Giray Aynali

Relationship between Toxocara seropositivity and allergic rhinitis.

Background Allergic rhinitis is the most common chronic disease in the upper respiratory tract, requiring better diagnostic methodology to counteract its onslaught. The purpose of this study was to investigate the association between Toxocara seropositivity and allergic rhinitis. Methods Sixty-four consecutive patients with allergic rhinitis and 61 healthy volunteers in the control group were included in this study. The diagnosis of allergic rhinitis was defined by positive epicutaneous prick test. The diagnosis of toxocariasis was established by IgG and specific IgE antibodies against Toxocara by ELISA method. All cases were examined for intestinal parasites also. The seropositive cases with Toxocara were reevaluated for symptoms and signs of toxocariasis. Results Higher toxocariasis seropositivity (ELISA IgG; 28.1%) rate was determined in the patients with allergic rhinitis and compared with the control groups (11.5%; p < 0.05). Specific IgE seropositivity (17.2%) was high for the patients with allergic rhinitis compared with the control group (3.3%; p < 0.05). Conclusion Our results show that there was a possible causal relationship between Toxocara infection and allergic rhinitis. Patients with allergic rhinitis from a region with high prevalence for this parasitic infection should be evaluated for Toxocara infection.

Carotid CT-angiography: Low versus standard volume contrast media and low kV protocol for 128-slice MDCT

Availability and utilization of computed tomography angiography has been increasing recently. We aimed to assess the effectiveness of low amount of contrast media and low kV value in order to reduce possible side effects of contrast media and to provide optimization of kV value in the evaluation of the carotid artery with multi-detector computed tomography angiography. Forty one patients were randomized into two groups. Contrast media was administered at a dose of 1 ml/kg in group A patients and of 0.5 ml/kg in group B patients. kV value of 120 in group A and 100 in group B were chosen. Bolus tracking technique was used. Attenuation values of certain arterial segments were measured, and values over 200 HU were considered as significant. North American Symptomatic Carotid Endartherectomy Trial criteria were utilized in the evaluation of stenosis. Image quality in arterial segments of all cases was found to be sufficient for diagnosis. Arterial attenuation values were found to be higher in group B than group A. When compared separately in all arterial segments, there was no statistically significant difference between the groups. For stenosis, 615 arterial segments were evaluated. Moderate stenosis in eight segments and severe stenosis in three segments were identified in group A. Occlusion in three segments, severe stenosis in three segments, and moderate stenosis in 25 segments were detected in group B. Better image quality can be obtained, and the amount of contrast media can be reduced using low kV technique in carotid artery multi-detector computed tomography angiography examination.

Polymorphic variants of MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genotypes and the risk of laryngeal cancer in a smoking population

OBJECTIVE To investigate the relationship between development of laryngeal cancer and the presence of polymorphisms of the MnSOD Val16Ala, CAT-262 C < T and GPx1 Pro198Leu genes in a smoking population. PATIENTS AND METHODS Single nucleotide polymorphisms were determined in DNA from the peripheral blood erythrocytes of 48 heavy smokers (25 patients with laryngeal cancer and 23 cancer-free controls), using polymerase chain reaction. RESULTS There were no significant differences in age, smoking duration or smoking intensity, comparing the two groups. The homozygous AA genotype of MnSOD Val16Ala was significantly more prevalent in the cancer group than the control group (92 vs 13 per cent, respectively), while the heterozygous AV genotype of MnSOD Val16Ala was more prevalent in the control group than the cancer group (87 vs 8 per cent, respectively) (p < 0.001). There were no significant differences between the cancer and control groups regarding GPx1 Pro198Leu or CAT-262 C < T polymorphisms. CONCLUSION Polymorphism of the MnSOD Val16Ala gene may contribute to susceptibility to laryngeal cancer among smokers.

