Gultekin F.A. | Bakkal, Bekir Hakan | Tayfun S. | Babuccu O. | Comert M.

Article | 2013 | Annals of Coloproctology29 ( 4 ) , pp.172 - 176

Presacral abscess formation due to rectal stump insufficiency following Hartmann procedure is very rare complication. If the abscess cavity is large, it might delay the reversal of the stoma and will probably result in a devastating future functioning of the neorectum. Moreover, very invasive treatments will be required in order to prevent severe septic complications. We present the case of a 58-year-old man with a past history of Hartmann procedure for a low rectal carcinoma who presented with rectal stump insufficiency and a large presacral abscess. Following extensive debridement and rectal stump resection, a vacuum-assisted clos . . .ure (VAC) system was applied to the large abscess cavity to facilitate gracilis muscle flap reconstruction and to optimize wound healing. The satisfactory results showed in the present report led us to favor a combination of VAC therapy and a gracilis muscle flap in intrapelvic and perineal reconstruction in the case of large defects associated with high risks of septic complications. © 2013 The Korean Society of Coloproctology Daha fazlası Daha az

Barut F. | Özdamar Ş.O. | Kertiş G. | Bahadir B. | Cömert M. | Banu Dogan G.Ü.N.

Article | 2008 | Ondokuz Mayis Universitesi Tip Dergisi25 ( 1 ) , pp.30 - 34

Majority of hepatic carcinoid tumors are metastatic, and frequently the origin of the tumor is gastrointestinal system. It is occasionally regarded as primary, after long term of clinical follow up or without any incidental finding during otopsy for focus of tumor. For carcinoid tumor cases, high frequency of secondary non-carcinoid neoplasm sourced from gastrointestinal system especially colon adenocarcinoma is well known. Though, carcinoid tumor accompany with gallbladder carcinoma is extremely rare. 73 years old woman applied to the emergency service with abdominal pain. Abdominal ultrasonography and tomography revealed multiple . . .metastasis concordant with abdominal mass and after that, with the preliminary diagnosis 'acute cholecystitidis' and 'hepatic metastatic mass lesion' the patient underwent cholecystectomy and hepatic local mass exicision. A brown lesion in 1 cm diameter at the fundus is observed during macroscopic examination. Microscopic examination of this lesion showed adenocarcinoma infiltration up to serosa and focal reaction with musicarmine within the tumor cells. Immunohistochemically, there is positive reaction with pancytokeratin (AE1/AE3) with no chromogranin-A expression. Gross examination of hepatic mass lesion is solid with smooth surface and microscopic examination revealed tumor, composed of cells exhibiting organoid pattern, which has centrally located vesicular nucleus and large granular eosinophilic cytoplasm, and adjacent to normal liver tissue. Immunohistochemically, it is determined that there is weak reaction with pancytokeratin (AE1/AE3) within tumor cells and strong and diffuse expression of chromogranin-A and synaptophysin. With these findings, it is concluded that the hepatic mass is 'carcinoid tumor'. To rule out the possibility of a metastatic lesion because of its multiple quantity, further investigations are done to determine a primary focus but cannot be found. For the cases of carcinoid tumor, encountered with gallbladder adenocarcinoma, clinical course of the disease depends upon biologic behaviour of adenocarcinoma. Because of rarerity, we report the case Daha fazlası Daha az

Numanoğlu, Kemal Varın | Tatlı, Duygu

Article | 2008 | Journal of Pediatric Surgery43 ( 7 ) , pp.30 - 34

We report the first case of urinary bladder hemangioma that caused hemorrhagic shock consequent to massive hematuria. A 2-year-old girl was presented with hemorrhagic shock and macroscopic hematuria. After rapid resuscitation was performed, radiologic investigations demonstrated a solid enhancing mass originating from the dome of bladder. Partial cystectomy was made. Histopathologic examination of resected specimen revealed cavernous hemangioma. Although bladder hemangiomas are rare benign tumors, it should be kept in mind that they can lead to life-threatening complications when the diagnosis is delayed. © 2008 Elsevier Inc. All ri . . .ghts reserved Daha fazlası Daha az

Kandemir O. | Buyukates M. | Kandemir N.O. | Aktunc E. | Gul A.E. | Gul S. | Turan S.A.

