Erciyes Medical Journal - 2011; 33(4) - Current Issue

Tranfused Human Umbilical Cord Blood Cells Prevent Progressive Renal Failure Induced by 5/6 Nephrectomy in Rats

Nurcan Dursun, Eylem Ta�k�n, Hatice Ar�n, H�lya Akg�n — 2011-12-01

Purpose: We attempted to assess the therapeutic effectiveness of human umbilical blood stem cells (HUCBSCs) in a 5/6 nephrectomy rat model. Material and Methods: We used the 5/6 nephrectomy model in rats to induce chronic renal failure. Male Sprague-Dawley rats were allocated to 3 groups: Sham, 5/6 Nephrectomy and 5/6 nephrectomy plus human umbilical cord blood stem cells transfusion. We assessed blood pressure, renal blood flow, glomerular filtration rate, fractional excretion sodium percentage and histological examination. Result: HUCBSCS-treated animals had significantly better renal function and better injury scores at day 10 after nephrectomy. HUCBSCs treatment prevented the progressive increment in plasma creatinin and blood urea nitrogen observed in the 5/6 nephrectomized rats. The decrement in glomerular filtration rate induced by renal ablation was modified by HUCBSCs treatment. Increments in systolic, diastolic and mean arterial blood pressures induced by 5/6 nephrectomy did not return to control levels in the HUCBSCs-treated group. There were remarkable tubular necrosis, protein cast, medullary congestion and fibrosis in 5/6 nephrectomized rats but HUCBSCs treatment significantly reduced all but fibrosis was not responding to treatment. Conclusion: HUCBSCs ameliorated progressive renal damage and some renal function in the remnant kidney after 5/6 nephrectomy, whereas renal blood flow and systemic hypertension was unchanged.

Effects of Matrix Metalloproteinase Inhibition on Long-Term Plasticity at Perforant Pathway/ Dentate Gyrus Synapses: in vivo Study

Nazan Dolu, Cem S�er, Seda Art��, Derya Elalm�� — 2011-12-01

Purpose: The aim of the study was to explore whether matrix metalloproteinases (MMPs) is a requisite for efficient hippocampal-dependent learning in the perforant pathway/dentate gyrus synapses. With this aim, we infused FN-439 which is a MMPs inhibitor into the dentate gyrus. Material and Methods: The experiments were carried out on 18 male Wistar rats. Rats were anesthetized with urethane, and the head was fixed in stereotaxic head-holder. A bipolar stimulating electrode was placed on the medial perforant path. One of the barrels of double- barreled glass micropipette was filled with aCSF or FN-439 and applied to dentate gyrus before the EPSP recordings. Other barrel was filled with 3 M NaCl and field excitatory postsynaptic potentials (fEPSPs) were recorded from this barrel. The high frequency stimulation (HFS) protocol was applied. Results: Infusion of FN-439 resulted in a clear inhibition of the fEPSP slope and population spike amplitude in the early and maintenance phase. The HFS protocol caused significantly less potentiation of dentate synapses subjected to FN-439 when compared to infusion of aCSF. Conclusion: Acute application of FN-439 significantly inhibited long-term plasticity in the perforant patway/dentate gyrus neurons of anaesthetized rats. Thus, we showed that MMPs are necessary for long term potentials which are important model for learning.

The Relationship of Serum Triglyseride Level with Emphysema Pattern and the Parameters Which Indicate of Disease in Patients with Stable Chronic Obstructive Pulmonary Disease

Hayrettin G��men, Dane Ediger, Esra Uzaslan, Erc�ment Ege — 2011-12-01

Purpose: When chronic obstructive pulmonary disease (COPD) deteriorates, lipid metabolism may worsen and serum triglyceride levels decrease in response to hypoxia. It was aimed to evaluate the relationship between severity of disease, emphysema pattern and serum triglyceride level. Material and Methods: The patients with stable COPD who had not additional clinical problem that could be the reason of malnutrition were included in the study. Serum triglyceride levels, spirometric, anthropometric and demographic characteristics of cases were recorded and evaluated prospectively. Results: A hundred patients (81/19 M/F) with stable COPD were evaluated. Mean serum triglyceride level was 109.7�12.2mg/dl. It was observed that serum triglyceride level correlated with the duration of disease (r=0.298; p=0.003), the number of hospitalization (r=0.199 p=0.047), retrosternal distance (r=0.214; p=0.033) negatively and with %FEV1(r=0.247; p=0.013), FEV1/FVC (r=0.212; p=0.035) and distances of intersinusal line to dome of diaphragm(r=0.286; p=0.004) positively. In 29 cases serum triglyceride levels were in normal range, but in 71 cases not. The values of %FEV1 (p=0.049) and %PEF (p=0.001) were found significantly lower than others in cases that serum triglyceride levels were out of normal range. Conclusion: Serum triglyceride level correlated with spirometric findings positively. It was observed that lower serum triglyceride level, so frequent emphysema pattern was. We think that serum triglyceride level might be effective parameter for evaluating severity of disease, emphysema pattern and systemic impacts of hypoxia.

