1996;27(3):115-178.
CONTENTS


ABSTRACTS

An evaluation of tumour markers in gastrointestinal carcinomas

Uras C, Yardimci H, Sener S, Balcisoy U, Akcal T

Cerrahpasa J Med 1996;27: 119-123.

BACKGROUND AND DESIGN: The levels of CEA, AFP, CA 19-9, CA 12-5, TAG-72 and CAR 3 were measured in 67 patients with gastrointestinal system cancers diagnosed between December 1992 and February 1994 and the results were evaluated with respect to the presence and stages of the tumours. The control group consisted of 21 patients having benign gastrointestinal disorders. RESULT AND CONCLUSION: CA 19-9 was positive in 68% of colonic carcinomas and in 64% of gastric carcinomas. Tag-72 was positive in 43% of rectal carcinomas whereas CEA was present in 52% of colonic carcinomas. It was also deetermined that CA 19-9 correlated very well with the stages of colonic carcinomas (p<0.001, r=0.83) whereas the level of CA 19-9 correlated well with the stage of gastric carcinomas (p=0.001, r=0.54). A mild correlation between the stage of rectal tumours and TAG-72 also existed (p=0.03, r=0.59).(Return)


The diagnostic value of different techniques in lung cancer

Filizel F, Akman M, Yilmaz T, Oruc N

Cerrahpasa J Med 1996;27: 124-130.

BACKGROUND AND DESIGN: The diagnostic accuracy of various tecniques used in the diagnosis of pirimary lung carcinoma were compared. The value of bronchial forceps biopsy, bronchial washings, transbronchial needle aspiration obtained with flexible fiberoptic bronchoscopy, sputum specimens, transthoracic needle biopsy, aspiration biopsy from metastatic sites and thoracotomy in diagnosis, were evaluated in 55 patients with lung carcinoma. RESULTS: 19 (34.5%) had positive results with the sputum specimen. Bronchoscopy and bronchial washings were positive in 19 (38%), bronchial biopsy in 30 (60%), postbronchoscopic sputum specimen in 18 (36%) and transbronchial needle aspiration in 5 (20%). In 19 patients who yielded negative results with the preceding methods, transthoracic needle biopsy was performed and 15 (78.9%) had positive results. In 4 patients with negative results with all diagnostic techniques, two could be diagnosed with thoracotomy and two could be diagnosed with needle aspiration from metastatic sites. CONCLUSION: Although forceps biopsy and transthoracic needle biopsy have the highest diagnostic yield, sputum, bronchial washings, postbronchoscopic sputum and transbronchial needle aspiration are also important diagnostic techiniques and should be routinely performed.(Return)


Assessment of left atrial function by echocardiographic acoustic quantification imaging

Koldas L, Ayan F, Sirmaci N

Cerrahpasa J Med 1996;27: 131-138.

BACKGROUND AND DESIGN: Echocardiographic assessment of left atrial area, area changes, systolic and diastolic function with a new real-time acoustic quantification (AQ) imaging method (to track blood-tissue interfaces based on their quantitative acoustic properties), comparison with conventional echocardiographic measurements and estimation of the clinical significance in structural or functional cardiac abnormalities. We studied nonconsecutive 40 patients (17 female, 23 male; mean age 52±7) and 10 normal subject (5 female, 5 male; mean age 42±8) in whom the left atrial cavity and walls were adequately visualized, performed conventional 2-dimensional (2-D) echocardiography-Doppler color-flow imaging and after this procedures the AQ system was activated. Both methods, the conventional plannimetric measurements of atrial area and area change at end-systole and end-diastole and the on-line measurement of the same parameters using AQ at apical 4-chamber view were compared. 32 of our patients had structural or functional cardiac abnormalities and mitral regurgitation was noted in 12 patients. 29 patients were in sinus rhythm and 11 patients had atrial fibrillation. In 8 patients including 6 with hypertension and 2 with ischemic heart disease normal cardiac dimensions and left ventricular function were observed. RESULTS: There was a strong correlation between the left atrial end-systolic and end-diastolic areas measured with AQ and those measured conventionally (r=0.90, r=0.88 respectively). Patients in atrial fibrillation had depressed diastolic emptying index compared with those in sinus rhythm (0.29±0.1 versus 0.47±0.2, p<0.01). Futhermore patients with mitral regurgitation exhibited depressed systolic expansion index and diastolic emptying index compared with those without mitral regurgitation (0.50 0.3 versus 0.83 0.2, p<0.01; 0.33 0.1 versus 0.46 0.2, p<0.05 respectively). In addition the Doppler-determined mitral E/A ratio correlated closely with the ratio of early diastolic-to-late diastolic change in left atrial area (r=0.80) measured instantaneously by the AQ method. CONCLUSION: AQ measurement of the left atrial cavity is feasible and well-related to conventional 2-dimensional echocardiography in patients with diverse cardiac disorders. Left atrial functional indexes measured with AQ method correlate well with the Doppler determined transmitral E/A ratio and can provide an approach for quantitative evaluations of left atrial-left ventricular interactions noninvasively.(Return)


