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Öğe Chronic sympathetic activation affects dispersion of ventricular repolarization in syndrome X(Medimond S R L, 1997) Altun, A; Ozkan, B; Ozcelik, F; Altun, G; Ozbay, GPrevious studies of syndrome X (typical chest pain, positive treadmill exercise test, negative ergonovine test, negative hyperventilation test and angiographically normal coronary arteries) have suggested a potential etiologic role for excessive activation of the sympathetic nervous system. We evaluated the dispersions of Tapex-Tend(TT) and corrected TT as markers of sympathetic effects. Because TTd reflects inhomogeneity of the terminal part of ventricular repolarization. The present study we found TTd and TTcd increased in patients with syndrome X. We suggest these dispersions may be used to show chronic excessive sympathetic activation in patients with syndrome X or other diseases (LQTS etc) and predict the risk for arrhythmias and cardiac sudden death.Öğe Comparison between semiquantitative interictal Tc-99m HMPAO SPECT and clinical parameters in children with partial seizures(Elsevier Science Bv, 1999) Sarikaya, A; Kaya, M; Karasalihoglu, S; Alemdar, A; Altun, G; Berkarda, SThe aim of the present study was to correlate between clinical parameters (age, age of onset, frequency and durationof seizures) and semiquantitative interictal SPECT parameters in children with partial seizures. We obtained 30 patients who had hypoperfusion in interictal SPECT, retrospectively. All patients underwent a detailed clinical examination, electroencephalography (EEG) investigation and brain computerized tomography (CT) and/or magnetic resonance imaging (MRI). Single photon emission computerized tomography (SPECT) studies were evaluated visually and by calculating semiquantitative parameters (the degree (asymmetry index, Al) and extent (number of ROI) of hypoperfusion). Visual analysis detected ipsilateral hypoperfusion in 23 (76%) patients with a unilateral focus and contralateral hypoperfusion in seven patients. We found an inverse correlation between the age at onset of seizure (r = -0.40, P = 0.025), frequency of seizures(but positive correlation; r = 0.77, P = 0.000) and AI. Number of ROIs showed a moderate correlation with the frequency of seizures (r = 0.67, P = 0.000), while correlation of the age at onset of seizures was not significant. This study per-formed in pediatric patients also suggested that either SPECT parameters may be used for correlating with clinical parameters. (C) 1999 Elsevier Science B.V. All rights reserved.Öğe Confirmation of alleged falanga torture by bone scintigraphy - Case report(Springer-Verlag, 2003) Altun, G; Durmus-Altun, GAny objective persisting signs of previous torture would be very valuable in the late assessment of the individual claiming such abuse of human rights. We present the case of a 32-year-old man referred to our hospital for an opinion on alleged torture by the falanga method. Magnetic resonance imaging and bone scintigraphy were evaluated and compared as methods of confirming such torture.Öğe Deaths among homeless people in Istanbul(Elsevier Sci Ireland Ltd, 1999) Altun, G; Yilmaz, A; Azmak, DThe number of the homeless people in Istanbul, one of the largest cities in the world, is at present unknown. There has been no previous study in Turkey on cases and causes of death occurring among these individuals. In this paper, documents and autopsy reports of the Mortuary Section of the Council of Forensic Medicine, Istanbul, covering the period January 1st, 1991-December 31st, 1995, were reviewed. We established that there were 126 cases of death among homeless individuals in Istanbul during this period, 120 of them being males (95%), four (3%) females, and two (2%) transsexuals. Ninety-four corpses were found outdoors, 32 indoors. No personal documents, such as identity cards, were found in 110 individuals (87%), whereas only 16 individuals could be identified. Most deaths occurred in the age group of 41-50 years. One hundred and three of the cases (82%) died in the cold season between October and April. The deaths of 98 cases were attributable to natural causes, whereas the remaining 28 cases died from unnatural causes. Respiratory tract diseases occupied the first rank among cases of death from natural causes (44%). Alcohol abuse and other infections were further striking factors contributing to the fatal outcome. This is the first retrospective study on this topic in Turkey. However, more detailed and anterospectively programmed studies on this subject, a growing social problem, should be carried out. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe Deaths due to hunger strike: post-mortem findings(Elsevier Ireland Ltd, 2004) Altun, G; Akansu, B; Altun, BU; Azmak, D; Yilmaz, AHunger strike is described as voluntary refusal of food and/or fluids. Prolonged starvation may produce many adverse events including even death in rare circumstances. Here, we present three fatal cases (all males, 25-38 years) died from hunger strike. In all corpses, obvious muscle wasting with reduced subcutaneous and internal fat deposits, and atrophy in some organs were demonstrated at autopsy. The extraordinary long starvation period before death could presumably be linked to the thiamine uptake in this period, which had been discontinued by all subjects before the death occurred. Prolonged caloric deficiency with subsequent complications such as multiple organ failure, severe sepsis and ventricular fibrillation could account as major causes of death in these subjects. The competence of the physicians working with hunger strikers about the processes and potential problems is of great importance since they have to acknowledge about them to their patients. (C) 2004 Elsevier Ireland Ltd. All rights reserved.