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Biomedical subjects

B Sahin

Publications and source records attributed to B Sahin.

At least 37 records · Page 2Linked to original sources

Effectiveness of endoscopic treatment modalities in complicated hepatic hydatid disease after surgical intervention.

BACKGROUND AND STUDY AIMS: Hepatic hydatid cyst is a common disease in Turkey and the rupture of the cyst into the biliary tract is the most common complication which is difficult to detect and to manage. The aim of this study was to investigate the effectiveness of endoscopic treatment modalities in hydatid cyst patients with biliary complications who had previously undergone surgery. PATIENTS AND METHODS: Over the last 8 years, by means of endoscopic retrograde cholangiopancreatography (ERCP), we have examined 87 patients with postoperative biliary symptoms who had previously undergone surgery for hepatic hydatid disease of the liver. Endoscopic treatment modalities were as follows: endoscopic sphincterotomy (ES) and nasobiliary drainage in patients with biliary fistula; balloon and or bougie dilation and stenting in patients with biliary stricture; and ES and balloon extraction in patients with residual hydatid material within the bile duct. RESULTS: Findings from ERCP included biliary fistula in 55 patients (63.2 %), biliary stricture in 16 (18.4 %), and residual hydatid material within the bile duct in 14 (16.1 %). Two patients had normal findings on ERCP. In total, 85 patients were treated by means of endoscopic modalities. The time to closure of fistula was 17.8 +/- 5 days and the rate of fistula closure was 81 %. Biliary stenting was performed in 13 patients with biliary stricture. Endoscopic removal of hydatid material was achieved in 14 patients. The overall success rate of endoscopic treatment was 86 %, and a second surgical intervention was required only in six patients. No serious complication was encountered after endoscopic procedures. CONCLUSIONS: Endoscopic treatment modalities are safe and helpful methods for the treatment of biliary complications of hepatic hydatid cyst in the postoperative period.

Adolescent↗

Endoscopic management of a duodenal duplication cyst associated with biliary obstruction in an adult.

Duodenal duplication cysts are distinctly uncommon and most often present in infancy or early childhood. The clinical presentation is generally duodenal obstruction, hemorrhage, or pancreatitis. Duodenal duplication cysts rarely cause biliary obstruction in adults. So far, duodenal duplication cysts have been almost exclusively treated by surgical intervention. This report describes both endoscopic diagnosis and treatment of a large periampullary duodenal duplication cyst associated with biliary obstruction in an adult patient.

Adult↗

Primary sclerosing cholangitis in patients with inflammatory bowel disease in Turkey.

BACKGROUND: Primary sclerosing cholangitis (PSC), which is a progressive cholestatic liver disease of unknown etiology, is strongly correlated with inflammatory bowel disease (IBD). GOALS: To determine the prevalence and describe the characteristics of PSC in patients with IBD in Turkey. STUDY: We determined the prevalence of PSC in patients with IBD admitted to our department during a 6-year period. Also, patients with PSC were investigated from an IBD aspect. Regardless of whether the patient had symptoms such as itching, jaundice, and abdominal pain, endoscopic retrograde cholangiopancreatography was performed on those with elevated alkaline phosphatase, and liver biopsy was done if endoscopic retrograde cholangiopancreatography failed to bring about the diagnosis. RESULTS: Overall prevalence of PSC was 9 of 386 (2.3%) patients with ulcerative colitis (UC) and 4 of 110 (3.6%) patients with Crohn's disease (CD). Inflammatory bowel disease was established in 13 of 18 (72.2%; UC, 50.0%; CD, 22.2%) patients who were being observed for PSC. The male-to-female ratio was 5:4 in UC and 3:1 in CD patients with PSC. The mean age at diagnosis of PSC was 43.6 years (range, 30-54 years) in patients with UC and 30.5 years (range, 26-41 years) in patients with CD. In patients with UC, the extension of colitis was total in seven patients (7/110, 6.3%) and left-sided in two patients (2/142, 1.4%). In patients with CD, the disease was located in the ileum and colon in one patient (1/47, 2.1%) and in colon alone in three patients (3/21, 14.2%). CONCLUSIONS: Prevalence of PSC-associated IBD in the Turkish community appear to be similar to the results of western origin studies.

