... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with ... more ... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with histopathologic findings Ugur Ilga1, Mustafa Ozyurt1*, Sukru Yıldırım2, Koray Ergunay3, Nurittin Ardic1, Levent Demirturk4, Tuncer Haznedaroglu1 ...
Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been su... more Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been suggested to have an additive effect in curing Helicobacter pylori infection. Seventy Hpylori-positive patients were given either eradication treatment consisting of 500 mg clarithromycin bid and 30 mg lansoprazole bid for 10 days plus 10 mL (400 mg) N-acetyl cysteine (NAC) liquid tid (AC group) or eradication treatment only (control group). The results were compared 1 month after the completion of the treatment. Fifty-eight patients were available for statistical analysis. Of the 28 patients in the AC group, 14 (50.0%) eradicated the infection after treatment, whereas only 7 of 30 (23.3%) patients in the control group had negative results. The difference between the AC group and the control group was statistically significant (P = 0.034). In both groups, there was no difference in the number of smokers and in the eradication rates between smokers and nonsmokers. Eradication treatment with or without NAC caused no significant side effects in either group. Our findings suggest that NAC has an additive effect on the eradication rates of H pylori obtained with dual therapy with lansoprazole and clarithromycin. NAC does not have any known activity against H pylori, but it may improve the delivery of antibiotics at the site of infection due to its ability to reduce the thickness of the mucus.
Dental plaque is considered by some to be a secondary reservoir for Helicobacter pylori and thus ... more Dental plaque is considered by some to be a secondary reservoir for Helicobacter pylori and thus responsible for gastric reinfection. The aim of this study was to investigate whether testing dental plaque using a rapid urease test (CLOtest) can be used to determine gastric H. pylori status. We investigated dental plaque colonization by H. pylori and its correlation with gastric infection in 75 dyspeptic patients. CLOtest was used to determine H. pylori positivity. Tests for H. pylori were positive in dental plaque samples from 68 patients and in stomach samples from 65 patients. The sensitivity of using CLOtest in dental plaque to determine gastric H. pylori status was 89.7%, with a diagnostic accuracy of 86.7%. Gastric eradication was achieved in 83% of patients, but efforts to eradicate dental plaque colonization were unsuccessful in all patients. Using CLOtest to detect H. pylori in dental plaque is a reliable first-line diagnostic approach for gastric H. pylori infection. Dental plaque might be a sanctuary for H. pylori, leading to gastric recurrence.
ABSTRACT The primary source of ammonia is the gut. Ammonia can also be generated by the urease ac... more ABSTRACT The primary source of ammonia is the gut. Ammonia can also be generated by the urease activity of Helicobacter pylori in the gastric mucosa. The aim of this study was to investigate the effect of H. pylori eradication on blood and gastric juice ammonia levels and on visual evoked potential (VEP) recordings in cirrhotic patients. Male patients with cirrhosis and H. pylori infection were prospectively evaluated. All patients were given triple regimen for eradication for 10 days. Gastroscopy together with gastric juice sampling for ammonia and mucosal sampling for H. pylori status was performed before and after therapy. Gastric juice and blood ammonia levels were measured and VEP recordings were obtained before and after treatment. Twenty-seven patients were included in the study. Patients with overt clinical hepatic encephalopathy were excluded from the study. Twenty-four out of twenty-seven patients became H. pylori-negative after the treatment. Ammonia measurements and VEP recordings were evaluated in the 24 patients in whom eradication was successful. A slight but statistically significant decrease in blood and a considerable decrease in gastric juice ammonia levels were observed after treatment [from 44.23 micromol/l to 41.6 micromol/l compared with 3234 micromol/l to 2709 micromol/l, respectively (p <.05)] in patients in whom H. pylori was eradicated. VEP recordings were abnormal in 14 out of 24 patients before the treatment. Only four of these 14 patients with abnormal recordings showed improvement. (p > .05). Helicobacter pylori eradication in cirrhotics decreases blood and gastric juice ammonia concentrations whereas it does not provide an improvement in VEP recordings.
