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Biomedical subjects

Damlanur Sakiz

Publications and source records attributed to Damlanur Sakiz.

8 recordsLinked to original sources

The role of gastric Helicobacter pylori infection in laryngopharyngeal reflux disease.

OBJECTIVES: To investigate the role of Helicobacter pylori (H pylori) infection in laryngopharyngeal reflux (LPR). STUDY DESIGN: A prospective multidisciplinary clinical study. METHODS: Forty-four adult patients who applied to our ENT clinic with LPR symptoms were evaluated. Then these patients underwent upper gastrointestinal system endoscopy and double probe pH monitoring. In addition, during the endoscopy multiple biopsies from the stomach were obtained to detect H pylori. RESULTS: Results from 32 LPR positive patients were assessed (10 male and 22 female). There were no statistically significant differences between the presence of H pylori and sex, age, degree of gastritis and esophagitis, and also the number of reflux, fractional acid exposure time regarding proximal probe readings. Similarly for both proximal and distal probe readings, the average score of esophageal acid clearance was not statistically significant (P > 0.05). In addition, no statistically significant difference was found between the presence of H pylori and GERD (P > 0.05). CONCLUSIONS: The results of this study demonstrated that there is no relationship between gastric H pylori infection and LPR. EBM RATING: B-3b.

Adult↗

Cryptococcal parotid involvement: an uncommon localization of Cryptococcus neoformans.

We describe a cryptococcal infection localized in the parotid gland of an otherwise healthy 72-year-old woman. The patient presented with a painful, approximately 4.5 cm diameter mass in the anterior region of her right ear. Her symptoms were mild and uncharacteristic. The patient had previously fallen on her face in her garden, causing the loss and breakage of her dentures. Since the soil of the garden contained chicken droppings, it is quite likely that the oral prothesis became contaminated on contacting the soil. The fungus probably entered the parotid gland through the traumatization of the posterior lateral wall of her oral cavity by her broken denture. Numerous intra- and extracellular cryptococcal yeast cells were observed in both histopathological and mycological slide preparations. The yeastlike fungus was recovered in cultures inoculated with tissue collected through three biopsies of her parotid region. The isolates were identified as Cryptococcus neoformans by classical mycology methods and found to be susceptible, in vitro, to fluconazole, amphotericin B and flucytosine. Fluconazole treatment (400 mg/d, for 6 months) was started and the patients facial swelling resolved and the pain significantly reduced within 5 weeks of the initiation of treatment. While fungal infection of the parotid gland have been reported, to our knowledge, this is the first description of a non-disseminated primary parotid infection due to C. neoformans.

Aged↗

Heterotopic gastric mucosa in the cervical esophagus: could this play a role in the pathogenesis of laryngopharyngeal reflux in a subgroup of patients with posterior laryngitis?

OBJECTIVE: Acid secretion produced by a heterotopic gastric mucosal patch (HGMP) in the proximal esophagus, instead of gastric acid, may be responsible for laryngopharyngeal reflux (LPR), passing the upper esophageal sphincter. The aim of this study was to investigate the prevalence of HGMP in the proximal esophagus in patients with posterior laryngitis indicating the presence of LPR in comparison with a control group and to elucidate the possible role of this lesion in the pathogenesis of LPR. MATERIAL AND METHODS: A total of 36 consecutive patients with posterior laryngitis diagnosed on laryngoscopic examination were enrolled in the study. Esophagoscopy and ambulatory 24-h intra-esophageal dual-probe pH monitoring were performed in all patients. During endoscopy, special attention was paid to the proximal part of the esophagus, and the proximal electrode for pH monitoring was placed in this region under endoscopic view. The control group comprised 660 consecutive patients who had undergone upper gastrointestinal endoscopy for the usual indications. When HGMP was found, biopsies were taken for histological confirmation. RESULTS: HGMP was detected in 5 out of 36 patients. One out of five patients with patches was excluded from the study because the histopathology of this patient's patch revealed antral-type mucosa, which is not capable of acid secretion. Thus a total of 35 patients were included in the study, yielding a HGMP prevalence of 11.4% (4/35). Compared with the prevalence of the control group (1.6%), a significant difference was observed (p<0.005). pH monitoring showed that 45.4% of the patients had abnormal proximal acid reflux. All of four HGMP (+) patients with posterior laryngitis revealed significantly higher abnormal proximal reflux compared to the patients without patches (p<0.05). CONCLUSIONS: This first preliminary study may suggest that HGMP in the cervical esophagus could play a role in the pathogenesis of LPR, at least in a minor group of patients with posterior laryngitis, depending on its capability to produce acid in situ, although isolated proximal reflux could not be demonstrated. This finding may need to be supported by further studies with larger patient populations and using acid stimulation tests.

Adolescent↗

Predictive value of morphologic characteristics in rectosigmoid adenomatous polyps for the probability of synchronous polyps or cancer in the proximal colon.

BACKGROUND/AIMS: Sigmoidoscopy is performed more frequently than colonoscopy, especially for screening purposes and searching for colorectal neoplasm. The necessity of colonoscopy in patients with an adenoma of or=11 mm) polyps. These groups were compared regarding the presence of proximal adenoma and advanced proximal neoplasia (>10 mm adenoma and/or villous histology and/or high grade dysplasia or cancer). Polyps found in the rectum and sigmoid colon were considered as distal polyps and polyps other than these were considered as proximal polyps. RESULTS: In this study, of 1124 consecutive patients who underwent colonoscopy between April 1997 and January 2002, 184 (16%) had 258 adenomatous polyps in the rectosigmoid area. The polyps were diminutive ( or=11 mm) in 33 patients. Forty-one of the patients (39%) with diminutive polyps, 20 of the patients (43%) with small polyps and 19 of the patients (57%) with large polyps had neoplasm in the proximal bowel. In these patients, advanced proximal neoplasm was found in 8 (8%), in 6 (13%) and in 11 (33%), respectively. There was no difference regarding the presence of neoplasm in the proximal colon between these groups. The rate of advanced proximal neoplasm was found to be significantly higher in the group with large polyps in the rectosigmoid area than in the groups with small and diminutive polyps (p<0.05). In 104 patients (57%) with polyp(s) in rectum and sigmoid colon, no associated polyp or cancer was encountered in the proximal colon. CONCLUSION: Colonoscopy is indicated when adenomatous polyp, regardless of size, is found on rectosigmoidoscopy performed because of symptoms.