Article | 2010 | Journal of Cardiothoracic Surgery5 ( 1 ) , pp.30 - 34

Background: Ankaferd Blood Stopper®(ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.Methods: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from . . .Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.Results: The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.Conclusions: In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required. © 2010 Kandemir et al; licensee BioMed Central Ltd Daha fazlası Daha az

Cömert M. | Tekin I.Ö. | Açikgöz Ş. | Üstundag Y. | Uçan B.H. | Acun Z. | Barut F.

Article | 2004 | Journal of Gastroenterology and Hepatology (Australia)19 ( 9 ) , pp.1052 - 1057

Background and Aim: Oxidized low-density lipoproteins (LDL), which are produced during oxidative stress by the process of lipid peroxidation, have also been proposed to have complex roles in many other immuno-inflammatory mechanisms. It has been shown that bile-duct ligation results in oxidative stress in the liver of animals. The aim of this study was to investigate if oxidized LDL are produced in the liver tissues of bile-duct-ligated mice. Methods: Obstructive jaundice was induced in BALB/c mice by the ligation and division of the common bile duct. Liver concentrations of glutathione and malondialdehyde were measured in the sham- . . .operated (n = 10) and bile-duct-ligated (n = 10) mice on the 10th day of obstructive jaundice. The presence of oxidized LDL in the liver tissue sections was evaluated using a special, novel immunofluorescent staining method. The final step was to explore the existence of oxidized LDL under fluorescent microscopy. Results: Compared with sham-operated mice, jaundiced mice showed significantly higher levels of malondialdehyde and lower concentrations of reduced glutathione in the liver. While there was no staining in the sham-operated group, bile-duct ligation resulted in positive oxidized LDL staining in the liver tissues of mice. The present study testifies that bile-duct ligation results in oxidative stress and enhanced lipid peroxidation in the hepatic tissues of BALB/c mice and moreover, that oxidized LDL accumulate in the liver of mice with experimental obstructive jaundice. Conclusion: Oxidized LDL may be an important and direct indicator of ongoing oxidative stress and enhanced lipid peroxidation in obstructive jaundice. The potential roles of this finding were also discussed, briefly. © 2004 Blackwell Publishing Asia Pty Ltd Daha fazlası Daha az

Turan, İnci | Özaçmak-Sayan, Hale | Özaçmak, Veysel Haktan | Barut, Figen | Özaçmak, I. Diler

Article | 2018 | Tissue and Cell52 , pp.35 - 41

Background: Intestinal ischemia and reperfusion (I/R) induces oxidative stress, inflammatory response, and acute lung injury. S-nitrosoglutathione (GSNO), a nitric oxide donor, has been documented to have protective effects on experimental ischemia models. Aim: The aim of this study was to examine the effect of GSNO on I/R-induced intestine and lung damage and detect the potential mechanisms emphasizing the protective role of GSNO. Methods: Intestinal I/R was induced by occluding the superior mesenteric artery for 30 min followed by reperfusion for 180 min. GSNO was administered intravenously before reperfusion period (0.25 mg/kg). . . .The levels of lipid peroxidation, reduced glutathione, and myeloperoxidase (MPO), histopathological evaluation and immunohistochemical expressions of both nuclear factor KappaB (NF-?B) and inducible nitric oxide (iNOS) in intestine and lung tissues were assessed. Results: Histolopathologic evaluation demonstrated that intestinal I/R induced severe damages in the intestine and the lung tissues. Histopathological scores decreased with GSNO treatment. GSNO treatment reduced lipid peroxidation and MPO levels and inhibited expression of NF-?B and iNOS in the intestine. Conclusion: Our results suggest that GSNO treatment may ameliorate the intestinal and lung injury in rats, at least in part, by inhibiting inflammatory response and oxidative stress. © 2018 Elsevier Lt Daha fazlası Daha az

Onak Kandemir N. | Barut F. | Barut A. | Birol İ.E. | Dogan Gun B. | Ozdamar S.O.

