Browsing by Author "Kucukmetin N."

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    The effect of perendoscopic sclerosing agent injection in Forrest's II ulcers- A pilot study from Turkey
    (2002) Saruc M.; Ozden N.; Kucukmetin N.; Tuzcuoglu I.; Yuceyar H.
    Background: We aimed to clarify the outcome of perendoscopic prophylactic injection of sclerosing agent in Forrest's II ulcers. Material/Methods: Patients with upper gastrointestinal bleeding in last 6 hours were performed emergency endoscopy and were enrolled. The patients in group-1 were performed prophylactic injection therapy with 1% aethoxysclerol and then given medical treatment with intravenous 40 mg omeprazole twice a day and somatostatin infusion at the dose of 6 mg/day during 3 days. Group-2 patients were only given medical treatment with same agents and at same doses without having any perendoscopic therapy. Results: There were 32 patients in group-1 and 20 in group-2. In emergency endoscopy, 20 (62.5%) patients had IIa ulcers and 12 (37.5%) patients had IIb ulcers in group-1. These patients underwent prophylactic perendoscopic hemostasis by 1% aethoxysclerol in addition to medical treatment. Early rebleeding occurred in 9 (28.1%) patients of group-1 and 3 (15%) in group-2 (p<0.001). At the endoscopic control after 48 hours 13 (40.6%) patients in the group-1 and 15 (75%) patients in group-2 showed improved local ulcer stigmata (p<0.001). The numbers of blood units transfused were lower in the group-2 (p=0.002). The hospital stay was longer in group-1 (p=0.01). In the group-1, more endoscopic intervention was needed. Any death and the need for surgical intervention did not occurred in any groups. Conclusion: According to our results; the indication of perendoscopic prophylactic injection of sclerosing agent in non-bleeding ulcers with high risk of rebleeding must be reviewed by large population based, prospective, radomized trials.
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    Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis
    (2003) Ayhan S.; Demir M.A.; Kandiloglu A.R.; Saruc M.; Kucukmetin N.
    Background: The etiopathogenesis of chronic inflammation at the gastric cardia is still debated. It is suggested that carditis may be a finding of gastro-oesophageal reflux disease (GORD) or it may occur as a result of the gastritis caused by Helicobacterpylori (H. pylori) infection. Aim: To examine morphological features of carditis, as well as the associations of carditis with Helicobacter pylori gastritis and oesophagitis as a marker of gastro-oesophageal reflux disease. Patients and methods: Endoscopic biopsy specimens obtained systematically from oesophagus, cardia, corpus and antrum of 135 dyspeptic patients were retrospectively evaluated. In biopsies, we have searched for any correlations between clinical, endoscopic, and histological features. Results: Carditis was detected in 123 (91.1%) of the cases. The mean age of the carditis group was 47.9 years and the male-to-female ratio was 1.08:1. The relation of carditis with age and sex was not significant (p = 0.19 and p = 0.24, respectively). All cases of the carditis group had concomitant chronic gastritis. In these cases, chronic inflammation, degree of neutrophil-mediated activity and H. pylori colonisation were significantly correlated in cardia, corpus and antrum (p < 0.001). Intestinal metaplasia was observed in 14 cases (11.3%) and, was associated with H. pylori colonisation (p < 0.001). Microscopic oesophagitis detected in 37.7% cases also showed correlation with reflux symptoms and endoscopic oesophagitis but not carditis. When all cases with carditis were evaluated for H. pylori infection and oesophagitis, which are presumed risk factors for carditis, H. pylori infection appeared to be an independent risk factor for carditis (p = 0.012), while oesophagitis did not. Conclusions: This study suggests that carditis is commonly found in patients presenting with dyspepsia and the histological features of carditis were similar to those seen in H. pylori gastritis in antrum and corpus. In addition, our data have also shown that carditis was significantly associated with H. pylori infection but not with symptoms or signs of GORD.