176
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Serel TA, Akhan G, Koyuncuoğlu HR, Oztürk A, Doğruer K, Unal S, Celik K. Epidemiology of enuresis in Turkish children. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1997; 31:537-9. [PMID: 9458511 DOI: 10.3109/00365599709030658] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To establish the prevalence of enuresis in Turkish children and to identify common methods of managing enuresis, a self-administered questionnaire was distributed to parents of 5754 children aged 7-12 years. From a response rate of 96% the overall prevalence of any reported nocturnal enuresis was 11.5% and diurnal enuresis was 0.5%. The prevalence of enuresis was higher in boys than in girls. Turkish parents primarily administered behavioural techniques for the management of enuresis. These results suggest that prevalence rates for nocturnal enuresis in Turkish children are similar to those in previous studies reported from Western Europe, the USA and Australia.
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177
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Akhan Ascioglu S, Hayran M, Sain G, Unal S. PP2. Costs of inappropriate hospital use in cancer and non-cancer patients in a tertiary university hospital. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85915-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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178
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Doğan UB, Cindoruk M, Dumlu S, Unlü R, Unal S. Diagnostic value of serum copper, zinc and plasma fibrinogen in cirrhotic patients with and without hepatocellular carcinoma. ITALIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 1997; 29:476-7. [PMID: 9494860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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179
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Kocagöz S, Unal S. The practical use of PCR for rapid detection of methicillin resistance among staphylococcal clinical isolates from Turkish hospitals. J Clin Microbiol 1997; 35:2188-9. [PMID: 9230416 PMCID: PMC229937 DOI: 10.1128/jcm.35.8.2188-2189.1997] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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180
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Topeli A, Unal S, Hayran M, Akalin HE. Septic shock as a predictor of mortality in bacteremia caused by coagulase-negative staphylococci. Eur J Clin Microbiol Infect Dis 1997; 16:411-6. [PMID: 9248743 DOI: 10.1007/bf02471904] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Fifty episodes of bacteremia caused by coagulase-negative staphylococci at Hacettepe University Hospital over a five-year period were reviewed to evaluate the factors influencing the prognosis. Overall mortality and mortality due to bacteremia were 36% and 24%, respectively. Septic shock was determined to be the only factor adversely influencing mortality in both univariate and multivariate analyses. Age, sex, duration of hospitalization, origin of infection, underlying disease, presence of central intravascular or urinary catheters, and prior antibiotic therapy were not statistically significant parameters in predicting septic shock.
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181
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Uzun O, Kocagöz S, Cetinkaya Y, Arikan S, Unal S. In vitro activity of a new echinocandin, LY303366, compared with those of amphotericin B and fluconazole against clinical yeast isolates. Antimicrob Agents Chemother 1997; 41:1156-7. [PMID: 9145888 PMCID: PMC163869 DOI: 10.1128/aac.41.5.1156] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The in vitro activity of LY303366, a new echinocandin derivative, was evaluated with 191 yeast isolates by a broth microdilution method. The MICs at which 50% of the isolates were inhibited were 0.125 microg/ml for Candida albicans and C. tropicalis, 0.25 microg/ml for C. krusei, C. kefyr, and C. glabrata, and 2.0 microg/ml for C. parapsilosis.
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182
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Menteş BB, Kayhan B, Görgül A, Unal S. Hepatic hydrothorax in the absence of ascites: report of two cases and review of the mechanism. Dig Dis Sci 1997; 42:781-8. [PMID: 9125649 DOI: 10.1023/a:1018864130570] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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183
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Akcan Y, Tuncer S, Hayran M, Sungur A, Unal S. PCR on disseminated tuberculosis in bone marrow and liver biopsy specimens: correlation to histopathological and clinical diagnosis. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1997; 29:271-4. [PMID: 9255888 DOI: 10.3109/00365549709019041] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Disseminated tuberculosis with negative pulmonary findings is a diagnostic problem. Histopathological studies of bone marrow (BM) and liver (LV) biopsies are the most reliable methods for diagnosis in such cases; however, their sensitivity is limited. In this retrospective study, 41 BM and 7 LV paraffin-embedded biopsy specimens from clinically (clinical response to antituberculous treatment after 6 months follow-up) and/or histopathologically diagnosed tuberculosis were analysed for the detection of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). Two different primer sets, one based on the repeated IS6110 sequence of M. tuberculosis and the other based on the mtp40 gene region, were used for amplification. Histopathological and PCR studies were positive for M. tuberculosis in 12/41, and 30/41 in BM and 4/7, and 6/7 in LV biopsy specimens, respectively. As the control group, 17 BM biopsy specimens obtained from patients with a positive Mantoux skin test but no active tuberculosis were analysed. One BM biopsy out of 17 control cases was positive with PCR while none was consistent with TB histopathologically. In conclusion, PCR might be applicable and more reliable than histopathological studies for detection of tuberculosis in BM and LV biopsy specimens.
