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Biomedical subjects

Cetin Vural

Publications and source records attributed to Cetin Vural.

6 recordsLinked to original sources

[Nitric oxide and the upper airways: recent discoveries].

Nitric oxide (NO) is produced from L-arginine in mammalian tissues. Nitric oxide synthase (NOS) catalyzes this reaction in human tissues. It has been shown that NO serves as an important signaling molecule in the cardiovascular system and is responsible for vasoregulation. In 1991, NO was discovered in exhaled air. More recently, it has been shown that the main production site of exhaled NO is the nose and sinuses. In the upper airways NO upregulates ciliary motility and provides a first-line defense mechanism against microorganisms by antiviral and antimicrobial activity. In the lungs it is involved in ventilation/perfusion matching. Nitric oxide is also a marker for inflammation, with increased nasal output in allergic rhinitis, and a decreased output in sinusitis, nasal polyps and Kartagener's syndrome. This report reviews some aspects of the origin, metabolism, and functions of NO in the upper airways, together with the techniques for, and implications of, nasal NO measurement.

Humans↗

A method for off-line nasal nitric oxide measurement.

We conducted a study to test the accuracy of an immediate and delayed off-line technique for measuring nasal nitric oxide (NO) by comparing it with on-line measurements. With the assistance of one volunteer, we obtained these measurements during 30 sessions over a period of 2 months. Off-line measurements were made immediately following the acquisition of NO samples and 1, 2, and 4 hours later. NO samples were obtained from nasal air collected in syringes. We found that the correlation between on-line measurements and the immediate and delayed off-line measurements ranged from 95 to 98%, according to a Bland-Altman analysis. We conclude that off-line nasal NO measurements can be reliably used in clinical practice and research projects, thus obviating the need for patients/subjects to be in close proximity to the analyzer. Off-line nasal NO measurements can effectively substitute for on-line measurements when the latter technique is not practical.

Adult↗

Accuracy of computerized tomography in deep neck infections in the pediatric population.

OBJECTIVES: Computerized tomography (CT) is used widely to diagnose deep neck infections (DNIs), and, generally, the decision of surgical intervention is based on findings of a CT study. This study examines the accuracy of CT in differentiating abscess versus cellulitis in DNIs (lateral pharyngeal and retropharyngeal). STUDY DESIGN: This is a retrospective chart review study with re-evaluation of the CT scans by a blinded observer. METHODS: A retrospective review of medical records of 80 patients with DNIs who were evaluated with a CT study was performed. CT scans of these patients were reviewed by a radiologist who was blinded to the clinical and surgical findings and to the original CT study report. To diagnose the infection and differentiate abscess from cellulitis, our radiologist scored the CT scans regarding the following variables: low-density core, rim enhancement, soft-tissue swelling, obliterated fat planes, and mass effect. Radiologic diagnosis was compared with operative findings (whether pus found at surgery or not) in all cases treated surgically. Accuracy, sensitivity, specificity, and positive and negative predictive values of CT study were calculated. RESULTS: Thirty-nine (49%) patients were treated medically with intravenous (IV) antibiotics alone, and 41 (%51) patients were treated both surgically and medically. The overall accuracy of CT in DNI was 63%. The sensitivity, specificity, and positive and negative predictive values were 68%, 56%, 71%, and 53%, respectively. CONCLUSION: CT study has important limitations in differentiating abscess versus cellulitis in DNIs. Clinical findings as well as CT diagnosis should guide the decision of surgery.

Anti-Bacterial Agents↗

Variations of nasal nitric oxide in a subject with allergic rhinitis: a longitudinal study.

PURPOSE: Nitric oxide (NO) in the exhaled air is mainly produced by the upper respiratory airway mucosa, and the output of NO has been found to differ from normal in sinonasal disease. In allergic rhinitis (AR) nasal NO output (V(NO)) has been reported to increase compared with healthy individuals. The purpose of this study was to observe daily variations in V(NO) in a subject with AR and to investigate the effect of environmental factors on V(NO). MATERIAL AND METHODS: We measured V(NO) daily in an individual with AR over a period of 5-1/2 months to determine the variability of V(NO) from day to day. We used a 41-year-old, nonsmoking volunteer with AR as our subject to investigate the relationship between V(NO) and some environmental factors likely to affect V(NO). The correlation between V(NO) and nasal symptom scores was also investigated. Daily ambient NO concentrations, humidity, atmospheric pressure, and atmospheric grass pollen concentrations were recorded along with morning nasal NO measurements. At each measurement session, online NO measurements were done from both nostrils at 5 L/min constant transnasal flow. During the study the subject had a short period of a cold and a short period of purulent rhinitis and started using a nasal steroid spray at the end of the study. RESULTS: V(NO) levels for our subject were higher than previously published values for normal and allergic adults. There was an increase in V(NO) (the highest value throughout the study) in the prodromal period of the cold and a significant decrease (the lowest values throughout the study) during the cold. Change during the purulent rhinitis was less remarkable than change during the cold. CONCLUSION: No correlations between environmental conditions (humidity, atmospheric pressure, pollen count) and V(NO) were found. V(NO) changes were also independent of specific and cumulative nasal symptom scores.

Adult↗

Synovial sarcoma arising from the hypopharynx: a case report.

Synovial sarcoma is a relatively rare soft tissue tumor. About 3 to 10% of cases arise in the head and neck, with the majority in the parapharyngeal region. We hereby report a 22-year-old male patient with synovial sarcoma confined to the hypopharynx. Treatment included wide surgical excision followed by radiotherapy. It is of interest that the lesion recurred 12 years after the initial primary surgery for synovial sarcoma at the same site. The patient has been disease-free for five years.

Adult↗