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Short-segment Barrett&amp... more Short-segment Barrett's esophagus (SSBE) is defined by the presence of columnar-appearing mucosa in distal esophagus (involving less than 2 to 3 cm), with intestinal metaplasia on biopsy. Its potential to develop dysplasia and cancer may require a surveillance program with better diagnostic tools to detect intestinal metaplasia. To investigate the role of imprint cytology as a diagnostic tool either alone or combined with histology in SSBE. Seventy-nine patients (46 men, 33 women) with SSBE diagnosed during elective upper gastroscopy were included. Patients with serrated z-line with short tongues of pink mucosa and patients with a circular non-serrated z-line that extended less than 2 cm above the esophagogastric junction were biopsied on four quadrants just distal to z-line. Four slides of imprint preparation (including 1, 2, 3, and 4 touching of each biopsy specimen) was made for cytologic examination. Hematoxylin and eosin and Alcian blue staining for histologic examinations and Alcian Blue for cytologic evaluations were used to find evidence of intestinal metaplasia. Intestinal metaplasia was detected in 15 (19%), 21 (27%), and 30 (38%) patients by histologic examination with hematoxylin and eosin alone, by Alcian blue alone, and by histologic plus cytologic examination with Alcian blue, respectively. Nine patients with negative histologic but positive cytologic results were positive for intestinal metaplasia when they were reevaluated after further sectioning and staining. Sensitivity of imprint cytology alone was 53%. When imprint cytology was combined with the histologic evaluation, the prevalence of intestinal metaplasia increased from 27% to 38% (p < 0.05). Imprint cytology might be a complementary diagnostic tool for histology in detecting patients with SSBE.
... Does High Albumin Gradient Ascites Accompany Tuberculous Peritonitis? Gürbüz, Ahmet Kemal MD;... more ... Does High Albumin Gradient Ascites Accompany Tuberculous Peritonitis? Gürbüz, Ahmet Kemal MD; Yazgan, Yusuf MD; Ozel, Melih AMD; Çavuşlu, Şaban MD; Altunay, Hüsnü MD; Yildirim, Şükrü MD. Article Outline. Collapse Box Author Information. ...
Metastatic carcinoma to the testis is very rare. Metastasis of prostate adenocarcinoma to testis ... more Metastatic carcinoma to the testis is very rare. Metastasis of prostate adenocarcinoma to testis was detected incidentally after bilateral orchiectomy for hormonal management of metastatic prostate carcinoma. The metastatic lesion was not identified in physical examination or in macroscopic dissection of the testis after surgery. Microscopy revealed an adenocarcinoma which, given the history of the patient and a positive immunohistochemical stain for PSA, was identified as metastatic prostatic adenocarcinoma. Int
Background. N-acetyl cystein, a mucolytic agent, might make Helicobacter pylori antigens shed mor... more Background. N-acetyl cystein, a mucolytic agent, might make Helicobacter pylori antigens shed more easily to stool, and might therefore contribute to the diagnostic accuracy of the Helicobacter pylori stool antigen test. The aim of this study is to investigate if N-acetyl cystein contributes to the diagnostic accuracy of the Helicobacter pylori stool antigen test by increasing the sensitivity and specificity of the test. Materials and Methods. 107 patients were separated into treatment and placebo groups. The AC group (n = 53) was given 5 ml of acetyl cystein (4%) t.i.d. and the Placebo group (n = 54) was given placebo, for 3 days. Helicobacter pylori status was determined by both histology and CLOtest. Stool samples were assayed using a specific ELISA kit for Helicobacter pylori stool antigen.
CagA seropositivity is closely associated with that of vacuolating cytotoxin (VacA). Helicobacter... more CagA seropositivity is closely associated with that of vacuolating cytotoxin (VacA). Helicobacter pylori strains positive for both VacA and CagA were reported to be strongly associated with peptic ulcer disease. Different results reporting that cagA gene is not associated with more serious diseases, lowers the importance of CagA protein as a marker. In this study, CagA seropositivity is examined in Turkish peptic ulcer and nonulcer dyspepsia patients; histopathologic scores of CagA (+) and CagA (-) groups were compared. Sixty consecutive patients (one gastric ulcer, 13 duodenal ulcer and 46 nonulcer dyspepsia) (mean age 40.9 +/- 14.7; 33 women, 27 men) with dyspeptic complaints who underwent upper gastrointestinal (GI) endoscopy were included. Biopsies from the antrum and corpus were used for histopathologic examination and for rapid urease test. H. pylori-negative patients comprised the control group. Histopathologic findings were graded using a previously described grading system (for inflammation, activity, atrophy, intestinal metaplasia and H. pylori, grades from 0 to 3 were used to quantify the findings). In H. pylori-positive patients, antibodies against CagA protein were determined using an ELISA METHOD: H. pylori was (+) in 46 patients. One duodenal ulcer and 13 nonulcer dyspepsia patients were negative for H. pylori. CagA positivity is significantly higher in peptic ulcer patients [12/12] than in nonulcer dyspepsia patients [25/33]. While inflammation, activity and atrophy scores were significantly higher in CagA positive patients, intestinal metaplasia and H. pylori load scores were not. Although the histopathologic scores in controls were lower than CagA (-) group, statistical significance was observed only in inflammation and intestinal metaplasia scores. Development of more prominent gastritis and severe atrophy in CagA (+) patients is an indicator of the importance of CagA rather than H. pylori load. Therefore, we suggest that nonulcer dyspepsia patients should also be tested for CagA status along with the tests for H. pylori status; and a positive CagA testing should be considered as an indication for eradication treatment. If CagA is negative, further assesment should be performed to decide whether or not to treat the patient.
