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Browsing by Author "Aydede, H"

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Are Inflammation Markers Derived from Hemogram Parameters Predictive for Papillary Thyroid Carcinoma in Hashimoto's Thyroiditis Patients?
Akcura, C; Guney, SC; Alkan, S; Cavdar, GG; Tan, AY; Aydede, H; Hekimsoy, Z; Ozdemir, N
Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) are two endocrine disorders, and chronic inflammation plays a key role in their pathogeneses. Recent studies have shown that some inflammation markers derived from hemogram parameters such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are helpful in showing inflammation in many autoimmune diseases and cancers. We aimed to investigate how the coexistence of HT and PTC will affect the inflammation markers derived from hemogram parameters. Eighty PTC patients with coexisting HT (Group 1) and PTC and 80 HT patients without PTC (Group 2) were selected. Hemogram parameters, thyroid function tests, and thyroid autoantibodies of the patients were analyzed. Relevant inflammatory markers were calculated, and the results were statistically analyzed. NLR, PLR, and SII values were found to be significantly higher in Group 1 (p = 0.032, p = 0.005, and p = 0.002, respectively) compared to Group 2. ROC curve analysis revealed the most appropriate cut-off point for NLR to be 495.34, for PLR to be 1.77, and for SII to be 115.99. NLR, PLR, and SII levels have been shown to be sensitive in predicting the development of PTC in HT patients.
Late diagnosis of a lateral abdominal wall hematoma presenting with nonspecific findings
Ilkgül, Ö; Özden, S; Özsoy, Y; Yoleri, L; Erhan, Y; Aydede, H
We report a case with a late diagnosis of posttraumatic lateral abdominal wall hematoma. The patient was admitted with a giant hematoma presenting with pleural effusion, anemia and weight loss on postoperative 30th day after a blunt trauma. Computerized tomography analysis revealed a hematoma extending from axilla to the gluteus. Fine-needle aspiration revealed an exudative fluid and five liters of fluid collection was drained. Misdiagnosed lateral abdominal wall hematomas can be diagnosed with nonspecific findings as in this case.
Double acute appendicitis in appendical duplication
Sahin, ST; Erhan, Y; Aydede, H
Duplication of the vermiform appendix is a rare congenital abnormality and usually found incidentally during laparotomy. The Modified Cave-Wallbridge classification is used to describe the location of the appendixes in relation to each other and to the cecum as well as the extent of the duplication. We report a 45-year-old patient who underwent laparotomy for acute abdominal pain. The operative finding was double acute appendicitis in appendical duplication. The appendixes were removed separately, as it was type B duplication. Since appendectomy is the most common abdominal operation, all surgeons should keep this rare clinical entity in mind.
Effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the differentiation of thyroid nodules
Özer, BM; Pabusçu, Y; Tarhan, S; Ovali, GY; Aydede, H; Demireli, P; Karadeniz, T
BackgroundThe aim was to investigate which of two different b values (b 500 s/mm(2) and b 800 s/mm(2)) are more effective in the differentiation of benign-malignant nodules using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI).Materials and methodsPatients presenting with a preoperative diagnosis of nodular goiter or multinodular goiter were included in this study. These patients underwent neck MRI examinations, and their cases were analyzed retrospectively. A total of 26 patients were included in the study. A total of 46 nodules meeting the study criteria were examined. Measurements were performed on Apparent Diffusion Coefficient (ADC) maps of patients at two different b values (b 500 s/mm(2) and b 800 s/mm(2)), and the results were compared with histopathological findings.ResultsOut of a total of 46 nodules, 37 were identified as benign, and 9 as malignant based on histopathological analysis. The mean ADC value at b 500 was lower in malignant nodules (1259.65 +/- 328.13) compared to benign nodules (19037.48 +/- 472.74). Similarly, the mean ADC value at b 800 was lower in malignant nodules (1081.72 +/- 200.23) compared to benign nodules (1610.44 +/- 418.06). When a cut-off value of 1.1 x 10- 3 was accepted for the differentiation of pathology, the sensitivity for distinguishing pathology with ADC values at b 500 was 83.3%, with a specificity of 90.0%, and for ADC values at b 800, the sensitivity was 71.4%, with a specificity of 89.7%.ConclusionDW-MRI without the need for contrast agent administration is a useful method in the differentiation of benign-malignant thyroid nodules.
