Ergun Karaagaoglu

Turkish children's performance on Denver II: effect of sex and mother's education.

One thousand and ninety‐one healthy Turkish children were tested with the Denver II developmental screening test and the data were analysed for sex and sociocultural differences. Few and inconsistent differences were observed between boys and girls. On the other hand, there were marked differences between sociocultural groups, particularly in terms of fine motor and language areas and in older preschool children. The effect of maternal education on the childs development is more important in countries where preschool education is not commonly available. Whether this effect diminishes after 1 or 2 years of schooling is to be investigated.

Levels of IgE in the serum of patients with coronary arterial disease

Because previous studies have shown that mast cells can be activated by IgE-mediated mechanisms to release potent mediators which affect coronary blood flow, we measured serum IgE levels in 156 patients with coronary arterial disease and in 53 healthy controls (27 men, 26 women, mean 54 years). Patients were classified into 3 groups according to well established criteria as having stable angina pectoris (28 men, 15 women, mean 58 years), unstable angina pectoris (37 men, 15 women, mean 57 years), and acute myocardial infarction (52 men, 9 women, mean 58 years). In every subject, serum IgE measurement, eosinophil count, and stool examination for parasites were performed. Every subject was interviewed concerning history of allergy, smoking habits and the other risk factors for coronary arterial disease. In a model including the factors that may affect the serum levels of IgE (namely, age, sex, cigarette smoking, parasites, and family and personal history of allergy), IgE levels were found to be significantly higher in the patients with unstable angina and acute myocardial infarction compared to the patients with stable angina pectoris and controls. These data indicate that IgE may play a role in the pathogenesis of unstable angina pectoris and acute myocardial infarction.

Reexamination of the characteristics of the deficit schizophrenia patients

Abstract.The aim of this study was to reexamine and compare the characteristics of the deficit and nondeficit schizophrenic patients. This cross-sectional study consisted of 62 in- and out-patients, 18–65 years of age, diagnosed with schizophrenia according to DSM-IV. The sociodemographic variables, premorbid adjustment, clinical course and general functioning level in the past five years were evaluated by utilizing the appropriate sections of Comprehensive Assessment of Symptoms and History (CASH). In addition, GAF, the Schedule for the Deficit Syndrome (SDS), Positive and Negative Syndrome Scale (PANSS), Montgomery Äsberg Depression Scale (MADRS), the Neurological Evaluation Scale (NES) and the Simpson Angus Extrapyramidal Side Effects (EPS) Rating Scale, Trail A and B, Verbal Fluency, Stroop, Block Design and Finger Tapper tests were administered. Using the SDS, 19 patients (30.6 %) were categorized as deficit; 43 (69.4 %) were categorized as nondeficit. The deficit patients were worse on the Functioning During Past Five Years score of CASH. The PANSS and MADRS mean scores were not significantly different between the two groups, except a higher level of negative symptoms observed in the deficit group. NES scores were also significantly higher in the deficit group. However, sociodemographic and other clinical variables, neurocognitive measures and EPS symptoms did not show any significant difference between the two groups. Our findings suggest that the deficit schizophrenia is a distinct subgroup comprised of patients who have more negative symptoms, neurological impairment and poor functioning which may have a common underlying pathology.

Development and Evaluation of Paclitaxel Nanoparticles Using a Quality‐by‐Design Approach

