Erciyes Medical Journal - 2012; 34(1) - Current Issue

EFFECT OF PHYSICAL ACTIVITY ON PLASMA ADRENOMEDULLIN CONCENTRATION AND ITS RELATIONSHIP WITH NITRIC OXIDE IN ATHLETES

Nurcan Dursun, Muhittin Y�rekli, Kalender �zdo�an — 2012-03-01

Objective: The aim of this study was to determine whether regular physical activity or acute exercise influenced plasma adrenomedullin (AM) concentration and whether it was related to gender, blood pressure and nitric oxide (NO) production. Material and Methods: Sixty healthy students participated in this study. They were divided into two groups. The first group consisted of 30 students, 16 female, 14 male athletes carrying out regular exercise. The second group was made up of 15 females, 15 males nonathletes. All students submitted to a cycle exercise test until volitional exhaustion. Heart rate (HR), blood pressure, maximal oxygen uptake (VO₂ max) and carbon dioxide production (VCO₂ ) were measured continously. Before starting, at the 1st min and at the 30^th min of exercise, venous blood samples were taken to determine AM and NO production. Results: AM in the female and male athletes were significantly higher than in the female and male non-athletes. The plasma AM concentration in female athletes was found be significantly higher than in male athletes. Acute exercise did not affect AM concentration in subjects. We did not find any relationship between AM/BMI (Body mass index) and other variables such as systolic, diastolic pressure, heart rate, VO₂ max and VCO₂ but there was a negative relationship with NO production. Conclusion: The present data suggest that an increase in AM during prolonged physical activity may be a compensatory mechanism against further elevation of blood pressure.

THE EFFECTS OF TAEKWONDO TRAINING ON OXIDATIVE STRESS LEVELS IN CHILDREN

Recep K�rk��, Alpay �akmak, Dost Zeyrek — 2012-03-01

Objective: In this study, the objective was to compare the oxidative- antioxidative status and oxidative stress index (OSI) in child athletes who take part ins taekwondo sport, the volunteer group was of the same age and in healthy condition. Also, the other objective was to determine the effect of regular exercise on total oxidative status (TOS)-total antioxidative status (TAC) and oxidative stress index. Material and Method: The experiment group consisted of 16 amateur taekwondo athletes who regularly participated in a 2-hour training per day, 3 days per week for at least 2 years. The control group was formed from 12 healthy adolescents of similar age and same sex who had not had any form of regular sports or exercise and they continued their usual sedentary life. Total antioxidative status (TAC), lipid y hydroperoxide (LOOH), Total oxidative status (TOS) parameters were measured. Percent ratio of total peroxide level to TAC level was accepted as an oxidative stress index (OSI) Results: We found LOOH, TOS, OS� and TAC values (p<0.05) at a significantly higer level in the teakwondo group. Conclusion: It is thought that the study results show that the person who does exercise regularly creates oxidative radicals, and also induces antioxidant enzymes in order to increase the antioxidant defense.

EXAMINATION OF DENTAL CALCULUS STRUCTURE AND MINERAL DENSITY OF PATIENTS WITH DIABETES MELLITUS

2012-03-01

Objective: It is known that the risk of developing periodontal disease is high in patients with diabetes. In this study, a comparison of the mineral density and structure of calculus in teeth of individuals with diabetes and healthy subjects was aimed at by examining with scanning electron microscopy. Material and Methods: In this study, the teeth of 17 diabetic patients were used. After removal of the soft tissues, teeth were embedded in bakalite and sections were obtained from the region including calculus. Teeth covered with gold-palladium were observed by scanning electron microscope and mineral analysis was performed with energy-dispersive system. Results: The calculus away from homogeneous structure and seen high was being porosities. Intensive cracks in the calculus attaching to the sementum region of control and diabetic groups was also seen tocontinue into the sementum. When the mineral analysis of the control and diabetic groups were compared, there was no significant difference among the proportions of calcium. In diabetics, while the amount of phosphate of calculus in sementum was lower than in the controls, the amount of phosphate in enamel was seen higher than controls and this was statistically significant. Conclusion: While a significant effect of diabetes on formation of calculus and the amount of inorganic material was not shown, there may be deterioration in the structure of sementum depending on the calculus.

