MCBÜ Açıkerişim Sistemi :: Browsing by Author "Aydede H."

Browsing by Author "Aydede H."

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Preoperative staging of rectal carcinoma by endorectal ultrasonography
(2000) Can M.; Dural T.; Aydede H.; Ermete M.; Guney S.
Purpose: To evaluate the efficacy and accuracy of endorectal ultrasonography (EUS) in detecting preoperatively rectal wall invasion and nodal involvement in patients with rectal carcinoma. Materials and methods: EUS was applied to 27 patients prediagnosed as having rectal carcinoma by using a 7.5 MHz endorectal transducers with water bag. Sonographic evaluation consisted of estimation of tumour invasion into the rectal wall and adjacent lymph node involvement. All of the patients were operated on with curative intend and the sonographic stage was compared with the postoperative pathologic stage. Results: The accuracy rates of EUS compared with the postoperative pathologic staging were 81%, 70.3% and 59.3% in determining wall invasion, nodal involvement and overall tumour stage, respectively. The most frequent factor leading to false-positive results was the abnormally reactive-hyperplastic lymph nodes which were hypoechoic and larger than 5 mm in diameter. Conclusion: It is concluded that EUS is a moderately reliable imaging method for local tumour staging, mainly due to its relatively high rate of nodal imaging failure.
Value of P53 protein expression and its relationship with short-term prognosis in colorectal cancer
(King Faisal Specialist Hospital and Research Centre, 2002) Erhan Y.; Korkut M.A.; Kara E.; Aydede H.; Sakarya A.; Ilkgül Ö.
[No abstract available]
Ectopic liver (choristoma) associated with the gallbladder encountered during laparoscopic cholecystectomy
(Springer New York LLC, 2002) Sakarya A.; Erhan Y.; Aydede H.; Kara E.; Ilkgül Ö.; Çiftdoğan C.
Ectopic liver has been but rarely described usually in the vicinity of liver such as on the gallbladder, hepatic lig-aments, diaphragm, thoracic cavity, adrenal glands, pancreas, omentum, spleen, esophagus and umblical cord. A simple classification for anomalous liver tissues found on the wall of gallbladder is 1. Accessory liver lobe 2. Ectopic nodule 3. Aberrant microscopic tissue. Ectopic nodules of liver tissue attached to the gallbladder are completely detached from the liver and has been described by various names such as accessory lobe, ectopic liver, accessory liver and heterotopic liver but the specific pathological term for this entity is choristoma introduced by Albert in 1904 meaning displacement. Several possible mechanisms may explain ectopic liver at various sites such as the development of an accessory lobe of the liver with atrophy or regression of the original connection to the main liver or migration of pars hepatica to the rudiment of various organs. In this paper we present a case of ectopic liver or choristoma attached to the gallbladder encountered during an elective laparoscopic cholecystectomy which was successfully removed with the gallbladder. © 2002, Springer-Verlag New York Inc.
p53 and Ki-67 expression as prognostic factors in cystosarcoma phyllodes
(2002) Erhan Y.; Zekioglu O.; Ersoy Ö.; Tugan D.; Aydede H.; Sakarya A.; Kapkaç M.; Özdemir N.; Özbal O.; Erhan Y.
We have reviewed the histopathological, clinical outcome and immunohistochemical status in 21 women with cystosarcoma phyllodes (CSP) tumors of the breast. We assessed 12 tumors as histopathologically benign and 9 tumors as malignant. The median patient ages in benign and malignant CSP tumors were 39.6 and 45.4 years of age, respectively. The stromal cellularity, stromal cellular atypism, high mitotic activity, atypic mitoses, stromal overgrowth, infiltrative tumor contour, and heterologous stromal elements were significant features of the malignant CSP tumors. Benign CSP tumors were predominantly of fibroadenomatous architecture with cellular stroma (mild or moderate) and some distortion and elongation of glandular elements. Five malignant CSP tumors were stained positively with p53, and 6 malignant CSP tumors were stained immunohistochemically with Ki-67. All benign CSP tumors were negatively stained for p53 and Ki-67. The patients with benign CSP tumors were treated with local excision (n = 11) and with subcutaneous mastectomy (n = 1). Malignant CSP tumors were treated with wide local excision (n = 1), partial mastectomy (n = 1), simple mastectomy (n = 2), and modified radical mastectomy (n = 5). Two patients with a high mitotic rate and high values of p53 and Ki-67 received additional radiotherapy and chemotherapy. One case had liver metastasis. This tumor had high mitotic figures, strornal overgrowth, severe stromal cellularity, and 20% Ki-67 and mild p53 positivity. We suggest that p53 and Ki-67 can play an important role in predicting prognosis and yielding additional therapy besides conventional prognostic factors in the treatment of the CSP patients.