Objective: There is a small number of studies in adult nonpalpable testes cases, and there is no ... more Objective: There is a small number of studies in adult nonpalpable testes cases, and there is no published paper on the diagnostic value of their ultrasonographic examination. In this prospective study, we compared the sonographic and laparoscopic findings in adult cases with nonpalpable testes to assess the necessity and the profits of ultrasound. Materials and Methods: 50 cases, 38 unilateral and 12 bilateral, with nonpalpable testes were investigated. Patients' ages ranged from 20 to 25 years with a mean of 22. Sonographic examinations were performed with a highresolution ultrasonography device. Results: Laparoscopic evaluation of the patients with unilateral nonpalpable testis yielded 27 testes out of a total 38. In one case, the testis was detected in the inguinal canal with inguinal exploration. The remaining 10 cases were regarded as vanishing testes. All 24 testes of 12 patients with bilateral nonpalpable testes were found. The pre-laparoscopic ultrasonographic examination detected 20 of 24 testes in bilateral cases (83% sensitivity), and 17 of 26 testes in unilateral cases (65% sensitivity). Conclusion: Our results suggest that ultrasonography does not exclude the necessity for laparoscopy, and it is not superior to physical examination in detection of the inguinal atrophic testes or testicular nubbin. #
New prognostic factors in gastric carcinoma to determine the prognosis of the disease or to ident... more New prognostic factors in gastric carcinoma to determine the prognosis of the disease or to identify patients who will benefit from adjuvant therapy are being researched. The aim of this study is to investigate the correlation between microvessel count (MVC) and various clinicopathologic features in gastric carcinoma in order to evaluate the role of angiogenesis on the prognosis of gastric cancer. Fifty-seven patients who underwent surgical intervention for gastric carcinoma between 1993 and 1997 were reviewed retrospectively. The relationship between MVC and various clinicopathological features was assessed. The effect of angiogenesis on overall survival and the role of MVC and other prognostic factors on distant metastases were assessed by multivariate analysis. Microvessels were outlined by anti-factor VIII, which is a specific monoclonal antibody to factor VIII in vessel endothelial cells, using the streptavidin-biotin method and counted under light microscopy x200 magnification. There was no correlation between MVC and age or sex of the patient, duration of symptoms or tumor size. Proximally located, undifferentiated, diffuse type, serosal invasion positive, lymph node invasion positive, advanced stage, or distantly metastasized tumors had higher MVCs. Higher MVCs affected the overall survival adversely. Lymph node metastasis, serosal invasion and MVC were found as independent prognostic factors affecting distant metastases. MVC was the sole factor affecting recurrent liver metastasis. It is concluded that MVC in gastric carcinoma may be a valuable prognostic factor to predict patients at high-risk for possible recurrences and to decide on postoperative adjuvant therapy.
Kikuchi-Fujimoto Disease (KFD) was first described in Japan in 1972. The disease frequently mimic... more Kikuchi-Fujimoto Disease (KFD) was first described in Japan in 1972. The disease frequently mimics tuberculous lymphadenitis, malign lymphoma, and many other benign and malignant conditions. To our knowledge, there is no previous study comparing the clinical and laboratory characteristics of patients from different geographical parts of the world. We searched literature records beginning from 1991 and analyzed epidemiological, clinical, and laboratory data of 244 patients (including cases diagnosed in our institution) reported in 181 publications. Of the 244 cases, 33% were male and 77% were female. Mean age was 25 (1-64) and 70% was younger than 30. Most of the cases were reported from Taiwan (36%), USA (6.6%), and Spain (6.3%). Fever (35%), fatigue (7%) and joint pain (7%) were the most frequent symptoms, while lymphadenomegaly (100%), erythematous rashes (10%), arthritis (5%), hepatosplenomegaly (3%), leucopenia (43%), high erythrocyte sedimentation rate (40%), and anemia (23%) being the most common findings. KFD was associated with SLE (32 cases), non-infectious inflammatory diseases (24 cases), and viral infections (17 cases). SLE was more frequent in cases from Asia than Europe (28 and 9%, respectively). The disease was self-limiting in 156 (64%) and corticosteroid treatment was necessary in 16 (16%) of the cases. The mortality rate was 2.1%. Early diagnosis is crucial as the clinical and laboratory presentation generally imitates situations needing lengthy and costly diagnostic and therapeutic interventions. Additionally, association with SLE needs further investigation.