ADIPOSE TISSUE MEASUREMENT IN GYNECOMASTIA WITH COMPUTERIZED TOMOGRAPHY

2012-03-01

Objective: The purpose of this study is to evaluate the ratio of gynecomastic adipose tissue (GAT) to total gynecomastic tissue (TGT) with computerized tomography (CT) and determine its benefits for selection of surgical technique in gynecomastia. Material and Methods: Prospectively; 20 young patients with gynecomastia who were treated between 2006 and 2009 years were included in the study. Patients' mean age was 22 years (19-28). Nine patients were treated with subcutaneous mastectomy (13 breasts) and 7 patients (13 breasts) were treated with suction assisted lipectomy (SAL). Four patients (7 breasts) were operated with subcutaneous mastectomy and SAL. An experienced radiologist used standard software to determine the ratio of gynecomastic adipose tissue (GAT) to total gynecomastic tissue (TGT) in all patients. Results: The mean GAT/TGT ratio was 0.7 (0.6-0.9) in patients treated with SAL and 0.2 (0.1-0.3) treated with subcutaneous mastectomy. The mean GAT/TGT ratio in patients treated with SAL combined with subcutaneous mastectomy was 0.4 (0.3- 0.5). Thedifference between all surgical protocols was statistically significant (p<0.05). Conclusions: We suggest that CT analysis is a useful tool for selection of gynecomastia surgery protocol. If the patient's GAT/ TGT ratio is larger than 0.6; SAL should be preferred as the method for gynecomastia treatment.

THE ASSOCIATION BETWEEN NOCTURNAL ENURESIS AND TUBERCULOSIS: COINCIDENCE OR COMORBIDITY?

Funda Ba�tu�, Kaz�m �z�m, Osman Ba�tu�, �skender G�n — 2012-03-01

Objective: We observed that some children with Tuberculosis (TB) had nocturnal enuresis and the enuresis complaint in these children healed with anti TB drugs. We aimed to investigate a possible relation between nocturnal enuresis and tuberculosis in a prospective study. Material and Methods: One hundred and forty two enuretic children were enrolled to our study. Enuretic cases were treated and followed according to the choice of the children and their parents. The PPD test was performed in enuretic and nonenuretic children of similar age and sex. Enuretic cases were divided into five groups; desmopressin was given to 45 cases, PPD positive 33 cases were treated with isoniazid, and antituberculosis treatment was given to 10 cases with pulmonary TB. Ten cases with PPD positive and 44 PPD negative patients were viewed without drug treatment. Results: A positive PPD skin test was found at a ratio of 30.2% and 24% in enuretic and non-enuretic children, respectively. There was no significant difference between these ratios. Although the TB-group had a small number of cases (n=10), full recovery was observed in 60% of these patients, and their relapse rate (28.5%) was lower than the desmopressin group (70.3%). Conclusion: Because the TB-group had a high remission rate and low relapse rate, and the PPD positivity rate was high in enuretic patients, we concluded that the hypothesis of a possible association between enuresis and tuberculosis should be examined by future studies.

RESTLESS LEGS SYNDROME IN COPD PATIENTS WITHOUT ACCOMPANYING DISEASE

2012-03-01

Objective: Sleep problems, which may also affect mortality, frequently occur in chronic obstructive pulmonary disease (COPD) patients, but few studies have addressed sleep problems due to the restless legs syndrome (RLS). This study aimed to investigate the prevalence and severity of RLS and associated clinical and laboratory parameters in COPD patients without accompanying disease. Material and Methods: Fifty male COPD patients without accompanying disease and 20 male controls were enrolled to the study. RLS and RLS severity were assessed with a standard international questionnaire. Clinical and laboratory parameters which may be associated with RLS were investigated in COPD patients. Results: No statistically significant difference was found in the prevalence (COPD: 24%, controls: 10%) and severity of RLS. RLS family history was reported in 16% of COPD patients. No significant association existed between presence and severity of RLS and clinical and laboratory parameters. H A higher proportion of inhaled anticholinergic therapy was reported in COPD patients with RLS (11/12 vs 22/38; p<0.05). Conclusion: To our knowledge this is the first study which investigated the prevalence of RLS in COPD patients without accompanying disease and found an association between RLS and inhaled anticholinergic therapy. The major limitations were small sample size and lack of female patients. Large scale prospective studies would help to elicit these findings.

