MCBÜ Açıkerişim Sistemi :: Browsing by Author "Coşkun T."

Browsing by Author "Coşkun T."

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Effects of rofecoxib, a selective cyclooxygenase-2 inhibitor, on endothelial dysfunction, lipid peroxidation, and hepatocyte morphology in rats with sepsis-induced liver damage
(2004) Kara E.; Var A.; Vatansever S.; Cilaker S.; Kaya Y.; Coşkun T.
Sepsis remains a difficult problem for clinicians, with its systemic effects and high morbidity and mortality rates. The roles of oxidative stress, endothelial dysfunction, and lipid peroxidation in sepsis-induced organ damage are being investigated. The aim of this study was to investigate the effects of selective cyclooxygenase (COX)-2 inhibition on tissue lipid peroxidation, endothelial dysfunction, and hepatic cell morphology in a rat model of sepsis. Thirty rats with sepsis induced by cecal ligation and puncture were divided equally into 3 groups: treatment group (rofecoxib 1 mg/kg PO), control group (saline 1 mL PO), and sham group (sham surgery only). All the rats were sacrificed 1 day after sepsis induction. The livers were removed using a median laparotomy for histopathologic and biochemical analysis. Histomorphologic hepatic damage and lipid peroxidation were significantly reduced in the rofecoxib treatment group compared with the control group (P < 0.05 and P = 0.001, respectively). Endothelial nitric oxide synthase and inducible nitric oxide synthase staining of liver samples was statistically significantly reduced in the treatment group compared with the control group (both, P < 0.001). The hepatic nitric oxide level and malonyldialdehyde activity decreased significantly (P < 0.001 and P = 0.001, respectively) in the rofecoxib group compared with the control group. Hepatic myeloperoxidase activity was similar between the treatment and control groups. Further investigation of selective COX-2 inhibition as an alternate therapeutic choice for sepsis-induced hepatic damage should be considered. Copyright © 2004 Excerpta Medica, Inc.
Effects of silymarin and pentoxifylline on matrix metalloproteinase-1 and -2 expression and apoptosis in experimental hepatic fibrosis
(2008) Kara E.; Coşkun T.; Kaya Y.; Yumuş O.; Vatansever S.; Var A.
Background: Many therapeutic strategies have been proposed to treat liver fibrosis, but no drugs have been proved effective. Matrix metalloproteinases (MMPs) have been reported to play a role in some cellular cascades of hepatic inflammation and fibrosis. Objective: The purpose of this study was to investigate whether silymarin and pentoxifylline (PTX) have hepatoprotective and antifibrotic effects in experimental hepatic fibrosis. Methods: Sprague-Dawley rats were divided into 4 groups: silymarin group (silymarin 4 mg/kg · d-1 orally, common bile duct ligation [CBDL]); PTX group (PTX 2 mg/kg · d-1 intraperitoneally, CBDL); sham group (common bile duct [CBD] exploration only); and control group (saline 1 mL/d orally, CBDL). The CBD was explored and dissected sufficiently to allow passage of a 3/0 silk suture via midline laparotomy. On day 10, all animals were euthanized via cervical dislocation. Then, 5-cm3 liver samples from the right lobe were removed for histomorphologic evaluation and 3-mL blood samples were taken via cardiac puncture for biochemical analyses. Apoptosis was determined using the terminal deoxynucleotidyltransferase-biotin nick end-label (TUNEL) staining method. Plasma levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase; total and indirect bilirubin concentration; hepatic MMP-1 and -2 and tissue inhibitor of MMP (TIMP)-l and -2 activity; and transforming-growth factor (TGF)-β1 concentration were measured. Collagen content was determined by measuring hydroxyproline in liver samples. Malondialdehyde (MDA) was used to estimate lipid peroxidation. Results: Thirty-two adult male Sprague-Dawley rats were divided into 4 groups: silymarin group (n = 7), PTX group (n = 7), sham group (n = 9), and control group (n = 9). Compared with the control group (14.6 [2.44]), mean (SD) hepatocyte apoptosis (as measured by the ratio of TUNEL-positive cells) was significantly suppressed in the silymarin group (1.2 [0.13]; P = 0.001) and