The aims of this study were to develop and characterize paclitaxel nanoparticles, to identify and control critical sources of variability in the process, and to understand the impact of formulation and process parameters on the critical quality attributes (CQAs) using a quality-by-design (QbD) approach. For this, a risk assessment study was performed with various formulation and process parameters to determine their impact on CQAs of nanoparticles, which were determined to be average particle size, zeta potential, and encapsulation efficiency. Potential risk factors were identified using an Ishikawa diagram and screened by Plackett-Burman design and finally nanoparticles were optimized using Box-Behnken design. The optimized formulation was further characterized by Fourier transform infrared spectroscopy, X-ray diffractometry, differential scanning calorimetry, scanning electron microscopy, atomic force microscopy, and gas chromatography. It was observed that paclitaxel transformed from crystalline state to amorphous state while totally encapsulating into the nanoparticles. The nanoparticles were spherical, smooth, and homogenous with no dichloromethane residue. In vitro cytotoxicity test showed that the developed nanoparticles are more efficient than free paclitaxel in terms of antitumor activity (more than 25%). In conclusion, this study demonstrated that understanding formulation and process parameters with the philosophy of QbD is useful for the optimization of complex drug delivery systems.

Thickness of the retinal nerve fiber layer in patients with anisometropic and strabismic amblyopia.

PURPOSE: To compare the retinal nerve fiber layer [RNFL] thickness of the amblyopic eye with that of the normal eye in patients with anisometropic and strabismic amblyopia. METHODS: Scanning laser polarimetry was performed with the GDx Nerve Fiber Analyzer (NFA), a scanning laser ophthalmoscope that measures the thickness of the peripapillary RNFL quantitatively and objectively, in vivo, based on the birefringence of the RNFL. Eighteen anisometropic, two strabismic and four combined amblyopic (both anisometropia and strabismus) patients were enrolled in the study. There were 9 male and 15 female patients, age range 7-66 years. Using Student’s t -test, 14 GDx parameters in the amblyopic eyes and sound eyes were compared. RESULTS: The GDx parameters showed no significant differences between the two groups [p > 0.5]. The superior average and inferior average values were 79.50µm and 80.41µm, respectively, in the amblyopic group, and 80.75µm and 82.75µm, respectively, in the healthy eyes. The average thickness did not differ between amblyopic and sound eyes (65.50µm and 66.45µm, respectively). CONCLUSION: Assessment of RNFL thickness by means of scanning laser polarimetry revealed no difference between the two eyes in patients with unilateral amblyopia.

Effect of peripapillary chorioretinal atrophy on GDx parameters in patients with degenerative myopia

Purpose: To determine the effect of peripapillary chorioretinal atrophy in degenerative myopia on the retinal nerve fibre layer (RNFL) thickness measurements performed by scanning laser polarimetry.

Relationship between LYVE-1, VEGFR-3 and CD44 gene expressions and lymphatic metastasis in gastric cancer.

AIM To investigate the expression levels of lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), vascular endothelial growth factor receptor-3 (VEGFR-3) and CD44 genes and the relationship between their levels and clinicopathological parameters in gastric cancer. METHODS Tissue samples were obtained from 33 patients (8 females) with gastric cancer. mRNA levels of LYVE-1, VEGFR-3 and CD44 in normal and tumor tissues were quantitatively measured using real time polymerase chain reaction. The results were correlated with lymph node metastasis, histological type and differentiation of the tumor, T-stage, and presence of vascular, perineural and lymphatic invasions. The distribution of molecules in the tissue was evaluated using immunohistochemistry. RESULTS LYVE-1, CD44 and VEGFR-3 gene expression levels were significantly higher in gastric cancer than in normal tissue. While there was no correlation between gene expressions and clinicopathologic features such as histologic type, differentiation and stage, gene expression levels were found to be increased in conjunction with positive lymph node/total lymph node ratio and the presence of perineural invasion. A significant correlation was also found between LYVE-1 and CD44 over-expressions and perineural invasion and lymph node positivity in gastric cancers. When the distribution of LYVE-1 antibody-stained lymphatic vessels in tissue was evaluated, lymphatic vessels were located intra-tumorally in 13% and peri-tumorally in 27% of the patients. Moreover, lymph node metastases were also positive in all patients with LYVE-1-staining. CONCLUSION LYVE-1, VEGFR-3 and CD44 all play an important role in lymphangiogenesis, invasion and metastasis. LYVE-1 is a perfectly reliable lymphatic vessel marker and useful for immunohistochemistry.