A case of systemic sclerosis and diverticulosis coli complicated by intestinal haemorrhage [4]
(2002) Pirildar T.; Saruç M.; Aydede H.; Ayhan S.
[No abstract available]
Bile duct response to repeated cerulein induced pancreatitis in the rat
(2002) Menteş A.; Aydede H.; Bayol Ü.; Yilmaz F.
The typical morphology of common bile duct strictures in chronic pancreatitis suggests a pathogenesis not of encasement, but of mural changes in the common bile duct. Cerulein, 20 μg/kg was administered to male Wistar rats in four subcutaneous doses, hourly for 3 h, and was recorded as one application. Group A served as controls and received subcutaneous saline. Group B1 received one application of Cerulein and was sacrificed after 24 h. Group B2 was similar to B1, but was sacrificed two weeks later. Group B3 was given two applications of Cerulein with an interval of two weeks and was sacrificed two weeks after the second application. Group B4 received one application of Cerulein every week for four weeks and was sacrificed two weeks after the last application. Serum amylase levels, pancreatic edema and peripancreatic inflammatory infiltration scores increased with the severity and persistance of the insult. Bilirubin and alkaline phosphatase levels suggested cholestatic response in the groups that received repeated insults with Cerulein (Groups B3 and B4: p < 0.01). Moderate to strong immuno-histochemical positivity for type IV collagen at the wall of the common bile duct in animals with a persisting insult is suggestive of circumstantial evidence for mural changes as a causative factor of stricture formation in similar settings such as chronic pancreatitis with persistent inflammatory attacks.
Ileocolic intussusception due to ileal lymphoma (Case report)
(2002) Aydede H.; Sakarya A.; Erhan Y.; Ilkgül Ö.; Kara E.; Özkul M.
Intussusception occurs rarely in adults. It presents with a variety of acute, intermittent, and chronic symptoms, thus making its preoperative diagnosis difficult. In adults, intussusceptions are mostly caused by organic lesions and the majority of these lesions are benign tumours. Computed tomography scanning and endoscopy have proved to be the most useful diagnostic methods. Confirmation of diagnosis and treatment of adult intussusception is surgical, with surgical resection of the intussusception without reduction being the preferred treatment in adults, as almost half of both colonic and enteric intussusceptions are associated with malignancy. We report the case of a patient with ileocolic intussusception due to an ileal lymphoma.
Effect of mesh and its localisation on testicular flow and spermatogenesis in patients with Groin Hernia
(ARSMB-KVBMG, 2003) 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 II: 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 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. 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.
A case of large mucinous adenocarcinoma arising in a long-standing fistula-in-ano
(2003) Erhan Y.; Sakarya A.; Aydede H.; Demir A.; Seyhan A.; Atici E.
Background: Chronic anal fistulas are not rare conditions, however, the development of a carcinoma in a long-standing fistula-in-ano is rare. Methods: The case of a 77-year-old male with a large perianal mucinous adenocarcinoma arising in a long-standing fistula-in-ano is presented. Results: Perianal biopsy revealed mucinous adenocarcinoma. Abdominal CT, double contrast barium examination and flexible sigmoidoscopy revealed no other tumoral lesion in the colon and rectum. Conclusion: The patient underwent abdominoperineal resection including wide tumor excision on the gluteal region. The final reconstruction was performed by bilateral gracilis musculocutaneous flaps. Due to clinical and histopathological evidence it was thought that a curative resection had been performed. To date he is clinically disease free. Copyright © 2003 S. Karger AG, Basel.