the PTX group (3.8 [0.34]; P = 0.001). Mean (SD) MMP-2 activity in the silymarin group (57.35 [9.89] μg/mL; P = 0.04) and the PTX group (46.88 [9.56] μg/mL; P = 0.04) was significantly lower than that observed in the control group (232.32 [79.76] μg/mL). Compared with the control group (1.37 [0.38] μg/mL), TIMP-2 activity was significantly lower in the silymarin group (0.55 [0.13] μg/mL; P = 0.04) and the PTX group (0.42 [0.09] μg/mL; P = 0.01). Compared with the control group (909.17 [117.35] μg/mL), TGF-β1 was significantly lower in the silymarin group (518.24 [30.34] μg/mL; P = 0.01) and the PTX group (519.57 [47.27] μg/mL; P = 0.01). Histomorphologic changes were significantly greater in the sham group than in the silymarin and PTX groups: hemorrhage (2.44 [0.29] vs 1.29 [0.18] and 1.57 [0.20], respectively; both, P = 0.04); sinusoidal dilatation (2.22 [0.22] vs 1.57 [0.20] and 1.71 [0.18]; both, P = 0.04); presinusoidal polymorphonuclear cell infiltration (3-44 [0.24] vs 2.57 [0.20] and 2.14 [0.26]; P = 0.03 and P = 0.008, respectively); and inflammation (3.44 [0.24] vs 2.57 [0.20] and 2.14 [0.26]; P = 0.03 and P = 0.008, respectively). In the control group, all biochemical markers were elevated, supporting the presence of liver injury. Compared with the control group (630.00 [46.80] U/L), plasma AST activity was significantly lower in the silymarin group (443.11 [78.73]; P = 0.04) and the PTX group (349.42 [34.00]; P = 0.03). Compared with the control group (191.12 [32.93] U/L), plasma ALT activity was significantly lower in the silymarin group (86.14 [4.97]; P = 0.04) and the PTX group (84.14 [11.21]; P = 0.04). MDA concentration was significantly lower in the silymarin group compared with the control group (0.08 [0.01] vs 0.22 [0.03] nmol/mL; P = 0.004); MDA was also significantly lower in the silymarin group than in the PTX group (0.11 [0.02]; P = 0.03). Conclusions: Silymarin and PTX were associated with lower histopathologic liver damage, hepatocyte apoptosis, and regulation of extracellular matrix proteins. Lipid peroxidation in hepatocytes was significantly lower in the silymarin group compared with the PTX group. Silymarin and PTX appeared to have hepatoprotective effects in this experimental liver fibrosis model, but further clinical and experimental studies are needed. © 2008 Excerpta Medica Inc. All rights reserved.
Hepatic perfusion changes in an experimental model of acute pancreatitis: Evaluation by perfusion CT
(Elsevier Ireland Ltd, 2010) Tutcu S.; Serter S.; Kaya Y.; Kara E.; Neşe N.; Pekindi G.; Coşkun T.
Purpose: It is known that acute pancreatitis may cause secondary changes in several organs. Liver is one of these involved organs. In different experimental studies hepatic damages were shown histopathologically in acute pancreatitis but there are a few studies about perfusion disorders that accompany these histopathologic changes. Perfusion CT (pCT) provides the ability to detect regional and global alterations in organ blood flow. The purpose of the study was to describe hepatic perfusion changes in experimental acute pancreatitis model with pCT. Materials and methods: Forty Sprague-Dawley rats of both genders with average weights of 250 g were used. Rats were randomized into two groups. Twenty rats were in control group and 20 in acute pancreatitis group. pCT was performed. Perfusion maps were formed by processing the obtained images with perfusion CT software. Blood flow (BF) and blood volume (BV) values were obtained from these maps. All pancreatic and liver tissues were taken off with laparotomy and histopathologic investigation was performed. Student's t test was used for statistical analyses. Results: In pCT we found statistically significant increase in blood volume in both lobes of liver and in blood flow in right lobe of the liver (p < 0.01). Although blood flow in left lobe of the liver increased, it did not reach statistical significance. Conclusion: The quantitative analysis of liver parenchyma with pCT showed that acute pancreatitis causes a significant perfusion changes in the hepatic tissue. Systemic mediators seem to be effective as well as local inflammatory changes in perfusion changes. © 2009 Elsevier Ireland Ltd.
