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Öğe The approach of the patients to the rigid rectosigmoidoscopy [RIJID REKTOSIGMOIDOSKOPIYE HASTALARIN YAKLASIM VE DEGERLENDIRMESI](1996) Tuzomay N.; Isler M.; Artut S.; Akarca U.S.; Ozutemiz A.O.; Aydin A.; Cavusoglu H.Patients' informations, perceptions and reflections about rigid rectosigmoidoscopy were investigated before and after rigid rectosigmoidoscopy. 307 patients (15-84), of these patients (155 women, 152 men) were included in the study. 248 were of urban (81%) and 59 were from of rural (19%) origin. 48% of the patients graduated from high school or higher degree. Before the procedure, 36% stated that they had had enough information about the examination, 59% knew that we would perform the procedure through anus. 45% of the patients requested a pre-procedure explanation from a doctor, 16% from a nurse and for 39% of the patients it did not matter. 32% of the men and 60% of the women predicted the procedure distressing (p<0.001). Patients from rural area the procedure as more distressing when compared with the urban patients (80% vs 66% (p<0.05)). During the procedure, 36 patients (12%) stated that they would rather not have had this examination, 18 patients (6%) said that they would have never let it be done. This study indicates: (i) that in Turkey a significant number of patients undergoing rectosigmoidoscopy have no information about the procedure; (ii) that most patients prefer a medical doctor rather than a nurse to give procedure related information and (iii) that women.Öğe The comparison of two different esophageal motility catheters recording lower esophageal sphincter pressure [KARDIOOZOFAGEAL SFINKTER BASINCININ OLCULMESINDE IKI AYRI MOTILITE KATETERININ KARSILASTIRILMASI](1996) Bor S.; Tekesin O.; Yuceyar H.; Yonetci N.; Cavusoglu H.Lower esophageal sphincter (LES) has an asymmetric structure. Esophageal motility recording catheters usually have one side hole to measure the pressure and this may cause some errors in. the measurement of LES pressure. To get rid of this problem a new catheter that has four additional holes at the tip placed radially has been developed. In this study, to evaluate the advantage of this catheter, 23 male, 27 female patients' esophageal motility was recorded using the regular and newly developed catheter. Mean LES pressure measured with regular catheter (22.36 ± 16.6) was significantly higher than that recorded with radial catheter (15.23 ± 10.15) (p<0.01) in SPT technique. However mean LES pressure, mean LES asymmetry, vector volume, mean maximum pressure, sphincter length, and length of high pressure zone were similar in two groups by using RPT technique. In conclusion, the new catheter appears to be more accurate in the measurement of LES pressure.Öğe Effect of botulinum toxin injection and pneumotic dilatation on lower esophageal sphincter in achalasia(2000) Bor S.; Gunsar F.; Ozutemiz O.; Musoglu A.; Cavusoglu H.Although a number of the therapeutic techniques are used for the treatment of achalasia, none of them give satisfactory results and new treatment modalities continue to be investigated. One of these is the use of botulinum toxin injection, which was evaluated in this study by manometry, using different parameters of the lower esophageal sphincter (LES). Twenty three patients with achalasia were treated with either botulinum toxin or pneumatic dilation and compared with 13 controls. LES evaluation was performed on all patients prior to, and during the early and late stages of the procedure with rapid and stationary pull-throughs. The correlation between different manometric parameters and success of the therapy was investigated. Symptoms recurred in all patients in the botulinum group while the pneumatic dilatation group were all symptom-free. The best parameters were vector volume and the measurement of LES pressure by stationary pull- through. Pneumatic dilatation was accompanied by a great asymmetry without any adverse effect on the resolution of symptoms. Botulinum toxin injection is not an effective therapy but might be used when other options are unsuitable LES pressure measured by stationary pull-through is the most useful parameter for the evaluation of the success of therapy and the rapid pull-through technique adds no further information.Öğe The effect of cimetidine and propantheline combination on nocturnal gastric secretion(1989) Izmirli A.; Cavusoglu H.[No abstract available]Öğe The effect of ranitidine on nucturnal gastric secretion(1989) Ozcan B.; Cavusoglu H.