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Biomedical subjects

B Gürsel

Publications and source records attributed to B Gürsel.

18 recordsLinked to original sources
PubMed2001

Positive surgical margins in cancer of the larynx.

In order to determine what should be done for laryngeal cancer patients when surgical margins are positive, and to evaluate their prognosis, a retrospective review of 21 laryngeal cancer patients with positive surgical margins out of 714 surgically treated cases (2.9%) was carried out. Nineteen patients were treated with postoperative radiation therapy. Two patients who had had endolaryngeal partial laryngectomy were treated with vertical partial laryngectomy. Two patients were lost to follow-up. Ten patients (10/19; 53%) were recurrence-free. Four patients had local, two had regional, and two had locoregional recurrences. Only one patient with a local recurrence could be salvaged with total laryngectomy and is disease-free. One patient developed liver metastasis. Nineteen patients had a mean and median disease-free survival of 48 and 36 months, respectively. Nine out of fourteen patients (64%) treated curatively were recurrence-free. The patients with positive margins developed significantly more locoregional recurrences than those with free margins (P < 0.05). We conclude that surgical margins must be checked peroperatively with frozen sections to make sure that they are free. The margins of every laryngectomy specimen must be diligently examined. If positive, re-excision, postoperative radiotherapy and chemotherapy are treatment alternatives. They should not just be managed with close follow-up. However, whatever treatment is applied, the prognosis for patients with positive margins is significantly worse than for those with free margins.

Adult↗
PubMed2001

Effect of teflon piston diameter on hearing result after stapedotomy.

This study compares hearing results after stapedotomy by 0.6 mm and 0.8 mm teflon pistons. Retrospective analysis studied 100 patients randomly selected who underwent stapedotomy for otosclerosis with insertion of 0.8 mm teflon piston prosthesis and 100 patients with 0.6 mm teflon piston prosthesis. Air-conduction hearing level in both groups were measured before and after the procedure and the gain of the air conduction between the 2 groups at different frequencies were compared statistically. The group with the 0.8 mm prosthesis had better results that were statistically significant and more pronounced at lower frequencies.

Acoustic Stimulation↗
PubMed1997

Effects of gamma irradiation on the survival of Listeria monocytogenes and on its growth at refrigeration temperature in poultry and red meat.

Gamma irradiation sensitivity of a strain of Listeria monocytogenes was determined in trypticase soy broth supplemented with yeast extract (TSB-YE), in a slurry of chicken breast meat and in raw ground beef. D10 values in these different media were 0.364, 0.599, and 0.699 kGy, respectively. This organism appeared most sensitive in TSB-YE, more resistant in minced fresh chicken breast meat, and most resistant in fresh minced beef. It was found that irradiation at 2.5 kGy prior to refrigeration is an efficient way for the preservation of meat products contaminated at 10(3) to 10(4) per gram initial load of L. monocytogenes for about 7 d. However, with this initial load, the injured cells might repair themselves and cause a health hazard during storage at 4 C in the presence of air after 7 d.

Animals↗
PubMed1996

MRI of the facial nerve in idiopathic facial palsy.

The purpose of this prospective study was to define the enhancement pattern of the facial nerve in idiopathic facial paralysis (Bell's palsy) on magnetic resonance (MR) imaging with routine doses of gadolinium-DTPA (0.1 mmol/kg). Using 0.5T imager, 24 patients were examined with a mean interval time of 13.7 days between the onset of symptoms and the MR examination. Contralateral asymptomatic facial nerves constituted the control group and five of the normal facial nerves (20.8%) showed enhancement confined to the geniculate ganglion. Hence, contrast enhancement limited to the geniculate ganglion in the abnormal facial nerve (3 of 24) was referred to as equivocal. Not encountered in any of the normal facial nerves, enhancement of other segments alone or associated with geniculate ganglion enhancement was considered to be abnormal and noted in 70.8% of the symptomatic facial nerves. The most frequently enhancing segments were the geniculate ganglion and the distal intracanalicular segment.

Adolescent↗
PubMed1996

[Primary cholesteatoma of the petrous bone apex].

BACKGROUND: Primary cholesteatoma of the temporal bone is a very rare disease. Initially, the tympanic membrane is intact, and often facial palsy may be the presenting symptom. The authors present a case of primary cholesteatoma which was surgically treated using a transmastoid-translabyrinthine approach. Other surgical approaches to the petrous apex are discussed.

