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Öğe Prevalence and annual risk of tuberculosis infection in Edirne, Turkey(Informa Healthcare, 2002) Yorulmaz, F; Çaglar, T; Erel, C; Özaydin, MTuberculosis is still an important problem in developing countries. A total of 3,774 students from primary schools in Edirne, Turkey were included in this study in order to determine the annual infection risk for the year 1994. Five tuberculin units of purified protein derivative were applied using a Mantoux test and evaluated. The mean induration diameter was 14.6 mm. A total of 51.6% of the students were found to be sensitive to tuberculin. The annual infection risk of tuberculosis was found to be 1.51%, lower than that found in 1987. Other studies from Turkey have reported lower values than ours. We did not diagnose any cases of tuberculosis. We revealed that the annual infection risk among primary schoolchildren in Edirne is close to the average for Turkey and thus tuberculosis is still a serious risk for these children. Tuberculosis remains an important public health problem in Turkey and is partially attributable to socioeconomic difficulties.Öğe The prevalence of hereditary thrombophilia in the Trakya region of Turkey(Yonsei Univ College Medicine, 2000) Demir, M; Vural, Ö; Sunar, H; Altun, A; Yorulmaz, F; Özbay, GThe prevalences of deficiencies in antithrombin III (AT III), protein C (PC), protein S (PS) and in the activated protein C (APC) resistance in the thrombotic population of the Trakya region, Turkey were investigated. 37 patients with venous thrombosis (VT) and 17 patients with arterial thrombosis (ArT) were included in this study. The mean ages of the patients with VT and ArT were 46 years (range 20-70) and 38 years (range 32-40), respectively; The activity of AT III was measured by commercially available immuno-turbidimetric assay. The activities of PC and PS were determined by coagulometric assay. The APC resistance was measured using a modified APTT-based clotting assay. Among the VT patients, there were 2 cases (5.4%) with AT Ill, 5 (13.51%) with PC deficiency, 5 (13.51%) with PS deficiency and 2 (5.4%) with APC resistance. In the ArT patient group, there was 1 patient (5.88%) with AT III, 3 (17.64%) with PC deficiency, 1 (5.88%) with PS deficiency and no APC resistant patients, while there was one (2.08%) with PC deficiency and one (2.08%) with APC resistance in the control group (49 persons, mean age 41 years). The relative risk of thrombosis (odds ratio) was 1.7 in the deficiency of PC and 5.6 in the deficiency of PS. The data presented suggests that the prevalences of AT III, PC and PS deficiencies causing thrombophilia in the Trakya region of Turkey are higher than in other reported studies while the APC resistance is lower than in others. Further studies including more patients would be required to clarify these discrepancies.Öğe Relationship between serum sialic acids, sialic acid-rich inflammation-sensitive proteins and cell damage in patients with acute myocardial infarction(Walter De Gruyter Gmbh, 2006) Gökmen, SS; Kazezoglu, C; Sunar, B; Özçelik, F; Güngör, Ö; Yorulmaz, F; Gülen, SThe role of sialic acid ( SA) in the pathogenesis of atherosclerosis and as a predictor of cardiovascular events has attracted much attention in recent years. However, most studies investigating the role of total and lipid-bound sialic acids ( TSA and LSA) in the pathogenesis of atherosclerosis lack information on the reason for the elevated SA concentrations in coronary heart disease and myocardial infarction. Since the inflammation-sensitive proteins are glycoproteins with SA residues, an increase in their levels due to some type of acute-phase reaction or inflammation could be responsible for the elevated TSA levels in acute myocardial infarction ( AMI). Elevated serum SA levels might also be due to either shedding or secretion of free SA from the cell or cell membrane surface if neuraminidase levels are increased, or to the release of cellular SA-containing glycolipids and/ or glycoproteins into plasma from myocardial cells after AMI. The aim of the present study was to investigate both the possible role of SA-rich inflammation-sensitive proteins and the cell damage due to elevated serum TSA levels in AMI. A possible role of serum LSA as an indicator of the shedding or secretion of SA from the cell or cell membrane surface in AMI was also evaluated. The study included 38 subjects with AMI and 32 healthy volunteers. Serum TSA and LSA were determined using the methods of Warren and Katopodis, respectively. The concentrations of serum SA-rich inflammation-sensitive proteins, namely alpha(1)-antitrypsin, alpha(2)-macroglobulin and ceruloplasmin were determined immunoturbidimetrically. Our data showed that: a) mean levels of serum TSA and LSA and SA-rich inflammation-sensitive proteins in patients with AMI were significantly increased; and b) there was a significant positive correlation between TSA and LSA and alpha(1)-antitrypsin in patients with AMI. Since the transfer of free SA to lipoproteins is required for an increase in serum LSA levels, and free SA for this transfer can be provided by the secretion of SA from the cell, it is obvious that the shedding or secretion of SA from the cell membrane surface or release of cellular SA from cells into the bloodstream due to cell damage after AMI also occur after AMI. As a result, we can report that either the shedding or secretion of SA from the cell or cell membrane surface and the increased output of SA-rich inflammation-sensitive proteins may together be responsible for the elevated TSA levels in AMI.