Pigment epithelium‐derived factor increases in type 2 diabetes after treatment with metformin

Pigment epithelium‐derived factor (PEDF) has anti‐angiogenic, immunomodulatory and anti‐inflammatory properties. In addition to the significant role it plays in reducing diabetic complications, PEDF is now used in the treatment of certain cancers. It possibly plays a role in insulin resistance cases, too. However, whether metformin treatment has any significant effects on PEDF levels is not known. In this study, we investigated the regulation of PEDF in type 2 diabetes in relation to fat mass and insulin resistance before and after the use of metformin for treatment.

Diagnostic accuracy of fine-needle aspiration cytology of palpable breast masses: an SROC curve with fixed and random effects linear meta-regression models.

We used various meta‐analytic methods to compare 25 studies describing fine‐needle aspiration (FNA) cytologic analyses performed from 1984 to 2007 on palpable breast masses. We found that in the 25 studies examined, the sensitivity ranged from 78% to 100%, the specificity ranged from 76% to 100%, and the diagnostic odds ratio (DOR) ranged from 15.83 to 33 198. The overall diagnostic accuracy was found to be as follows: 0.93 (95% CI: 0.92–0.94) for sensitivity, 0.98 (95% CI: 0.97–0.98) for specificity, and 505.209 (95% CI: 273.08–934.95) for the DOR. The overall diagnostic accuracy according to the results of summary receiving operating characteristic (SROC) curve analysis was 0.95 ± 0.0032, and the overall weighted area under the (receiving operating characteristic [ROC]) curve (AUC) was 0.99 ± 0.0014. The DOR values did not show a large variation in the various positivity threshold values. However, the results of those studies had some heterogeneity. The four covariates that were added to the standard SROC model to evaluate variations in the results of the studies were the year of publication, the number of aspirations, the percentage of insufficient material, and the study design. The relative diagnostic accuracy of studies performed after 1990 was 3.98 times higher than that of studies performed before 1990. The relative DOR (RDOR) value was also found to be statistically significant (95% CI: 1.22–13.02). That result may be attributed to the technologic improvements in diagnostic tools over the years. Although it was not statistically significant, an increase in the number of aspirations caused an increase in the RDOR of the FNA cytology (95% CI: 0.52–8.11). In contrast, increasing the percent of insufficient material caused a statistically insignificant but clinically significant decrease in the RDOR of FNA (RDOR = 0.79, 95% CI: 0.21–2.98). In conclusion, our meta‐analysis has shown that FNA cytologic analysis of palpable breast masses is highly accurate in the diagnostic differentiation of benign from malignant tumors. Diagn. Cytopathol. 2008;36:303–310.

Oral health status in a group of the elderly population residing at home.

OBJECTIVES To determine the oral health status and treatment needs of subjects aged 65 years and older residing in different districts of Ankara. MATERIALS AND METHODS A total of 1300 patients, 751 females and 549 males, age 65 and over with a mean age of 72.8 ± 6.34 were included in this study. The subjects were visited at home and toothbrushing habits, visiting the dentist, tooth loss, denture needs were questioned and body mass index values were recorded. RESULTS 52.5% of the subjects were completely edentulous, 83.3% subjects reported wearing a removable denture. Females had a higher total tooth loss frequency when compared to males (p < 0.05). Total tooth loss between 65 and 69 ages was 47.3%, and increased to 62.4% among those aged 75 and over (p < 0.05). 16.2% of the subjects had not visited a dentist in the last 10 years, and only 3% visited a dentist for control check-ups; no gender-based difference was observed as to the frequency of dental visits (P > 0.05). No significant relationship was found between tooth loss and BMI values (P > 0.05). 46.3% of the subjects had chewing problems. CONCLUSIONS The subjects included in this study showed high tooth loss frequency and poor oral hygiene habits. Education regarding maintenance of oral hygiene and regular dental check up should be stressed for the elderly.