[No abstract available]Öğe Gastro-esophageal reflux following Helicobacter pylori eradication [Helicobacter pylori eradikasyonundan sonra gastroozofajial reflu sendromu](1999) Gunsar F.; Aydin A.; Ersoz G.; Yilmaz M.; Akarca U.S.; Ozutemiz O.; Alkanat M.; Cavusoglu H.The interrelation between Helicobacter pylori (H. pylori) and gastro- esophageal reflux disease is complex and not fully understood. It has recently been reported that eradication of H. pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. In order to determine whether H. pylori eradication promotes the development of gastro-esophageal reflux and reflux oesophagitis, we performed endoscopy, esophageal manometry and 24-hour intraesophageal pH-monitoring prior to and following H. pylori eradication. Biopsies were taken from the antrum, corpus and esophagus during endoscopy. Whilst the study group comprised 21 patients, results were evaluated in only 19 (10 duodenal ulcer and nine non-ulcer dyspepsia) in whom H. pylori eradication was achieved. After eradication all parameters of pH monitoring were increased (p < 0.05) and these the changes were more pronounced in patients with corpus gastritis or esophagitis (p < 0.05). Esophagitis increased from 21% to 47% endoscopically and from 73% to 84% endoscopically and histologically following eradication but this increase was not significant. In conclusion, H. pylori eradication caused an increase in gastro-oesophageal refux, especially in patients with corpus gastritis or esophagitis.Öğe The management of upper gastrointestinal bleeding in hemophilia patients by sclerotherapy [Hemofili hastalarinda ust gastrointestinal sistem kanamasinin endoskopik skleroterapi ile tedavisi](1998) Yonetci N.; Yilmaz M.; Ozutemiz O.; Gunsar F.; Donmez A.; Tekesin O.; Batur Y.; Cavusoglu H.Upper gastrointestinal bleeding is a common finding in hemophilia patient's and has an incidence of 20%. Endoscopic sclerotherapy is a widely and successfully used treatment for upper gastrointestinal bleeding in Turkey as in other countries. Studies regarding the effectiveness of sclerotherapy in patients who have bleeding diathesis and upper gastrointestinal bleeding, such as in hemophilia, are limited in number. In our study, seven hemophilia patients with an age rance of 32 to 55 were studied. All patients had upper gastrointestinal bleeding and the effectiveness of sclerotherapy was retrospectively analyzed from 1991 to 1995. All patients were endoscopically examined with in the first 24 hours of admission was duodenal ulcer was diagnosed in four cases, hemorrhagic gastritis in two, and gastric ulcer in one. In four of the patients, active bleeding was observed and injection sclerotherapy (adrenalin 1/10.000 and polydocanol % 1) was performed successfully, with hemostasis occuring during endoscopy. These patients had a history of former gastrointestinal bleeding. In addition to sclerotherapy, factor VIII and fresh blood were administered. In two patients there was a recurrence of bleeding after 6 mounts but endoscopicaly active bleeding could not be seen. Conclusion: Endoscopic injection sclerotherapy is a safe and effective method in the treatment of upper gastrointestinal bleeding in hemophilia.Öğe One-week triple therapies for Helicobacter pylori eradication [Helicobacter pylori eradikasyonunda bit haftalik uclu tedaviler](1998) Aydin A.; Ersoz G.; Tuncyurek M.; Cavusoglu H.Studies have shown that omeprazole plus antibiotic treatments are effective in Helicobacter pylori (H.pylori) eradication. But, the optimal drug regimen for H.pylori infection remains uncertain. In this study, 94 H.pylori-positive patients with duodenal ulcer or non-ulcer dyspepsia were examined to investigate the efficacy of one-week triple therapies consisting of omeprazole (O), clarithromycin (C), and amoxicillin (A) or metronidazole (M). The patients were treated with either OAC500 OAC250 or OMC500 combinations for one week. Eighty-six cases completed he study. H.pylori eradication was achieved in 93.3%, 93.1% and 88.9% of the patients in OAC500, OAC250 and OMC500 treatment groups, respectively. Side effects occured at a rate of 33.3%, 10.3% and 22.2%, respectively. No patient discontinued treatment due to adverse reactions. In conclusion, one-week OAC500, OAC250 and OMC500 therapies are highly efficient in H.pylori eradication. Side effects occur less frequently in patients treated with OAC250. One-week OAC250 combination may become the treatment of choice for eradication of H.pylori.