... Mecit Kantarci, MD,* Bulent Karaman, MD,* C. Cinar Basekim, MD,* Mehmet Incedayi, MD,* Hakan ... more ... Mecit Kantarci, MD,* Bulent Karaman, MD,* C. Cinar Basekim, MD,* Mehmet Incedayi, MD,* Hakan Mutlu, MD,* Onur Sildiroglu, MD,* Sukru Yildirim ... REFERENCES 1. Saglam L, Akgun M, Aktas E. The usefulness of induced-sputum and fiberoptic bronchoscopy in diagnosis of ...
Background: This study evaluates the possibility of enhancing the beneficial effect of the delay ... more Background: This study evaluates the possibility of enhancing the beneficial effect of the delay procedure by using hyperbaric oxygen therapy, and the possibility of lessening the time required for maximal effect of delay procedure. Methods: Eight male Wistar rats were ...
The aim of this study is to investigate the effects of different fixatives on DNA, and to evaluat... more The aim of this study is to investigate the effects of different fixatives on DNA, and to evaluate the fixation options for molecular studies including polymerase chain reaction (PCR) and fluorescence in-situ hybridization (FISH). Three normal-looking colonic segments from surgical resections were used for tissue sampling. The full thickness of the colonic tissues (3 mm diameter) was sampled. Tissues were fixed in 70% ethanol, 10% neutral-buffered formalin, Hollande, B5, Bouin, and Zenker solutions for 1, 2, 5, 12, 24, and 48 hours, and processed and embedded in paraffin in a standard protocol. Quantitative measurements of the extracted DNA were carried out. DNA quality was tested by PCR for the human beta globin gene. Tissue sections were also tested for the availability of FISH, by using a Her-2/neu protocol. All fixation alternatives were found to be reasonable sources of DNA for molecular studies, and they enabled the successful PCR amplification of a housekeeping gene. DNA yields were predominantly over 1000 bp in 70% ethanol and 24-hour 10% neutral-buffered formalin fixations. As for B5 and Hollande, the DNA molecules obtained were almost all smaller than 100 bp. All tissues fixed in formalin, ethanol, and Hollande were found suitable for Her-2/neu visualization after standard FISH applications, but tissues fixed in Zenker, B5, and Bouin were not found suitable.
The aim of the study was to compare the effects of mitomycin-C (MMC) and 5-fluorouracil/triamcino... more The aim of the study was to compare the effects of mitomycin-C (MMC) and 5-fluorouracil/triamcinolone acetonide (5-FU/TA) on the development of fibrosis/scar tissue formation of rabbit subglottic area, which is injured acutely. After standardized trauma to subglottic area the rabbits were divided into those that received treatment and those that did not (controls). The subjects were treated with either topical 0.4 mg/mL MMC or 5 mg 5-FU/TA injection. Those groups were further divided into subgroups depending on the time of examination: at 2 or 6 weeks. Each subgroup had 4 rabbits. The specimens were examined histopathologically and the measurements were performed using a software. The fibrosis indices (FIs) of the treated subgroups were significantly less than the FIs of their corresponding control subgroups (P<.05). The difference in FIs of the MMC-treated and 5-FU/TA-treated groups was not statistically significant (P>.05). MMC and 5-FU/TA did not interfere with regeneration of the epithelium although in 2 cases treated with 5-FU/TA the regenerated epithelium showed squamous metaplasia. Both MMC and 5-FU/TA decrease fibrosis/scar tissue formation secondary to experimentally induced acute subglottic trauma. There is no significant difference between the effects of the 2 drugs.
This study was performed to evaluate the effects of tamoxifen on pulmonary fibrosis, given concur... more This study was performed to evaluate the effects of tamoxifen on pulmonary fibrosis, given concurrently with or after irradiation in Wistar albino rats. Twenty-one female Wistar albino rats were randomized into three groups. The first group (Group A) had tamoxifen, which was started after the completion of irradiation. The second group (Group B) had tamoxifen concomitant with irradiation.
... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with ... more ... cagE and virB11 detection in patients with non-ulcer dyspepsia from Turkey: Correlation with histopathologic findings Ugur Ilga1, Mustafa Ozyurt1*, Sukru Yıldırım2, Koray Ergunay3, Nurittin Ardic1, Levent Demirturk4, Tuncer Haznedaroglu1 ...
Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been su... more Use of mucolytic agents that result in reduced mucous viscosity of the gastric mucous has been suggested to have an additive effect in curing Helicobacter pylori infection. Seventy Hpylori-positive patients were given either eradication treatment consisting of 500 mg clarithromycin bid and 30 mg lansoprazole bid for 10 days plus 10 mL (400 mg) N-acetyl cysteine (NAC) liquid tid (AC group) or eradication treatment only (control group). The results were compared 1 month after the completion of the treatment. Fifty-eight patients were available for statistical analysis. Of the 28 patients in the AC group, 14 (50.0%) eradicated the infection after treatment, whereas only 7 of 30 (23.3%) patients in the control group had negative results. The difference between the AC group and the control group was statistically significant (P = 0.034). In both groups, there was no difference in the number of smokers and in the eradication rates between smokers and nonsmokers. Eradication treatment with or without NAC caused no significant side effects in either group. Our findings suggest that NAC has an additive effect on the eradication rates of H pylori obtained with dual therapy with lansoprazole and clarithromycin. NAC does not have any known activity against H pylori, but it may improve the delivery of antibiotics at the site of infection due to its ability to reduce the thickness of the mucus.
Dental plaque is considered by some to be a secondary reservoir for Helicobacter pylori and thus ... more Dental plaque is considered by some to be a secondary reservoir for Helicobacter pylori and thus responsible for gastric reinfection. The aim of this study was to investigate whether testing dental plaque using a rapid urease test (CLOtest) can be used to determine gastric H. pylori status. We investigated dental plaque colonization by H. pylori and its correlation with gastric infection in 75 dyspeptic patients. CLOtest was used to determine H. pylori positivity. Tests for H. pylori were positive in dental plaque samples from 68 patients and in stomach samples from 65 patients. The sensitivity of using CLOtest in dental plaque to determine gastric H. pylori status was 89.7%, with a diagnostic accuracy of 86.7%. Gastric eradication was achieved in 83% of patients, but efforts to eradicate dental plaque colonization were unsuccessful in all patients. Using CLOtest to detect H. pylori in dental plaque is a reliable first-line diagnostic approach for gastric H. pylori infection. Dental plaque might be a sanctuary for H. pylori, leading to gastric recurrence.
ABSTRACT The primary source of ammonia is the gut. Ammonia can also be generated by the urease ac... more ABSTRACT The primary source of ammonia is the gut. Ammonia can also be generated by the urease activity of Helicobacter pylori in the gastric mucosa. The aim of this study was to investigate the effect of H. pylori eradication on blood and gastric juice ammonia levels and on visual evoked potential (VEP) recordings in cirrhotic patients. Male patients with cirrhosis and H. pylori infection were prospectively evaluated. All patients were given triple regimen for eradication for 10 days. Gastroscopy together with gastric juice sampling for ammonia and mucosal sampling for H. pylori status was performed before and after therapy. Gastric juice and blood ammonia levels were measured and VEP recordings were obtained before and after treatment. Twenty-seven patients were included in the study. Patients with overt clinical hepatic encephalopathy were excluded from the study. Twenty-four out of twenty-seven patients became H. pylori-negative after the treatment. Ammonia measurements and VEP recordings were evaluated in the 24 patients in whom eradication was successful. A slight but statistically significant decrease in blood and a considerable decrease in gastric juice ammonia levels were observed after treatment [from 44.23 micromol/l to 41.6 micromol/l compared with 3234 micromol/l to 2709 micromol/l, respectively (p <.05)] in patients in whom H. pylori was eradicated. VEP recordings were abnormal in 14 out of 24 patients before the treatment. Only four of these 14 patients with abnormal recordings showed improvement. (p > .05). Helicobacter pylori eradication in cirrhotics decreases blood and gastric juice ammonia concentrations whereas it does not provide an improvement in VEP recordings.
Scandinavian Journal of Urology and Nephrology, 2003
To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 pa... more To evaluate changes occurring in the mucosa of the neobladder over a period of 60 months in 24 patients with orthotopic ileal neobladder. A total of 36 male patients have undergone radical cystoprostatectomy and received an orthotopic ileal neobladder in our hospital during the last 10 years; 24 of these patients, all of whom completed a follow-up period of 60 months, are included in this study. All cases underwent a biopsy of the ileal mucosa at the time of surgery and their neobladder mucosa was then biopsied at 6, 12, 24, 36 and 60 months. The specimens were stained with hematoxylin-eosin in order to examine the changes in the thickness of the mucosa and its villi. Sections were also stained with Alcian blue and periodic acid-Schiff in order to determine the number of goblet cells. A morphometric scoring system was created to quantify the change in villi size. The mean thickness of the ileal mucosa at the initial biopsy was 270.9 +/- 35.9 microm and displayed a continuous decrease at all of the subsequent biopsies. The number of luminal goblet cells increased during follow-up. Villus atrophy was found to be a continuous process during follow-up. No dysplasia or malignancy was detected in any of the biopsies. During a follow-up period of 5 years, there were no neoplastic changes in our patients, but instead a protective response of the mucosa to its new environment was observed.
