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Biomedical subjects

Deniz Demir

Publications and source records attributed to Deniz Demir.

12 recordsLinked to original sources
PubMed2006

Autologous fat augmentation for voice and swallow improvement after cordectomy.

Surgery for the treatment of early-stage glottic carcinoma still remains a valid option. In most patients, newly formed neocord tissue preserves glottic functions, but in some patients an important glottic gap leading to glottic insufficiency may occur. In our study, 11 patients who had serious glottic insufficiency after endoscopic laser and laryngofissure cordectomy were treated with autologous fat injection (AFI) into the neocord tissue for voice and swallowing rehabilitation. One patient did not attend the first control visit and was excluded from the study. The remaining 10 patients were evaluated in the preoperative and postoperative periods for phonatory functions and efficacy of AFI by videolaryngostroboscopy and computerized acoustic analysis. Phonatory functions showed statistically significant improvement in the shimmer, noise-to-harmonic ratio, maximum phonation time and fundamental frequency. Perceptual ratings (GRBAS scale) also showed statistically significant improvement in all 5 parameters. Despite improvement in glottic closure, the mucosal wave deteriorated. Due to recurrence of symptoms of glottic insufficiency, AFI was repeated in 2 patients at the third and fifth months, respectively. One year later, the AFI resulted in successful rehabilitation of swallowing in all patients. The probability of resorption of autologous fat and the deterioration of the mucosal wave after AFI remain a problem, but re-injection can be done easily. As AFI is an easy, safe and cheap method, we concluded that it is a promising alternative procedure for managing voice problems after laser or laryngofissure cordectomy defects.

Adipose Tissue↗
PubMed2006

Decrease of total antioxidant capacity during coronary artery bypass surgery.

OBJECTIVE: Cardiac surgery induces an oxidative stress, which may lead to impairment of cardiac function. In this study, we aimed to measure the changes of oxidative and antioxidative status of patients undergoing coronary artery bypass surgery (CABG). MATERIALS AND METHODS: We studied 79 patients who underwent CABG with and without cardiopulmonary bypass (CPB). Of the 79 patients, 39 had CPB and 40 did not. Blood samples were drawn before, during, and after the surgery. Antioxidant status was evaluated by measuring total antioxidant capacity (TAC), and oxidative status was evaluated by measuring total peroxide (TP) levels and oxidative stress index (OSI). RESULTS: TP and OSI levels increased, while TAC decreased progressively after the beginning of surgery, for all patients. There were negative correlations between TAC levels and aortic cross-clamping period and anastomosis time ( r = -0.553, p < 0.001 and r = -0.500, p < 0.001, respectively). In addition, there was a positive correlation between TAC and ejection fraction (r = 0.647, p < 0.001). CONCLUSIONS: During CABG, oxidant and OSI levels significantly increase and TAC significantly decreases. This situation is influenced by long CPB and anastomosis time, and also by low ventricular ejection fraction. We concluded that the patients who undergo CABG are exposed to potent oxidative stress that impairs their TAC. We speculate that supplementation with antioxidant vitamins such as vitamins C and E may be beneficial for patients undergoing CABG.

Antioxidants↗
PubMed2006

The effects of ventilated and non-ventilated nasal packs on Eustachian tube function: nine-step inflation-deflation test results.

The effects of different types of nasal packs on Eustachian tube function have been a source of debate. Past study results have been based on single tympanometric evaluations. To our knowledge, this study is the first to use the nine-step inflation-deflation test for evaluation of Eustachian tube function in patients undergoing nasal packing. No significant difference was observed between ventilated or glove-finger nasal packs, in terms of preserving Eustachian tube function in our patient population.

Acoustic Impedance Tests↗
PubMed2005

Polymorphisms of the XRCC1 DNA repair gene in head and neck cancer.