The effects of methylprednisolone, montelukast and indomethacine in experimental otitis media with effusion

OBJECTIVES The present study aimed to investigate the effects of indomethacine, montelukast and methylprednisolone in management of experimental otitis media with effusion. METHODS Forty Wistar albino rats of which the weights ranged between 310 and 370 g were included in this study. Middle ear effusion was created by transtympanic histamine injection. The presence of effusion was confirmed by otomicroscopic examination. Thirty-seven rats with effusion were divided into 4 groups (methylprednisolone, montelukast, indomethacine and saline-control groups). All agents were administered for a period of consecutive 10 days. At the 11th days of administration, the recovery of effusion was confirmed by otomicroscopic examination. Tympanic bullae of the rats were removed and histopathological examinations were carried out. In the histopathological examination, the neutrophil leukocytes accumulated in the middle ear submucosa were counted. RESULTS The mean numbers of submucosal neutrophils in the methylprednisolone, montelukast, indomethacine, and saline groups were 24.6±8.1, 54.1±6.2, 52.3±7.3, 55.7±8.3, respectively. The otomicroscopic recovery rates of effusion in the methylprednisolone, montelukast, indomethacine, and saline groups were 18/18 (100%), 8/18 (44%), 2/14 (14%), 2/18 (11%) respectively. CONCLUSIONS Methylprednisolone and montelukast ameliorate the middle ear effusion. However, only methylprednisolone reduces the submucosal infiltration of the neutrophil leukocytes which are the most evident cell of inflammatory process. Montelukast is effective in the resolution of experimental otitis media with effusion.

The Importance of the Neutrophil-Lymphocyte Ratio in Patients with Idiopathic Peripheral Facial Palsy

Objective. The purpose of this study was to investigate whether or not there was a correlation between the neutrophil-to-lymphocyte ratio (NLR) value and the severity of idiopathic peripheral facial palsy (IPFP) and to determine whether or not NLR could be used as an early predictive parameter in the prognosis of IPFP patients. Material and Method. This retrospective study was conducted on 146 patients who were diagnosed with IPFP. The control group comprised 140 patients. Patients with IPFP were categorized according to the House-Brackmann grading system (HBS). The NLR value was obtained by dividing the neutrophil value by the lymphocyte value. Results. In the IPFP group, the mean NLR value was 3.63 ± 2.74 and, in the control group, 1.84 ± 0.78. The mean NLR value was significantly higher in IPFP patients than in the control subjects (p < 0.0001). The mean NLR value in group A (Grades I-II ) was 2.61 ± 2.28, in group B (Grades III-IV) 3.22 ± 2.65, and in group C (Grades V-VI) 10.69 ± 6.30. Conclusion. We determined that as the severity of IPFP increased, the NLR value increased. The NLR value can be used as a prognostic factor in the early prediction of IPFP prognosis.

Is There A Systemıc Inflammatory Effect of Cholesteatoma

Introduction Inflammation causes squamous epithelial transformation of the mucosa in the middle ear cavity and plays a role in the onset, growth, spread, and recurrence of cholesteatoma. Objectives The objective of this study is to investigate the systemic inflammatory effect in chronic otitis with cholesteatoma. Methods The study included a total of 311 patients comprising 156 patients with a pathology diagnosis of cholesteatoma and a control group of 155 with no active inflammation. The Neutrophil-to-lymphocyte Ratio (NLR) was calculated by dividing the neutrophil value by the lymphocyte value. Results The mean NLR was 1.94 ± 0.91 in the patients with cholesteatoma and 1.94 ± 0.85 in the control group. We determined no statistically significant difference between the groups in respect of NLR (p = 0.983). We calculated the NLR as 2.01 ± 1.00 in patients with ossicle erosion and 1.82 ± 0.69 in those without ossicle erosion, 1.86 ± 0.85 in patients with bone erosion and 1.98 ± 0.95 in those without bone erosion. We determined no statistical difference between these values (p = 0.175). Conclusion The results of this study showed that NLR had no predictive value in respect of bone erosions and associated complications in patients with cholesteatoma. The inflammatory effect of cholesteatoma is not systemic but remains more local.

Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor

Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patients old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions.

A NEW FRONTAL DRAINAGE PATHWAY IN A PATIENT WITH BILATERAL FRONTAL MUCOCELE

Frontal sinus and frontal recess anomalies are not very rare. These include bilateral or unilateral aplasia or hypoplasia, absence of frontal sinus ostium, hyperpneumatization and frontal cells (extensive Agger nasi). We reported first case of frontal sinus draining to the contralateral nasal cavity, in a patient with bilateral frontal mucocele.

Solunum sıkıntısı sebebi olarak tiroid papiller karsinomu

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 2005 Haziran; 12(2) Solunum sikintisi sebebi olarak tiroid papiller karsinomu Giray Aynali, Hasan Yasan, Mustafa Tuz, Metin Ciris, Orhan Oyar Ozet Papiller tiroid karsinomu (PTK) primer olarak lenfatik yol ile yayilim gosterir. Bu nedenle hastalar siklikla boyunda kitle sikayeti ile hekime basvurmaktadirlar. PTK, nadir de olsa direkt invazyon veya metastaz yoluyla larenkse yayilim gosterir ve bu bolgeye ozgu ses kisikligi, nefes darligi gibi sikayetler de boyunda kitleye eslik edebilir. Bu calismada seste bogukluk ve nefes darligi primer sikayetleriyle gogus hastaliklari poliklinigine basvuran ve KOAH tedavisi alan daha sonra klinigimizce konsulte edilen 51 yasinda PTK olgusu sunulmustur. Yapilan fizik muayenede tiroid kartilaj seviyesinde, orta hattin saginda, 3x3 cm boyutlarinda, sert kitle palpe edildi. Direkt laringoskopide larengeal lumeni sagdan daraltan, subglottik vejetan kitle saptandi. Boyundaki kitleden alinan ince igne aspirasyon biyopsi sonucu malign kuskulu sitoloji olarak geldi. Suspansiyon laringoskopi ile larenksteki vejetan kitleden alinan biyopsi papiller tiroid karsinom olarak rapor edildi. Hastaya total tiroidektomi, total larenjektomi, bilateral fonksiyonel boyun diseksiyonu uygulandi. Cerrahi sonrasinda 131I ve tiroid replasman tedavisine alindi. Solunum sikintisi ve seste bogukluk sikayetleri ile basvuran hastada larenksin PTK ile invazyonu da ayirici tanida dusunulmelidir. Anahtar kelimeler: Papiller tiroid karsinomu, Larenks, Total larenjektomi, Dispne Abstract Thyroid papillary carcinoma leading to dispnea Papillary thyroid carcinoma (PTC), metastasizes and invades primarily spreading through lymphatics. For this reason, patients mostly presents with the complaints of neck mass. PTC rarely spreads to larynx by direct invasion or by metastasis. Symptoms like hoarseness and dyspnea can accompany to the mass in the neck. In this study, a case at 51 taking current COPD treatment and with PTC who admitted to the hospital with hoarseness and dyspnea was presented. In physical examination, a rigid mass with 3 x 3 cm of diameter was palpated in the right neck, at the level of the thyroid cartilage. In direct laryngoscopy, a subglottically located vegetan mass which narrowed the laryngeal lumen from right was determined. Fine needle aspiration biopsy reealed a suspicios malignancy. Biopsy which was taken from the vegetan mass with direct laryngoscopy method resulted in papillary thyroid carcinoma. The patient underwent an operation of total laryngectomy, total thyroidectomy and bilateral functional neck dissection. After the surgery, 131I and thyroid replacement treatment was administered to the patient. PTC invasion to larynx must be kept in mind in differential diagnosis when a patient applies to the clinic with dyspnea and hoarseness Key words: Papillary thyroid carcinoma, Larynx, Total laryngectomy, Dispnea