Short-segment Barrett&amp... more Short-segment Barrett's esophagus (SSBE) is defined by the presence of columnar-appearing mucosa in distal esophagus (involving less than 2 to 3 cm), with intestinal metaplasia on biopsy. Its potential to develop dysplasia and cancer may require a surveillance program with better diagnostic tools to detect intestinal metaplasia. To investigate the role of imprint cytology as a diagnostic tool either alone or combined with histology in SSBE. Seventy-nine patients (46 men, 33 women) with SSBE diagnosed during elective upper gastroscopy were included. Patients with serrated z-line with short tongues of pink mucosa and patients with a circular non-serrated z-line that extended less than 2 cm above the esophagogastric junction were biopsied on four quadrants just distal to z-line. Four slides of imprint preparation (including 1, 2, 3, and 4 touching of each biopsy specimen) was made for cytologic examination. Hematoxylin and eosin and Alcian blue staining for histologic examinations and Alcian Blue for cytologic evaluations were used to find evidence of intestinal metaplasia. Intestinal metaplasia was detected in 15 (19%), 21 (27%), and 30 (38%) patients by histologic examination with hematoxylin and eosin alone, by Alcian blue alone, and by histologic plus cytologic examination with Alcian blue, respectively. Nine patients with negative histologic but positive cytologic results were positive for intestinal metaplasia when they were reevaluated after further sectioning and staining. Sensitivity of imprint cytology alone was 53%. When imprint cytology was combined with the histologic evaluation, the prevalence of intestinal metaplasia increased from 27% to 38% (p < 0.05). Imprint cytology might be a complementary diagnostic tool for histology in detecting patients with SSBE.
... Does High Albumin Gradient Ascites Accompany Tuberculous Peritonitis? Gürbüz, Ahmet Kemal MD;... more ... Does High Albumin Gradient Ascites Accompany Tuberculous Peritonitis? Gürbüz, Ahmet Kemal MD; Yazgan, Yusuf MD; Ozel, Melih AMD; Çavuşlu, Şaban MD; Altunay, Hüsnü MD; Yildirim, Şükrü MD. Article Outline. Collapse Box Author Information. ...
Metastatic carcinoma to the testis is very rare. Metastasis of prostate adenocarcinoma to testis ... more Metastatic carcinoma to the testis is very rare. Metastasis of prostate adenocarcinoma to testis was detected incidentally after bilateral orchiectomy for hormonal management of metastatic prostate carcinoma. The metastatic lesion was not identified in physical examination or in macroscopic dissection of the testis after surgery. Microscopy revealed an adenocarcinoma which, given the history of the patient and a positive immunohistochemical stain for PSA, was identified as metastatic prostatic adenocarcinoma. Int
Background. N-acetyl cystein, a mucolytic agent, might make Helicobacter pylori antigens shed mor... more Background. N-acetyl cystein, a mucolytic agent, might make Helicobacter pylori antigens shed more easily to stool, and might therefore contribute to the diagnostic accuracy of the Helicobacter pylori stool antigen test. The aim of this study is to investigate if N-acetyl cystein contributes to the diagnostic accuracy of the Helicobacter pylori stool antigen test by increasing the sensitivity and specificity of the test. Materials and Methods. 107 patients were separated into treatment and placebo groups. The AC group (n = 53) was given 5 ml of acetyl cystein (4%) t.i.d. and the Placebo group (n = 54) was given placebo, for 3 days. Helicobacter pylori status was determined by both histology and CLOtest. Stool samples were assayed using a specific ELISA kit for Helicobacter pylori stool antigen.
CagA seropositivity is closely associated with that of vacuolating cytotoxin (VacA). Helicobacter... more CagA seropositivity is closely associated with that of vacuolating cytotoxin (VacA). Helicobacter pylori strains positive for both VacA and CagA were reported to be strongly associated with peptic ulcer disease. Different results reporting that cagA gene is not associated with more serious diseases, lowers the importance of CagA protein as a marker. In this study, CagA seropositivity is examined in Turkish peptic ulcer and nonulcer dyspepsia patients; histopathologic scores of CagA (+) and CagA (-) groups were compared. Sixty consecutive patients (one gastric ulcer, 13 duodenal ulcer and 46 nonulcer dyspepsia) (mean age 40.9 +/- 14.7; 33 women, 27 men) with dyspeptic complaints who underwent upper gastrointestinal (GI) endoscopy were included. Biopsies from the antrum and corpus were used for histopathologic examination and for rapid urease test. H. pylori-negative patients comprised the control group. Histopathologic findings were graded using a previously described grading system (for inflammation, activity, atrophy, intestinal metaplasia and H. pylori, grades from 0 to 3 were used to quantify the findings). In H. pylori-positive patients, antibodies against CagA protein were determined using an ELISA METHOD: H. pylori was (+) in 46 patients. One duodenal ulcer and 13 nonulcer dyspepsia patients were negative for H. pylori. CagA positivity is significantly higher in peptic ulcer patients [12/12] than in nonulcer dyspepsia patients [25/33]. While inflammation, activity and atrophy scores were significantly higher in CagA positive patients, intestinal metaplasia and H. pylori load scores were not. Although the histopathologic scores in controls were lower than CagA (-) group, statistical significance was observed only in inflammation and intestinal metaplasia scores. Development of more prominent gastritis and severe atrophy in CagA (+) patients is an indicator of the importance of CagA rather than H. pylori load. Therefore, we suggest that nonulcer dyspepsia patients should also be tested for CagA status along with the tests for H. pylori status; and a positive CagA testing should be considered as an indication for eradication treatment. If CagA is negative, further assesment should be performed to decide whether or not to treat the patient.
