Browsing by Author "Demireli, P"

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    Assessment of the efficacy of absorbable adhesion barriers on dissection in esophagus operations
    Yilmaz, O; Genc, A; Taneli, F; Demireli, P; Deliaga, H; Taneli, C
    Objective: During childhood, recent repeated operations for esophagus are normally conducted if long gap esophageal atresia exists. During multistaged extrathoracic esophageal elongation procedure, the dissection of the esophagus poses severe problems due to adhesion. However, Gore-Tex membrane may simplify esophagus dissection. The most popular adhesion barriers used today are sodium hyaluronate, (Seprafilm(R); Genzyme Corp., Cambridge, MA) and oxidized regenerated cellulose (Interceed(R); Johnson Et Johnson Medical Inc., New Brunswick, NJ). The purpose of this study is to investigate the efficacy of adhesion barriers on esophagus dissection. Methods: In the study, 21 Wistar albino adult male rats were worked on. The rats were randomly divided into three groups, each including seven rats. About 1 cm-segment of the esophagus, located just behind the trachea, was dissected from the surrounding tissues through blunt dissection. Rats in group 1 were wrapped with Seprafilm(R), and in group 2 with Interceed(R). But the rats in group 3 underwent only esophagus dissection. Three weeks later, during esophagus dissection, adhesion scoring was performed and esophagus was divided into two parts: one for the assessment of hydroxyproline level, and the other for histological examination. Results: When the adhesion scores of the three groups were compared, there was not a significant difference between the groups (p = 0.75). In terms of tissue hydroxyproline levels, mean scores of hydroxyproline revealed no significant difference between the three groups (p = 0.19). When the histopathological results were examined, esophagus looked normal and no connective tissues were seen around esophagus. Conclusion: Seprafilm(R) and Interceed(R) had no effect on esophagus dissection. Although Seprafilm(R) had the best mean score, this was statistically insignificant. Gore-Tex might play a better role than Interceed(R) in preventing adhesion formation; however, it is still not certain whether adhesion barrier should be used in such organs as esophagus having no serosa. Published by Elsevier Ireland Ltd.
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    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.
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    Long-term effect of pentoxifylline and NG-nitro-L-arginine methyl ester on testicular function in spermatic artery ligation
    Yilmaz, O; Genc, A; Taneli, F; Demireli, P; Kocakoc, ID; Sencan, A; Gunsar, C; Mir, E; Taneli, C
    Objective. To investigate long-term testicular function in pentoxifylline- and NG-nitro-L-arginine methyl ester (L- NAME)treated rats prior to spermatic artery ligation by assessing serum inhibin B concentration, a reliable endocrine marker of spermatogenesis. Material and methods. Forty prepubertal rats were randomly divided into four equal groups. Right orchiectomy was performed in all rats. Intraperitoneal pentoxifylline and L- NAME were administered to Groups 1 and 2, respectively. Rats in Group 3 did not receive any medication. The spermatic arteries of the left testes were ligated in all groups with the exception of the sham controls ( Group 4). One month postoperatively, a histopathologic evaluation was performed and serum inhibin B concentrations were assessed in all groups. Results. There were no statistically significant differences in testis size or serum inhibin B concentration between Groups 1, 2 and 3. However, the testes were significantly smaller (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) and serum inhibin B levels were significantly decreased (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) when Groups 1 - 3 were compared with Group 4. Histopathological evaluations revealed necrosis and calcification in all specimens with the exception of the sham-operated group. Conclusions. The long-term outcomes of spermatic artery ligation were poor and testicular atrophy developed in rat testes in all study groups. Testicular atrophy could not be reversed by preoperative administration of pentoxifylline and L- NAME.
