Browsing by Author "Coskun T."
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Item Increased intraabdominal pressure impairs liver regeneration after partial hepatectomy in rats(Academic Press Inc., 2002) Kaya Y.; Aral E.; Coskun T.; Erkasap N.; Var A.Background. There are many experimental studies showing that increased intraabdominal pressure (IAP) reduces liver blood flow, leading to ischemia and portal venous congestion. But, there is no study evaluating the effect of increased IAP on liver regeneration. It is well known that acute liver ischemia and portal venous congestion impair liver regeneration. We, therefore, aimed to determine the effect of increased IAP on liver regeneration in this study. Methods. Sprague-Dawley rats underwent partial hepatectomy with or without IAP of 12-14 mm Hg for 24 h or sham operation. Rats were randomly divided into six groups: two sham-operated groups, two hepatectomy groups, and two hepatectomy with increased IAP groups. Mitotic index, proliferating cell nuclear antigen (PCNA)-labeling index, and liver regeneration rate as liver regeneration parameters were studied on day 1 or on day 4 after operation. Additionally, serum aspartate transaminase (AST) level and histopathological changes in intestinal mucosa were studied. Results. Hepatectomy with/without increased IAP groups had significantly higher serum AST levels than the sham-operated group on day 1. Serum AST level was found to be significantly higher in the hepatectomy with increased IAP group than in the other groups on day 4. Intestinal mucosal injury was found in the hepatectomy with increased IAP groups on days 1 and 4. Mitotic index and PCNA-labeling index were markedly higher in all hepatectomy with/without increased IAP groups than in the sham-operated groups. However, together with liver regeneration rate, both indices were significantly less in the hepatectomy with increased IAP groups than in the hepatectomy groups both on day 1 and on day 4. Conclusion. Maintenance of IAP between 12 and 14 mm Hg for 24 h impaired liver regeneration after partial hepatectomy in rats. © 2002 Elsevier Science (USA).Item A rare complication of radical nephrectomy: A pancreatic pseudocyst(2002) Lekili M.; Coskun T.; Gunduz I.; Temeltas G.; Buyuksu C.[No abstract available]Item A rare complication of radical nephrectomy: A pancreatic pseudocyst(2002) Lekili M.; Coskun T.; Gunduz I.; Temeltas G.; Buyuksu C.[No abstract available]Item The effect of trimetazidine on liver regeneration after partial hepatectomy under hepatic blood inflow occlusion(2003) Kaya Y.; Coskun T.; Aral E.; Erkasap N.; Var A.Background/Aims: It has been shown that hepatic blood inflow occlusion impairs liver regeneration. Our aim in this study was to investigate the effect of trimetazidine, known as an anti-ischemic and anti-oxidant agent, on liver regeneration after hepatic blood inflow occlusion. Methodology: Sprague-Dawley rats were randomized into three groups. Rats in group 1 underwent 65% hepatectomy. Rats in group 2 and 3 were subjected to 15 minutes of hepatic blood inflow occlusion during 65% hepatectomy. Rats were treated with saline (in group 1 and 2) or trimetazidine (in group 3) 30 minutes before operation. Serum level of aspartate transaminase, wet to dry liver weight ratio, and liver injury score in light microscopy were studied for the evaluation of liver injury. Liver regeneration was evaluated by PCNA-labeling index (the percentage of hepatocytes staining for proliferating cell nuclear antigen), mitotic index (the percentage of mitotic hepatocytes), and liver regeneration rate (the percentage of initial liver weight). Results: Rats in group 2 and 3 had significantly higher serum aspartate transaminase level, wet to dry liver weight ratio and injury score than those in group 1 on day 1 posthepatectomy. Except for serum aspartate transaminase level on day 4, these parameters were significantly higher in group 2 than in group 1 and 3 on day 1 and 4. PCNA-labeling index and mitotic index were significantly less in group 2 and 3 than in group 1 on day 1. In contrast to liver regeneration rate, both indices in group 2 were significantly less than those in group 3 on day 1. There were no differences in regeneration parameters between the groups on day 4. Survival rate was significantly higher in group 3 than in group 2. Conclusions: Fifteen minutes of hepatic blood inflow occlusion caused an injury in the remnant liver, impaired liver regeneration, and decreased survival rate after partial hepatectomy. However, pretreatment with trimetazidine reduced liver injury, and improved liver regeneration and survival rate. For situations where hepatic blood inflow occlusion is planned in major liver resection, trimetazidine pretreatment would be useful strategy to improve post-operative outcome.Item Free oxygen radical-induced acute pancreatitis. A light and electron microscopic study(2003) Coskun T.; Korkusuz P.; Kaya Y.; Örs Ü.; Aker Y.; Kilinç K.Background/Aims: To date direct toxic effects of free oxygen radicals in vivo on pancreatic parenchyma have not been studied thoroughly. We aimed to study: 1) the detailed histopathological changes induced by free oxygen radicals in pancreas; and 2) the preventive effect of intraductal catalase in H2O2-induced acute pancreatitis. Methodology: Wistar Albino rats were randomized into six groups. 