The Relationship Between Dental Fear and Sociodemographic Variables

Soley Arslan, Elif Tar�m Erta�, Mustafa �lker — 2011-12-01

Purpose: The aim of the study was to investigate the effects of age, gender and educational level on the dental anxiety of patients admitted to the Department of Restorative Dentistry and Endodontics at Erciyes Universitys Faculty of Dentistry. Patients and Methods: In the study, 324 patients were asked to complete a questionnaire. The survey consisted of two sections. The first section requested participants sociodemographic information such as including age, gender and educational level. The second section consisted of the Modified Dental Anxiety Scale (MDAS). Results: No correlation was found between age and MDAS (r= -0.011, p=0.844). Females tend to be more anxious than males (p< 0.001). The results showed that educational level had no significant effect on dental anxiety (p=0.837). Conclusions: In this study, it was observed that dental anxiety was not affected by age or education level, and that the dental anxiety levels of females were higher than males.

Prevalence of Urinary Incontinence and Affecting Factors Among the Women Attending Gynaecology Clinics of Kayseri Education and Research Hospital

�zlem �ift�i, Osman G�nay — 2011-12-01

Aim: The aim of this investigation was to determine frequency of urinary incontinence among the women attending outpatient clinics of gynaecology of Kayseri Education and Research Hospital and to investigate the impacts of some socio demographic and medical factors. Material and Methods: The study was performed on the patients who attended outpatient clinics of gynaecology in 2007. A questionnaire including 45 questions was applied. A total of 775 questionnaires were evaluated. Chi square test and logistic regression method were used for statistical analyses. Results: Frequency of urinary incontinence was found 36.6 percent. Of the study group, 33.5 percent had stress urinary incontinence and 26.8 percent had urge urinary incontinence. It was found out that frequency of stress urinary incontinence and urge urinary incontinence increased by age. The age 40 and over, to be housewife, smoking, and genital prolapsus were found as significant risk factors for both stress urinary incontinence and urge urinary incontinence. Conclusion: It was concluded that approximately one third of the study group have urinary incontinence. Various socio demographic and medical factors may affect frequency of urinary incontinence. Preventive measures should be performed in order to prevent urinary incontinence and the incontinent women should be encouraged to consult physician.

The Evaluation of a Groningen Model of Pharmacotherapy Training for General Practitioners in Kayseri

Hasan Basri Ulusoy, Tuncer Sumak, Serkan �ahin, H�lya G�ltekin — 2011-12-01

Purpose: To evaluate Groningen Model of rational pharmacotherapy training developed by World Health Organization given to a group of general practitioners in Kayseri. Material and Methods: A Groningen Model of rational pharmacotherapy training was given to 24 general practitioners in Kayseri. The Objective Structured Clinical Examinations (OSCEs) before and after the training were evaluated and prescriptions written in these examinations were analyzed. Results: The average score of general practitioners in OSCE after the training (92.38�1.42) is significantly higher than the average score obtained in OSCE before the training (37.21�4.11). The average score of prescriptions written in OSCE after the training (75.88 � 2.46) was significantly higher than the average score of prescriptions written in OSCE before the training (51.42 � 2.22). There are inappropriate drugs in 62.5 % of prescriptions written in OSCE before the training while there is no inappropriate drug in prescriptions written in OSCE after the training. The 37.5% of prescriptions in OSCE before the training were hardly readable, this ratio was increased to 42% in prescriptions OSCE after the training Conclusion: According to our results, this training was very successful. These results indicate that “Groningen Model” of rational pharmacotherapy training developed by World Health Organisation is a very effective method.

