1999;30(2):151-198.
CONTENTS


ABSTRACTS

Effect of iron overloading on the plasma copper and zinc levels

Seymen HO, Mengi M, Ozcelik D, Gulyasar T, Seymen P, Yigit G

Cerrahpasa J Med 1999;30: 155-158.

BACKGROUND AND DESIGN: The harmful effects of acute and chronic iron loading are well documented. Increased lipid peroxidation is an important expression of both chronic and acute iron toxicity. In the structure of some antioxidant enzymes such as SOD, the copper and the zinc are involved. Our aim was to study the effect of iron overloading on the plasma copper and zinc levels. RESULTS: Adult male Wistar albino rats weighing 200-250g were used. The animals were divided into 2 weight-matched groups. Group 1: Control group (n=6) and Group 2: Iron overloading group (n=7). The rats of group 2 received intraperitoneal iron (Ferro III hydroxide polymaltose) at a dose of 250 mg/kg/day for 10 days. At the end of the administration period, the rats were killed under ketamine anesthesia (50 mg/kg). Heparinized blood samples were obtained via aorta abdominalis. The plasma iron, copper and zinc levels were measured by atomic absorbtion spectrophotometer. The plasma free iron values for rats receiving iron were significantly (p<0.001) higher. This finding confirmed the establishment of the iron overloading state. The plasma free copper levels of iron overloading group were higher (p<0.01) than those of control rats. There was no significantly difference between the plasma zinc levels of two groups (p>0.05). CONCLUSION: We concluded that the trace elements such as copper and zinc have very important effects on the oxidant/antioxidant status of the organism. These are : 1- High iron levels of the plasma under iron overloading condition indicate oxidant status in the organism. 2- The plasma Cu+ levels increase under iron overloading condition. This contributes to the metabolic activation of the antioxidant enzymes such as SOD. 3- The plasma Zn+ concentrations of two groups are almost the same levels. This impact may be due to over utilization of zinc ions in iron overloading group.(Return)


Upper lid loading to obtain function to the upper eyelid in the treatment of lagophthalmos

Aygit AC, Ayhan MS, Baycin N

Cerrahpasa J Med 1999;30: 159-162.

BACKGROUND AND DESIGN: In order to gain functional and cosmetic improvement in the lagophtalmos due to facial paralyses, gold weight was inserted into upper eyelid. Seven cases with paralytic lagophtalmus due to facial paralyses were treated with gold weight implantation between July 1997- August 1998 in our department. Each patient had 24-carat gold weight inserted into a small pocket between the orbicularis muscle and the tarsal plate of the upper eyelid. RESULTS: Complete eyelid closure and restoration of blink reflex were obtained in all patients at the postoperative examination. There was no corneal irritation symptoms. One patient was operated again because of implant migration. CONCLUSION: This technique is simple to perform, has a relatively low complication rate and produces an acceptable functional and cosmetic result. (Return)


Association of HLA class I and II antigens with sarcoidosis

Bilir M, Sipahi S, Yilmaz E, Midilli K, Yanardag H, Cagatay T, Demirci S, Karayel T, Erdogan E

Cerrahpasa J Med 1999;30: 163-166.

BACKGROUND AND DESIGN: There are several reports suggesting ano association between certain human leukocyte antigens (HLA) and sarcoidosis. In different races different HLA antigens were found more frequent in sarcoidosis patients compared to the controls. RESULTS AND CONCLUSION: Thirty eight sarcoidosis patients with pulmonary and extrapulmonary involvement (31 females and 7 males, mean age 38±16.1) were included to the study. PA chest x-ray examinations revealed that 13 patients had radiologic stage I, 21 satge II and 4 stage III disease. An historical control group consisting of 160 kidney donnor candidates was used as control group. HLA-A, HLA-B, HLA-DR and HLA-DQ antigens were determined by lymphocytotoxicity assay. The frequencies of HLA-A2, -B8, -B22, -B38, -DR4 and DR14 were significantly higher in sarcoidosis patients (OR values 3.36, 5.42, 14.8, 29.81, 5.35 and 14.81 respectively) compared to the control group. There were no association between radiologic stage and time of onset of the disease, therapeutic response to corticosteroids, but frequency of HLA-A2 in patients with pulmonary involvement and HLA-B38 in patients with extrapulmonary involvement was higher. (Return)


Reconstruction of total upper eyelid defect with fricke flap

Aygit AC, Aydin Y, Ayhan MS, Baycin HN

Cerrahpasa J Med 1999;30: 167-170.