Value of P53 protein expression and its relationship with short-term prognosis in colorectal cancer
Erhan, Y; Korkut, MA; Kara, E; Aydede, H; Sakarya, A; Ilkgül, Ö
Ondansetron, granisetron, and dexamethasone compared for the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy
Erhan, Y; Erhan, E; Aydede, H; Yumus, O; Yentur, A
Background Laparoscopic cholecystectomies are associated with an appreciably high rate of postoperative nausea and vomiting (PONV). This study was designed to compare the effectiveness of ondansetron, granisetron, and dexamethasone for the prevention of PONV in patients after laparoscopic cholecystectomy. Methods A total of 80 American Society of Anesthesiologists (ASA) physical class I-II patients scheduled for laparoscopic cholecystectomy were included in this randomized, double blind, placebo-controlled study. All patients received a similar standardized anesthesia and operative treatment. Patients were randomly divided into four groups (n = 20 each). Group 1, consisting of control patients, received 0.9% NaCl; group 2 patients received ondansetron 4 mg i.v.; group 3 patients received granisetron 3 mg i.v.; and group 4 patients received dexamethasone 8 mg i.v., all before the induction of anesthesia. Both nausea and vomiting were assessed during the first 24 h after the procedure. Results The total incidence of PONV was 75% with placebo, 35% with ondansetron, 30% with granisetron, and 25% with dexamethasone. The incidence of PONV was significantly less frequent in groups receiving antiemetics (p < 0.05). The differences between dexamethasone, granisetron, and ondansetron were not significant. Conclusions Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy. Dexamethasone 8 mg was as effective as ondansetron 4 mg and granisetron 3 mg, and it was more effective than placebo.
Effects of ocreotide on intestinal mucosa in rats with portal hypertensive enteropathy
Aydede, H; Vatansever, HS; Erhan, Y; Ilkgül, O
To clarify the effects of long-term ocreotide (a long-acting somatostatin analogue) treatment on mucosal changes in a rat model of portal hypertensive enteropathy, groups of mate Swiss albino rats (n = 15 each) were randomly assigned to one of three treatment arms. These were: sham laparotomy+twice daily subcutaneous saline 0.5mL (Group 1); portal hypertension induction+twice daily subcutaneous saline 0.5 mL (Group 2); and portal hypertension induction+subcutaneous ocreotide 100 mu g/kg/12h (Group 3). After 12 weeks of treatment, jejunal and ilea( tissue specimens were obtained and evaluated histopathologically (villus/crypt ratio, mean diameter of dilated vessels, mucosal edema, and fibromuscular proliferation in the lamina propria) and immunohistochemically (vascular endothelial growth factor (VEGF), von Willebrand factor (F8), and cluster of differentiation 34 (034) [abetting). In jejunal. specimens, the villus/crypt ratio was markedly lower in Group 2 (2.38 +/- 0.46 mu m) than in Group 1(5.07 +/- 2.25 mu m) or Group 3 (4.97 +/- 2.19 mu m); mean diameter of dilated vessels was markedly higher in Group 2 (43.30 +/- 5.71 mu m) than in Group 1 (33.53 +/- 4.00 mu m) or Group 3 (36.76 +/- 3.96 mu m); mucosal edema and fibromuscular proliferation were universally absent in Group 1 when compared with the other groups. There were statistically significant differences (p<0.05) between Groups 1 and 2 for villus/crypt ratio, mean diameter of dilated vessels, VEGF immunolabelling intensity, and CD34 immunolabelling intensity; between Groups 1 and 3 for mean diameter of dilated vessels, VEGF immunolabelling intensity, and CD34 immunolabelling intensity; and between Groups 2 and 3 for villus/crypt ratio, mean diameter of dilated vessels, and VEGF immunolabelling intensity. In ileal. tissue specimens, the villus/crypt ratio was markedly lower in Group 2 (5.51 +/- 0.67 mu m) than in either Group 1 (7.19 +/- 2.18 mu m) or Group 3 (7.62 +/- 2.58 mu m); mean diameter of dilated vessels was markedly higher in Group 2 (46.36 +/- 4.77 mu m) than in either Group 1 (36.43 +/- 4.57 mu m) or Group 3 (41.31 +/- 4.70 mu m); white mucosal edema was absent in Group 1, it was present in Group 2 and Group 3; and fibromuscular proliferation was universally absent. There were statistically significant differences (p<0.05) between Groups 1 and 2 for villus/crypt ratio and mean diameter of dilated vessels; between Groups 1 and 3 for mean diameter of dilated vessels; and between Groups 2 and 3 for villus/crypt ratio, mean diameter of dilated vessels, and VEGF immunolabelling intensity. Together, these findings indicate that ocreotide treatment ameliorates histomorphological changes in a rat model of portal hypertensive enteropathy. (C) 2008 Elsevier GmbH. All rights reserved.