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184
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Unal S, Hayran M, Tuncer S, Gür D, Uzun O, Akova M, Akalin HE. Treatment of enteric fever with pefloxacin for 7 days versus 5 days: a randomized clinical trial. Antimicrob Agents Chemother 1996; 40:2898-900. [PMID: 9124864 PMCID: PMC163645 DOI: 10.1128/aac.40.12.2898] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
In this prospective study of enteric fever, 22 patients received 400 mg of pefloxacin twice daily for 5 days (group A) and 24 received 400 mg of pefloxacin twice daily for 7 days (group B). Causative microorganisms were Salmonella typhi (8 in group A, 11 in group B) and Salmonella paratyphi B (14 in group A, 13 in group B). The clinical cure and bacterial eradication rates were 96% (21 of 22) in group A and 100% in group B. In conclusion, 5-day oral administration of pefloxacin was as effective as 7-day treatment of enteric fever caused by Salmonella spp.
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Alborn WE, Hoskins J, Unal S, Flokowitsch JE, Hayes CA, Dotzlaf JE, Yeh WK, Skatrud PL. Cloning and characterization of femA and femB from Staphylococcus epidermidis. Gene X 1996; 180:177-81. [PMID: 8973364 DOI: 10.1016/s0378-1119(96)00450-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A DNA fragment was identified and cloned from Staphylococcus epidermidis (Se) using femA from S. aureus (Sa) as a heterologous hybridization probe. DNA sequence analysis of a portion of this clone revealed two complete ORFs highly related to femA and femB of Sa. The genomic arrangement of the Se femA/B complex was nearly identical to that observed in Sa. Intra- and interspecies relatedness of these genes and conservation of genomic organization were consistent with gene duplication of one of these genes in an ancestral organism. Recombinant FEMA, produced in Escherichia coli (Ec), was purified to near homogeneity. Identity of the purified protein was verified by N-terminal amino acid (aa) sequence analysis.
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187
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Doğan UB, Unal S. Kruis scoring system and Manning's criteria in diagnosis of irritable bowel syndrome: is it better to use combined? Acta Gastroenterol Belg 1996; 59:225-8. [PMID: 9085621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Irritable bowel syndrome (IBS) is characterized by abdominal pain and alteration of bowel habits. Manning et al. have reported that certain symptoms distinguished IBS from organic gastrointestinal disease (OGD); these were pain relieved by defecation, looser or more frequent stools at the onset of pain, abdominal distention, mucus, and a feeling of incomplete evacuation. Another simple scoring system for discriminating IBS from OGD that incorporated historical data, physical examination findings, and basic investigations was first devised by Kruis et al. In differential diagnosis of IBS from OGD, to evaluate the reliability of Manning's criteria and Kruis scoring system when used apart or combined; we studied 347 out-patients who completed a bowel disease questionnaire which objectively measured Manning's criteria and scoring system of Kruis. The group included 165 patients with IBS and 182 patients with OGD. The Manning's criteria discriminated IBS from OGD with a sensitivity of 90% and a specificity of 87% if three or more items were regarded as positive. Also the Kruis scoring system discriminated IBS from OGD with a sensitivity of 81% and a specificity of 91%. When used together, these systems discriminated IBS from OGD with a sensitivity of 80% and a specificity of 97%. Manning's criteria and Kruis scoring system had a strong correlation when compared in IBS, but not in OGD.
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188
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Koçak H, Cakar N, Hekimoglu B, Atakan C, Akkök N, Unal S. The coexistence of familial Mediterranean fever and polyarteritis nodosa; report of a case. Pediatr Nephrol 1996; 10:631-3. [PMID: 8897571 DOI: 10.1007/s004670050176] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We describe a 14-year-old boy with a 5-year history of familial Mediterranean fever (FMF), treated with colchicine, who developed polyarteritis nodosa (PAN). He was admitted to our hospital with fever, general weakness, arthritis, and purpura. Five weeks after admission, hypertension was noted. Skin biopsy showed perivascular leukocyte infiltration in the epidermis. An aortography revealed multiple aneurysms of the renal, common hepatic, and intercostal arteries. He was treated with intravenous methylprednisolone, oral cyclophosphamide, and azathioprine. The known rare association of FMF and PAN is discussed.