BACKGROUND AND DESIGN: Between May 1996 - January 1998, four cases with total full-thickness upper eyelid defects resulted from tumor resection were reconstructed with Fricke flap in four cases between may 1996 and may 1998. Oral mucosa graft was used for reconstruction of inner side of the eyelid. RESULTS: Complete eyelid closure and preservation of blink reflex were obtained in all patients at the postoperative examination. There was no corneal irritation symptoms. The results were satisfactory both aesthetically and functionally at the end of 21 months period of mean follow-up. CONCLUSION: This technique is simple to perform, has a relatively low complication rate and produces a functional and aesthetically acceptable result. (Return)


Reconstruction of total lower lip defects with bilateral fan flaps

Aygit AC, Guzel MZ, Bayramicli M, Aydin Y, Yucel A

Cerrahpasa J Med 1999;30: 171-174.

BACKGROUND AND DESIGN: Reconstruction of large defects of the lower lip continue to be formidable challenge. Total excision of the lower lip is rarely necessary, so many surgeons' experience in repair of this size defect is limited. In this paper, we described the reconstruction of total lower lip defects using bilateral fan flaps without mucosal flap or graft. RESULTS: We had used bilateral fan flap reconstructions for total lower lip defects in 17 patients. Only two patients were not able to use dentures after the operation. In other 15 patients, the aesthetic and functional goals were achieved. CONCLUSION: The technique of total lower lip reconstruction with bilateral fan flap was further refined in this report. (Return)


The importance of antiphospholipid antibodies in sarcoidosis: A preliminary study

Sipahi S, Bilir M, Ozbakir F, Yanardag H, Cagatay T

Cerrahpasa J Med 1999;30: 175-178.

BACKGROUND AND DESIGN: It is well-known that patients with sarcoidosis have humoral immunologic abnormalities. Increases in serum immunglobulins and some autoantibodies as antinuclear antibody and rheumatoid factor have been reported. In a wide variety of autoimmune and non-autoimmune disorders, occuring of antiphospholipid antibodies have been detected. Since, we purposed to evaluate the relationship between the occurence of antiphospholipid antibodies (APL-Ab) and sarcoidosis. IgG and IgM APL-Ab were estimated by enzyme linked immunoabsorbent assay (ELISA) in 26 untreated sarcoidosis patients (with a mean age of 45.2±16.8) whose diagnosis were establised with histopathological and clinico-radiologic findings as welle as 12 healthy controls (with a mean age of 45±15.7). RESULTS: No significant correlation was observed between serum ALP-Ab level and sarcoidosis but only 4 of 26 sarcoidosis patients who had skin lesions and erythema nodosum showed either positive IgG or positive IgM APL-Ab. CONCLUSION: This preliminary study suggests that further studies are needed to assess the relationship between skin lesions and APL-Ab levels in patients with sarcoidosis. (Return)


A case of autoimmune hypothyroidism under immunotherapy

Gursu RU, Demir G, Serdengecti S

Cerrahpasa J Med 1999;30: 179-183.

BACKGROUND: Immunotherapy is one of the current treatment modalities used for the therapy of malignant melanoma and various other malignancies. The immunomodulator agents used for immunotherapy have different side effects such as autoimmune thyroid dysfunction. OBSERVATION: A case of metastatic malignant melanoma who developed autoimmune thyroid dysfunction while under chemoimmunotherapy is presented and the side effects of treatment with immunomodulators are discussed. (Return)


Free floating thrombus in the left atrium

Mutlu H, Kucukoglu S, Okcun B, Yigit Z, Kansiz E, Uner S

Cerrahpasa J Med 1999;30: 184-186.

BACKGROUND: Free floating thrombus in the left atrium is very rare and it may cause fatal systemic emboli or sudden death due to occlusion of mitral valve orifice. For this reason, early diagnosis is very important and prompt surgery is essential. OBSERVATION: We present a case of 48 years old woman who had mitral stenosis and atrial fibrillation, with a free floating thrombus in the left atrium who had the thrombus removed by emergent surgery. (Return)


Reconstruction of the lower leg soft tissue defects using partial soleus muscle flap

Aygit AC, Baycin HN, Orak F

Cerrahpasa J Med 1999;30: 187-190.

BACKGROUND: Reconstruction of soft tissue defects of the ankle and distal part of the leg is still considerable because of the local source of the soft tissue for coverage is limited. Soleus muscle flap based on minor vascular pedicle is an available alternative for defects in these regions. OBSERVATION: Two cases which defects on the distal lower leg were repaired by soleus muscle flap based on minor vascular pedicle were presented. Except partial skin graft loss in one case, no complication was observed in follow up period. (Return)


Medical mycology: Yesterday and Today

Yucel A

Cerrahpasa J Med 1999;30: 191-198.

BACKGROUND: This paper gives an outline of the histological and present situation of medical mycology concerning on its various aspects such as the known pathogen fungi and new emerging oppurtunistic ones, host characteristics, current antifungals, some leading instutitons and mycologists both in our country and on the world. (Return)