Adult↗

Endoscopic ultrasonography in the evaluation of dilated common bile duct.

Abdominal ultrasonography (US) is the procedure of first choice in the evaluation of a dilated common bile duct (CBD). Dilated bile ducts and the level of obstruction can be reliably demonstrated with US, but the cause can be determined in only two thirds of patients. The aim of this prospective study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom US could not demonstrate the cause of dilation or in whom US revealed equivocal results. This 13-month study included the evaluation of 985 patients. Ninety consecutive patients found to have an enlarged CBD (diameter, > or =7 mm) of unexplained origin during US examination were included in this study. All patients were evaluated by EUS. Final diagnosis was determined by endoscopic retrograde cholangiopancreatography with or without sphincterotomy ( n = 72) and surgical exploration ( n = 17). The following diagnoses were made by EUS: choledocholithiasis in 40 patients, benign distal stricture in 8, choledochal cyst in 2, and ova of Ascaris in 1. The dilatation of CBD was found by EUS examination to be caused by a tumor in 13 cases. These included tumor of the papilla of the Vater in six patients, distal cholangiocarcinoma in five, and pancreatic head cancer in two. Endoscopic ultrasonography provided an accurate explanation for CBD dilatation in 70 of the 76 patients (92%). We conclude that the diagnostic strategy for cholestasis should include US as a first choice. When the diagnosis of biliary obstruction remains probable, EUS should be carried out. Endoscopic retrograde cholangiopancreatography with sphincterotomy should be reserved for therapeutic use rather than diagnostic.

Adult↗

Chronic pancreatitis and aortic pseudoaneurysm in Behçet's disease.

Behçet's disease is a chronic, recurrent, systemic disease characterized by orogenital ulcers and oculocutaneous inflammatory lesions. Cardiovascular, pulmonary, neurological, articular, and GI involvement are common features, but pancreatic involvement is very rare. We present a case of Behçet's disease with both chronic pancreatitis and abdominal aorta pseudoaneurysm.

Adult↗

Arterial, neural and muscular variations in the upper limbs of a single cadaver.

Arterial, neural and muscular variations were observed in both upper limbs of a female adult cadaver during routine student dissection. Two superficial radial arteries were observed, which originated from the brachial and axillary arteries in the left and right upper limbs respectively. In the right upper limb, an ulnar nerve with a lateral root from the lateral cord of the brachial plexus in the axilla and, in the left forearm, an accessory muscle belly inserting into the muscle belly of the flexor digitorum superficialis were also observed. Formation of these variations is discussed on the basis of the embryological development of the upper limb structures. The clinical importance of the variations is emphasized.

Adult↗

Sweet's syndrome accompanying leukaemia: seven cases and review of the literature.

Seven patients with Sweet's Syndrome (SS) accompanying leukaemia are presented. Six had acute myeloid leukaemia and one chronic myeloid leukaemia. SS developed during G-CSF therapy in two patients and following long periods of chemotherapy-associated neutropenia in two. This finding may suggest a possible role of G-CSF in the pathogenesis of SS. SS was diagnosed during the first presentation of three patients with leukaemia. Skin lesions on the lower extremities in two patients, widespread distribution in one, a local infiltration at the inguinal region and pleural effusion in one were interesting findings in our patients which are not usual for classical SS.

Acute Disease↗

Granulocytic sarcoma as the cause of giant abdominal mass: diagnosis by fine needle aspiration and review of the literature.

Granulocytic sarcoma (GS) or chloroma is a neoplasia consisting of myeloid precursors in an extramedullary site. It is generally associated with myeloproliferative disorders especially with myeloid neoplasias. A young woman with huge abdominal mass due to GS associated with chronic myelocytic leukemia (CML) has been reported and literature is reviewed.

Abdominal Neoplasms↗

Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy.