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189
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Akova M, Ozcebe O, Güllü I, Unal S, Gür D, Akalin S, Tokgözoglu M, Telatar F, Akalin HE. Efficacy of sulbactam-ampicillin for the treatment of severe diabetic foot infections. J Chemother 1996; 8:284-9. [PMID: 8873834 DOI: 10.1179/joc.1996.8.4.284] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Diabetic foot infections, a frequent and serious cause of morbidity in patients with diabetes mellitus, are caused by anaerobic and aerobic bacteria. Given the fact that seriously impaired host defense factors are almost always present in these patients, bactericidal agents with a broad spectrum of antimicrobial activity are required for their treatment. Seventy-four patients with diabetic foot infections were treated with parenteral sulbactam-ampicillin (1.5 g, q.i.d.). All patients were followed-up prospectively in order to determine the efficacy and safety of sulbactam-ampicillin. The mean duration (+/- SD) of treatment in patients with osteomyelitis (n = 49) and soft tissue infections (n = 25) was 41 +/- 5 and 14 +/- 3 days, respectively. Infected limbs were amputated at various levels in 14 patients (19%). Clinical cure rates were 86% and 100% in patients with osteomyelitis and with soft tissue infection, respectively. The most frequent side effect was diarrhea and observed in 10 patients (14%). The results of the present study indicate that sulbactam-ampicillin is safe and effective in the treatment of diabetic foot infections.
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190
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Yalçinkaya F, Topaloğlu H, Ozmen E, Unal S. Is general anaesthesia necessary for URS in women? Int Urol Nephrol 1996; 28:153-6. [PMID: 8836781 DOI: 10.1007/bf02550853] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A total of 65 women with ureteral stone who underwent ureteroscopy were divided randomly into two groups between April 1993 and March 1994. URS was performed under general anaesthesia in the first group (35 patients), and under local anaesthesia with sedation analgesia in the second group (30 patients). Only 2 patients of the second group did not tolerate the operation. The success rate was 88% in the first group and 83.3% in the second. There was no significant difference between the two groups. Since URS under local anaesthesia is time-saving, cost-effective, and highly tolerable in women, it is a good choice for ureteral stones.
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191
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Unal S, Oĝuz H, Alagöl F, Cantez S. Misinterpretation of I-131 scintigraphy because of diaphragmatic hernia. Clin Nucl Med 1996; 21:151-2. [PMID: 8697691 DOI: 10.1097/00003072-199602000-00019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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192
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Doğan I, Unal S, Sindel S, Tunçer C, Arinsoy T, Bali M, Kandilci U, Hasanoğlu E. Esophageal motor dysfunction in chronic renal failure. Nephron Clin Pract 1996; 72:346-7. [PMID: 8684564 DOI: 10.1159/000188879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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193
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Görgül A, Kayhan B, Dogan I, Unal S. Disappearance of the pseudo-cholangiocarcinoma sign after TIPSS. Am J Gastroenterol 1996; 91:150-4. [PMID: 8561119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bile duct varices, also named the "pseudo-cholangio- carcinoma sign<" are frequently encountered by ERCP in portal hypertension cases due to cavernous transformation of the portal vein. There is a documentation that, in three cases, this sign disappeared after placement of a transjugular intrahepatic portosystemic shunt.
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194
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Cercenado E, Unal S, Eliopoulos CT, Rubin LG, Isenberg HD, Moellering RC, Eliopoulos GM. Characterization of vancomycin resistance in Enterococcus durans. J Antimicrob Chemother 1995; 36:821-5. [PMID: 8626263 DOI: 10.1093/jac/36.5.821] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
During investigation of an outbreak of vancomycin resistant Enterococcus faecium in a paediatric hospital, an isolate of Enterococcus durans resistant to vancomycin, teicoplanin, ampicillin and highly resistant to gentamicin and streptomycin was found in the stools of a patient also colonized with a strain of E. faecium with the same resistance pattern. Minimal inhibitory concentrations of vancomycin and teicoplanin were 512 and 64 mg/mL, respectively. Resistance to vancomycin as well as high-level resistance to gentamicin was transferable to an E. faecium recipient strain. Both multiresistant E. faecium and E. durans isolates as well as the transconjugant presented only one plasmid. The vanA gene was detected and localized to the high molecular weight plasmid by DNA hybridization with a vanA gene probe. Growth in vancomycin resulted in induction of an approximately 40 kDa protein visible in membrane preparations from these cells. Genetic linkage between vancomycin and gentamicin resistance genes in the same plasmid is suggested.
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195
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Demircin M, Doğan R, Peker O, Unal S, Pasaoğlu I. Aortic insufficiency and enterococcal endocarditis complicating systemic lupus erythematosus. Thorac Cardiovasc Surg 1995; 43:302-4. [PMID: 8610295 DOI: 10.1055/s-2007-1013800] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A case of aortic valve replacement for aortic insufficiency complicated with enterococcal endocarditis in a patient with systemic lupus erythematosus (SLE) is described. The cardiac complications of SLE may involve the endocardium, myocardium, pericardium, and coronary vessels. Steroids which are used for treatment probably increase the incidence of valve incompetence. Aortic insufficiency or infective endocarditis complicating Libman-Sacks endocarditis is rarely observed and may require valve replacement. Echocardiography is an important diagnostic tool. Renal function, pulmonary status, and cerebral complications require special attention in these patients.