Primary squamous cell carcinoma of the breast: A case report and immunohistochemical features for differential diagnosis; [Memenin primer skuamöz hücreli karsinomu: Olgu sunumu ve Ayırıcı tanı açı;sından İmmunohistokimyasal özellikleri]
(Ekin Tibbi Yayincilik, 2010) Temiz P.; Kandiloǧlu A.R.; Şimşek G.; Coşkun T.; Göktan C.
We present a 68-year-old postmenopausal woman with a rapidly growing right breast mass. It was diagnosed as "invasive ductal carcinoma" on tru-cut biopsy owing to infiltrative pattern and c-erbB-2 (HER2/neu) and progesterone receptor positivities. Partial response was obtained after four cure chemotherapy (adriamycin and cyclophosphamide). Then, she underwent a modified radical mastectomy with axillary lymph node dissection (level III). Grossly, a white-tan, solid, ill-defined tumor with 5 cm diameter located in the upper inner and outer quadrant of the breast was detected. Central portion of the tumor showed necrotic and hemorrhagic changes. Microscopic examination revealed poorly differentiated squamous cell carcinoma (SCC) having intraductal epithelial hyperplasia with squamous cell metaplasia and multiple small tumor foci at the periphery. The tumor had patchy necrotic, hemorrhagic and fibrotic areas representing regressive changes due to chemotherapy effect. Immunohistochemically, the tumor stained diffusely with CK7, CK8, CK19, HMW-CK and E-cadherin, whereas focally with CEA. Estrogenand progesterone receptors and c-erbB-2 were negative in the tumor. Five out of 20 lymph nodes dissected from the specimen were metastatic. Clinically, other organs were ruled out as the originating site of the tumor. She had taken oral chemotherapy (capecitabine) after surgery and has been living healthy for one year. © Medical Journal of Trakya University.
Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI: Association of unilateral increased vascularity with ipsilateral breast cancer
(2012) Örgüç S.; Başara I.; Coşkun T.; Pekindil G.
Purpose We aimed to retrospectively compare three-dimensional vascular maps of both breasts obtained by dynamic magnetic resonance imaging (MRI) and determine the association of one-sided vascular prominence with ipsilateral breast cancer. Materials and Methods MRI was performed using gadolinium in 194 cases. Two readers scored vascular density using maximum intensity projections (MIPs). Dynamic fat-saturated T1-weighted gradientecho MIPs were acquired. Two readers evaluated the MIPs, and vessels greater than 2 mm in diameter and longer than 3 cm were counted. The difference in vessel numbers detected in the two breasts determined the score. Results A total of 54 patients had malignant lesions (prevalence, 28%), including invasive ductal carcinoma (n=40), invasive mixed ductal-lobular carcinoma (n=5), invasive lobular carcinoma (n=3), ductal carcinoma in situ (n=3), mucinous carcinoma (n=1), medullary carcinoma (n=1), and leukemic metastasis (n=1). In 62 patients, there were benign lesions (fibroadenomas, fibrocysts), and four patients had inflammation (granulomatous mastitis in two patients, breast tuberculosis in two patients). There were 78 normal cases. When a difference of at least two vessels was scored as vascular asymmetry, the sensitivity, specificity, positive likelihood ratio (+LR), and negative (-LR) of unilaterally increased vascularity associated with ipsilateral malignancy were 69%, 92%, 8.72, and 0.34, respectively. When four infection and three post-operative cases with vascular asymmetry were excluded; prevalence, specificity, and +LR increased to 29%, 97%, and 22.8, respectively, with the same sensitivity and -LR. Differences in mean vascularity scores were evaluated with regard to tumor size. T1 and T2 tumors were not significantly different from each other. The mean score of T3 tumors differed significantly from T1 and T2 tumors. Conclusion MRI vascular mapping is an effective method for determining breast tissue vascularization. Ipsilateral increased vascularity was commonly associated with malignant breast lesions. © Turkish Society of Radiology 2012.