Article | 2019 | Scientific Reports9 ( 1 ) , pp.35 - 41

Podoplanin, a reliable marker of lymphatic endothelium, is a mucin-type transmembrane protein. Although the human placenta is devoid of a lymphatic system, chorionic villous stromal (CVS) cells express podoplanin. In this study, the pattern of podoplanin expression in normal and pathological placental tissues and the biological role of podoplanin were investigated. In total, 198 placental tissues belonging to 184 patients, seen at the Department of Pathology of Bulent Ecevit University Education and Research Hospital, Zonguldak, Turkey, were evaluated histopathologically and determined to meet the study criteria. The tissues were as . . .signed to control, cisternal placental disorders, inflammation and hypoxic-ischemic pathology groups. Podoplanin expression in CVS cells was graded from 0 to 3 depending on the staining intensity, as determined by an immunohistochemical evaluation of chorionic villi in the most intensively stained tissue region. Podoplanin levels in control CVS cells increased in parallel with placental maturation, whereas in molar pregnancies podoplanin expression was lower than in control tissues. In the acute placental inflammation group, podoplanin immunoreactivity was similar to that in the control group, whereas in the preeclampsia group, podoplanin expression was higher than in all other groups. Our study showed an increase in podoplanin expression in CVS cells during pregnancy. In preeclamptic patients, the increase in podoplanin expression may be a response to hypoxic-ischemic conditions, whereas in molar pregnancies the decrease in podoplanin levels may cause villous swelling by disrupting intercellular fluid homeostasis. © 2019, The Author(s) Daha fazlası Daha az

Barut F. | Onak Kandemir N. | Ozdamar S.O. | Gul S. | Bektas S. | Dogan Gun B. | Bahadir B.

Article | 2009 | Turkish Neurosurgery19 ( 4 ) , pp.417 - 422

https://hdl.handle.net/20.500.12628/5999

Barut F. | Özdamar S.O. | Dogan Gün B. | Bahadir B. | Bektaş S.

Article | 2011 | Turk Onkoloji Dergisi26 ( 2 ) , pp.76 - 81

Merkel cell carcinoma is an uncommon tumor arising usually on the sun-exposed skin of elderly individuals. A 64-year-old male patient, who undergone total laryngectomy operation seven years ago because of squamous cell carcinoma of larynx and got postoperative radiotherapy applied to the hospital with a subcostal mass. Histopathologic examination of the mass revealed tumoral infltration with cytokeratin-20 expression that forming sheets and solid nests in subcutaneous tissue. The diagnosis was Merkel cell carcinoma. A vegetative tumor located in left main bronchi was observed during synchronously performed bronchoscopy and multiple . . .biopsies were taken. Histopathologic diagnosis was pulmonary small cell carcinoma displaying positive reaction with thyroid transcription fac-tor-1 without cytokeratin-20 expression. It's extremely rare to encounter Merkel cell carcinoma coexisting with pulmonary small cell carcinoma. The current case has special importance due to being an extremely rare encountered tumor besides con-frming these markers' reliability in distinguishing Merkel cell carcinoma from pulmonary small cell carcinoma. © 2011 Association of Oncology Daha fazlası Daha az

Dogan S.M. | Yildirim N. | Gursurer M. | Aydin M. | Kalaycioglu E. | Cam F.