The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis
Taneli, F; Aydede, H; Vatansever, S; Ulman, C; Ari, Z; Uyanik, BS
Polypropylene mesh is the most widely used material in inguinal hernia repair. Although polypropylene mesh is known as an inert material, it is experimentally proven that mesh generates a chronic inflammatory tissue reaction. The aim of the present study was to investigate the long-term effects of polypropylene mesh material used in inguinal hernia operations on testicular function, testicular nitric oxide (NO) metabolism and germ cell-specific apoptosis in rats. The study comprised 40 male rats that were randomly allocated into two groups. In group 1, the left spermatic cord was elevated and a 0.5 x 1 cm polypropylene mesh was placed behind the left inguinal spermatic cord and group 2 consisted of the sham-operated controls. Blood samples were taken at 6 months preoperatively and postoperatively after to assess luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels for hormonal evaluation. Testicular NO was evaluated by the Griess method, apoptosis by a TUNEL method and inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) expressions by immunohistochemical staining. Mild (+) eNOS expression was observed in all specimens. Mild (+) iNOS expression was only detected in ipsilateral testis of the mesh-implanted study group. Apoptotic cells were not detected in any samples. We are of the opinion that long-term polypropylene mesh implantation has no effect on testicular hormonal function and only a limited effect on nitric oxide levels and this effect is not sufficient to cause apoptosis in testis that could lead to infertility. It seems that mesh implantation is a reliable method in inguinal hernia repair; however, further work is required by more sensitive methods to fully elucidate the potential testicular damage. Copyright (c) 2004 John Wiley & Sons, Ltd.
Laparoscopic repair of acquired lumbar hernia
Sakarya, A; Aydede, H; Erhan, MY; Kara, E; Ilkgul, O; Yavuz, C
Lumbar hernias are rare; approximately 300 cases have been described in the literature since their first description. They are typically subdivided by categories such as congenital or acquired and by their location. Acquired lumbar hernias may follow trauma, poliomyelitis, loin incision, and the use of iliac crest as a donor site for bone grafting. Although they tend to grow in size and have a 25% risk of incarceration and 8% risk of strangulation, surgery is indicated once the lesion is confirmed. Many techniques have been described for surgical repair of lumbar hernias, including primary repair, local tissue flaps, and conventional mesh repair. All these open techniques require a large incision plus extensive dissection to expose the area. The first laparoscopic repair of lumbar hernia was described in 1996. The laparoscopic approach for lumbar hernia has significant advantages: it enables exact localization of the anatomic defect, the mesh can be placed deep into the defect allowing intraabdominal pressure to hold it in position, and it also has all the well-known advantages of the laparoscopic approach. We present two cases of laparoscopically repaired acquired lumbar hernias.
MOLECULAR ANALYSIS OF KERATINOCYTES WHICH DERIVED FROM MOUSE EMBRYONIC STEM CELLS
Vatansever, HS; Turkoz-Uluer, E; Aydede, H; Ozbilgin, MK
The synchronous primary carcinomas of the rectum and prostate
Ayhan, S; Ozdamar, A; Nese, N; Aydede, H
The diagnosis of synchronous prostatic and rectal carcinomas is uncommon. To make a correct diagnosis, biopsies of both sites are mandatory. Pathological slides should be compared and immunohistochemical staining should be taken into consideration. In this paper, an unexpected case of synchronous rectal and prostatic carcinomas arising in an 84-year-old male with hematemesis and pelvic pain is reported. These two tumoral components have a distinctive histological appearance. Immunohistochemical evaluation confirmed the diagnosis of these synchronous tumors. This case emphasizes that rectal and prostatic carcinomas can arise simultaneously. In this situation, providing clinicopathological correlation and deciding the necessity of intraoperative consultation in proper time are extremely important.