Immunohistochemical examination of ubiquitin activating enzyme (E1) activity in neuronal degeneration

Pirim I, Zeybek A, Ozcan A, Pazarlioglu N

Cerrahpasa J Med 1996;27: 139-141.

BACKGROUND AND DESIGN: Recent studies show the joining of ubiquitin with abnormal and short life proteins with the help of ubiquitin activating enzyme. Ubiquitin activating enzyme was purified from erythrocytes and injected to rabbits for antibody induction. Antibody specificity and reactivity were assessed by ELISA. Human brain tissue sections with neurodegeneration were used for immunhistochemical staining. Stained tissues were examined under light microscope. RESULTS: The concentration of ubiquitin activating enzyme was increased in the presence of cell degeneration. CONCLUSION: The increased activitiy of the enzyme in the cells indicates to the removal of abnormal proteins by ubiquitin system. Abnormal proteins in excess amounts might cause disruption of the ubiquitin system and cause cell death.(Return)


The vaccination status of hospitalized children

Tasdelen E, Can G, Arvas A, Erginel A, Ilter O

Cerrahpasa J Med 1996;27: 142-146.

BACKGROUND AND DESIGN: The status of vaccination of 330 children aged between 0-5 who were hospitalized in the Pediatric Department of Cerrahpasa Medical School were evaluated. RESULTS: The total vaccinated case ratio was 53.9%. 76.7% of the total had BCG, 66.8% had completed DTP and polio vaccination and 69% had measles vaccination. When the relaitionship between vaccination and age, gender and parental education levels were examined, a correlation was found only between age and maternal education status (p<0.05). Gender and paternal educational levels did not significantly correlate with vaccination (p>0.05). CONCLUSION: There was no significant correlation between chronic disease, duration of hospitalization and vaccination. (p>0.05, p>0.05)(Return)


Influence of the time interval between instillation of two drops of cyclopentolate 1% on refraction and dilatation of the pupil in young adults.

Oguz H, Donmez H

Cerrahpasa J Med 1996;27: 147-149.

BACKGROUND AND DESIGN: The usual length of time to instill two drops of cyclopentolate (five to ten minutes) is time consuming and inconvenient for the clinical staff as well as for patients. We investigated the influence of the time interval between the instillation of two drops on refraction and mydriasis in young adults. A crossover clinical study consisting of 102 cases was conducted in the Ophtalmology Department of Kutahya Air Force Hospital and gender, iris color and age were recorded. Two cyclopentolate 1% eyedrops were instilled at a one to five minute interval and the mydriatic effect was recorded and retinoscopy performed. One week later the procedure was repeated with a different time interval. RESULTS: The time interval between the instillation of two drops had no influence on retinoscopy results. (p=0.06 and p<0.52 for right and left eyes respectively) or on pupil dilation (p=0.366 and p=0.166). CONCLUSION: Instilling two of cyclopentolate 1% one minute apart is as effective as instilling them five minutes apart. (Return)


The clinical characteristics of 37 patients with pulmonary embolism

Musellim B, Ongen G, Kucukusta AR, Umut S, Erk M

Cerrahpasa J Med 1996;27: 150-154.

BACKGROUND AND DESIGN: Pulmonary embolism (PE) is a frequent and potentially fatal disorder. It is usually underdiagnosed because of the lack of simple diagnostic methods. In this retrospective survey we present the clinical and laboratory characteristics of 37 patients with PE (24 males, 13 females; mean age 46±12 (SD) years), who had been hospitalized in our department between 1990 and 1995. RESULTS: Chest pain and dyspnea were present in 84% and 60% of the patients, respectively. A predisposing cuse was identified in 57% of patients. The leading risk factors were recent surgery and deep vein thrombosis. Erythrocyte sedimentation rate and fibrin degradation products were usually elevated. The most common radiographic changes were elevation of the diaphragm (42%) and linear densities (27%). Lung scans revealed high probability changes in 38%, moderate probability in 13% and low probability in 33% of the patients. CONCLUSION: Prompt clinical suspicion is of paramount importance in the diagnosis of PE.(Return)


Right ventricular diastolic function in systemic hypertension

Kucukoglu S, Mutlu H, Gurmen T, Sisli K, Agcal C, Gultekin N, Uner S

Cerrahpasa J Med 1996;27: 155-158.