Article | 2008 | Journal of Electrocardiology41 ( 1 ) , pp.55 - 59

Aim: P-wave dispersion (PD), and duration has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate the PD in patients with coronary slow flow (CSF) phenomenon. Methods: Study population included 48 patients with angiographically proven normal coronary arteries and slow coronary flow in all 3 coronary vessels (group I, 36 men; mean age, 54 ± 9 years) and 32 subjects with angiographically proven normal coronary arteries without associated slow coronary flow (group II, 24 men, mean age, 53 ± 10 years). Coronary flow rates of all patients and control . . .subjects were documented by Thrombolysis In Myocardial Infarction (TIMI) frame count. All patients in group I had TIMI frame counts greater than 2 SD above those of control subjects (group II). The mean TIMI frame count for each patient and control subject was calculated by adding the TIMI frame counts for each major epicardial coronary artery and then dividing the obtained value into 3. The maximum and minimum P-wave duration (Pmax and Pmin) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed. Results: There was no statistically significant difference between the 2 groups with respect to age, sex, hypertension, diabetes mellitus, hyperlipidemia, and cigarette smoking (P > .05). P-wave dispersion and Pmax of patients with CSF were found to be significantly higher than those of control subjects (39.4 ± 17 vs 21.2 ± 10 milliseconds and 121.6 ± 17.1 vs 104.3 ± 10.4 milliseconds, respectively; P < .0001). Moreover, we found a significant positive correlation between both Pmax and PD with mean TIMI frame count (r = 0.836 and r = 0.806, respectively; P < .0001). Conclusions: P-wave dispersion and P-wave duration both were found to be greater in patients with CSF than in controls. © 2008 Elsevier Inc. All rights reserved Daha fazlası Daha az

Barut F. | Özdamar Ş.O. | Bahadir B. | Dogan Gün B. | Bektaş S. | Çolak S. | Mocan Kuzey G.

Article | 2007 | Turkiye Klinikleri Journal of Medical Sciences27 ( 2 ) , pp.179 - 183

Objective: Bronchoalveolar lavage performed during bronchoscopic examination is a type of cytologic sampling with great diagnostic significance. Its diagnostic value is enhanced when biopsy is unavailable and bronchoalveolar lavage is the unique sample. Determining the diagnostic accuracy of bronchoalveolar lavage by comparing it with the diagnostic yield of synchronous biopsies is an indicator of its effectiveness. Material and Methods: In this study, 435 bronchoalveolar lavage and 273 bronchoscopic biopsy specimens obtained from January 2003 to December 2005 in the Department of Pulmonary Diseases were retrospectively evaluated in . . . the Department of Pathology, Faculty of Medicine, Zonguldak Karaelmas University. Results: Overall, 373 cases (85.8%) were diagnosed as benign and 12 cases (2.8%) were reported as malignant, while 18 cases (4.1%) were suspected to be malignant; the remaining 32 cases (7.3%) were reported as inadequate. The numbers and percentages of benign, malignant, suspected malignant and inadequate diagnoses of the 273 bronchoalveolar lavage cases with synchronous transbronchial biopsies were 229 (83.9%), 12 (4.5%), 16 (5.8%), and 16 (5.8%), respectively. After suspected malignant and inadequate samples were excluded, coomparison of cytologic and histologic diagnoses revealed that the diagnostic accuracy of bronchoalveolar lavage cytology was 79.4% and 91.6% for benign and malignant diagnoses, respectively; the rate of false negativity was 20.5% and false positivity was 8.3%. Conclusion: While sampling errors seemed to be the primary reason for false negative and false positive diagnoses, the rate of false cytologic evaluation was lower. Considering the false negative diagnoses for cases without biopsy specimens, comparison of bronchoalveolar lavage diagnoses with synchronous biopsies may serve as a quality control programme, since this condition may significantly influence the clinical course. Copyright © 2007 by Türkiye Klinikleri Daha fazlası Daha az

Aydemir, Selim | Bayraktaroğlu, Taner | Üstündağ, Yücel | Borazan, Ali | Sekirmez, Nedret | Aktunç, Erol | Numanoğlu, Gamze

