The role of gastric Helicobacter pylori infection in laryngopharyngeal reflux disease.

OBJECTIVES: To investigate the role of Helicobacter pylori (H pylori) infection in laryngopharyngeal reflux (LPR). STUDY DESIGN: A prospective multidisciplinary clinical study. METHODS: Forty-four adult patients who applied to our ENT clinic with LPR symptoms were evaluated. Then these patients underwent upper gastrointestinal system endoscopy and double probe pH monitoring. In addition, during the endoscopy multiple biopsies from the stomach were obtained to detect H pylori. RESULTS: Results from 32 LPR positive patients were assessed (10 male and 22 female). There were no statistically significant differences between the presence of H pylori and sex, age, degree of gastritis and esophagitis, and also the number of reflux, fractional acid exposure time regarding proximal probe readings. Similarly for both proximal and distal probe readings, the average score of esophageal acid clearance was not statistically significant (P > 0.05). In addition, no statistically significant difference was found between the presence of H pylori and GERD (P > 0.05). CONCLUSIONS: The results of this study demonstrated that there is no relationship between gastric H pylori infection and LPR. EBM rating: B-3b.     

A case report of doxycycline induced esophageal and gastric ulcer.

It is well-established that various drugs can induce esophageal and gastric mucosal injury. Generally neither motility disorder nor an anatomical stricture is found in such cases and the cause of mucosal injury is usually found to be inadequate fluid intake with medicine or consumption just prior to bedtime. Athough there are some case reports of doxycycline induced esophageal mucosal injury, doxycycline induced gastric ulcer has been reported only once in the literature. In this case report, a 33 year old female patient who had been prescribed doxycycline for pelvic inflammatory disease is presented. She was admitted with retrosternal and epigastric pain and odynophagia, which had begun after taking the second oral dose of the drug. Endoscopic examination showed ulcers in the mid esophagus and fundus of the stomach. Histologic findings supported a drug induced etiology in these ulcers. This is only the second case in the literature where gastric ulcer has been caused by doxycycline.     

Division of the genitofemoral nerve in normal scrotal testicular rats

The role of the genitofemoral nerve (GFN) on testicular descent has been clearly shown. It has also been suggested that in unilateral cryptorchid rats, after division of the ipsilateral GFN fertility rates are higher, i.e., transection of the GFN prevents contralateral testicular damage, but the mechanism is unclear. The purpose of this study was to investigate the effect of dividing the GFN on the normal scrotal testes. Thirty male Wistar albino rats were divided into three groups: group A, transection of right GFN; group B, bilateral transection of the GFN; and group C, sham operations, all at the age of 30 days. The animals were killed at 90 days of age and the testes were removed. Each excised testis was weighed and fixed for histological studies. Mean seminiferous tubular diameter was measured and germinal epithelium maturity was determined using the modified Johnsen testicular-biopsy score. In all groups, all three parameters were similar, suggesting that division of the GFN had no effect on normal testes. Accepted: 12 January 2000     

Effects of an anti-progestin steroid in women: interruption of the menstrual cycle or early pregnancy (author's transl)

The 19-nor steroid, RU-486, has an affinity for progestin receptors, and is also a progesterone as shown in animal studies. RU-486 was administered orally in a dose of 200 mg a day for 4 consecutive days to 11 women aged 18-34 seeking 1st trimester abortion. Bleeding occurred, in most cases, on the 1st day, followed by expulsion on the 3rd day in 2 cases, on the 4th day in 3 cases, on the 5th day in 3 cases, and on the 8th day in 1 case. 2 patients failed to abort. There were no complications, and only 1 patient required blood transfusion. Normal ovarian activity resumed in all cases. RU-486 can also be used to induce menstruation when administered in a dose of 50 mg a day for 4 days beginning on the 22nd day of a normal cycle. The use of RU-486 as an abortifacient agent seems to be more effective than the use of massive doses of estrogen or of prostaglandins, and to be certainly less traumatic than curettage or vacuum aspiration. Contraindications to its use and potential side effects, especially hepatic, have still to be established.     

Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review

Marjolin''s ulcer is an aggressive cutaneous malignancy common in previously traumatized or chronically inflamed skin. It has high regional metastasis and fatality rates. Our patient presented with subcutaneous nodules and ulcerations on the right limb. He had a history of osteomyelitis of the fifth toe. Histopathological examination of the nodule and ulceration demonstrated squamous cell carcinoma. The nodules and ulcerations were in-transit metastases of Marjolin''s ulcer. Here, we present a case of squamous cell carcinoma arising at a site of a chronic osteomyelitis with resultant in-transit metastases.     

Division of the genitofemoral nerve and late orchiectomy: effects on the contralateral testis in ipsilateral testicular torsion

Unilateral torsion of the spermatic cord has been demonstrated to damage the contralateral testis; however, the pathogenesis has not yet been examined in detail. The purpose of this study was to evaluate the influence of unilateral torsion on the contralateral testis in rats by performing ipsilateral division of the genitofemoral nerve (GFN) and/or late orchiectomy. Male 25-day-old, prepubertal Wistar albino rats were divided into five groups: (1) sham operation; (2) unilateral testicular torsion; (3) simultaneous unilateral testicular torsion and ipsilateral GFN division; (4) unilateral testicular torsion and orchiectomy on the 4th day after torsion; and (5) simultaneous unilateral testicular torsion and GFN ipsilateral division, and orchiectomy on the 4th day after torsion. Torsions performed were 720°, all on the right testes. On day 55 after torsion, which represents the early postpubertal period of the rat, the contralateral testes were removed. Tubular biopsy score (TBS) was calculated, and seminiferous tubular diameters (STD) were measured. Student's t-test was used for statistical analysis. There was no contralateral testicular damage in the control group, but in all of the study groups destructive changes were found in the left gonad after torsion of the right testicle. The mean TBS of the study groups was higher than that of the control group. STD values were lower in the study groups, but the differences were not statistically significant between groups. In prepubertal rats, unilateral torsion causes histologically measurable changes in the contralateral testis. Ipsilateral division of the GFN and late orchiectomy did not cause any significant alterations in terms of contralateral damage. Further investigations are needed to determine the role of the GFN in testicular torsion.     

Congenital blaschkoid eccrine spiradenoma on the face

Eccrine spiradenoma is an uncommon tumour of the sweat gland(s) and generally occurs as a solitary small painful nodule. Very rarely, it may present as multiple tumours arranged in a linear/blaschkoid pattern. An 8-year-old girl had many papulonodular lesions, arranged in a linear pattern on the left half of the face, involving the forehead and lateral side of the nose. The lesions were along Blaschko's lines. Lesions were reported to be present at birth; no family member had similar lesion(s), either in solitary or multiple form. Histopathologic examination of a biopsy specimen revealed characteristic features of eccrine spiradenoma. The case is reported because of the rare occurrence of this presentation.     

The effect of the genitofemoral nerve division on the contralateral descended testis in the unilateral cryptorchidism model

It is widely accepted that there are degenerative changes and decreased spermatogenesis in the contralateral descended testis (CDT) in unilateral undescended testis (UUDT). While some investigators have postulated that the mechanism may be related to primary (congenital) or secondary (autoimmune, vascular, and neural) events, the exact mechanism of the damage to the CDT is still unknown. The present study was planned to investigate the role of the genitofemoral nerve (GFN) on the changes in the CDT. Forty male Wistar albino rats were divided into four groups of 10 each. During the newborn period a UUDT model was created and at the age of 30 days ipsilateral GFN division was done (group A). In addition, UUDT with intact GFN (group B), divided right GFN with bilateral scrotal testes (group C), and control (group D) groups were formed. When the animals reached early adulthood, they were killed and the testes were removed. Mean seminiferous-tubular diameter (STD) and germinal-ephitelium maturity was determined using modified Johnson testicular biopsy scores (TBS). The mean STD and TBS of the study groups did not show any differences suggesting that ipsilateral division of the GFN has no effect on the CDT in the UUDT model. Accepted: 11 August 2000