2000; 31(3): 125-186.
CONTENTS


ABSTRACTS

The effect of lead concentration on blood viscosity and erythrocyte osmotic resistance

Ozcelik D, Toplan S, Dariyerli N, Gulyasar T, Dursun S

Cerrahpasa J Med 2000; 31 (3): 129-133.

BACKGROUND: In this study, the effect of lead concentration on blood viscosity and erythrocyte osmotic resistance were tried to be investigated in rats. DESIGN: Fourteen Wistar-Albino type female rats were picked and animals were divided into two as control and experimental groups. Nutrition's type and content of both groups was same. But lead acetate was added to the drinking water of experimental group for four weeks. At the end of fourth week, blood samples were drawn from abdominal aorta of rats. Blood viscosity and erythrocyte osmotic fragility were determined. RESULTS: While increase in blood lead concentration values of experimental group was detected, the osmotic resistance and blood viscosity values were found to be decreased according to the same parameters of control group. CONCLUSION: Our study indicated that the intake of lead through the drinking water leads to reduce of blood viscosity and osmotic resistance of erythrocytes. (Return)


HLA phenotypes in myasthenia gravis

Akalin MA, Altintas A, Yilmaz E, Erkol G, Erdogan E, Baslo P

Cerrahpasa J Med 2000; 31 (3): 134-139.

BACKGROUND AND DESIGN: The aim of this study was to investigate HLA phenotype frequencies and associations in myasthenia gravis patients considering sex, antibody titer, thymic pathology, age of onset, clinical type and try to understand immunogenetic basis for myasthenia gravis in Turkey. HLA phenotypes were studied in 30 patients (18 female, 12 male) with myasthenia gravis (MG) and 214 healthy controls, using standard microcytotoxicity assay. RESULTS: When compared with the control group, all MG patients showed significant increase in HLA-B38(16) (odds ratio (OR): 8.08 and p< 0.005), HLA-DR1 (OR:3.31 and p< 0.05) HLA-DQ2 (OR:14.07, p<0.005), DQ4 (OR:2.47, p<0.05) and DQ7(3) (OR: 3.35, p<0.005), but these results lost significance when corrected p value used. No association with HLA phenotypes was found considering level of antibody titer, thymic pathologies, and age of onset. CONCLUSION: These findings may provide some information for future studies on the immunogenetic basis of myasthenia gravis. (Return)


The evaluation of our pyeloplasty operations

Atakan IH, Kaya E, Kaplan M, Alagol B, Inci O

Cerrahpasa J Med 2000; 31 (3): 140-143.

BACKGROUND AND DESIGN: Totally 36 patients who had undergone pyeloplasty operation for ureteropelvic obstruction in our clinic between 1986 and 1998 were evaluated retrospectively. RESULTS: The mean age of these cases was 30,7 years, of which 12 were female and 24 male. Anderson Hynes technique had been undertaken in 30 patients, Foley Y-V plasty in 5, Culp DeWeered spiral flap in 1 patient. In all cases other than those who had undergone Foley Y-V plasty required nephrostomy and stend application. The development of severe wound infection requiring reoperation in 1 patient and a late fistula healing spontaneously in an other was observed. The mean duration of hospital stay was 9 days. CONCLUSION: In all cases an improvement had been noted when the findings of preoperative urography were compared with those taken 3 months after the operation.(Return)


Reconstruction of shallow upper buccal sulcus deformity secondary to cleft lip and palate repair

Yucel A, Aydin Y, Guzel MZ, Yildirim AM

Cerrahpasa J Med 2000; 31 (3): 144-148.

BACKGROUND AND DESIGN: Shallow upper buccal sulcus deformity, one of the secondary deformities after cleft lip-palate repair, causes both aesthetic and functional problems. This deformity also avoids or hardens orthodontic and prostodontic procedures. Upper buccal sulcus deepening procedure was performed in 14 patients for the last 5 years. In 12 cases premaxilla based mucosal flaps were combined either with lip repair, Abbé flap or bilateral buccal mucosal advancement flaps, and in 2 cases buccal mucosal graft that was applied to the premaxilla was combined with bilateral buccal mucosal advancement flaps. RESULTS: The follow-up period was 2 to 5 years. Results were satisfactory both for the surgeon, orthodontist, prostodontist and the patient. CONCLUSION: Upper buccal sulcus reconstruction with premaxillary thin mucosal flap or full-thickness mucosal graft combined with tissue sparing techniques provide successful and durable results. (Return)


Evaluation of tissue concentrations of PSA in patients with prostate cancer

Coskuner E, Ataus S, Erozenci A, Uygun N, Solok V

Cerrahpasa J Med 2000; 31 (3): 149-154.

