respectively. Seropositivity was found to be increasing with age (p < 0.05). According to logistic regression analysis results; mother's education, SES of family, history of hepatitis in primary family members and the number of brothers or sisters were determined as factors increasing the seropositivity of HAV. Furthermore, HAV infection risk was found to be a decreasing function of income that is higher the income less likely the infection. These results showed that HAV infection rate in Edirne is in middle endemicity and the most likely way of exposure is transmission from family members. Although it requires further cost-effectiveness studies, our results indicate that applying the HAV vaccination in early childhood would be beneficial to decrease the prevalence of the infection and prevent HAV epidemics.

Unusual complication of tonsillectomy: taste disturbance and the lingual branch of the glossopharyngeal nerve

Abstract: Taste disturbance is an unusual complication of tonsillectomy of which there are very few reports in the literature. The possible causes of this rare complication are: (1) direct or indirect damage to the glossopharyngeal nerve or its lingual branch (LBGN), (2) lack of dietary zinc, and (3) habitual drug intake. We report a 41-year-old man, who complained of taste disturbance following tonsillectomy that was performed for chronic tonsillitis and unilateral (left) tonsillar hypertrophy. During surgery, hypertrophic tonsils were found to be sited deeply into the tonsillar bed, especially at the lower pole of the left tonsil. Pathologic examination following tonsillectomy revealed a keratinous cyst and chronic infection at the left tonsil, and lymphoid hyperplasia and chronic infection at the right tonsil. Although his complaint had been getting better, qualitative examination of his taste function revealed bilateral impairment of the sense of sweet taste on the base of his tongue two months after the surgery, and a taste disturbance of sweet taste on the left side persisted the 10th month after the surgery. His serum zinc value was normal, and he did not take any drug that could affect his sense of taste. Depending on the literature data, possible indirect damage to the LBGN was suspected as the cause of the taste disturbance. This symptom may be reversible within two years after tonsillectomy, but it can also be irreversible. Therefore, tonsillectomy should be performed with minimal trauma to the tonsillar bed, especially when there is an additional pathology extending into the lower pole, and such a patient should be informed of the risk of post-operative taste disturbance after tonsillectomy as being one of the rare complications of this surgery.

Insulin resistance and lipid profile in women with polycystic appearing ovaries : Implications with regard to polycystic ovary syndrome

Abstract: The aim of this study was to investigate carbohydrate and lipid profiles in women with polycystic appearing ovaries (PCO) on ultrasound examination who did not fulfill the criteria for polycystic ovary syndrome (PCOS). We sonographically evaluated and biochemically diagnosed 35 patients with PCO, 31 women with PCOS and 23 healthy controls. We performed oral glucose tolerance tests (OGTT) and calculated the quantitative insulin sensitivity check index (QUICKI) and the homeostatic model assessment (HOMAIR) scores. Serum fasting insulin levels, 1-h insulin response, HOMAIR and QUICKI scores were significantly higher in the PCO and PCOS groups than in the controls. However, serum fasting glucose levels, fasting insulin levels, HOMAIR and QUICKI scores were similar in women with PCO and PCOS. In women with PCO, high-density lipoprotein (HDL) levels were higher, and very-low-density lipoprotein (VLDL) and triglyceride levels were lower compared with women with PCOS. Furthermore, insulin responses to OGTT, HOMAI...

Hysteresis During Sol-Gel and Gel-Sol Phase Transitions of k-Carrageenan: A Photon Transmission Study

Abstract: Photon transmission techniques were used to study sol-gel and gel-sol transitions in k-carrageenan-water systems with various carrageenan contents. The photon transmission intensity, Itr was monito...

Sister chromatid exchanges in lymphocytes of nuclear medicine physicians.

Abstract: Objective : The aim of this study was to assess whether occupational exposure to chronic, low doses of Iodine 131 (I-131) and Technetium 99m (Tc-99m) may lead to genotoxicity. Medical personnel occupied in nuclear medicine departments are occupationally exposed to low doses of I-131 and Tc-99m. The determination of the frequency of sister chromatid exchanges (SCEs) and of cells with a high frequency of SCEs (HFC) is considered to be a sensitive indicator for detecting genotoxic potential of mutagenic and carcinogenic agents. Therefore, we examined peripheral lymphocytes from nuclear medicine physicians for the presence of both SCE and HFC. Methods : Sixteen exposed nuclear medicine physicians (non-smokers) were compared to 16 physicians (non-smokers) who had not been exposed to chemical or physical mutagens in their usual working environment at the same hospital. Results : A statistically significant difference was found between SCE frequencies and HFC percentages measured in lymphocytes from the exposed and control groups. Conclusions : The present observation on the effect of chronic low doses of I-131 and Tc-99m indicates the possibility of genotoxic implications of this type of occupational exposure. Hence, the personnel who work in nuclear medicine departments should carefully apply the radiation protection procedures and should minimize, as low as possible, radiation exposure to avoid possible genotoxic effects.