Chronic pain after Lichtenstein and preperitoneal (posterior) hernia repair
Erhan, Y; Erhan, E; Aydede, H; Mercan, M; Tok, D
Background: Hernia repair is one of the most common surgical procedures, and some patients suffer from chronic pain after hernia surgery. The aim of the present study was to evaluate chronic post-herniorrhaphy pain in men who underwent Lichtenstein mesh repair or preperitoneal (posterior) repair. Methods: Our study included 94 male inpatients. Two surgeons experienced in both Lichtenstein and preperitoneal hernia repair performed the procedures. We controlled postoperative pain with systemic analgesic therapy. We evaluated the patients over the subsequent 12 months, using a questionnaire to focus on chronic pain and its limitations to their quality of life. Results: The overall incidence of chronic pain at 2 months was 5%. About 6% of patients who underwent Lichtenstein repair (n =70) and 4% of patients who underwent preperitoneal repair (n =24) experienced chronic pain. All patients with chronic pain rated their pain as slight or moderate. Their pain was present occasionally and was related to physical stress. None of the patients were unable to work. After 12 months of follow-up, the overall incidence of chronic pain decreased to 3%, with 3 patients in Lichtenstein group reporting chronic pain with slight limitations in sports and social activities. Conclusion: The incidence rates of chronic pain after Lichtenstein and preperitoneal repair were 6% and 4%, respectively. Inpatient status might have resulted in low incidences with both approaches.
Effect of portal vein occlusion on the pancreas
Aydede, H; Erhan, Y; Ikgül, O; Cilaker, S; Sakarya, A; Vatansever, S
Background: The effects of portal vein occlusion on the pancreas are not clearly understood. Therefore, we studied histomorphological changes induced in the rat pancreas by various periods of portal vein occlusion. Materials and methods: Sixty female Wistar albino rats were randomly allocated into four groups of 15 each. In Group I (control), rats underwent sham laparotomy to expose the portal vein proximal to its bifurcation. In Groups II-IV, rats underwent laparotomy followed by portal vein occlusion by clamping for 15, 30, and 60 minutes respectively. The pancreas was removed immediately after sham laparotomy in Group I and immediately after clamp release in Groups II-IV. Pancreatic tissue specimens were subjected to histochemical analysis for cell typing and diagnosis, immunohistochemical analysis for identification of the inflammatory markers tumor necrosis factor-a (TNF-alpha), interleukin-1 beta (IL-1 beta), endothelial nitric oxide synthase (eNOS), and inducible NOS (iNOS), and TUNEL analysis was carried out for identification of apoptotic cells. Results: Histochemistry revealed signs of inflammation in pancreatic tissue from rats subjected to portal vein occlusion. Immunohistochemistry revealed that the expression of proinflammatory cytokines TNF-alpha and IL-1 beta and the oxidative damage indicator iNOS in rat pancreatic tissue increased progressively with the duration of portal vein occlusion. TUNEL assay revealed no signs of apoptosis in any of the groups. Conclusion: We conclude that portal vein occlusion triggers an inflammatory response in the pancreas that worsens the longer the occlusion lasts.
Keratinocytes derived from embryonic stem cells induce wound healing in mice
Uluer, ET; Vatansever, HS; Aydede, H; Ozbilgin, MK
The skin plays an important role in defending the body against the environment. Treatments for burns and skin injuries that use autologous or allogenic skin grafts derived from adult or embryonic stem cells are promising. Embryonic stem cells are candidates for regenerative and reparative medicine. We investigated the utility of keratinocyte-like cells, which are differentiated from mouse embryonic stem cells, for wound healing using a mouse surgical wound model. Mice were allocated to the following groups: experimental, in which dressing and differentiated cells were applied after the surgical wound was created; control, in which only the surgical wound was created; sham, in which only the dressing was applied after the surgical wound was created; and untreated animal controls with healthy skin. Biopsies were taken from each group on days 3, 5 and 7 after cell transfer. Samples were fixed in formalin, then stained with Masson's trichrome and primary antibodies to interleukin-8 (IL-8), fibroblast growth factor-2 (FGF-2), monocyte chemoattractant protein-1 (MCP-1), collagen-1 and epidermal growth factor (EGF) using the indirect immunoperoxidase technique for light microscopy. Wound healing was faster in the experimental group compared to the sham and control groups. The experimental group exhibited increased expression of IL-8, FGF-2 and MCP-1 during early stages of wound healing (inflammation) and collagen-1 and EGF expression during late stages of wound healing (proliferation and remodeling). Keratinocytes derived from embryonic stem cells improved wound healing and influenced the wound healing stages.