Öğe Reversible ototoxic effect of azithromycin and clarithromycin on transiently evoked otoacoustic emissions in guinea pigs(Headley Brothers Ltd, 2001) Uzun, C; Koten, M; Adali, MK; Yorulmaz, F; Yagiz, R; Karasalihoglu, ARThe possible cochlear toxicity of systemically applied macrolides-erythromycin (ER), azithromycin (AZ) and clarithromycin(CL)-was investigated in guinea pigs by measuring transiently evoked otoacoustic emissions (TEOA-Es). A single dose of 125 mg/kg intravenous (i.v.) ER caused no change in TEOAEs in guinea pigs (p>0.05), whereas AZ (45 mg/kg orally) and CL (75 mg/kg i.v.) reversibly reduced the emission response (p<0.05). The reversible reduction of TEOAE responses due to AZ and CL, which is in accordance with the clinical picture of AZ and CL ototoxicity, could likely be attributable to the transient dysfunction of outer hair cells. The present study reveals that at least one ototoxic effect of AZ and CL is on the inner ear. The results may also encourage planning clinical researches on TEOAE monitoring in patients receiving high doses of AZ or CL.Öğe Significance of arginase and ornithine in malignant tumors of the human skin(Mosby-Elsevier, 2001) Gökmen, SS; Aygit, AC; Ayhan, MS; Yorulmaz, F; Gülen, SDuring neoplastic development, several aspects of the regulation of polyamine synthesis undergo profound changes. In extrahepatic mammalian tissues in which the urea cycle is not functioning, arginase is believed to supply the cell with ornithine, a non-protein amino acid that is a precursor for biosynthesis of polyamines. Because the activity of ornithine decarboxylase and polyamine levels have been shown to be elevated during carcinogenesis, we decided to investigate the role of arginase in the development of malignant tumors of the human skin and to examine whether arginase activity and ornithine level can be used as biologic markers for distinguishing patients with squamous cell cancer from patients with basal cell cancer. For this purpose, we studied tissue arginase activity and ornithine level in tumor and adjacent normal tissues in 16 patients (55 +/- 10 years of age) with malignant skin tumors (8 of which were squamous cell cancers and 8 of which were basal cell cancers). The mean arginase activity and ornithine levels in tumor tissues (total) were 17.75 +/- 8.54 U/mg protein and 40.89 +/- 14.88 nmol/mg protein, respectively, versus 3.69 +/- 1.71 U/mg protein and 12.98 +/- 6.21 nmol/mg protein, respectively, for normal tissues. The mean specific arginase activity levels in squamous cell and basal cell cancers of the human skin were 18.49 +/- 10.47 U/mg protein and 16.63 +/- 6.00 U/mg protein, respectively. The mean ornithine levels in squamous cell and basal cell cancers of the human skin were 42.45 +/- 9.10 nmol/mg protein and 39.33 +/- 10.19 nmol/mg protein, respectively. Our results indicated that (1) arginase activity and ornithine levels are elevated in squamous cell and basal cell cancers of the human skin (2) the increased activity of arginase and hence the elevated levels of ornithine may be important in the development of malignant tumors of the human skin; and (3) although arginase activity and ornithine level may be useful for distinguishing patients with malignant skin tumors from healthy subjects they cannot be used as biologic markers for distinguishing patients with squamous cell cancer from patients with basal cell cancer.Öğe Smoking among adolescents(E M H Swiss Medical Publishers Ltd, 2002) Yorulmaz, F; Aktürk, Z; Dagdeviren, N; Dalkilic, AObjective: Smoking is a worldwide health problem. This study was designed to evaluate the current status and to examine some potential factors affecting smoking among adolescents. Design: Descriptive, cross-sectional study. Setting. Community based study. Subjects: Of all middle and high school students in Edirne, Turkey, 883 (6.83%) were randomly sampled. Mean age of the subjects was 15.0 +/- 1.8 years. Method: A self-applied questionnaire was used to collect demographic data, smoking status, school success, nutritional behaviour and self-esteem. The influence of different factors on smoking was evaluated with a logistic regression model. Results: There were 89 active smokers (11.1%) with the critical age of 15 years for smoking commitment. 609 students (71.9%) were exposed to environmental tobacco smoke. Nutritional behaviour rich in vegetables (OR = 0.813), high school success (OR = 0.807), longer time reserved for homework (OR = 0.718) and eating breakfast (OR = 0.353) were significantly associated with a lower smoking rate. Having a mother, who smoked (OR = 2.155), increasing age (OR = 1.704), increasing number of siblings (OR = 1.351) and eating fast food (OR = 1.150) were associated with significantly higher smoking rates. Conclusion: An educational programme aimed at changing behaviour and attitude to tobacco smoking and including nutritional counselling with high emphasis on the transition age from early to late adolescence may be a successful primary prevention. In addition projects designed to improve school performance may lead to a reduction in smoking rates while providing an investment in the future of the teenagers.