1) First experiment: Bile-pancreatic duct was cannulated close to the liver and perfused through the duodenum with (i) normal saline solution, (ii) iron sulfate (FeSO4), (iii) hydrogen peroxide (H2O2), (iv) hydrogen peroxide and iron sulfate simultaneously. 2) Second experiment: Bile pancreatic duct was perfused either with H2O2 or H2O2+catalase. Serum amylase and pancreas malondialdehyde levels were measured in both experiments after 3 hours of perfusion period. Tissue samples were obtained for histopathological examinations. Results: 1) First experiment: Intraductal perfusion of FeSO4 or H2O2 or H2O2+FeSO4 induced acute edematous pancreatitis with focal parenchymal necrosis. At the ultrastructural level, intracytoplasmic formation of vacuoles, fusion of the vacuoles and zymogen granules, and autophagosomes containing cellular organelles were found. Serum amylase and pancreas malondialdehyde levels, and morphological score were significantly higher in these groups than control group (p<0.001). 2) Second experiment: Catalase perfusion simultaneously with H2O2 decreased the serum amylase and pancreas malondialdehyde levels, and morphological score significantly (p<0.001) and prevented the desquamation of the columnar epithelium and development of gross edema but not parenchymal necrosis. Conclusions: Intraductal perfusion of FeSO4 or H2O2 or H2O2+FeSO4-induced acute pancreatitis with marked light and electronmicroscopic changes. Intraductal perfusion of catalase and H2O2 simultaneously did not prevent or lessen the parenchymal necrosis. These findings have suggested that another mechanism of injury may also play a role in parenchymal injury in oxygen radical-induced acute pancreatitis.Item Intestinal ischemia-reperfusion impairs liver regeneration after partial hepatectomy in rats(2003) Atici A.E.; Kaya Y.; Coskun T.; Aral E.; Var A.Background/Aims: The deleterious effects of intestinal ischemia-reperfusion on liver are realized, but its effect on the regenerative capacity of the liver has not been studied. Our aim in this study was to determine the effect of intestinal ischemia-reperfusion on liver regeneration. Methodology: Sprague-Dawley rats were randomly divided into six groups; two sham-operated, two hepatectomy, and two hepatectomy with intestinal ischemia-reperfusion groups. To create intestinal ischemia-reperfusion, the superior mesenteric artery and collateral arteries supplying the small intestine were occluded for 20 minutes. Partial hepatectomy was performed during the period of ischemia. Ischemia-reperfusion injury in the mucosal layer of the small intestine was scored in light microscopy. Liver regeneration parameters (proliferating cell nuclear antigen labeling index for hepatocytes and liver regeneration rate), and serum levels of aspartate aminotransferase and alanine aminotransferase were studied on day 1 or 4 after operation. Results: Mucosal injury score was high in the hepatectomy with intestinal ischemia-reperfusion groups. Liver regeneration rate and proliferating cell nuclear antigen labeling index were less in these groups than the hepatectomy groups on day 1 and 4. There were no differences in the serum levels of aspartate aminotransferase and alanine aminotransferase between hepatectomy and hepatectomy with intestinal ischemia-reperfusion groups. The mortality rate was higher in the hepatectomy with intestinal ischemia-reperfusion groups than the other groups. Conclusions: Ischemia and reperfusion of the small intestine impaired liver regeneration with high mortality after partial hepatectomy in the rats.Item A case of a diaphragmatic rupture complicated with lacerations of stomach and spleen caused by a violent cough presenting with mediastinal shift(Academy of Medicine Singapore, 2004) Kara E.; Kaya Y.; Zeybek R.; Coskun T.; Yavuz C.Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors. Clinical Picture: A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rapture, mediastinal shift and herniation of gastric fundus into the pleural cavity. Treatment: Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fondus and a diaphragmatic gap were performed. Outcome: He made an uneventful recovery. Conclusions: Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.Item Bilateral breast edema in intestinal lymphangiectasia(2005) Goktan C.; Pekindil G.; Orguc S.; Coskun T.; Serter S.[No abstract available]Item Serum Her-2/neu and survivin levels and their relationship to histological parameters in early-stage breast cancer(Cambridge Medical Publications, 2007) Goksel G.; Taneli F.; Uslu R.; Ulman C.; Dinc G.; Coskun T.; Kandiloglu A.R.This study was conducted to investigate the serum levels of her-2/neu and survivin in patients with early-stage breast cancer and their relationship with known histological parameters. Forty-one patients with early-stage breast cancer were investigated. Serum samples were collected from patients on their first admission before adjuvant chemotherapy, and from healthy controls. Serum her-2/neu and survivin levels were determined using an enzyme-linked immunosorbent assay. There was no difference in the levels of serum her-2/neu and survivin between the breast cancer patients and the control group. Serum her-2/neu concentration showed moderate correlations with disease stage and the Ki-67 level, and the serum survivin level showed a moderate correlation with progesterone receptor concentration. Serum levels of her-2/neu and survivin were not significantly related to age and histological parameters in patients with early-stage breast cancer. However, much research continues on the prognostic value of serum her-2/neu and survivin levels, and important new knowledge may ultimately emerge. Copyright © 2007 Cambridge Medical Publications.Item Evaluation of risk factors and severity of a life threatening surgical emergency: Founder's gangrene (a report of 15 cases)(ARSMB-KVBMG, 2009) Kara E.; Müezzinoglu T.; Temeltas G.; Dinçer L.; Kaya Y.; Sakarya A.; Coskun T.Background: Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external genitalia and perineum with high morbidity and mortality. Patients and Methods: 15 patients with Fournier's gangrene were enrolled. Gender, age, aetiology, predisposing factors, symptomatology, associated diseases, hospital stay, FGSI, and body surface area were analysed. Results: Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). E.coli and acinetobacter were the common organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. Common predisposing factors included diabetes mellitus (73.3%), poor personal hygiene (60%), obesity (33.3%), psychosis (20%) and decubitus ulcers (13.2%). Whereas five (33.3%) patients developed synergistic gangrene of the scrotum secondary to anorectal disease, five (33.3%) had a urological source of infection. Mean BSA and FSGI scores were 15.93 ±3.13 and 6.02 ±0.95, respectively. Serum glucose > 140 mg/dl, the existence of septic shock on admission, the spread of gangrene to the perineum and abdominal wall (Groups C and D), BSA ≥: 24 cm2, a cutaneous source of infection and FGSI scores ≥ 7 were factors affecting mortality rates with statistical significance (p < 0.05). There was a direct correlation between the culture of mixed type micro-organisms and the cutaneous source of infection (p > 0.05). The extent of gangrene correlated with higher FGSI scores (≥ 7) (p < 0.05). Mortality and morbidity rates were as 20% (n = 3) and 60% (n = 9). Conclusion: Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.Item Oil cyst mimicking intracystic neoplasm(2009) Orgue S.; Basara I.; Coskun T.; Kandiloglu A.R.[No abstract available]Item The effect of tadalafil on anastomotic healing in ischemic small intestine in rats(2010) Kaya Y.; Coskun T.; Ayhan S.; Kara E.; Sakarya A.; Var A.Purpose: To investigate the effect of tadalafil on anastomotic healing in an ischemic small intestine. Methods: Standardized transection and anastomosis in the small intestine were performed in 48 male Sprague-Dawley rats divided into four equal groups (n = 12): group 1, normal anastomosis; group 2, ischemic anastomosis; group 3, normal anastomosis+tadalafil treatment; group 4, ischemic anastomosis+tadalafil treatment. Ischemia was established by ligating 2 cm of mesentery on either side of the anastomosis. Tadalafil was given to the rats once a day at dose of 5 mg/kg. The anastomotic bursting pressures and hydroxyproline concentrations were measured on postoperative day 4. A histopathological evaluation of the anastomoses was also performed. Results: The bursting pressure and hydroxyproline concentration in group 2 were significantly lower than those in the other groups. There