EFFECTS OF CLIMATE CHANGE ON CHILD HEALTH

2012-03-01

Global climate change is now recognized as one of the threats of the 21st century and human activities are very likely (90% probability) the main cause of this problem. Global climate change has multiple adverse effects on human health, and vulnerable populations especially (children, the elderly and poor people) have been disproportionately affected. Children are particularly vulnerable to these adverse health effects because of their physical, physiologic and cognitive immaturity and their dependence on caregivers. Pediatricians and health care professionals have a critical leadership role in implementing programs that mitigate and adapt the climate change at local, national and international levels.

APPENDICO-ILEAL FISTULA IN AN ACUTE ILEUS PATIENT

Mehmet Ya�ar, Arif Aslaner, Orhan Bat — 2012-03-01

Appendico-ileal fistula is a rare condition with acute ileus. We report a case of appendico-ileal fistule in a 46-year-old man patient who has undergone laparatomy for intestinal mechanical obstruction. Intraoperatively, an appendix with a lumen was found with a fistula to the terminal ileum. It has been observed that proximal ileal and jejunal intestinal anses were distended. Appendectomy, segmental ileum resection and end-to-end anastomoses were performed as a surgical procedure. This case describes an elderly man with acute ileus presenting with small bowel obstruction. We conclude that, appendico-ileal fistula should be kept in mind in cases with acute ileus presenting with small bowel obstruction.

BLOODSTREAM INFECTION DUE TO STREPTOCOCCUS DYSGALACTIAE SUBSP EQUISIMILIS IN A HEMODIALYSIS PATIENT

Duygu Per�in, B�lent Tokg�z, Altay Atalay, Cengiz Uta� — 2012-03-01

Catheter-related bacteremia is a frequent complication in patients undergoing hemodialysis. We report the first case of catheter-related bacteremia with Streptococcus dysgalactiae subsp equisimilis in a patient on hemodialysis. The organism was isolated from both the hemodialysis catheter and blood of the patient. Although the hemodialysis cathether was removed and ceftriaxone was given, the patient died of a subarachnoidal bleeding complicating end-stage renal disease.

RADIOLOGICAL AND FUNCTIONAL RESULTS OF SURGICALLY TREATED PATELLAR FRACTURES

Metin Uzun, Faik Se�kin, Ramazan Erden Ert�rer, �rfan �zt�rk, Murat B�lb�l — 2012-03-01

In the present study, the surgical treatment options are discussed in the cases with diagnosed patellar bone fractures. Thirty-eight cases (39 knees) were treated surgically. Sixteen cases with transverse and pole fractures were treated with the modified tension band technique, 18 cases with transverse and comminicated fractures were treated by the peripheral circular technique; 4 cases with comminicated fractures were treated by the peripheral circular technique + modified tension band technique and in one case pole resection were applied. Clinical results were assessed using the modified B�stman scoring system. According to the B�stman system, clinical results were exellent in 20 cases (51.3%), good in 16 cases 41%), poor in three cases (7.7%). We achieved 90% good/exellent clinical results in patellar fractures treated with different techniques. We recommend modified tension band techniques in cases with transverse patellar fractures.

PELVIC ABSCESS: MESH COMPLICATION, A CASE REPORT

G�ls�m Uysal, Ercan Aygen, O�uz Ekmek�io�lu — 2012-03-01

Synthetic meshes for increasing the success of some surgical procedures and treatment to extend life, are increasingly being used. However, the increasing use of mesh introduces the risk of complications associated with meshes. Complications are a wide range of chronic erosion, dyspareunia, pain, infection, abscess and sinus formation, rectum, bladder and vascular injuries. In this case report, we presented a patient who underwent abdominal hysterectomy and sacrospinous fixation for pelvic organ prolapse and developed postoperative mesh complication. Good indications for the use of mesh in selected cases, and the appropriate surgical technique can give more useful results. In this respect, algorithms and common consensus are needed. Nowadays data about meshes, except for clinical trials, are not available to support the routine use of meshes in pelvic reconstructive surgery. We consider that this type of single or serial case presentation will contribute to the formation of the algorithms on the use of mesh.

TEMPORARY HEART FAILURE ASSOCIATED WITH LONG-TERM DAILY ORAL CYCLOPHOSPHAMIDE USE IN A PATIENT WITH WEGENER'S GRANULOMATOSIS

2012-03-01

ERRATUM

2012-03-01

Editorial

Cem S�er — 2012-03-01

Edit�rden

Cem S�er — 2012-03-01