Inherited polymorphisms in the genes controlling the cell cycle or functioning in the DNA repair mechanisms may impair their function and contribute to genetic susceptibility. Abnormalities in the DNA repair have been reported in head and neck cancer. The XRCC1 gene functions in singlestrand break and base excision repair processes. In this study, two polymorphisms of the XRCC1 gene, Arg194Trp and Arg399Gln were investigated in 95 patients with head and neck carcinoma. The polymorphic regions were amplified by PCR followed by digestion with methylation-specific restriction enzymes, and analyzed electrophoretically. Genotype and allele frequencies were calculated, and association with cancer risk or clinical parameters was investigated. No association was observed between the genotypes and head and neck cancer for either polymorphism. Distribution of the alleles did not significantly differ between the patients and the control group. A significant association was only found for the Trp194 allele among the smoking individuals. Our data indicate that the Arg194Trp and Arg399Gln polymorphisms do not confer a significant risk for head and neck carcinogenesis.

Adult↗
PubMed2005

Mini-dose pump-prime aprotinin inhibited enhanced fibrinolytic activity and reduced blood loss and transfusion requirements after coronary artery bypass surgery.

OBJECTIVES: Low-dose aprotinin in the pump during cardiopulmonary bypass (CPB) has been shown to improve postoperative hemostasis and platelet preservation. This investigation was undertaken to evaluate the effects of mini-dose pump prime only aprotinin (70 mg) on the hemostatic parameters and blood transfusion requirements in patients undergoing on-pump coronary artery bypass surgery (CABG). MATERIALS AND METHODS: We studied 86 patients who underwent CABG. Forty patients received mini-dose aprotinin (500.000 KIU [70 mg] in the pump), and a control group of 46 did not. D-dimer level, full blood count, postoperative blood loss, and transfusion requirements were analyzed before, after one hour operation and first day after operation. RESULTS: Twenty-four-hour postoperative blood loss was significantly reduced in the aprotinin group (188+/- 51.5 ml vs. 818+/- 243.5 ml, [mean +/- standard deviation] p < 0.01). Patients in the aprotinin group also received significantly less banked blood posoperatively than the control group (1.20 +/- 0.52 vs. 3.33 +/- 1.13 Units/per patient (p < 0.04). One hour after operation, and 24 hours after operation D-dimer level was significantly reduced in the aprotinin group (p < 0.008 and p < 0.017, respectively). CONCLUSIONS: Mini dose pump-prime aprotinin reduces postoperative blood loss, transfusion requirements and yet confers hemostatic improvement through reduced fibrinolysis in patients undergoing routine coronary artery bypass grafting.

Aged↗
PubMed2005

[Long-term results of intracordal or neocordal autologous fat injection in patients with unilateral vocal cord paralysis and cordectomy].

OBJECTIVES: We investigated the long-term results of autologous fat injections for unilateral vocal cord paralysis and laryngofissure and cordectomy defects. PATIENTS AND METHODS: We evaluated the efficacy of autologous fat injections in 21 patients (16 males, 5 females; mean age 57 years; range 24 to 72 years) with unilateral vocal cord paralysis (n=11) and cordectomy defects (n=10) in the light of computed acoustic analysis, phonatory functions, and videolaryngostroboscopic findings and the effect of injections on swallowing. The mean follow-up was 14 months (range 10 to 22 months). RESULTS: Voice quality improved in 14 patients. Glottic insufficiency recurred in three patients in the early period, and in two patients in the late period. Phonatory functions showed significant improvement in all parameters except for jitter and functional interference (p<0.05). Videolaryngostroboscopy showed significant improvement in glottic closure, but mucosal waves remained unchanged. Of 18 patients with swallowing disorders, aspiration symptoms improved in 15 patients. Patients with unilateral vocal cord paralysis had better results compared to those with cordectomy defects. CONCLUSION: Autologous fat injections may be considered effective in patients with cordectomy defects or unilateral vocal cord paralysis.

Adipose Tissue↗
PubMed2005

Simultaneous existence of papillary carcinoma in the thyroid gland and thyroglossal duct cyst in two patients.

Papillary carcinoma of the thyroglossal duct cyst is a rare occurrence. Two patients presenting with medial neck masses were diagnosed as having thyroglossal duct cysts by ultrasonography. The Sistrunk operation was performed. Histopathologic evaluation demonstrated papillary carcinoma in the surgical specimens of both patients. The thyroid glands were examined by ultrasonography, scintigraphy, and fine-needle aspiration biopsy. Biopsy showed papillary carcinoma, and total thyroidectomies were performed. Micropapillary carcinoma was detected in the resected thyroid glands. The patients were asymptomatic without complications after 24 and 32 months of follow-up, respectively.