Öğe Firearm fatalities in Edirne, 1984-1997(Elsevier Ireland Ltd, 1998) Azmak, D; Altun, G; Bilgi, S; Yilmaz, ADuring the 14-year period from 1984 to 1997 there were 85 firearm fatalities investigated by the Department of Forensic Medicine and the Department of Pathology in Edirne, Turkey. We determined the characteristics of these 85 firearm deaths which comprised 17.03% of all medicolegal autopsies. The overall incidence was 1.58 per 100 000 population. The median age was 35.5 years. Fifty-four percent of the victims were aged between 20 and 40 years. Males constituted 82% of the victims. The most frequent manner of death was homicide (68.3%). Handguns accounted for 62.4% of the weapons used. The most common sites for the firearm entrance wounds were both head-neck-nape (32.8%) and chest (32%). In conclusion, our study shows that, in spite of legal restrictions, illegal access to firearms is easy and deaths by firearms are still increasing. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.Öğe Hemopericardium-related fatalities: A 10-year medicolegal autopsy experience(Karger, 2005) Altun, G; Altun, A; Yilmaz, ABackground: Patients with blunt or penetrating cardiac injury usually present with cardiac tamponade and hemorrhagic shock upon hospital arrival. Many victims die before they reach hospital. In this study, we present a detailed analysis of hemopericardium-related fatalities. Methods: We retrospectively reviewed the medicolegal autopsy records of hemopericardium-related fatalities that occurred from 1994 to 2003. The parameters investigated were demographic characteristics, hospitalization before death, the cause of death, the manner of death, the mechanism of death, the location of the entrance wound, the number of wounds reaching the target and the site of target perforation. Results: Seven women (mean age: 45 +/- 23 years) and 33 men (mean age: 34 +/- 12 years) were included in the study. Only 5 patients (12.5%) with cardiac activity reached the hospital. Twenty individuals (50%) were victims of stabbings, which was the most common cause of death. The most commonly encountered manner of death was homicide (79%). Thirty-one (77.5%) victims died of hemorrhagic shock and 9 (22.5%) of cardiac tamponade. Entrance wounds were frequently located on the left chest (n = 26). The perforated cardiac chambers were the left atrium (n = 1), the left ventricle (n = 12), the right atrium (n = 2) and the right ventricle (n = 15). One victim had coronary artery perforation. Nine victims had perforations on the intrapericardial part of the aorta. Conclusions: In our series, the hemopericardium-related deaths occurred predominantly in men. Stabbing was the most common cause of death. Entrance wounds were most commonly located on the left chest, and perforated sites were ventricles. Death at the scene was also frequent, and the mechanism of death was hemorrhagic shock. Copyright (c) 2005 S. Karger AG, Basel.Öğe Intra- and perioral shooting fatalities(Elsevier Sci Ireland Ltd, 1999) Azmak, D; Altun, G; Koç, S; Yorulmaz, C; Özaslan, ADetermination of the manner of death in the case of intra- and perioral firearm wounds can be difficult especially if death scene investigation is unclear and inadequate. In this study, we investigated some characteristics of these firearm wounds which were autopsied in Istanbul. During the 5-year period from 1991 through 1995, there were 15 intra- and perioral firearm fatalities investigated. In all the cases, only one shot was fired into the mouth. They constituted 1% of all the firearm fatalities. The mean age of the victims was 27 years and males constituted 73.3% of the victims. Most of the wounds were caused by handguns. Homicides accounted for 53.3% of these deaths. Three of 15 cases could not be identified as intraoral firearm wounds by general practitioners during the scene investigations. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe Planned complex suicide: Report of three cases(Elsevier Ireland Ltd, 2006) Altun, GThis article presents three planned complex suicide cases. The first case was a 46-year-old man, who had taken some antidepressant and antipsychotic drugs before cutting his right wrist and ingesting a large amount of concentrated hydrochloric acid. In the second case, a 34-year-old man was found dead in his home, hanging by his neck, with a suicidal stab wound on the left side of the chest. In the third case, a 22-year-old woman was found dead, hanging by her neck from a ceiling beam of her grandmother's a storage room, after taking of a solid rodenticide. The histories revealed psychiatric problems in all cases. The investigation of scene, the method employed, the autopsy findings and the interview with their relatives altogether pointed toward a suicidal etiology. (C) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe QT dispersion in hypothyroidism(Elsevier Sci Ireland Ltd, 1999) Altun, A; Altun, G; Özbay, GWe studied ten women (age: 40+/-12 years) with primary hypothyroidism. Baseline and after T4 treatment (euthyroid stage), all patients' resting ECGs were recorded. After T4 treatment, QTd (P=0.036), QTad (P=0.016), JTd (P=0.0001), JTad (P=0.005), Ted (P=0.036), QRS (P=0.046), QTcd (P=0.036), QTacd (P=0.028), JTcd (P=0.006), JTacd (P=0.016), Tecd (P=0.036) values shortened in patients with hypothyroidism. We found that regional inhomogeneity of ventricular repolarization in patients with hypothyroidism improves after T4 treatment. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe Sudden cardiac death in a hunger striker(Karger, 2003) Altun, G; Ugur-Altun, B; Altun, A; Azmak, D[Abstract Not Available]Öğe Sudden death due to cardiac tamponade caused by metastasis of squamous cell carcinoma of the lung(Karger, 2005) Altun, G; Bilgi, S; Altun, A[Abstract Not Available]