Objective: There is a small number of studies in adult nonpalpable testes cases, and there is no ... more Objective: There is a small number of studies in adult nonpalpable testes cases, and there is no published paper on the diagnostic value of their ultrasonographic examination. In this prospective study, we compared the sonographic and laparoscopic findings in adult cases with nonpalpable testes to assess the necessity and the profits of ultrasound. Materials and Methods: 50 cases, 38 unilateral and 12 bilateral, with nonpalpable testes were investigated. Patients' ages ranged from 20 to 25 years with a mean of 22. Sonographic examinations were performed with a highresolution ultrasonography device. Results: Laparoscopic evaluation of the patients with unilateral nonpalpable testis yielded 27 testes out of a total 38. In one case, the testis was detected in the inguinal canal with inguinal exploration. The remaining 10 cases were regarded as vanishing testes. All 24 testes of 12 patients with bilateral nonpalpable testes were found. The pre-laparoscopic ultrasonographic examination detected 20 of 24 testes in bilateral cases (83% sensitivity), and 17 of 26 testes in unilateral cases (65% sensitivity). Conclusion: Our results suggest that ultrasonography does not exclude the necessity for laparoscopy, and it is not superior to physical examination in detection of the inguinal atrophic testes or testicular nubbin. #
New prognostic factors in gastric carcinoma to determine the prognosis of the disease or to ident... more New prognostic factors in gastric carcinoma to determine the prognosis of the disease or to identify patients who will benefit from adjuvant therapy are being researched. The aim of this study is to investigate the correlation between microvessel count (MVC) and various clinicopathologic features in gastric carcinoma in order to evaluate the role of angiogenesis on the prognosis of gastric cancer. Fifty-seven patients who underwent surgical intervention for gastric carcinoma between 1993 and 1997 were reviewed retrospectively. The relationship between MVC and various clinicopathological features was assessed. The effect of angiogenesis on overall survival and the role of MVC and other prognostic factors on distant metastases were assessed by multivariate analysis. Microvessels were outlined by anti-factor VIII, which is a specific monoclonal antibody to factor VIII in vessel endothelial cells, using the streptavidin-biotin method and counted under light microscopy x200 magnification. There was no correlation between MVC and age or sex of the patient, duration of symptoms or tumor size. Proximally located, undifferentiated, diffuse type, serosal invasion positive, lymph node invasion positive, advanced stage, or distantly metastasized tumors had higher MVCs. Higher MVCs affected the overall survival adversely. Lymph node metastasis, serosal invasion and MVC were found as independent prognostic factors affecting distant metastases. MVC was the sole factor affecting recurrent liver metastasis. It is concluded that MVC in gastric carcinoma may be a valuable prognostic factor to predict patients at high-risk for possible recurrences and to decide on postoperative adjuvant therapy.
Kikuchi-Fujimoto Disease (KFD) was first described in Japan in 1972. The disease frequently mimic... more Kikuchi-Fujimoto Disease (KFD) was first described in Japan in 1972. The disease frequently mimics tuberculous lymphadenitis, malign lymphoma, and many other benign and malignant conditions. To our knowledge, there is no previous study comparing the clinical and laboratory characteristics of patients from different geographical parts of the world. We searched literature records beginning from 1991 and analyzed epidemiological, clinical, and laboratory data of 244 patients (including cases diagnosed in our institution) reported in 181 publications. Of the 244 cases, 33% were male and 77% were female. Mean age was 25 (1-64) and 70% was younger than 30. Most of the cases were reported from Taiwan (36%), USA (6.6%), and Spain (6.3%). Fever (35%), fatigue (7%) and joint pain (7%) were the most frequent symptoms, while lymphadenomegaly (100%), erythematous rashes (10%), arthritis (5%), hepatosplenomegaly (3%), leucopenia (43%), high erythrocyte sedimentation rate (40%), and anemia (23%) being the most common findings. KFD was associated with SLE (32 cases), non-infectious inflammatory diseases (24 cases), and viral infections (17 cases). SLE was more frequent in cases from Asia than Europe (28 and 9%, respectively). The disease was self-limiting in 156 (64%) and corticosteroid treatment was necessary in 16 (16%) of the cases. The mortality rate was 2.1%. Early diagnosis is crucial as the clinical and laboratory presentation generally imitates situations needing lengthy and costly diagnostic and therapeutic interventions. Additionally, association with SLE needs further investigation.