Adult↗
PubMed1996

Role of MRI in the diagnosis of otitic hydrocephalus.

The pathogenesis of otitic hydrocephalus still remains doubtful. Magnetic resonance imaging (MRI) demonstrated sigmoid and transverse sinus thrombosis in two consecutive patients. The role of MRI in the diagnosis and pathogenesis of this complication, together with literature findings, is discussed. Until now, lumbar puncture, which is a minimally invasive technique, was the only diagnostic measure. MRI, however, can be used to establish the diagnosis of otitic hydrocephalus by showing the thrombosis in the sigmoid and transverse sinus.

Child, Preschool↗
PubMed1994

The effect of lymphocytic infiltration on clinical survival in cancer of the tongue.

Many factors have been claimed to influence the clinical prognosis of cancer of the tongue, one of them being the inflammatory response at the advancing tumor border. In a retrospective study of 60 patients with squamous cell carcinoma of the oral tongue, lymphocytic peritumoral inflammation was not found to be an objective prognostic marker.

Adult↗
PubMed1994

Wegener's granulomatosis: case report and review of the literature.

The clinical manifestations of Wegener's granulomatosis (WG) may be varied and easily overlooked. Awareness of distinguishing signs and symptoms allows early recognition and appropriate management. The body of literature dealing with the various facets of this disorder has grown in the past few years. Development of new diagnostic markers and successful therapies has rekindled interest in this disease. To assure early diagnosis and optimal prognosis the physician must maintain a high index of suspicion for WG. Although introduction of immunosuppressive therapy has dramatically improved the course of this disorder, treatment-related morbidity is often profound.

Adult↗
PubMed1993

Giant osteoma of the frontal sinus.

Osteoma is the most common benign tumour of the nose and paranasal sinuses, and the frontal sinus is its most frequent location. This tumour may be discovered incidentally on radiographs, or may enlarge to produce symptoms and, rarely, complications referable to its location near the orbit and anterior cranial vault. A 61-year-old man presented with right proptosis was found to have a giant osteoma involving frontal sinus. The aetiology, presenting features, and treatment of this tumour are reviewed.

Frontal Sinus↗
PubMed1993

Blindness after intranasal ethmoidectomy.

Orbital haemorrhage is an unusual and frustrating complication of ethmoid surgery. A case of reversible blindness which was due to intra-operative orbital haemorrhage occurring after intranasal ethmoidectomy is presented. Prevention and management of this kind of blindness can be reversed, if treated aggressively.

Adult↗
PubMed1991

Quantitative 99mTc-DTPA scintigraphy for determination of maxillary sinus drainage following Caldwell-Luc surgery.

Nine maxillary sinuses of 8 patients who had undergone Caldwell-Luc surgery (CWL) were injected with 100-125 microCi 99mTc-DTPA in 0.2 ml from the gingivo-buccal sulcus, passing through the canine fossa window. Sinus half-emptying times and percent contribution of the natural ostium (NO) and the naso-antral window (NA) to the clearance from the sinus were calculated, using time-activity curves as well as the activity of cotton wool plugs placed into the middle and lower conchae. Mean half-emptying times in patients in whom the mucosa had been removed were shorter than those in patients in whom it had been left in place. In the former group percent drainage through the NO was higher than that through the NA whereas in the latter group the opposite was the case. These findings are consistent with the thesis that if the mucosa is retained, the cilia continue their sweeping action towards the NO but if it is removed the NA gains importance in the drainage. This method is promising for the evaluation of maxillary sinus drainage following CWL.

Humans↗
PubMed1990

Androgen receptors in laryngeal carcinoma.

Specific androgen receptors were assayed from the cytosol fraction of laryngeal carcinomas from 15 male patients. Specimens also included the non-malignant laryngeal tissues from 3 of these patients. A specific radioligand was used and involved (3H) dihydrotestosterone incubation and a dextran-coated charcoal technique. Twelve of the laryngeal carcinomas showed detectable levels of high affinity but limited capacity androgen receptors. The number of binding sites varied from zero to 23.3 fmol/mg cytosol protein, with the dissociation coefficient (Kd) ranging from 0.46 to 1.85 x 10(-9) M. Androgen receptors were also found in all three non-malignant laryngeal tissues. Binding sites for these latter androgen receptors were 4.09 to 8.16 fmol/mg cytosol protein, with a Kd of 0.81 to 0.35 x 10(-9) M. Although further studies are necessary, the presence of androgen receptors in laryngeal carcinomas suggests that antiandrogen therapy might be used in the future for treating such disease.