BACKGROUND AND DESIGN: PAP and PSA are known to be serum markers for prostate cancer, and the use of immunohistochemical methods to determine their localization is a well established procedure. Aim of the study is to determine the correlation between immunohistochemical staining of PSA and Gleason grade of tumor and pretreatment serum PSA levels. Radical prostatectomy specimens of 29 patients were stained by a Biotin-Streptavidin method. We used immunoperoxidase staining to assess the effect of grade on the PSA content of prostate cancer by counting 7494 acini. 34 cancer foci (grade 2-4) were stained. The intensity of PSA staining was graded by comparison with the benign epithelial cells on the same slide. RESULTS: Seven grade 2 foci in 5 (%17.24) patients, 21 grade 3 foci in 19 (%65.51) patients and 6 grade 4 foci in 5 (%17.64) patients were stained and evaluated. Overall, 7403 (%98.8) of the 7494 acini, were PSA positive. There was a strong correlation between gleason grade and the per cent of acini that were PSA positive . (p=0.0001) Although a decreased frequency of intensity of PSA immunostaining as tumor grade increased was found, this is not significant statistically (p>0.05). CONCLUSION: Except for limited cases the positive staining for PSA in a tissue shows that its of prostate origin. This fact is valuable for metastatic anaplastic tumors to the prostate and bladder, as well as defining the primary site of metastatic tumors in pelvic masses with multiple organ involvement. The presence and concentration of PSA shows its content but doesn't yield any information on the note of secretion or serum levels. (Return)


Effects of calcitonin on the contractility of isolated electrically driven guinea-pig and mouse left atria and rat diaphragm

Askin C, Barlas A, Kucukhuseyin C

Cerrahpasa J Med 2000; 31 (3): 155-162.

BACKGROUND: Although the regulatory role of calcitonin released from the parafolicular cells of thyroid gland and plays essential role in the haemoestasis of blood Ca2+ was well documented, its effects on the physiological functions of tissues except bones is not as yet fully established. Therefore, the aim of this study was to explore, how calcitonin act on the contractile activity of heart and striated muscle. DESIGN AND RESULTS: Experiments were carried out on the isolated electrically driven left atria of guinea-pigs and mice and phrenic nerve-diaphragm preparations of rats. In the electrically driven guinea-pig left atria (1 Hz, 2 msec, 2x threshold voltage), contractility was depressed by ampule calcitonin (miacalcic) in a dose-dependent manner at concentrations in range of 0.25-4 mg/ml. This effect of ampule calcitonin was weaker with respect to those produced by the solvent being in the same size. Especially at 2 and 4mg/ml of ampule calcitonin, the contractile response was biphasic, e.g. an initial short-lived positive inotropic effect was preceding the main negative inotropic one. Theophylline (0.5 mM), atropine (2 mg/ml) and methylene blue (2 mg/ml) antagonized ampule calcitonin nonsignificantly, whereas the effect of solvent remained unaltered. Verapamil (0.5 mg/ml), however, augmented the negative inotropic effect of both ampule calcitonin and the solvent. In the phrenic nerve-diaphragm preparation, although contractions induced by direct electrical stimulation (0.1 Hz, 5 msec, 2x threshold voltage) was depressed by ampule calcitonin dose-dependently in a concentration range of 1-8 mg/ml, contractions induced by nerve stimulation (0.1 Hz, 1 msec, 2x threshold voltage) was augmented over a concentration of 4 mg/ml. CONCLUSION: Depending on these findings, it was concluded that calcitonin has a stimulatory effect on the contractile function of heart and striated muscle which is masked by the solvent and that cAMP, cGMP and Ca2+ channels all appeared to involve in the cardiac effects of the test agent. (Return)


Superficial siderosis of the nervous system: A case report

Saltik S, Kiziltan G, Bozluolcay M

Cerrahpasa J Med 2000; 31 (3): 163-167.

BACKGROUND: Superficial siderosis of the nervous system is a rare condition caused by repeated subarachnoid hemorrhage. OBSERVATION: We report a 58 year-old-man who had undergone surgery of cervical neurinoma 22 years ago. He was presented with progressive gait ataxia, hearing loss, dementia, anosmia and pyramidal signs. Disease - onset was 3 years ago. The diagnosis of superficial siderosis was made by means of Magnetic Resonance Imaging of the head, and was confirmed by increased iron level in the CSF. Since surgical treatment prevent further bleeding and possibly progression of the disease, the possible cause of bleeding and treatment options are discussed in this report. (Return)


A case of intralobar pulmonary sequestration and the review of the literature

Sipahi S, Gursu RU, Koksal C, Gurel Sayin A, Karayel T

Cerrahpasa J Med 2000; 31 (3): 168-171.

BACKGROUND: Pulmonary sequestrations are congenital lesions comprised of nonfunctional lung tissue that does not communicate with the normal tracheobronchial tree and has a systemic arterial blood supply. Intralobar sequestration is the most seen type of pulmonary sequestrations. Surgical resection is the only choice of management. An abnormal systemic artery supplies the blood for the sequestrated lung tissue. This artery is usually come from the thoracic aorta. OBSERVATION: In this paper a 37 year old female patient whom was diagnosed as an intralobar pulmonary sequestration and whose abnormal artery is from was presented, and the literature was reviewed. (Return)


Pathogenicity determinants of Candida

Yucel A, Kantarcioglu AS

Cerrahpasa J Med 2000; 31 (3): 172-186.

BACKGROUND: A number of factors mainly related to fungus species and strains have contributed to overcome the host defences. The so called pathogenicity determinants confer virulence on Candida albicans and other Candida species. These factors are adherence (adhesion to mucosal surfaces), dimorphism (production of hyphae and resistance to phagocytosis), toxin and enzyme production and cell surface composition. (Return)