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Biomedical subjects

Gulchin Ergun

Publications and source records attributed to Gulchin Ergun.

4 recordsLinked to original sources

Anthropometric correlates of intragastric pressure.

OBJECTIVE: Obesity may increase intra-abdominal pressure on the stomach leading to an increase in intragastric pressure, which in turn induces lower esophageal sphincter relaxation, with subsequent reflux. However, the association between anthropometric measures of total body as well as abdominal obesity and intragastric pressure has not been examined. MATERIAL AND METHODS: This prospective cross-sectional study included consecutive patients undergoing manometry at an open access Reflux Center. Standardized measurements of body-weight, height, and waist and hip circumference were prospectively obtained. To assess the intragastric pressure, the perfusion port levels of the catheter were verified to be at the same vertical height (0 mmHg) inside the patient as they were outside the patient during calibration. Correlation between gastric pressure and anthropometric measures was calculated and adjusted for demographic features and presenting symptoms. RESULTS: A total of 322 patients (67% women) with a mean age of 52.5 years were enrolled. The mean values for weight, height, and body mass index (BMI) were 77.2 kg, 168 cm, and 27.5 kg/m2, respectively (range 16.0-52.0, median 27.0). The mean intragastric pressure was 2.9 cm H2O (SD: 1.7). There was a weak, positive correlation between gastric pressure and both BMI (r=0.11, p=0.05) and waist circumference (r=0.11, p=0.06). The associations between gastric pressure and both BMI and waist circumference were relatively unaffected by adjusting for several variables including age, indications for manometry, race, and gender in a multivariable linear regression model. For each unit increase in BMI, there was approximately a 10% increase in intragastric pressure. CONCLUSIONS: In this study of consecutive patients with wide-ranging BMI values, there was a weak, positive correlation between intragastric pressure and both BMI and waist circumference. This indicates that obesity operates to increase the risk of gastroesophageal reflux disease (GERD) at least partly by increasing intragastric pressure.

Body Fat Distribution↗

Expression of the high mobility group proteins HMGI(Y) correlates with malignant progression in Barrett's metaplasia.

Expression of the high mobility group proteins HMGI(Y) has been shown to be a marker of malignancy in thyroid and pancreatic lesions and to correlate significantly with malignant progression in the colon. The aim of this study was to determine whether HMGI(Y) expression is associated with malignant progression in Barrett's metaplasia (BM). Immunoperoxidase staining for HMGI(Y) was performed on sections of formalin-fixed paraffin-embedded endoscopic esophageal biopsies from 42 patients with BM. These consisted of 19 biopsies negative for dysplasia (ND), 16 with low-grade dysplasia (LGD)/indeterminate for dysplasia (IND), and 7 with high-grade dysplasia (HGD)/adenocarcinoma (CA). The percentage of positive cells was recorded, and nuclear HMGI(Y) immunoreactivity in >10% of the cells was considered positive. Statistical analysis was performed using Fisher's exact test. Positive HMGI(Y) staining was detected in 2 of 19 (11%) cases ND, 5 of 16 (30%) LGD/IND cases, and 7 of 7 (100%) HGD/CA cases. Biopsies with HGD/CA were significantly more likely to be positive for HMGI(Y) than biopsies ND (P < 0.0001) or with LGD/IND (P = 0.0046). We conclude that HMGI(Y) expression is significantly associated with malignant progression in BM. Additional studies are needed to determine whether BM biopsies that are ND or LGD/IND and positive for HMGI(Y) are more likely to progress to adenocarcinoma.

Adenocarcinoma↗

Non-small cell lung cancer staging techniques and endoscopic ultrasound: tissue is still the issue.

Non-small cell lung cancer (NSCLC) in the United States will continue to be a major public health issue, particularly as our elderly population grows. As surgery offers the best hope of cure for NSCLC, staging of NSCLC is critical because it directly impacts on the management of lung cancer. Cost, quality of life, safety, and accuracy of various staging methods all influence the clinical outcome. Staging of NSCLC is evolving due to the emergence of new and improved technologies. The objective of this article is to review the current methods used in staging of NSCLC. Currently, positron emission tomography and endoscopic ultrasound (EUS) show promise in identifying patients that may benefit from surgery. Histologic confirmation via EUS-guided fine-needle aspiration, however, may still be necessary to accurately stage the mediastinum.

Biopsy↗