Article | 2004 | Akademik Gastroenteroloji Dergisi3 ( 3 ) , pp.129 - 133

Giriş ve amaç: Standart üçlü tedavi ile Helicobacter pylori (H. pylori) eradikasyonu sağlanmayan olgularda ikinci tedavi ile eradikasyon daha zordur. H. pylori eradikasyon başarısızlıklarında uygulanacak tedavi kombinasyonları kesin belirlenmemiştir. Bu çalışmada lansoprazol, amoksisilin ve klaritromisin (LAK) ile yapılan standart üçlü tedavi ile H. pylori eradikasyonu sağlanamayan olgularda lansoprazol, ranitidin bizmut sitrat, tetrasiklin ve metronidazolden (LBTM) oluşan dörtlü tedavinin etkinliğini araştırdık. Gereç ve yöntem: Peptik ülser hastalığı veya nonülser dispepsi nedeniyle standart üçlü LAK tedavisi verilen ve H. pylori . . .eradikasyonu sağlanamayan toplam 36 olgu çalışmaya alındı. Bu olgulara lansoprazol (2x30 mg), ranitidin bizmut sitrat (2x400 mg), tetrasiklin (4x500 mg) ve metronidazolden (3x500 mg) oluşan dörtlü tedavi 14 gün verildi. Tedavinin bitiminden iki ay sonra endoskopik biyopsi ile H. pylori eradikasyonu değerlendirildi. Bulgular: Olgulardan beşi tedavi bitiminde kontrole gelmediğinden çalışma dışı bırakıldı. Dörtlü tedavi ile H. pylori eradikasyon oranı çalışmaya alınan tüm olgular değerlendirildiğinde %58.3, çalışma sonunda kontrole gelen olgular değerlendirildiğinde ise %67.7 saptandı. Sonuç: Bölgemizde standart LAK tedavisi ile H. pylori eradikasyonu sağlanamayan olgularda LBMT dörtlü tedavi kombinasyonunun başarı oranını oldukça düşük bulduk. Bu durumun ülkemizdeki metronidazol direncinin yüksek seviyelerde olması ile açıklanabileceğini düşünmekteyiz. Ülkemizde farklı bölgelerde H. pylorinin antibiyotik direnç durumunu ve tedavi başarısızlığı sebeplerini değerlendiren araştırmalara ihtiyaç vardır. Background/aim: Successful eradication of Helicobacter pylori (H. pylori) infection after failure of standard triple therapy is difficult. There are no guidelines on second-line therapies for H. pylori eradication failures. In the present study we investigated the efficacy of a 14-day quadruple regimen combining lansoprazole, ranitidine bismuth citrate (RBC), tetracycline and metronidazole as rescue treatment for Helicobacter pylori infection after failure of standard triple therapy combining lansoprazole, amoxicillin, clarithromycin (LAC). Materials and methods: A prospective study was designed consisting 36 patients infected with H. pylori and diagnosed with peptic ulcer or non-ulcer dyspepsia in whom triple therapy with LAC had failed. The patients were treated with quadruple therapy including lansoprazole, 30 mg twice daily, RBC, 400 mg twice daily, tetracycline, 500 mg four times daily, and metronidazole, 500 mg three times daily, for 14 days. Two months after completion of therapy, endoscopic biopsy evaluation was performed to confirm eradication. Results: Five cases who did not attend to the appointment were excluded from the study. With quadruple therapy, the H. pylori eradication rates were 58.3% by intention-to-treat analysis and 67.7% by per protocol analysis. Conclusion: The success rate of quadruple therapy with LBTM was found to be low in patients in whom standard triple therapy had failed in western Blacksea region. This finding may be explained by higher rates of metronidasole resistance in our country. We conclude that further studies about the drug resistance rates and explanation of reasons for treatment failure must be carried out Daha fazlası Daha az