Adult↗
PubMed2005

Transoral microlaryngoscopic approach for schwannoma of the larynx.

Neurogenous tumors of the larynx are extremely rare. We present a 66-year-old male patient who underwent surgical excision of schwannoma of the larynx, which originated from the left aryepiglottic fold. Excision of the mass was performed through an endolaryngeal approach (suspension microlaryngoscopy). In the early postoperative period, the patient was breathing comfortably and his swallowing and phonation were normal. During a follow-up of three years, no evidence for recurrence was detected and he had no complaints of dysphagia, globus sensation, dyspnea on exertion, or cough.

Aged↗
PubMed2004

Normocalcemic hyperparathyroidism presented with mandibular brown tumor: report of a case.

Brown tumor is a rare clinical entity complicating hyperparathyroidism. It may occur in the head and neck, with the mandible being the most frequent site. Hyperparathyroidism is usually associated with hypercalcemia. We report a case of madibular Brown tumor secondary to primary hyperparathyroidism. In this case in spite of hyperparathyroidism and the bony lesion the serum calcium level was within normal range. The case managed by surgical excision of the mandibular tumor with an en-bloc hemithyroidectomy with inclusion of the diseased parathyroid gland. This case demonstrates that in osteolytic bony lesions a hyperparathyroid complication can be expected even with normal serum calcium level. The presence of normocalcemia in primary hyperparathyroidism should prompt the physician to look for vitamin D deficiency.

Biopsy, Needle↗
PubMed2004

[Orbital complications of acute sinusitis].

OBJECTIVES: We investigated orbital complications of acute sinusitis. PATIENTS AND METHODS: We retrospectively evaluated 25 patients (13 males, 12 females; mean age 21 years; range 2-56 years) treated for orbital complications of acute sinusitis. The symptoms, physical findings, and prognosis of the patients were investigated. Cases were evaluated according to age, sex, etiologic factors, localization, treatment, morbidity, and mortality. RESULTS: There were periorbital cellulitis in 20 patients (80%), orbital cellulitis in 2 patients (8%), and subperiosteal abscess in 3 patients (12%). In 5 of 9 cases who were above 16 years of age, a history of surgery and trauma were present. All the patients received high-dose intravenous antibiotic therapy. Three cases with subperiosteal abscess and 2 cases with orbital cellulitis underwent endoscopic surgery. Orbital complications recurred in two patients. There was no mortality or blindness after the treatment of orbital complications of acute sinusitis. Diplopia persisted only in two cases. CONCLUSION: Orbital complications in adult patients are often related with trauma. The patients with orbital complications should be treated with aggressive parenteral antibiotics. Surgical treatment is indicated when subperiosteal orbital abscess, orbital cellulitis, and orbital abscess are seen.

Abscess↗
PubMed2004

[Factors that affect in situ lifetime of Provox voice prosthesis].

OBJECTIVES: We evaluated the effect of age, radiotherapy, insertion time of prosthesis, the period between radiotherapy and insertion time on in situ lifetime of Provox, voice quality and complications. PATIENTS AND METHODS: The study included the use of 62 Provox voice prosthesis in 50 total laryngectomy patients (46 males, 4 females; mean age 61 years; range 43 to 77 years). The patients visited our clinic regularly every three months for the first year after insertion and every six months in subsequent years. The ease of use and complications of prothesis and voice quality of the patients were evaluated. RESULTS: The mean in situ lifetime was 24 months (range 1 to 49 months). Age, radiotherapy, insertion time of the prosthesis, the period between radiotherapy and the insertion time had no influence on the in situ lifetime of Provox. These variables were not associated with the complications of the prosthesis. A statistically significant good voice quality was found in nonirradiated patients and those in whom the prosthesis was inserted between 6 and 24 months after laryngectomy. The use of Provox was easier in nonirradiated patients than irradiated patients (p<0.001). CONCLUSION: In situ lifetime of Provox was not influenced by age, radiotherapy, insertion time, and the period between radiotherapy and insertion time of prosthesis. We believe that the patient factor is the most important factor that affect the in situ lifetime of Provox.

Adult↗