was no difference in the hydroxyproline concentration among groups 1, 3, and 4. While there was no difference between groups 3 and 4, the bursting pressures were significantly higher in groups 3 and 4 than in group 1. The histopathological evaluation revealed no significant differences in inflammatory cell infiltration, vascularization, or anastomotic collagen deposition among the groups. Conclusion: Tadalafil treatment improved the anastomotic bursting pressure and the hydroxyproline concentration in both normal and ischemic small intestine anastomosis. © 2010 Springer.Item Comparison of the desmoplastic reaction and invading ability in invasive ductal carcinoma of the breast and prostatic adenocarcinoma based on the expression of heat shock protein 47 and fascin(2010) Nese N.; Kandiloglu A.R.; Simsek G.; Lekili M.; Ozdamar A.; Catalkaya A.; Coskun T.OBJECTIVE: To investigate the diversity within invasive ductal carcinoma (IDC) and prostatic adenocarcinoma (PCa) by evaluating immunohistochemical expression of heat shock protein 47 (HSP47) and fascin, the molecules that are related to desmoplasia and invasion, and analyze its correlation with clinicopathologic parameters. STUDY DESIGN: HSP47 and fascin immunoreactivity (IR) was evaluated in 49 mastectomies diagnosed as IDC and 57 radical prostatectomies diagnosed as PCa. IR was evaluated as: 0: < 5%, 1+: 5-25%, 2+: 25-50%, 3+: >50%. RESULTS: HSP47 and fascin were localized to cytoplasm, and HSP47 and fascin IR were higher in IDC and PCa than benign groups (p<0.05). HSP47 IR in neoplastic cells was 42.1% and 28.6%, in stroma was 81.6% and 15.8% in IDC and PCa, respectively; fascin IR in neoplastic cells was 65.3% in IDC and 15.8% in PCa. Fascin expression correlated with estrogen receptor and progesterone receptor negativity, tumor size and stage in IDC and surgical margin status in PCa. HSP47 expression correlated bilaterality in PCa. HSP47 positively correlated with survival in IDC. CONCLUSION: HSP47 and fascin expression may play role in the pathogenesis of IDC and PCa because their expression is significantly higher in IDC and PCa than their normal counterpart. Although there is no relationship with recurrence or metastatic status, fascin overexpression correlated with tumor size, which may prompt its use as a prognostic factor in IDC. © Science Printers and Publishers, Inc.Item The effects of l-arginine on liver damage in experimental acute cholestasis an immunohistochemical study(2011) Ozsoy M.; Ozsoy Y.; Coskun T.; Naml K.; Var A.; Özyurt B.Obstructive jaundice damages critical functions in the liver. Nitric oxide modulation would influence liver damage induced by biliary obstruction, and little is known about it Acute cholestasis was induced by bile duct ligation (BDL) in two groups of male Sprague-Dawley rats. L-Arginine or serum physiologic was administered to treatment and control group. Histopathological and immunohistochemical iNOS expression was investigated in hepatic tissue. Plasma enzyme activities were increased in acute cholestasis, and that L-arginine treatment partially but significantly prevented the elevation of these markers of liver damage (P<.05). Also histopathology scoring showed that the liver injury was prevented and immunohistochemical iNOS activity was increased significantly in L-arginine group (P<.05). This study shows that, after 7 days of biliary obstruction, liver damage is well established and exogenous L-arginine treatment partially but significantly prevented the liver injury in acute cholestasis. Copyright 2011 Yucel Ozsoy et al.Item Diffusion-weighted MR imaging of the breast: Comparison of apparent diffusion coefficient values of normal breast tissue with benign and malignant breast lesions(Singapore Medical Association, 2012) Orguc S.; Basara I.; Coskun T.Introduction The specificity of conventional magnetic resonance (MR) imaging is lower than its high sensitivity. Diffusion-weighted imaging (DWI), based on alterations in the microscopic motion of water molecules, promises improved specificity for breast MR imaging. In this study, we aimed to determine the diagnostic potential of DWI to differentiate between benign and malignant breast lesions and normal breast tissue. Methods Dynamic contrast-enhanced breast MR imaging and DWI were applied to 108 women. Apparent diffusion coefficient (ADC) values were obtained for normal breast tissue (n = 183), benign lesions (n = 66) and malignant lesions (n = 58). The results were compared with the patients' final diagnoses. Resu lts Mean ADC values for benign and malignant breast lesions were 1.04 × 10-3 ± 0.29 × 10-3 mm2/s and 2.00 × 10-3 ± 0.55 × 10-3 mm2/s, respectively (p = 0.001, Student's t-test), while that for normal breast tissue was 1.78 × 10-3 ± 0.33 × 10-3 mm2/s. With a cut-off value of 1.46 × 10-3 mm2/s for ADC in receiver operating characteristic analysis, 95% sensitivity and 85% specificity were achieved for differentiating between benign and malignant lesions. Conclusion DWI of the breast can help differentiate benign and malignant breast lesions from normal breast tissue. DWI, which can be easily introduced into standard breast MR imaging protocols without increasing imaging times, promises to increase the accuracy of breast MR imaging without contrast media. However, its clinical value will depend on the standardisation of b-values and other technical parameters in larger future study series.Item Adipocytokine levels of colon cancer patients before and after treatment(2013) Kosova F.; Coskun T.; Kaya Y.; Kara E.; Ari Z.Aims and background: In the present study, we investigated the associations between pre- and posttreatment levels of adiponectin, ghrelin, resistin, visfatin and leptin levels in malign and benign groups Methods and study design: 20 malign colon carcinoma groups and 20 benign groups were included in this study. Serum levels of leptin, adiponectin, resistin, ghrelin, and visfatin were measured by Elisa kits (Milipore Corporation, Billerica, MA, USA). Results: In the malign group, serum ghrelin (71.90±23.7) levels significantly decreased (p<0.05) when compared to those in the benign (88.00±16.9) group. However, serum resistin (4.92±2.2, 3.39±1.1) levels increased statistically significantly (p<0.05). In the malign group, serum visfatin (0.85±0.6, 0.83±0.5), adiponektin (60.31±23.1, 56.39±25.9) and leptin (3.08±1.4, 3.74±1.3) levels were not statistically significantly different from those in the benign group. In the malign treatment group, serum adiponectin (102.64±50.3, 66.64±27.0) levels were increased significantly (p<0.05); however, serum visfatin (1.17±0.9, 0.68±0.3), ghrelin (85.52±29.5, 82.18±18.0), leptin (5.65±2.8, 3.16±1.1), and resistin (5.96±2.8, 5.65±1.7) levels did not change significantly (p<0.05) compared to those in the respective benign treatment group. Conclusions: We showed that adipocytokines were involved in the carcinogenic process. The present results suggest that resistin and ghrelin may be important biomarkers of colon cancer. Furthermore, an in vitro study will also be necessary to evaluate the direct function of these adipocytokines in cancer cells. In addition, it will be appropriate to conduct new studies with a large number of patients at different stages.Item Erratum: The effects of L-arginine on liver damage in experimental acute cholestasis an immunohistochemical study(2013) Ozsoy Y.; Coskun T.; Kaya Y.; Ozbilgin K.; Var A.; Ozyurt B.[No abstract available]Item Contribution of advanced magnetic resonance imaging techniques in diagnosis of breast lesions(Kuwait Medical Association, 2014) Basara I.; Orguc S.; Coskun T.Objectives: To determine the diagnostic contribution of diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) identified either with mammography, ultrasonography or conventional enhanced magnetic resonance imaging (MRI) to cases with palpable breast lesions or for routine control Design: Prospective study Setting: Department of Radiology, Celal Bayar University, Turkey Subjects and Methods: Fifty female patients who applied to the clinic between November 2009 and April 2010 with different indications were included. We applied conventional breast MRI with the routine sequences. We added DWI and BREASE (MRS). After MRI examination postprocessing applications were applied. Intervention: Analysis of contribution of advanced techniques in breast lesions diagnosis Main Outcome Measure: Determining the value of DWI and MRS of breast lesions, which may be useful in improving the specificity Results: Fifty-two breast lesions in 37 cases were evaluated. In DWI when cut off apparent coefficient diffusion (ACD) value was accepted as 1.44 x10.3 mm2/sn, the sensitivity was found to be 91.3% and the specifity was 62.1% in discriminating malignant and benign lesions. When the lesions which have choline peak at 3.2 ppm were accepted as malignant and lesions which do not have choline peak were accepted as benign lesions in spectroscopic examination, the specifity was 80%, the sensitivity was 31.8%, negative predictive value (NPV) was 44.4% and positive predictive value (PPV) was found to be 70%. Conclusions: Our specifity was compatible with that in the literature but sensitivity and negative ppv were lower than reported in the literature. According to ADC values, the findings in our study were compatible with the literature.