Öğe A rare cause of upper gastrointestinal bleeding: Dieulafoy's disease [Seyrek gorulen bir ust gastrointestinal sistem kanama nedeni: Dieulafoy lezyonu](1998) Yilmaz M.; Ozutemiz O.; Ersoz G.; Demir A.; Aydin A.; Akarca U.; Karasu Z.; Batur Y.; Cavusoglu H.Dieulafoy's disease is an arterial lesion with is frequent and serious bleeding and in new cases it is macroscopically protruding into the intestial lumen having clot on its surface. In our clinic, between 1994 and 1996, Dieulafoy's disease was identified in 12 (2.3%) of 515 patients followed by the diagnosis of upper gastrointestinal bleeding without having varices. The clinical features of these cases were retrospectively analyzed. There were 8 males and 4 females, average ages 59±18. The reasons for applying to the hospital were hematemesis and melena in all patients. Hemoglobin values were between 5 to 10 g/dL at the hospitalization and blood transfusion during follow-up in the clinic was between 3 to 10 units. Additional systemic disease was diagnosed in 8 patients. Endoscopicaly the lesion was at the proximal corpus in 8, fundus in 3 and cardia in 1 case. During endoscopy, active bleeding was observed in 7 cases and in 5 cases, a vessel having clot on its surface was identified. Endoscopic injection sclerotherapy (Adrenalin 1/10.000, polidocanol % 1) was the treatment in all cases. Bleeding recurred in 2 cases after initial sclerotherapy. In one of these two cases, bleeding could not be stopped even after second sclerotherapy and the patient died during surgery. Sclerotherapy is generally successful in the treatment of Dieulafoy's disease. The diagnosis of Dieulafoy's disease should be remembered in cases of frequently recurring hemorrhage having unidentified reason endoscopically.Öğe The relationship between cagA positivity and serum gastrin and TNF- alpha levels in patients with chronic active gastritis and duodenal ulcer associated with Helicobacter pylori [Helicobacter pylori (+) kronik aktif gastrit ve duodenal ulserli hastalarda, cagA pozitifligi ile serum gastrin ve TNF-alfa iliskisi](1999) Yilmaz M.; Aydin A.; Ungan M.; Gunsar F.; Ersoz G.; Ozutemiz O.; Akarca U.; Cavusoglu H.Helicobacter pylori (H.pylori) infection, which is strongly associated with non-autoimmune chronic active gastritis and peptic ulcer disease, is also considered to be a co-factor in gastric adenocarcinoma and primer gastric B cell lymphoma. In order to examine the relationship between cag A (+) strain of H. pylori with gastrin and TNF-alpha, an inflammatory mediator, in both chronic active gastritis (CAG) and duodenal ulcer (DU) pathogenesis, 21 patients with CAG and 31 patients with DU disease were investigated in addition to 18 patients who had no pathological findings on either upper gastrointestinal endoscopy or histological examination. Prior to endoscopy, sera were collected from all of cases in order to evaluate gastrin and TNF- alpha and also for cag A antibody measurements. These three parameters were studied from the same blood sample. Cag A antibody was found in 33.3% (7/21) of patients with CAG and in 64.5% (20/31) of patients with DU disease (p < 0.05). When the cases with CAG (74.1 ± 26 pg/ml) and with DU (69.5 ± 22 pg/ml) were compared there was no significant difference between gastrin levels of the patient groups but both were significantly higher than the gastrin level (44.9 ± 5.7 pg/ml) of the control group (p < 0.001). The serum TNF-alpha level of cases with CAG (38 ± 34 pg/ml) was higher than control group (18 ± 9 pg/ml) (p < 0.05). There was no significant/difference between the serum gastrin and TNF-alpha levels of cag A(+) and cagA(-) cases. According to these results, there seems to be a positive relationship between cag A positive H. pylori strains and DU. Serum gastrin levels are high in H. pylori infection. This finding does not depend on the presence of cagA antibody of H. pylori and is also not related with CAG and DU, which are caused by H. pylori. As there is no correlation between the serum TNF-alpha level, gastrin level and presence of cagA antibody, we conclude that both the secretion of gastrin and the inflammatory cytokin response are free from the effect of cag A antibody.Öğe Review of 502 patients with upper gastrointestinal bleeding [Ust gastrointestinal sistem kanamali 502 hastanin degerlendirilmesi](1997) Gunsar F.; Akarca U.S.; Yonetci N.; Ozutemiz O.; Aydin A.; Ersoz G.; Bor S.; Musoglu A.; Cavusoglu H.; Batur Y.502 patients presented with upper gastrointestinal bleeding who were admitted to Ege University Gastroenterology Department in 1993-1995 were analyzed with respect to demographic data, symptomatology, etiology, treatment and outcome. 378 were male, 124 were female and the mean age was 53.6 ± 0.7. Of the patients with nonvariceal bleeding, 211 (50%) had a history of NSAID use. Ten patients had been using an anticoagulant drug. The presented bleeding was the first in 294 patients, the second in 114, the third in 35 and more in 59 patients. Of 464 patients (92%) in whom upper GI endoscopy was performed, 402 (80%) were examined within 24 hours. The most common causes of bleeding were duodenal ulcer (227 patients, 45%), gastric ulcer (89 patients, 17%), esophageal varices (80 patients, 15.8%), gastric mucosal erosion and gastritis (35 patients, 6.9%). Forty-five patients who did not respond to supportive measurement, drug treatment, sclerotherapy or Sengstaken-Blakemore tube application were transferred to the Department of Surgery; 31 (6.1%) were operated 26 patients (5.1%) died.