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    Early diagnosed but late treated subungual melanoma
    Sahin, MT; Ozturkcan, S; Seyhan, A; Demireli, P; Turel-Ermertcan, A
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    Secondary chondrosarcoma arising from a solitary enchondroma at the index finger of the right hand: A case report\
    Demireli, P; Çavdar, DK; Vural, S; Ovali, GY; Özalp, T
    Enchondromas are benign cartilaginous tumors and tend to present in small bones of hands and feet. Malignant transformation, though rare, is seen more often in multiple rather than solitary enchondromatous. A 70year-old woman presented with swelling and pain lasting for years at the index finger of the right hand. Excisional curettage material of the mass revealed to be entirely an enchondroma. Seven months later, the lesion recurred at the same localization and amputation of the finger was performed. This time the tumor was found to be transformed into an intermediate grade (grade II) which demonstrated chondrosarcoma intermingled with classical enchondromatous areas. Enchondromas arising at the hands and feet very rarely transform into chondrosarcomas. Since enchondromas at this site often show histological and clinical features suggestive of malignancy, it is often is difficult to make a histological distinction between benign cartilaginous tumors and chondrosarcomas. Detection of radiological as well as pathological findings are essential for differential diagnosis. This case is remarkable for she has a solitary enchondroma located at the index finger of the right hand that transformed into chondrosarcoma in seven months.
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    Expression of matrix metalloproteinases (MMP-2, MMP-3, and MMP-9) and fibronectin in lichen planus
    Gunduz, K; Demireli, P; Inanir, I; Nese, N
    Background: Keratinocyte damage and lichenoid-interface reaction are the two major pathologic findings in lichen planus (LP). Matrix metalloproteinases (MMPs) are proteinases that participate in extracellular matrix (ECM) degradation and may play an important role in basal membrane (BM) damage in LP. Fibronectin (FN) mediates a variety of cellular interactions with ECM and plays important roles in cell adhesion, migration, growth and differentiation. Objective: To determine MMP-2, MMP-3, MMP-9 and FN expressions in LP and discuss the possible associations. Materials and methods: Skin biopsy samples of 55 patients with LP and 11 normal skin were investigated. Five discoid lupus erythematosus (DLE) and 5 chronic dermatitis (CD) samples were also examined for comparison. Immunochemical stainings were performed for MMP-2, MMP-3, MMP-9 and fibronectin. Results: Weak or absent expressions of MMP-2 and MMP-3 in epidermis; and dense MMP-9 expression in dermal inflammatory infiltrate cells were detected in LP. FN expression was lost in epidermal basal layer and papillary dermis. Conclusion: Loss of MMP-2, MMP-3 and FN in LP can be explained with the destruction of the epidermal basal layer. Similar expressions of MMP-2 and MMP-3 both in LP and DLE implied that these MMPs may be involved in the pathogenesis of interface dermatitis.
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    Low-Level Laser Therapy is More Effective Than Pulse Ultrasound Treatment on Wound Healing: Comperative Experimental Study
    Tikiz, C; Angin, A; Demireli, P; Taneli, F; Özyurt, B; Tüzün, Ç
    Objective: To investigate and compare the effects of pulse ultrasound (US) and low-level laser therapy (LLLT) on wound healing. Material and Methods: Thirty-two rats were included in the study and two full-thickness skin wounds were made on dorsum area of the rats bilaterally, with a 17 mm hole-punch. The animals were divided into two groups. Pulsed US (with a power of 0.1 W/cm(2), a frequency of 1 MHz, 5 minutes daily) was applied to to the right sided wounds of Group A (n=16) and Ga-As laser (830 nm wavelength, 0.5 J/cm(2) dosage of 1 MHz frequency for 1 minute duration) was applied to right sided wounds of Group B (n=16). Left sided wound were considered as controls and same procedures were applied without any current (sham). Biochemical and histopathological evaluations were performed in each group on 7(th) and 15(th) days. Results: Inflammatory cells tended to decrease in both treatment groups on the 7(th) day, however, this finding did not reach a statistical significance (p>0.05). Fibroblasts and collagen were found to be significantly increased in the laser group when compared to the other group on the 7(th) day (p<0.05). Angiogenesis was found to be significantly increased only in the laser group when compared to the other group on the 15(th) day (p<0.05). There were no significant differences in tissue nitric oxide values between the groups although the values in the laser group tended to be higher on the 15th day (p=0.058) Conclusion: In this comparative study. LLLT was found to significantly accelerate mainly proliferative phase while pulse US had no effect on wound healing. Our results support the consideration that LLLT may constitute a beneficial treatment modality for wound healing.
