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    Assessment of sapheno-femoral junction continence in patients with primary adolescent varicocoele
    (Springer-Verlag, 2003) Karadeniz-Bilgili, M.Y.; Basar, H.; Simsir, I.; Ünal, B.; Batislam, E.
    Background. Although there is much evidence supporting a relationship between primary varicocoele and venous incompetence of the saphenofemoral junction in adults, there is no evidence for such a relationship during adolescence. Because of the effect of age and future occupation (standing upright for long periods) on the aetiology, pathogenesis and frequency of varicose veins of the lower extremity and incompetence of saphenofemoral junctions in adulthood, a comparison during adolescence is appropriate. Objective. On the basis of a close physiopathological and haemodynamic relationship between primary varicose veins and primary varicocoele, we decided to evaluate the competence of the saphenofemoral junctions in a selected group of adolescents affected by primary varicocoele and compare these results with age-matched healthy adolescents. Materials and methods. Twenty-five adolescents with primary varicocoele and 23 age-matched healthy controls were included in the study. In all cases physical examination and colour Doppler US was used to diagnose or exclude the presence of primary varicocoele and to evaluate the continence of the saphenofemoral junction. Results. On the right side, 10 of 25 varicocoele patients and on the left side 11 of 25 varicocoele patients had incompetence of the saphenofemoral junction. For the control patients the incidence was 2/23 on the right side and 4/23 on the left side. The difference is statistically significant. Conclustions. We demonstrated high concurrence of varicocoele and valvular incompetence of the saphenofemoral junction in a particular adolescent group. We suggest clinical examination and US assessment of the saphenofemoral junctions of adolescents affected by varicocoele in order to detect the early diagnosis of venous insufficiency of the lower limbs among these patients.
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    Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma
    (Elsevier Science Bv, 2003) Kara, M.; Dikmen, E; Erdal, H.H.; Simsir, I.; Kara, S.A.
    Objective: Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of chest X-rays in showing the rib fractures is limited particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures, those overlooked on chest X-rays, with the use of ultrasonography in minor blunt chest trauma. Methods: A total of 37 patients, with minor blunt chest trauma showing no evidence of a rib fracture on chest X-rays, were examined with ultrasonography performed with a 7.5-MHz linear transducer. Logistic regression analysis was done to outline the clinical predictors of these insidious rib fractures. Results: A total of 15 (40.5%) patients showed rib lesions, whereas 22 (59.5%) patients had no evidence of rib lesions. Fracture of the rib associated with a subperiosteal hematoma was the most common finding in ten (66.7%) patients followed by the fracture of the rib alone in four (26.7%) patients, and subperiosteal hematoma alone in one (6.7%) patient. A total of eight (53.3%) patients had bony rib fractures, whereas seven (46.7%) patients had chondral rib fractures. Age (P = 0.617), gender (P = 0.552), type of etiology (P = 0.954), duration of pain (P = 0.234) and site of trauma (P = 0.740) did not appear as significant predictors for these rib fractures. However, the involved part of the rib showed a significant correlation with either age (P = 0.042) or duration of pain (P = 0.033). Bony rib fractures significantly occurred in elderly patients, and the duration of pain in patients with bony rib fractures was significantly longer than that of patients with chondral rib fractures. Conclusions: Ultrasonography is a useful imaging method in showing the rib fractures those overlooked on chest X-rays in minor blunt chest trauma, and no significant clinical feature exists as a predictor for these insidious fractures. However, bony rib fractures significantly Occur in elderly patients and result in a longer duration of pain. (C) 2003 Elsevier B.V. All rights reserved.
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    Increased Oxidative DNA Damage in Lean Normoglycemic Offspring of Type 2 Diabetic Patients
    (Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2011) Zengi, A.; Ercan, G.; Caglayan, O.; Tamsel, S.; Karadeniz, M.; Simsir, I.; Ozgen, G.
    Objective: Several studies have shown increased oxidative stress in patients with pre-diabetes and newly diagnosed Type 2 diabetes mellitus (T2DM). It has been proposed that oxidative stress initiates insulin resistance in genetically predisposed individuals. The aim of this study was to evaluate the markers of oxidative stress in the off spring of patients with T2DM. Material and Methods: We examined 60 lean normoglycemic off spring of Type 2 diabetics, and 52 age, sex and body mass index matched subjects without family history of T2DM as controls. Anthropometric, biochemical and carotid intima media thickness (IMT) measurements and oral glucose tolerance test (OGTT) were performed. Erythrocyte superoxide dismutase and glutathione peroxidase activities, serum nitric oxide, plasma total sulfhydryl (tSH) groups, plasma total antioxidant status, plasma malondialdehyde and serum 8-hydroxydeoxy-guanosine (8-OHdG) levels were compared between 2 groups. Results: 2 groups were similar for the measurements of anthropometric, blood pressure, lipids, fasting glucose, HOMA-IR and carotid IMT. Glucose levels during OGTT were significantly higher in the off spring of Type 2 diabetics than controls (p = 0.035). The off spring of Type 2 diabetics showed a significant increase in serum 8-OHdG level (p = 0.005) and plasma tSH groups (p = 0.032) when compared to the controls. Significant differences were not obtained in other oxidative stress marker levels between 2 groups. Conclusion: Main finding of our study was the presence of increased oxidative DNA damage in lean normoglycemic off spring of Type 2 diabetic patients. There is a need for further clinical studies in order to explain whether oxidative stress is present in genetically predisposed subjects and induces the insulin resistance.