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196
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Mudun A, Unal S, Aktay R, Akmehmet S, Cantez S. Tc-99m nanocolloid and Tc-99m MDP three-phase bone imaging in osteomyelitis and septic arthritis. A comparative study. Clin Nucl Med 1995; 20:772-8. [PMID: 8521652 DOI: 10.1097/00003072-199509000-00004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The aim of this study was to compare Tc-99m nanocolloid scintigraphy with Tc-99m MDP bone imaging in the diagnosis of osteomyelitis and septic arthritis. Overall, 31 Tc-99m MDP bone scans and 39 Tc-99m nanocolloid studies were performed in 34 patients (15 female, 19 male; mean age, 14.88 years +/- 19.00 years) who were suspected of osteomyelitis and/or septic arthritis. The final diagnoses were established by needle aspiration, cultures, radiography, clinical course, and, in some patients, with CT, ultrasonography, and biopsy. The sensitivity, specificity, and accuracy were 100%, 75%, and 92%, respectively for both Tc-99m MDP and Tc-99m nanocolloid scans in detecting osteomyelitis. For septic arthritis, Tc-99m MDP bone imaging showed 100%, 85%, and 94%, and Tc-99m nanocolloid scans showed 90%, 59%, and 76%, sensitivity, specificity, and accuracy, respectively. These results show that, although both scans are in good agreement for osteomyelitis, for septic arthritis nanocolloid is not specific enough to recommend it to be a complementary method to MDP bone scans.
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197
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Karamehmetoğlu SS, Unal S, Karacan I, Yílmaz H, Togay HS, Ertekin M, Döşoğlu M, Ziyal MI, Kasaro glu D, Hakan T. Traumatic spinal cord injuries in Istanbul, Turkey. An epidemiological study. PARAPLEGIA 1995; 33:469-71. [PMID: 7478742 DOI: 10.1038/sc.1995.102] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This is a retrospective study conducted in all of the hospitals of Istanbul to survey new patients with a traumatic spinal cord injury (SCI) in 1992. In that year 152 new traumatic SCI were identified. The estimated annual incidence was 21 per million population. The male/female ratio was 3/1. The mean age was 33, being 34 for male patients and 31 for female patients. 72% of all patients were under the age of forty. The major causes of SCI were falls (43%) and car accidents (41%), followed by being struck by an object (7%), gunshot injury (5%), stab injury (2%). Fifty patients (33%) were tetraplegic and 102 (67%) paraplegic. Regarding the tetraplegic patients the commonest level was C5, in those who were paraplegic L1. There were no cases at levels C1, T1 or T2. The commonest associated injury was head trauma, followed by fractures of an extremity (or extremities). Severe head trauma, as a major cause of death, may obscure the actual incidence of SCI in this study. Accidental falls (exceeding road accidents) were mostly due to falls from buildings and accidents on work premises.
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198
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Mudun A, Kocak M, Unal S, Cantez S. Tc-99m MIBI accumulation in remnant thymus. A cause of false-positive interpretation in parathyroid imaging. Clin Nucl Med 1995; 20:379-80. [PMID: 7789006 DOI: 10.1097/00003072-199504000-00025] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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199
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Unal S, Mudun A, Eren N, Meric M, Cantez S. Comparison of renal perfusion indices in captopril scintigraphy. Nucl Med Commun 1995; 16:132-6. [PMID: 7770234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Perfusion indices used in renal scintigraphy were adapted to captopril-enhanced renal scintigraphy in order to determine if these parameters have any value in differentiating patients with renovascular hypertension (RVH) from normal subjects. Regions of interest (ROIs) were chosen over the aorta and kidneys, and time-activity curves generated. The ratio of integrated aortic counts to renal counts, from the time of injection to arterial peak, was calculated. The difference in the value of this index between captopril and basal scintigraphies was -17 +/- 12 and -16 +/- 13 for the right and left kidneys, respectively, in the group of patients with essential hypertension, whereas in the patients with renovascular hypertension, these values were 24 in the stenotic and 14 in the non-stenotic kidney. This parameter is useful for separating patients with RVH from normal subjects.
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200
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Mudun A, Unal S, Ilhan R, Aktay R, Demiryont M, Cantez S. False-positive uptake of Tc-99m penta-DMSA in fibrous dysplasia of breast in a patient with medullary carcinoma of thyroid. Clin Nucl Med 1994; 19:364-5. [PMID: 7911752 DOI: 10.1097/00003072-199404000-00023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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