Adenomatous Polyps↗

Epithelialization process of free fascial flaps used in reconstruction of oral cavity mucosa defects in dogs.

Bare free fascial flaps are increasingly used for restoration of soft-tissue defects of the oral cavity because they provide thin, foldable tissues with high epithelialization capacity to preserve local anatomy as well as chewing, phonation, and deglutition. However, there are unanswered questions regarding the epithelialization process and other histopathologic changes occurring after transfer of these flaps into the oral cavity. To investigate these changes thoroughly, an experimental study was conducted in the dog model. Bare dorsal thoracic fascia was used as the free flap model. Ten adult dogs were used in this experiment. Oral mucosa defects measuring 6 x 5 cm were created. Free dorsal thoracic fascia flaps were harvested. The vascular pedicle of the fascia flap was anastomosed with the superior thyroidal artery and external jugular vein. Then, the flaps were transferred into the mucosa defects. The dogs were divided into groups, each composed of two animals. At 7, 14, 21, 30, and 60 days postoperatively, general anesthesia was administered to the groups 1, 2, 3, 4, and 5, respectively. First, clinical assessment was performed; then specimens were obtained. Initially, the flaps were gradually infiltrated by acute inflammatory cells coming from the circulation and then replaced by granulation tissue. Epithelial cells deriving from wound margins migrated onto the granulating flaps with eventual coverage of highly organized epithelium after 4 weeks, and the fascia flap could not be differentiated from the native mucosa. The flaps were replaced by normally maturated fibrous tissue containing regular collagen fibers, instead of atypical scar tissue. Wound contraction was calculated as 18 percent at postoperative day 60. It was detected that bare free fascia flaps used in the repair of mucosa defects act as a scaffold and complete epithelialization from surrounding margins. They can be accepted as the main surgical option for the reconstruction of oral cavity mucosa defects.

Animals↗

[The effect of antibiotic therapy on lung pathology in experimental models of sepsis].

AIMS: In this study, the effect of an extra-lung sepsis model on lung histopathology is evaluated. METHODOLOGY: In this study 20 Wistar-Albino rats were used. Following the ether anesthesia laparotomy was done. Caecum was ligated by a silk thread and was perforated by 18 gauge needle. It is squeezed until feces emerged. Abdominal wall is closed. By this method peritoneal sepsis was performed. The rats are divided into two groups (n:10). 0.5 ml of serum physiologic is applied to the control group, and imipenem is applied to the antibiotic group as 15 mg/kg/tid. 48 hours later rats were sacrificed by extreme ether anesthesia. Relaparatomy was done and diaphragm was open. Multiple biopsies were made from the lung. Biopsy materials was cultured and examined histopathologically. RESULTS: In control group; rats died in 48 hours (%100), but antibiotic group were alive (%0). The results of lung biopsy cultures are; in all rats in control group, Escherichia coli (E. coli) and Bacteroides fragilis (B. fragilis) were cultured (%100). Whereas in antibiotic group there is no bacteria cultured (p < 0.001). Histopathologic results are: in control group there was wide spread edema and congestion and inflammatory reaction. In antibiotic group there was slight edema, congestion and inflammatory reaction. CONCLUSION: In septic condition sings of adult respiratory distress syndrome occurs. Large spectrum antibiotics can prevent bacterial translocation in lungs and could minimize the lung injury.

Animals↗

A case report of doxycycline induced esophageal and gastric ulcer.

It is well-established that various drugs can induce esophageal and gastric mucosal injury. Generally neither motility disorder nor an anatomical stricture is found in such cases and the cause of mucosal injury is usually found to be inadequate fluid intake with medicine or consumption just prior to bedtime. Athough there are some case reports of doxycycline induced esophageal mucosal injury, doxycycline induced gastric ulcer has been reported only once in the literature. In this case report, a 33 year old female patient who had been prescribed doxycycline for pelvic inflammatory disease is presented. She was admitted with retrosternal and epigastric pain and odynophagia, which had begun after taking the second oral dose of the drug. Endoscopic examination showed ulcers in the mid esophagus and fundus of the stomach. Histologic findings supported a drug induced etiology in these ulcers. This is only the second case in the literature where gastric ulcer has been caused by doxycycline.

Journal Article↗

Congenital blaschkoid eccrine spiradenoma on the face.

Eccrine spiradenoma is an uncommon tumour of the sweat gland(s) and generally occurs as a solitary small painful nodule. Very rarely, it may present as multiple tumours arranged in a linear/blaschkoid pattern. An 8-year-old girl had many papulonodular lesions, arranged in a linear pattern on the left half of the face, involving the forehead and lateral side of the nose. The lesions were along Blaschko's lines. Lesions were reported to be present at birth; no family member had similar lesion(s), either in solitary or multiple form. Histopathologic examination of a biopsy specimen revealed characteristic features of eccrine spiradenoma. The case is reported because of the rare occurrence of this presentation.

Adenoma, Sweat Gland↗