... Mecit Kantarci, MD,* Bulent Karaman, MD,* C. Cinar Basekim, MD,* Mehmet Incedayi, MD,* Hakan ... more ... Mecit Kantarci, MD,* Bulent Karaman, MD,* C. Cinar Basekim, MD,* Mehmet Incedayi, MD,* Hakan Mutlu, MD,* Onur Sildiroglu, MD,* Sukru Yildirim ... REFERENCES 1. Saglam L, Akgun M, Aktas E. The usefulness of induced-sputum and fiberoptic bronchoscopy in diagnosis of ...
Background: This study evaluates the possibility of enhancing the beneficial effect of the delay ... more Background: This study evaluates the possibility of enhancing the beneficial effect of the delay procedure by using hyperbaric oxygen therapy, and the possibility of lessening the time required for maximal effect of delay procedure. Methods: Eight male Wistar rats were ...
The aim of this study is to investigate the effects of different fixatives on DNA, and to evaluat... more The aim of this study is to investigate the effects of different fixatives on DNA, and to evaluate the fixation options for molecular studies including polymerase chain reaction (PCR) and fluorescence in-situ hybridization (FISH). Three normal-looking colonic segments from surgical resections were used for tissue sampling. The full thickness of the colonic tissues (3 mm diameter) was sampled. Tissues were fixed in 70% ethanol, 10% neutral-buffered formalin, Hollande, B5, Bouin, and Zenker solutions for 1, 2, 5, 12, 24, and 48 hours, and processed and embedded in paraffin in a standard protocol. Quantitative measurements of the extracted DNA were carried out. DNA quality was tested by PCR for the human beta globin gene. Tissue sections were also tested for the availability of FISH, by using a Her-2/neu protocol. All fixation alternatives were found to be reasonable sources of DNA for molecular studies, and they enabled the successful PCR amplification of a housekeeping gene. DNA yields were predominantly over 1000 bp in 70% ethanol and 24-hour 10% neutral-buffered formalin fixations. As for B5 and Hollande, the DNA molecules obtained were almost all smaller than 100 bp. All tissues fixed in formalin, ethanol, and Hollande were found suitable for Her-2/neu visualization after standard FISH applications, but tissues fixed in Zenker, B5, and Bouin were not found suitable.
The aim of the study was to compare the effects of mitomycin-C (MMC) and 5-fluorouracil/triamcino... more The aim of the study was to compare the effects of mitomycin-C (MMC) and 5-fluorouracil/triamcinolone acetonide (5-FU/TA) on the development of fibrosis/scar tissue formation of rabbit subglottic area, which is injured acutely. After standardized trauma to subglottic area the rabbits were divided into those that received treatment and those that did not (controls). The subjects were treated with either topical 0.4 mg/mL MMC or 5 mg 5-FU/TA injection. Those groups were further divided into subgroups depending on the time of examination: at 2 or 6 weeks. Each subgroup had 4 rabbits. The specimens were examined histopathologically and the measurements were performed using a software. The fibrosis indices (FIs) of the treated subgroups were significantly less than the FIs of their corresponding control subgroups (P<.05). The difference in FIs of the MMC-treated and 5-FU/TA-treated groups was not statistically significant (P>.05). MMC and 5-FU/TA did not interfere with regeneration of the epithelium although in 2 cases treated with 5-FU/TA the regenerated epithelium showed squamous metaplasia. Both MMC and 5-FU/TA decrease fibrosis/scar tissue formation secondary to experimentally induced acute subglottic trauma. There is no significant difference between the effects of the 2 drugs.
This study was performed to evaluate the effects of tamoxifen on pulmonary fibrosis, given concur... more This study was performed to evaluate the effects of tamoxifen on pulmonary fibrosis, given concurrently with or after irradiation in Wistar albino rats. Twenty-one female Wistar albino rats were randomized into three groups. The first group (Group A) had tamoxifen, which was started after the completion of irradiation. The second group (Group B) had tamoxifen concomitant with irradiation.
Uploads
Papers by Şükrü Yildirim