The protective mechanisms of defibrotide on liver ischaemia-reperfusion injury
Aydemir, EO; Var, A; Uyanik, BS; Ilkgül, Ö; Aydede, H; Sakarya, A
During some surgical interventions, temporary occlusion of the hepatic blood supply may cause ischaemia-reperfusion (I/R) injury and hepatic dysfunction. In this study the protective effect of defibrotide (DEF) was evaluated in a rat model of liver I/R injury. Four groups of rats were subjected to the following protocols: saline infusion without ischaemia, DEF infusion without ischaemia, DEF infusion with hepatic I/R, and saline infusion with hepatic I/R. After a midline laporatomy, liver ischaemia was induced by 45 min of portal occlusion. DEF 175 mg/kg(-1) was infused before ischaemia in 10 ml of saline. The same volume of saline was infused into the control animals. At the end of the 45-min reperfusion interval, the animals were sacrified. Superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) enzyme activities were determined in haemolysates, and malondialdehyde (MDA) level in the liver tissue was measured. Tissue MDA levels were significantly higher in the I/R plus saline group compared to the sham operation control groups (p < 0.01 and p < 0.05, respectively). Tissue MDA levels decreased in the DEF plus I/R group compared to the I/R plus saline group (p < 0.05), but DEF could not reduce tissue lipid peroxidation to the levels of the control sham operation groups. SOD and GSH-Px enzyme activities were significantly higher in DEF-treated animals than in the other groups (p < 0.05). These results suggest that DEF protects liver against I/R injury by increasing the antioxidant enzyme levels. Copyright (C) 2003 John Wiley Sons, Ltd.
Analysis of transferred keratinocyte-like cells derived from mouse embryonic stem cells on experimental surgical skin wounds of mouse
Vatansever, HS; Uluer, ET; Aydede, H; Ozbilgin, MK
Autologous/allogenic skin grafts constituted from differentiated adult or embryonic stem cells can be used in treatment of skin disorders. In our study we aimed to differentiate keratinocytes from mouse embryonic stem cells and the transfer of viable keratinocyte-like cells to a model of surgical skin wound of mouse. Embryoid bodies, derived from mouse embryonic stem cells, were cultured on basement membrane matrix with added BMP-4 for 10 days. The identification of differentiated keratinocyte-like cells was done by detection of cytokeratin-8 and cytokeratin-14 localization using an indirect immunoperoxidase technique and transmission electron microscopy evaluation. Distribution of BrdU, cytokeratin-8 and cytokeratin-14 were evaluated using an indirect immunoperoxidase technique from the experimental (dressing including BrdU labelled cells applied after the surgical wound was created on mouse), control (only the surgical wound was created on mouse) and sham (only the dressing applied after the surgical wound was created on mouse) in groups after 3, 5 and 7 days. Immunohistochemically and ultrastructurally, cells derived from mouse embryonic stem cells were similar to differentiated keratinocyte-like cells. Differentiated keratinocyte-like cells were demonstrated by positive BrdU, cytokeratin-8 and cytokeratin-14 staining after transfer to the wound area. In the experimental group wound healing was better after transferring differentiated keratinocytes when compared to the sham and control groups. In vivo continuity and usability of derived cells are very important issues. In wound repair mechanisms, keratinocyte-like cells could provide positive effects during the wound healing and could be used in clinical treatments of wound repair process. (C) 2012 Elsevier GmbH. All rights reserved.
Axillary Schwannoma Mimicking Lymphadenopathy: Two Different Case Reports
Örgüç, S; Basara, I; Özkarakas, P; Poçan, T; Aydede, H
Schwannomas are essentially benign tumors originating from schwann cells of peripheral, cranial or sympathetic nerves. They are not aggressive, encapsulated and grow slowly. Malignant transformation can rarely be seen. Even though they can be localized in any where in the body, cutaneous nerves of the head-neck region and flexor parts of the extremities are most commonly involved. Schwannomas are usually solitary, however multiple schwannomas can rarely be seen in the peripheral nervous system including cranial nerves, spinal nerve roots, brachial-lumbosacral plexus and peripheral nerves. In these two cases, we aimed to report ultrasonography (US), magnetic resonance imaging (MRI) and pathology findings of different axillary schwannomas mimicking lymphadenopathy, and discuss the differential diagnosisin the light of the literature. In these patients, the lesions were noted to be in direct continuity with a cord-like structure resembling a nerve. US and MRI findings were compatible with the literature. Radiologic findings were confirmed by pathologic examination. As seen in our cases, a detailed differential diagnosis should be considered in every axillary lesion including frequently seen axillary lymphadenopathies.