Binding Sites↗
PubMedDate not supplied

Sister chromatid exchange in lymphocytes of patients with cancer of the larynx.

The frequency of sister chromatid exchange (SCE) was studied in cultured peripheral lymphocytes from 15 untreated patients with carcinoma of the larynx and 10 healthy control subjects. Bromodeoxyuridine-incorporated chromosomes were treated with Hoechst 33258 and stained according to conventional methods. To measure SCE frequency, at least 15 mitoses per donor were evaluated. The SCE values were found to be higher in cancer cases than in control cases.

Adult↗
PubMedDate not supplied

Prognostic significance of vascular and perineural invasion in cancer of the larynx.

PURPOSE: Perineural and vascular invasion are generally recognized as poor prognostic factors in cancer. The authors report the prognostic significance of perineural and vascular invasion in cancer of the larynx. MATERIALS AND METHODS: The laryngectomy specimens of 94 patients with squamous cell carcinoma of the larynx were analyzed histopathologically for vascular and perineural invasion. Prognostic significance of vascular and perineural invasion was evaluated related to the cervical lymph node metastasis, recurrence, and disease-free survival. RESULTS: Vascular invasion significantly influences cervical lymph node metastasis for supraglottic tumors, yet not for glottic and transglottic tumors. Perineural invasion has marginal significance in cases of cervical lymph node metastasis of supraglottic tumors; it has no significance in cases of cervical lymph node metastasis of glottic and transglottic tumors. Vascular invasion significantly increases local and regional recurrence rate, but not distant metastasis rate. Perineural invasion significantly increases local recurrence rate, but not regional recurrence and distant metastasis rate. The disease-free survival is significantly shortened by the presence of vascular and perineural invasion. According to multivariant analysis, neither vascular nor perineural invasion significantly effects the disease-free survival independently (P> .15). The presence of vascular invasion significantly affects the recurrence independently (P=.045). The presence of vascular invasion significantly reduces the interval between surgery and the development of recurrence (P=.013). CONCLUSION: The presence of vascular and perineural invasion should be checked in every laryngectomy specimen because both have a significant prognostic value; both influence the disease-free survival and recurrence significantly. Vascular invasion significantly increase cervical lymph node metastasis of supraglottic tumors; perineural invasion has only marginally significant effect on cervical lymph node metastasis of supraglottic cancers. Vascular invasion plays an independent role in determining the recurrence.

Adult↗
PubMedDate not supplied

The value of elective neck dissection in treatment of cancer of the tongue.

PURPOSE: The "adequate" therapy of tongue cancer has not yet been determined. The authors report their experience with 58 N(0) patients to elucidate the role of elective neck dissection in surgical treatment of cancer of the tongue. MATERIALS AND METHODS: The files of 58 N(0) patients with tongue cancer were evaluated retrospectively. In every patient, partial glossectomy continuous with neck dissection was the mainstay of the treatment. TNM staging, intraoperative N staging, pathologically confirmed cervical lymph node metastases and their levels, and clinical outcomes (local and regional recurrences) were recorded. The sensitivity and specificity of intraoperative staging was determined. RESULTS: Fifty-four percent (31/58) of the patients presented as T(1), and 26% (15/58) as T(2). The overall occult metastasis rate was 29.3% (17/58). The occult metastasis rate for T(1) and T(2) lesions was 19.4% (6/31) and 26.7% (4/15), respectively. The sensitivity of intraoperative staging was 76.5%, and the specificity was 51.2%. CONCLUSIONS: The rate of occult metastasis to the neck is too high in all tongue cancer cases to take the risk of regional recurrence, and the surgeon can not solely depend on neck palpation for determination of neck metastasis. Radiologic investigations and fine-needle aspiration decrease, but never reduce to zero the rate of false-negative examination. There is an obvious indication for neck dissection, even in early cases.

Adult↗