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    Assessment of ventricular repolarization in deaf-mute children
    (Springer, 2000) Tuncer, C; Çokkeser, Y; Komsuoglu, B; Ödemir, R; Güven, A; Pekdemir, H; Sezgin, AT
    The long QT syndrome is a congenital disease with frequent familial transmission, characterized primarily by prolongation of the QT interval and by the occurrence of life-threatening arrhythmias. The syndrome may be familial, with or without congenital deafness, or it may be idiopathic. We attempted to assess ventricular repolarization and to identify patients with the Jervell and Lange-Nielsen syndrome among 132 deaf-mute school children. Five deaf-mute subjects had Jervell and Lange-Nielsen syndrome. The deaf-mute subjects were divided into two subgroups according to the length of their QT intervals: group 1 included 5 cases with the long QT interval (>440 msec), and group 2 included 127 subjects with the normal QT interval (less than or equal to 440 msec). Group 3 was composed of 96 control subjects. The mean QT, QTc, JT, and JTc intervals (418 +/- 70, 500 +/- 38, 302 +/- 65, and 389 +/- 36 msec, respectively) in group 1 were significantly longer than those of group 2 (344 +/- 23, 408 +/- 22, 249 +/- 34, and 291 +/- 28 msec, respectively) and group 3 (325 +/- Il, 383 +/- 26, 228 +/- 36, and 269 +/- 46 msec, respectively). The dispersion (d) values (QT-d, QTc-d, JT-d, and JTc-d; 63 +/- 10, 73 +/- 8, 60 +/- 8, and 62 +/- Il msec, respectively) of group 1 were significantly longer than those of group 2 (49 +/- 16, 43 +/- 11, 48 +/- 21, and 45 +/- 18 msec, respectively) and group 3 (33 +/- 13, 33 +/- 14, 28 +/- 16, and 27 +/- 14 msec, respectively) at similar mean RR intervals. Also, the mean QT, QTc, JT, and JTc intervals and the dispersion values (QT-d, QTc-d, JT-d, and JTc-d) in group 2 were significantly longer than those of group 3 at similar mean RR intervals. Consequently, in this study, we determined that the deaf-mute children who did not meet the criteria for Jervell and Lange-Nielsen syndrome still had evidence of subtle derepolarization abnormalities evidenced by intermediate prolongation of QTc, JTc, and the corresponding measures of dispersion, and we believe an electrocardiogram examination of deaf-mute subjects will reveal this potentially life-threatening syndrome.
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    A case of herpes tester misdiagnosed and treated as unstable angina pectoris
    (European Acad Dermatology & Venereology, 2000) Özdemir, R; Tuncer, C; Güven, A; Sezgin, AT
    [Abstract Not Available]
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    Effect of trimetazidine on late potentials after acute myocardial infarction
    (Springer, 1999) Özdemir, R; Tuncer, C; Aladag, M; Güven, A; Sezgin, AT; Pekdemir, H; Korkmaz, ME
    The purpose of this study was to evaluate the effect of trimetazidine on late potentials in patients with acute myocardial infarction. A total of 60 patients (52 males, mean age 55 +/- 2 years, and 8 females, mean age 54 +/- 1.8 years) with the diagnosis of acute myocardial infarction were included in this study. The study was designed as a randomized, double-blinded, and placebo-controlled trial. Signal-averaged electrocardiography and echocardiography were performed during the first 2 days of acute myocardial infarction and were repeated between days of 8 and 15 (mean 11). Patients were treated with trimetazidine (n = 30) or placebo (n = 30). In the placebo group, the total filtered QRS duration and low-amplitude terminal signal duration increased (from 102.7 +/- 1.8 ms to 113.3 +/- 1.8 ms, and from 32.2 +/- 0.9 ms to 38.3 +/- 1.1 ms; P < 0.001), the root mean square voltage of the terminal 40 ms of the QRS decreased (from 28.6 +/- 2.1 mu V to 21.4 +/- 1.3 mu V; P < 0.001), and the incidence of late potentials increased (from 30% to 46%; P < 0.01) significantly. In the trimetazidine group, these measurements were a decrease from 102.9 +/- 1.9 ms to 100 +/- 2.0 ms (NS), an increase from 31.6 +/- 0.9 ms to 32.5 +/- 0.9 ms (NS), a decrease 9.3 +/- 2.0 mu V to 27.3 +/- 1.8 mu V (P < 0.01), and a decrease from 33% to 30% (NS), respectively. The ejection fraction was 47.1 +/- 1.3% to 50.8 +/- 1.2% in the placebo group (P = 0.05), and 48.1 +/- 1.1% to 53.4 +/- 1.2% (P < 0.01) in the trimetazidine group. It is concluded that trimetazidine reduces late potentials after acute myocardial infarction without changing blood pressure and heart rate.
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    Loss of nocturnal decline of blood pressure in patients with nasal polyposis
    (Taylor & Francis Ltd, 1999) Özdemir, R; Yorulmaz, A; Kutlu, R; Güven, A; Aladag, M; Sezgin, A; Korkmaz, ME
    The objective of this study was to assess the blood pressure pattern in patients with nasal polyposis. Twenty-seven patients with nasal polyposis (18 males and 9 females), ranging in age from 15 to 72 years (mean 37.1 years) were eligible for inclusion in the study. All patients were hospitalized overnight before surgery. After the basal blood pressure measurements were taken,: non-invasive ambulatory blood pressure monitoring was carried out. Oxygen saturation was measured via a finger probe and venous blood sampling was taken for catecholamine level during the full night.: All measurements were repeated 4 months after nasal surgery. Mean values for nocturnal decline in blood: pressure and heart rate before surgery were less marked than those measured after surgery. Mean decline values (+/- SD) were; 4.6 +/- 2.4 mmHg for systolic blood pressure, 5.8 +/- 3.8 mmHg for diastolic blood pressure, and 7.9 +/- 3.9 beats/min for heart rate before surgery, 9.3 +/- 2.8 mmHg, 8.5 +/- 4.1 mmHg and 10.4 +/- 4.3 beats/min after surgery (p < 0.01), respectively. Whereas mean and minimum SaO(2) (%) significantly increased (p < 0.01), catecholamine levels decreased (p < 0.05 for adrenaline, p < 0.01 for noradrenaline) after surgery. A correlation was found between BMI and blood pressure as well as between duration of obstruction and blood pressure. Patients who snored had higher blood pressure values than those who did not. Our data show that in cases of nasal polyposis, hypoxia, hypercapnia, snoring, and sleep disorders may develop and persons with nasal polyposis and snoring have an increased risk of hypertension and loss of nocturnal decline in blood pressure.