Contribution of kinetic characteristics of axillary lymph nodes to the diagnosis in breast magnetic resonance imaging
(Galenos Publishing House, 2012) Örgüç S.; Başara I.; Pekindil G.; Coşkun T.
Objective: To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes. Material and Methods: One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations postprocessing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (-LHR) of dynamic curves characterizing the axillary lymph nodes were calculated. Results: A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, -LHR were calculated as 14%, 1.04, 0.76 respectively. Conclusion: Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients. © Trakya University Faculty of Medicine.
Single voxel in vivo proton magnetic resonance spectroscopy of breast lesions: Experience in 77 cases
(2013) Başara I.; Örgüç Ş.; Coşkun T.
PURPOSE We aimed to determine the value of in vivo single voxel proton magnetic resonance spectroscopy (MRS) in characterizing breast lesions. MATERIALS AND METHODS Breast MRS was performed in 77 patients. Choline resonance peak at 3.2 parts per million (ppm) was defined positive when it was at least two times higher than baseline. MRS findings were compared with the final diagnosis of cases for two different values (3.23 and 3.28 ppm). RESULTS Thirty-one malignant and 13 benign lesions had choline peaks. Sensitivity was 84%, specificity was 64%. Positive likelihood ratio (LHR) was 2.32, negative LHR was 0.25. Twenty- two malignant and 5 benign lesions had a peak at 3.23 ppm. Nine malignant and 8 benign lesions had a peak at 3.28 ppm. When 3.23 ppm was accepted as positive; sensitivity, specificity, and positive and negative LHRs were 79%, 82%, 4.4, and 0.26, respectively. CONCLUSION MRS provides additional parameters on evaluation of breast lesions. However, MRS of breast has some false negative results, thus it is still insufficient in clinical diagnosis. © Turkish Society of Radiology 2013.
Assessment of pulmonary artery pressure and right ventricular function in children with adenotonsillar hypertrophy using different parameters
(Elsevier Ireland Ltd, 2014) Çetin M.; Yilmaz M.; Özen S.; Bozan N.; Coşkun T.
Objective: Our aim was comparison of preoperative and postoperative right ventricular functions of children with adenotonsillar hypertrophy (ATH) who have findings of upper airway obstruction, using new echocardiographic parameters. Methods: Forty-one children who have admitted to our hospital with symptoms suggestive of upper airway obstruction, whose history and physical examination findings suggest upper airway obstruction and who have undergone adenoidectomy/adenotonsillectomy and 40 healthy children, all of whom between 2 and 12 years of age, were included in the study. Patient group was evaluated by pulsed wave tissue Doppler echocardiography as well as with conventional echocardiography before the operation and 6 months after the operation. Results: Of 41 children in study group, 26 (63.4%) had adenotonsillectomy and 15 (36.6%) had adenoidectomy. Tricuspid annular plane systolic excursion (TAPSE) was significantly lower in preoperative group compared to control group (18.46. ±. 1.67, 19.77. ±. 1.62; p=0.000, respectively). Myocardial performance index (MPI) was significantly higher in preoperative group than postoperative and control group (0.40. ±. 0.07, 0.36. ±. 0.06, 0.35. ±. 0.07; p= 0.032, respectively). Tricuspid isovolumic acceleration (TIVA) was significantly lower in preoperative group than preoperative and control group (2.97. ±. 0.8, 3.43. ±. 0.7, 3.43. ±. 0.9; p= 0.020, respectively). Disappearance of this difference was found between postoperative and control groups (p= 0.984). Pulmonary acceleration time (PAcT) was found to be significantly lower in preoperative group compared to postoperative and control group (109.68. ±. 18.03, 118.93. ±. 17.46, 120.0. ±. 14.07; p= 0.010, respectively). Mean pulmonary artery pressure (mPAP) was significantly higher in preoperative group than control group (29.64. ±. 8.11, 24.95. ±. 6.33; p= 0.010, respectively). In postoperative group mPAP was found to be similar to control group (25.48. ±. 7.85, 24.95. ±. 6.33; p= 0.740, respectively). Conclusions: TAPSE, PAcT, MPI and TIVA are useful markers for evaluation of preoperative and postoperative ventricular function in children with ATH who have findings of upper airway obstruction. We think that using these practical and easy-to perform parameters may be relevant for evaluation and postoperative follow-up of patients with ATH who have findings of upper airway obstruction. Besides adenotonsillectomy is a beneficial treatment option for these patients. © 2014 Elsevier Ireland Ltd.