Laparoscopic repair of acquired lumbar hernia.
(2003) Sakarya A.; Aydede H.; Erhan M.Y.; 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.
The protective mechanisms of defibrotide on liver ischaemia-reperfusion injury
(2003) Aydemir E.O.; Varl A.; Uyanik B.S.; 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. © 2003 John Wiley & Sons, Ltd.
Effects of octreotide and propranolol on colonic mucosa in rats with portal hypertensive colopathy
(2003) Aydede H.; Sakarya A.; Erhan Y.; Kara E.; Ilkgul O.; Ozdemir N.
Background/Aims: The aim of the study is to clarify the effects of octreotide and propranolol, agents used in the treatment of portal hypertension, on mucosal changes in portal hypertensive colopathy. Methodology: Portal hypertension was induced in all rats by partial portal vein ligation, and after the operation all rats were caged for a 10-week period. Then, animals were divided into three groups and for two weeks medical treatment were administered to the individual groups as follows: Control group, saline 0.5mL/day, intraperitoneally. Octreotide group, octreotide 100μg/kg/12 hours, subcutaneously. Propranolol group, propranolol 20mg/kg/day, intraperitoneally. In order to assess the portal hypertensive colopathy, criteria such as mean diameters of dilated vessels in colonic mucosa, and the existence of mucosal edema, capillary ectasia, hyperemia and hemorrhage, inflammation were used. Results: When parameters were compared for the control versus propranolol groups, mucosal edema and hyperemia and hemorrhage criteria were found to be significant for the propranolol group; control versus octreotide groups, mucosal edema, capillary ectasia, and hyperemia and hemorrhage criteria were found to be significant for the octreotide group; octreotide versus propranolol groups, capillary ectasia and mucosal edema criteria were found to be significant for the octreotide group. Conclusions: The mucosal changes in portal hypertensive colopathy could be corrected by drugs modifying portal blood flow, octreotide may find a place in the treatment of portal hypertensive colopathy.
Long-term albendazole treatment in one case of alveolar echinococcosis: Case report
(2003) Çökmez A.; Aydede H.; Gür S.; Tarcan E.
Aims: Curative therapy of alveolar echinococcosis is total surgical removal of the infected tissue and concomitant chemotherapy. However, this curative resection can be done on a limited number of patients, for the remaining ones various palliative procedures can be performed. Method: In this article it is aimed to present the result of long-term albendazole treatment in patient who had a palliative hepatojejunostomy for obstructive jaundice due to unresectable alveolar echinococcosis. Results: Systemic albendazole treatment was initiated in this patient after palliative hepatojejunostomy procedure. During follow up there was no abnormality in blood chemistry and a considerable regression in size of the lesion was found in postoperative month 24. Residual hepatic lesion was histopathologically documented and showed apparently non-viable parasitic cysts by biopsy. These findings suggest the long-term albendazole therapy being parasitocidal. Conclusions: Palliative or mass reduction surgery combined with long-term albendazole therapy is the standard therapy for advanced disease, especially when curative resection might result in significant morbidity and mortality.
A case of a small cell lung carcinoma presenting with jaundice due to pancreatic metastasis.
(2005) Sakar A.; Kara E.; Aydede H.; Ayhan S.; Celik P.; Yorgancioglu A.
Though the high incidence of pancreatic metastasis of lung cancer has been reported in autopsy series, symptomatic cases with jaundice due to that is very rare. Dominant histological type with pancreatic metastases is small cell carcinoma and prognosis is poor. Hereby, we report a case initially presenting with gastroenterologic symptoms as jaundice, nausea, vomiting, weight loss and abdominal pain and then diagnosed as primary small cell carcinoma of the lung with metastasis to pancreas. He underwent a palliative surgery due to obstructive jaundice. This presented case is a rare one with its priority of gastroenterologic symptoms rather than pulmonary complaints.
Effect of selective gut decontamination on peritoneal fibrinolytic activity in rats; [Ratlarda oluşturulan selektif baḡirsak dekontaminasyonunun peritoneal fibrinolitik aktivite üzerine etkisi]
(Turkish Surgical Society, 2005) Ilkgül Ö.; Erhan Y.; Aydede H.; Var A.; Onur E.
