Sinasi Yalcin

Leeches in the larynx

Abstract This is a report of four patients who inhaled leeches. They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. Indirect laryngoscopy revealed a dark greenish living foreign body in the larynx in each case. Laryngoscopy was performed with local anaesthesia in two of the cases and general anaesthesia was used in the other two. The leeches were removed with forceps.

Hearing Loss in Insulin-Dependent Diabetes Mellitus

The purpose of this study was to examine the relationship between diabetes mellitus and hearing loss which is still controversial. Pure tone audiometry was performed in 75 patients with insulin-dependent diabetes mellitus, aged between 14 and 60 years (45 males and 30 females; average age 45.3 years), and in 40 randomly selected sex- and age-matched non-diabetic control subjects, using an Interacoustics Clinical Computer Audiometer Model AC5. The mean duration of diabetes in the study group was 15 +/- 7 years. Complications such as retinopathy, nephropathy, and neuropathy had developed in 64% of the diabetics. Statistical analyses showed that the hearing of the diabetic patients was significantly worse than control subjects. Complications were found to have a significant effect on sensorineural hearing loss in diabetics. The influence of duration of diabetes was noticed on hearing threshold at mid and high frequencies, especially after the first decade of the disease.

Evaluation of long-term impacts of tonsillectomy on immune functions of children : A follow-up study

OBJECTIVE The purpose of this follow-up study was to investigate the long-term effects of tonsillectomy in comparison with their short-term results. PATIENTS AND METHODS We successfully retrieved 20 out of our previously reported 37 patients who underwent tonsillectomy in our clinic 54 months ago. The blood levels of CD3+, CD4+, CD8+, CD19+, CD25+ and CD16++56+ (cellular immunity), and IgG, IgA, IgM, C3 and C4 (humoral immunity) were determined and compared with their previously reported short-term respective values. RESULTS There were no statistically significant differences between the short-term (1 month) and long-term (54 months) values of IgA, IgG, IgM and C4 levels of the patients (P>0.05). There was a slight but statistically significant decrease in complement factor C3 value compared to its the early-stage value (P<0.05) but this was not significantly different from age-matched healthy controls (P>0.05). The levels of CD4+ and CD19+ were higher and the levels of CD16++56+ and CD25+ were lower in the late-stage (54 months) compared to their early-stage values (P<0.05). When the long-term immune parameters of the tonsillectomized patients were compared with aged-match healthy controls, there were no significant differences between the levels of immunoglobulins, complements and lymphocytes (IgA, IgG, IgM, C3, C4, CD3+, CD4+, CD8+, CD19+, CD25+, CD16++56+) (P>0.05). CONCLUSION The results of this long-term follow-up study indicate that tonsillectomy do not compromise the immune functions of children as humoral and cellular immunity of patients recovered compared to their early-stage immune status (1 month), as they have similar immune capacity compared to their age-matched healthy controls at both early- and late-stages. Although a small sample of patients enrolled, our results are of importance with respect to the reassuring in settling the widely held urban myth that tonsillectomy compromises life long immunity.

Detection of Helicobacter pylori in children with otitis media with effusion : A preliminary report

Objective: To determine the presence of Helicobacter pylori in the middle ear effusion of patients with otitis media with effusion (OME) by polymerase chain reaction (PCR).

Free radicals and scavenging enzymes in chronic tonsillitis

OBJECTIVE: This study aimed to define the relationship between chronic tonsillitis and levels of malondialdehyde and superoxide dismutase in free radical and antioxidant forms. It is suggested that free oxygen radicals may play a role in chronic tonsillitis. MATERIALS AND METHODS: One hundred twenty-four patients were enrolled in the study. Tonsillectomy was performed via the usual dissection-snare method. Venous blood was taken preoperatively and at 2 weeks postoperatively. Blood samples and tonsil specimens were evaluated for malondialdehyde and superoxide dismutase analysis. RESULTS: The levels of malondialdehyde and superoxide dismutase in plasma were compared preoperatively and postoperatively, and there were statistically significant differences between these levels (P < 0.05). In contrast, the levels of malondialdehyde and superoxide dismutase in tonsil tissue were not correlated with the plasma levels of malondialdehyde and superoxide dismutase in pretonsillectomy and posttonsillectomy terms (P > 0.05). CONCLUSION: The presence of malondialdehyde and superoxide dismutase in plasma and tonsil tissue reinforces the involvement of oxidative stress in the pathophysiology of chronic tonsillitis.