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    Perfusion CT evaluation in experimentally induced testicular torsion
    Ovali, GY; Yilmaz, O; Tarhan, S; Genc, A; Demireli, P; Tunçyurek, O; Unden, C; Taneli, C; Pabuscu, Y
    Introduction: in this Study, we define the characteristics of perfusion computed tomography (CT) in an experimental model of testicular torsion. Methods: Twenty male Sprague-Dawley rats were included for the study. Torsion was applied to 10 rats and perfusion CT was performed in the first hour to evaluate the following perfusion parameters: blood flow (BF), blood volume (BV) and time to peak (TTP) values. Detorsion was done for the same rats, and perfusion CT was repeated 2 hours later to evaluate reperfusion. Ten rats were left as part of the control group. Results: There is significant statistical correlation between the BF and BV values in the torsion and control groups (p = 0.001 and p = 0.001, respectively). There is no statistical correlation of the TTP parameters between the groups. No correlation was found between torsion and detorsion perfusion parameters. Conclusion: Perfusion CT can demonstrate the testicular perfusion insult in an experimental model of torsion. Perfusion CT may be an alternative method for diagnosis of torsion in indeterminate cases. Following detorsion an interval of 2 hours is not sufficient for demonstrating luxury perfusion of the testis.
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    Chondroid chordoma of the thoracic spine: Case report
    Demireli, P; Ovah, GY; Yegen, G; Temiz, G; Tarhan, S
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    A rare disorder: idiopathic tumoral calcinosis
    Ovali, GY; Tarhan, S; Serter, S; Bayindir, P; Okcu, G; Demireli, P; Pabuscu, Y
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    Flexural follicular lichen planus
    Gunduz, K; Sacar, T; Inanir, I; Demireli, P
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    A case of mycetoma successfully treated with itraconazole and co-trimoxazole
    Gündüz, K; Örgüç, S; Demireli, P; Inanir, I; Sürücüoglu, S; Ovali, GY
    A 29-year-old woman with swelling, multiple nodules and discharging sinuses of her right foot is presented. A single nodule on the sole was excised 15 years ago and since then she has had recurrent attacks of swelling and discharging sinuses that improved partially with antibiotics. Magnetic resonance images (MRI) revealed an ill-defined mass predominantly with low signal intensity on T2W images. Within the granulomata, multiple unenhancing foci, with low T1W and T2W signal most likely representing the fungal balls or grains were detected. Histopathological examination revealed large clusters of microorganisms resembling fungal hyphae and bacteria, which were surrounded by mixed inflammatory infiltrate cells and stained positively by PAS and Gomori's methenamine silver stain. As minimal regression was seen on MRI with 4 months' itraconazole (200 mg day(-1)) treatment, co-trimoxazole (160 TMP/800 SMX b.i.d.) was added to treatment. Complete remission was established by MRI examination after 10 months with this combination therapy.
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    DESMOID TUMOR MIMICING BREAST CARCINOMA
    Göktan, C; Örguç, S; Ovali, GY; Demireli, P; Yavuz, K
    A desmoid tumor located at the right axilla of a 44 year old women mimicing breast carcinoma with physical examination, imaging and histopathologic findings is presented since it's a rare disorder. Desmoid tumor is a rare benign process where definitive diagnosis is usually established on histopathological examination. Locally aggressive benign tumors must be considered in differential diagnosis of atypical cases of breast carcinoma.
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    Endobronchial metastasis from urinary bladder cancer
    Sakar, A; Gencer, N; Demireli, P; Müezzinoglu, T; Celik, P; Yorgancioglu, A
    A rare case, a case of endobronchial metastasis from urinary bladder carcinoma is reported. A 70 years-old man was addmitted with hematuria. He has a mass in urinary bladder and a mass in lung. He has no pulmonologic symptom. He is a smoker with 75 pack-years. Thorax computerized tomography revealed a mass in left lung upper lobe. Bronchoscopy demonstrated an endobronchial tumor in left upper lobe, apikoposterior segment. Histopathologically diagnosis was endobronchial metastasis from urinary bladder carcinoma. He received five courses of chemotheraphy (cisplatin + gemcitabine). The mass was regressed after three months. Our patient lived for one year from diagnosis.