Purpose: Our goal with this experiment was to determine the influence of selective decontamination of the digestive tract (SDD) on peritoneal fibrinolytic activity in rats. Materials and Methods: Animals were divided into five groups. Group 1 was subjected to SDD-treated peritoneal adhesion. Group 2 was subjected only to perioneal adhesion. Group 3 was SDD-treated, whereas Group 4 was labeled as the control group. Group 5 was subjected to simple laparotomy. The rats in Group 1 and Group 3 were given SOD (tobramycin 20 mg/l and polymyxin E 25 mg/l) by gavage twice daily for 3 days preceding surgical operation. Control groups were fed orally with standard chow. After a 72-hour waiting period following the operation, biopsies of undamaged parietal peritoneum were obtained from the fibrinolytic parameters in order to measure tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1). Results: Average tPA levels were low in both the sdd-treated group and the sdd+adhesion model group, however no statistical significance was elicited. PAI-1 levels were higher in sdd-treated groups than in other groups, but no significantly meaningful difference was obtained. Conclusion: These results suggest that pretreatment with sdd reduces the peritoneal fibrinolytic activity and might also enhance the peritoneal adhesion formation in rats.
The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis
(2005) Taneli F.; Aydede H.; Vatansever S.; Ulman C.; Ari Z.; Uyanik B.S.
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 × 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 © 2004 John Wiley & Sons, Ltd.
Subcutaneous administration of live lactobacillus prevents sepsis-induced lung organ failure in rats
(2005) Ilkgul O.; Aydede H.; Erhan Y.; Surucuoglu S.; Gazi H.; Vatansever S.; Taneli F.; Ulman C.; Kose C.; Bengmark S.
The leading cause of death in intensive care units around the world is the syndrome of exaggerated and prolonged systemic inflammation response (SIRS), which if not controlled will lead to irreversible, often multiple, organ dysfunction and organ failure syndrome (MODS). Host phagocytic cells, predominantly macrophages and neutrophils, and their soluble products, play a central role. Accumulation of neutrophils is often observed, especially in the lungs, intestines, liver and kidneys. Neutrophilic infiltration of distant organs, and especially of the lungs, has been a characteristic finding of patients dying from sepsis. However, the mechanisms responsible for the exuberant inflammation and neutrophil infiltration are not yet fully understood. It has recently been demonstrated that this, at least in part, is due to an inhibition of neutrophil apoptosis, and there is a suggested association with activation of nuclear factor - κB (NF-κB), reduced activity of caspases-9 and -3 and maintenance of mitochondrial transmembrane potential.
Gallstone ileus presenting as gastric outlet obstruction (Bouveret's syndrome): A case report
(ARSMB-KVBMG, 2006) Sakarya A.; Erhan M.Y.; 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.
Early stage gastric cancer and treatment options; [Erken evre mide kanseri ve tedavi seçenekleri]
(2006) Güler Y.; Erhan Y.; Aydede H.
Early stage gastric cancer is defined as gastric adenocarcinoma limited to mucosa and submucosa. Most important diagnostic tests are serial endoscopies and multipl biopsies. Only treatment is total resection. Surgical procedure for antral tumors is subtotal gastrectomy and for the tumors placed at corpus and cardia total gastrectomy. Multifocal tumors are treated with total gastrectomy independent of their localisations. Radical lymph node dissection must be done for every patient with N2 disease. But, in small tumors limited to mucosa and type IIa tumors limited lymph node dissection (D1) is required. After D2 dissection for patients that lymph node (-), survey is excellent. For older and high risk patients noninvzsive surgical procedures (laser, endoscopic mucosal resection, laparoscopic wedge resection) can be choosen alternatively.
Effect of portal vein occlusion on the pancreas: An experimental model
(2006) 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-α (TNF-α), interleukin-1β (IL-1β), 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-α and IL-1β 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. © 2006 by the Société Internationale de Chirurgie.

Browsing by Author "Aydede H."

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