A Concise Review: Ghrelin and Reproductive System

Birkan Yakan — 2011-12-01

Ghrelin is a hormone, which has effects on growth hormone (GH) secretion, appetite, food intake, carbohydrate metabolism, gastrointestinal system, cardiovascular system, cell proliferation and reproductive system. Ghrelin, the endogen ligand of the GH secretagogue receptor (GHS-R), has been recently demonstrated as a pleiotropic regulator involved in a large array of endocrine and non-endocrine functions, including food intake and energy balance. The data so far available strongly suggest that, through local and /or systemic actions, ghrelin operates as a novel regulator of gonadal function that may contribute to the integrated control of energy balance and reproduction.

Useful Instructions for an Oral Presentation

Muzaffer �stdal, Ay�a �stdal — 2011-12-01

By a good background of knowledge and by a sufficent preparation, anyone can give an effective oral presentation. This article has been compiled in hopes of providing some helpful instructions on effective ways to present scientific communication. It is aimed at improving the quality of presentation and is designed primarily for young scientists who might be approaching their first professional conference, but other colleagues might also find useful information for improving their own presentations. Effectiveness of an oral presentation depends on the ability of the speaker to communicate with the audience. An important part of this kind of a scientific presentation is focusing on two to three key points and emphasizing those points during the talk. It's observed that the audience learns best when the information presented matches their needs; when they are motivated to learn and anticipate that they will benefit from the experience; when both visual and auditory aids are used; when the aims of an oral presentation are clear, relevant, and in context; when they are actively involved in the learning process or when the experience is enjoyable. If our instructions are kept in mind during both preparation and talk of an oral presentation, the people will be attentive and speaker's effort will be effective. Many oral presentations concern interesting scientific work, but are nevertheless difficult to follow because the speaker unknowingly makes a number of presentation errors. By far the largest mistake is that a speaker does not realize how an audience listens. If we are well aware of what errors we should avoid, the chances are high that we shall be able to greatly improve our oral presentations. These possible errors are evoked in this article.

Reconstruction of a Nasal Injury Caused by a Horse Bite: Case Report

Teoman Eskita��o�lu, Fatih Do�an, Mehmet Alt�parmak — 2011-12-01

In this context, we present a rare case of a pediatric patient who was bitten by a horse. The child had a subtotal nasal amputation. In the literature, there are examples about injuries of different animals. But to the best of our knowledge, there is no data about a nasal horse- bite and its reconstruction in the literature. Bites almost always cause defective crush injuries. We reconstructed the defect by applying a tissue expander to a paramedian forehead flap. This flap provided a well-vascularized, color-matched skin with appropriate thickness and covered the tip, columella and one-third of the alae.

Cardiac Myxoma with Glandular Component

Arzu Ta�demir, �zlem Can�z, Kutay Ta�demir — 2011-12-01

Glandular component is a very rare finding in myxomas which are one of the most common primary benign cardiac tumors. This rate was found ranging 1% to 5% in various series. They were found more common in middle aged women. Histogenesis of myxomas with glandular component is not known clearly. Cardiac myxomas with glandular component could show recurrence and malignity so they had to be followed. We presented a myxoma case with glandular component which was located in left atrium in 38 years old woman in this report.

A Case of Pancytopenia and Related Findings Complicating Primary Sj�gren's Syndrome

Mustafa Akar, Osman Yoku�, Leylag�l Kaynar, Fatih Kurnaz, B�lent Eser — 2011-12-01

Sj�gren's Syndrome, a common observed autoimmune disorder, should be considered in the differential diagnosis of apparently idiopathic cytopenias. In Sj�gren's Syndrome, pancytopenia is observed rarely. In this case, we report a 50 years old woman patient. The patient is diagnosed as primary Sj�gren's Syndrome by reason of the further examinations and she applied with hemolytic anemia, thrombocytopenia, neutropenia which are accompanied with fever and other clinical symptoms related to pancytopenia.

Following up a Case of Drug Addiction in the Intensive Care Unit

2011-12-01

Substance abuse is an important medical problem especially in young population. Induction of anesthesia in such patients and treatment of them in the intensive care unit demands special interest because there is an interaction between the drugs used for substance abuse and for anesthesia. We report the management of prominent sympathetic activity characterized with tachycardia and hypertension in spite of deep sedation in a drug abuser case hospitalized in the intensive care unit due to having multiple trauma.