BACKGROUND AND DESIGN: To asses the right ventricular (RV) diastolic function in systemic hypertension to compare the findings with left ventricular (LV) diastolic function. A controlled study of 20 patients with uncomplicated, mild systemic hypertension and 10 normotensive, healthy subjects with doppler echocardiography. RESULTS: In the hypertensive group, RV peak filling rate corrected to stroke volume was lower (3.02±0.7 SD SV/s v.s. 3.82±0.8 SD; p<0.01) compared to the controls and RV peak velocity of atrial (A) filling was higher (532.7±14 SD cm/sv.s. 43.7±9 SD; p<0.05). On the other hand, RV early filling velocity (E), E/A ratio and deceleration half time were not different between groups. LV peak filling rate was lower (3.49±0.9 SD SV/s v.s. 4.39±0.7 SD; p<0.05), LV peak velocity of atrial filling was higher (74.5±17 SD cm/s v.s. 61.1±12 SD; p<0.05) and E/A ratio was lower (1.01±0.2 v.s. 1.28±0.1; p<0.01). LV early filling velocity and decleration half time were not different between the two groups. CONCLUSION: Right ventricular diastolic function is abnormal like left ventricular diastolic function in systemic hypertension.(Return)


Evaluation of different controlled ovarian hyperstimulation (COH) protocols in polycystic ovarian syndrome with assisted reproductive technologies

Ahangari S, Cepni I, Ocal P, Idil MH, Aksu MF

Cerrahpasa J Med 1996;27: 159-166.

BACKGROUND: The induction of ovulation in patients with PCO (polycystic ovary syndrome) is not always successful. It has been suggested that the administration of pure FSH preparations may be more fruitful in this respect because the endogenous levels of LH in these patients is high. This study compares the effects of human menopausal gonadotropin (hMG) and pure FSH therapy in PCO patients. DESIGN: 20 patients who were diagnosed as having PCO (mean age 26.6±4.05) and 10 patients (mean age 29.8±5.01) took hMG after their hypothalamo-pituitary axis was desensitized with "short protocol" GnRH analogue (buserelin acetate). The levels of E2, LH, FSH, T, 4A, DHEAs and insulin, the number of devoloping follicles, follicle diameter, number of oocytes, the total number of vials administered, endometrial development and cleavage rates were evaluated in both groups. RESULTS AND CONCLUSION: The increase DHEAs in the pure FSH group was higher than that observed in the hMG group (p<0.05). The number of mature oocytes and pregnancies were higher in the hMG group (p<0.05). However, one patient in this group developed mild ovarian hyperstimulation syndrome (OHSS). The other parameters measured did not differ between the groups. It was concluded that high levels of follicular testosterone does not cause follicular atresia.(Return)


Asymptomatic bacteriuria among geriatric age population

Suna Erdincler D, Mert A, Tabak F, Hondor N, Demiroglu C, Aktuglu Y

Cerrahpasa J Med 1996;27: 167-171.

BACKGROUND: To assess the frequency of asymptomatic bacteriuria among the patients of the geriatrics outpatient clinic and to identify presdisposing factors. DESIGN: Prospective survey of 200 patients (47 males and 153 females) over the age of 60. RESULTS: the frequency of asymptomatic bacteriuria was 21%. Patients sex had no influence on the frequency. There was a significant correlation between increasing age and frequency of asymptomatic bacteriuria (p=0.03). Other predisposing factors in decreasing frequency were diabetes mellitus and nephrolithiasis. The most common pathogen was E. coli (71%). Bacteriuria was significantly more common among cases with pyuria (p<0.001). CONCLUSION: The incidence of asymptomatic bacteriuria among aged outpatients is high. The determination of pyuria is an indicator of bacteriuria. Old patients, especially in the presence of predisposing of asymptomatic bacteriuria. (Return)


Meta analysis

Cagatay P, Senocak M, Disci R, Narin Odabasi G

Cerrahpasa J Med 1996;27: 172-177.

BACKGROUND AND DESIGN: Meta-Analysis as a definition is the integration of the results of several different studies performed for a particular subject and statistical analysis of research findings. Meta-Analysis is a statistical method for evaluting a variety of research results with common analytical and integrating methods. In Meta-Analysis a group of researches are brought together and therore the number of subject and the statistical significance increase, giving a better answer to those quest¨ons which were not considered at the beginning of the study. It is also a helpful method for analysing the unsignificance rate when the results are not relevant with each other. (Return)