Effect of mesh and its localisation on testicular flow and spermatogenesis in patients with groin hernia
Aydede, H; Erhan, Y; Sakarya, A; Kara, E; Ilkgül, Ö; Can, M
In this study, the long-term effects of mesh and its localisation (i.e. anterior or posterior) on testicular perfusion and testicular function were evaluated in groin hernia patients. Testicular function has been evaluated with spermiogram and testicular perfusion with colour Doppler ultrasonography. Group I : consisted of 30 posterior preperitoneal mesh repair patients Group 11 : consisted of 30 anterior tension-free repair patients. The operation types were randomised with a systematic sampling method. There was no statistically significant difference between pre-operative and postoperative spermiogram results for both groups. No statistically significant difference was found between the two groups in terms of Doppler flow parameters (PSV, EDV, RI and PI) for pre-operative, early and late postoperative periods. When Doppler flow parameters were compared for group I, statistically significant differences were found between preoperative and early postoperative values. No statistically significant difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. When Doppler flow parameters were compared for group II, statistically significant differences were found between pre-operative and early postoperative values. No statistically significant difference was found between pre-operative and late postoperative values. This is also true for early postoperative values versus late postoperative values. These results support the idea that inguinal mesh application is still a safe procedure in patients with no children or who are undergoing infertility treatment, where testicular function is important.
Effects of levosimendan and dobutamine on experimental acute lung injury in rats
Erbüyün, K; Vatansever, S; Tok, D; Ok, G; Turköz, E; Aydede, H; Erhan, Y; Tekin, I
The effects of levosimendan on acute lung injury induced by peritonitis and abdominal hypertension in the early stages of sepsis in rats were investigated. Twenty-four adult male Wistar rats were randomized into: (1) sham, (2) subjected to abdominal hypertension and peritonitis induced lung injury using cecal ligation and puncture, then treated by dobutamine, (3) subjected to abdominal hypertension and peritonitis induced lung injury using cecal ligation and puncture, then treated by levosimendan, and (4) controls subjected to abdominal hypertension and peritonitis induced lung injury using cecal ligation and puncture with no treatment. In the control and levosimendan groups, cecal ligation and puncture resulted in moderate IL-1 beta immunolabelling in lung tissue; marked IL-1 beta immunolabelling was demonstrated in the dobutamine group. TNF-alpha immunolabelling was negative in both the sham and levosimendan groups, but moderate and weak immunoreactivities were observed in the dobutamine and control groups, respectively. There were almost no TUNEL positive cells in the sham, but they were prominent in the control. TUNEL positive cells were significantly less in the levosimendan treated lungs when compared to control and dobutamine groups. Immunoreactivity of eNOS was stronger in the dobutamine group when compared with the levosimendan group. In addition, iNOS immunoreactivity was strongly detected in the control group; this immunoreactivity was less in the levosimendan group than the dobutamine group. In this experimental sepsis model, treatment with levosimendan had a marked effect on attenuating or decreasing apoptosis and inflammation in the lung. (C) 2008 Elsevier GmbH. All rights reserved.
Gallstone ileus presenting as gastric outlet obstruction (Bouveret's syndrome)
Sakarya, A; Erhan, MY; Aydede, H; Kara, E; Ozkol, M; Ilkgül, O; Özsoy, Y
Gallstone ileus is an uncommon condition that may result when a gallbladder or commonduct stone enters into the intestinal tract, usually as a result of an internal fistula between the gallbladder and the duodenum. It most frequently occurs in the terminal ileum. Gastric outlet obstruction syndrome due to the impaction of a gallstone in the duodenum passing through a cholecystoduodenal fistula was first reported in 1896 by Bouveret concern in 1-3% of patients with gallstone ileus. Since the first case-report, 300 other cases has been documented in the literature. Here we report a case of Bouveret's syndrome in order to increase awareness of this unusual cause of gastric outlet obstruction.

Browsing by Author "Aydede, H"

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