The effect of Blastocystis hominis (B. hominis) in both immunocompetent and immunocompromised subjects has been the subject of debate in recent years, mostly in response to its unknown pathogenicity and frequency of occurrence. We performed a non-randomised, open labelled, single institute study in our hospital in order to investigate the clinical significance and frequency of B. hominis in patients suffering from hematological malignancy (HM) who displayed symptoms of gastrointestinal diseases during the period of chemotherapy-induced neutropenia. The presence and potential role of other intestinal inclusive of parasites were also studied. At least 3 stool samples from each of 206 HM patients with gastrointestinal complaints (the HM group) were studied. These were compared with stool samples from a control group of 200 patients without HM who were also suffering from gastrointestinal complaints. Samples were studied with saline-lugol, formalin-ether, and trichome staining methods. Groups were comparable in terms of gender, age and type of gastrointestinal complaints. In the HM group, the most common parasite was B. hominis. In this group, 23 patients (13%) had B. hominis, while in the control group only 2 patients (1%) had B. hominis. This difference was statistically significant (P < 0.05). Symptoms were non-specific for B. hominis or other parasites in the HM group. The predominant symptoms in both groups were abdominal pain (87-89.5%), diarrhea (70-89.5%), and flatulence (74-68.4%). Although all patients with HM were symptom-free at the end of treatment with oral metranidazol (1,500 mg per day for 10 days) 2 patients with HM had positive stool samples containing an insignificant number of parasites (< 5 cells per field). In conclusion, it appears that B. hominis is not rare and should be considered in patients with HM who have gastrointestinal complaints while being treated with chemotherapy. Furthermore, metranidazol appears to be effective in treating B. hominis infection.

Animals↗

Vasculitis and leukemia.

Vasculitis may accompany neoplasias and be of paraneoplastic type or associated with drugs used in patient treatment. We evaluated skin biopsies of twenty-eight cases with vasculitis accompanying leukemias reviewed and clinical outcome was evaluated. Eleven of the 28 cases had paraneoplastic vasculitis and 17 had vasculitis associated with various drugs including chemotherapy, cytokines and antibacterial agents. Paraneoplastic vasculitis was seen in 3 cases with chronic myelocytic leukemia in blastic phase, 5 patients with acute myeloblastic leukemia, and 3 with myelodysplastic syndrome. Drugs responsible for the 17 cases of vasculitis included hydroxyurea, vincristine, cytosine-arabinoside, methotrexate, all-trans retinoic acid, granulocyte-colony stimulating factor, interferon and antibiotics. Paraneoplastic vasculitis is not rare in leukemias and may be a manifestation of the blastic phase of chronic myeloid leukemia. Furthermore paraneoplastic vasculitis can be fatal in myelodysplastic syndromes and may be present clinically before the specific diagnosis is made. Drugs used in routine therapy may be the cause of the vasculitis, thus skin biopsy should be performed in all cutaneous lesions in patients with hemopoietic neoplasias.

Adolescent↗

Lymphomatous skin infiltration at the site of previous varicella zoster virus infection in a patient with T cell lymphoma.

Cutaneous infiltrations in hemopoietic neoplasias are not uncommon. They are generally localized on the legs, arms, back, anterior chest, scalp and face. In rare cases specific infiltration of neoplastic cells is localized in the site of herpes zoster and herpes simplex scars. In this report a case with T cell lymphoma in leukemic phase with skin infiltration in the previous Varicella Zoster Virus (VZV) site of infection is reported and literature is reviewed.

Adult↗

The association of thyrotoxicosis and chronic lymphoproliferative disorders.

We diagnosed thyrotoxicosis (Tx) and chronic lymphoproliferative disease (LPD) in nine cases; seven had chronic lymphocytic leukemia (CLL), one had hairy cell leukemia (HCL) and one had non-Hodgkin's lymphoma (NHL). In a literature review, we found only one reported case with Tx and CLL and documentation of an higher incidence of Tx in the relatives of CLL patients. We report these nine cases here and discuss this interesting association.

Aged↗

Postmastectomy malignant lymphoma.

Postmastectomy lymphedema (PML) is a morbid condition occurring in patients with breast carcinoma treated with radical/modified radical mastectomy. Postmastectomy angiosarcoma (PMA) is the most common neoplasia seen in these patients. Primary malignant lymphoma arising in PML is a rare neoplasia and 3 cases have been reported until now. In this report a patient with diffuse large cell lymphoma (DLCL) arising in PML is reported and the other three cases are reviewed.

Breast Neoplasms↗