Ménière’s disease and allergy: allergens and cytokines

The aim of this article is to evaluate the role of allergy in the pathogenesis of Menieres disease by means of cytokine profiles, allergic parameters and lymphocyte subgroups. A total of 46 patients aged between 26-68 years diagnosed with Menieres disease between 1993-2002 were recruited to this study. The control group consisted of 46 healthy volunteers who were from the same age group, living in the same region and possessing similar socioeconomic indicators. Lymphocyte subgroups were measured from the peripheral blood by employing Becton Dickinson (BD) monoclonal CD4, CD8, CD23 antibodies. IFN-gamma, IL4, total IgE levels, and specific IgE levels pertaining to tree, fungus, fruit, egg-white, cows milk, wheat flour, corn flour, beef, and rice allergens, in all seasons, were measured and compared in the patient and control groups. In patient serum samples there were positive correlations between CD23 and IgE, CD8 and IgE, CD4/CD8 and IgE, and CD23 and CD8 (p <0.01). There were negative correlations between IL-4 and IFN-gamma, IFN-gamma and IgE, and a positive correlation between IL-4 and IgE. Total IgE levels were above the normal values in 19/46 (41.3 per cent) of the patient group, but the ratio was nine out of 46 (19.5 per cent) in the control group. A history of allergy was found in 31/46 (67.3 per cent) when the patients were questioned. The ratio of a history of allergy was 16/46 (34.7 per cent) in the control group. When specific IgE levels were evaluated the ratio of patients with all the panels negative was eight out of 46 (17.9 per cent), but it was 31/46 (67.3 per cent) in the control group. This study found that the prevalence of allergy was higher in patients with Menieres disease than in the control group. Thus the authors suggest that allergy should be taken into account when patients with this disease are treated.

Comparison of Free Radicals and Antioxidant Enzymes in Chronic Otitis Media With and Without Tympanosclerosis

Objective/Hypothesis The pathogenesis of tympanosclerosis is unclear. The study was performed to investigate the role of nitric oxide, free oxygen radicals, and antioxidants in development of tympanosclerosis in patients with chronic otitis media.

Effects of Interferon-α-2b and Octreotide on Healing of Esophageal Corrosive Burns

Objective The aim of this study was to investigate the effect of interferon‐α to 2b and octreotide on the treatment of esophagus corrosive burns.

The effects of fine-needle biopsy on thyroid hormone levels

Objective Our study aim was to investigate the effects of fine-needle biopsy used for thyroid nodules on serum thyroid hormone levels. Study Design A total of 25 patients who had solid nodules of the thyroid gland and normal thyroid hormone levels underwent diagnostic fine-needle biopsy for a nodule of the thyroid gland. Methods Venous blood samples were drawn from the cases for measurement of serum total T3 and T4, free T3 and T4, thyroid-stimulating hormone, and thyroglobulin levels before, immediately after, and 30 minutes after the initial biopsy. Results Total T3 and thyroglobulin levels were found to be significantly higher immediately and 30 minutes following fine-needle aspiration biopsy, compared to the baseline levels (P < 0.05). Conclusion Prelminary data suggest that thryoid hormone levels show a mean increase of about 20% immediately after fine-needle aspiration. Significance The implication of this finding on patient care should be determined on an individual basis.

Evaluation of the effect of methylprednisolone and N-acetylcystein on anastomotic degeneration and regeneraton of the facial nerve

OBJECTIVES This study was aimed to determine the effects of methylprednisolone and N-acetylcystein on nerve healing in facial nerve anastomosis. METHODS Thirty rabbits were randomly divided into 3 groups: Group I: control group received no medication; Group II: 50mg/kg/day N-acetylcystein administered group; Group III, 1mg/kg/day Methylprednisolone administered group. All rabbits underwent the same standard surgical procedure. A 1mm segment was resected from the facial nerve and the free ends were anastomosed. The drugs were administered for two months twice a day. At the end of the second month, the anastomosed regions were dissected and examined under electron and light microscopy. RESULTS Best nerve regeneration was observed in the N-acetylcystein and the control groups, respectively, whereas the weakest regeneration was determined in the methylprednisolone group. In the N-acetylcystein group, due to Schwann cell and glial cell proliferation, the increased regeneration rate was significantly higher compared to that of the methylprednisolone group. In the methylprednisolone group, no significant regeneration was observed despite the presence of degenerative signs of significant axonal withdrawal and an increase in the number of myelin debris. CONCLUSION In the present study, we demonstrated that methylprednisolone had no beneficial effect in nerve regeneration after facial nerve anastomosis. It further caused increased degeneration. On the contrary, N-acetylcystein administration significantly increased the extent of regeneration, whereas it decreased the extent of degeneration compared to the control and the methylprednisolone groups.