Upper extremity problems and quality of life in patients with breast cancer; [Meme Kanserli Hastalarda üst Ekstremite Sorunları ve Yaşam Kalitesi]
(Galenos Publishing House, 2019) Yılmaz E.; Coşkun T.
Objective: The study was conducted to determine upper extremity problems and quality of life in patients with breast cancer who underwent breast surgery and axillary dissection. Methods: This descriptive and cross-sectional research was included 64 patients who admitted for outpatient clinic between 01.01.2015-01.01.2016 in university hospital in western of Turkey and previously undergone surgery for breast cancer. The data was collected personal information form, Shoulder Pain and Disability Index (SPADI) the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Q-DASH), Breast Cancer Module Quality of Life Scale (EORTC QLQ-BR23) and Short Form-36 (SF-36). Statistical analyses were performed using descriptive statistics, Chi Ssquare test, Mann Whitney U test, Kruskal Walles test and the Spearman’s correlation coefficient. Results: Mean age of the study group was 52.36±12.25 years. It was found that 54.7% of the patients were applied modified radical mastectomy and axillary dissection, and average time passed after surgery 11.27±10.00 months. Affected arm had shoulder pain (53.1%), restrictions on shoulder (51.6%) and lymphedema (21.9%).It was determined that patients were received low scores from SPADI and Q-DASH, and SF-36 physical and mental summary scores of below the average. The EORTC QLQ-BR23 functional status and symptom subscales scores of patients were low. Conclusion: It was seen that patients’ quality of life was low, their functional status was poor, and cancer-related symptoms to be less. The working with multidisciplinary team on preoperative and postoperative will help prevent complications and increase the quality of life. © 2018 Galenos Publishing House. All rights reserved.
Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative pain, limitation of movement and quality of life
(Bilimsel Tip Yayinevi, 2020) Kaya A.; Şahin S.T.; Kaya Y.; Coşkun T.; Sakarya A.
Objective: The study aimed to compare the techniques applying prolene mesh and progrip-self fixating mesh in terms of post-operative pain, limitation of movement and quality of life. Material and Methods: The study was conducted from November 2014 to January 2016 in Department of Surgery, Manisa Celal Bayar University Hospital. The study recruited 50 male patients, aged 18 and over and was carried out as a double blinded procedure. Twenty-five patients were randomly selected to receive hernia repair by progrip self-fixating mesh and 25 patients were treated with hernia repair with suture fixation method by using prolene grafts, and patients' pain follow-up was performed with face-to-face or telephone interviews with VAS (Visual Analogue Scale) and return to daily routine activities were evaluated with SF-36 (Short Form-36) quality of life scale. Recurrent hernias and emergency cases were excluded. Results: The pain scores were lower and a statistically significant difference was achieved in patients in whom progrip self-fixating mesh was used in the early postoperative period. Both methods gave statistically similar results in terms of pain and quality of life. Conclusion: In the literature, there are some evidence that the repair applied with progrip self-fixating graft has more positive outcomes compared to the repairs applied with suture fixation. It is concluded that there is a need for longer follow-ups and larger series of cases in order to achieve a definite result. © Copyright 2020 by Turkish Surgical Society.

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