Gulistan Gumrukcu

Haydarpasa Numune Research and Teaching Hospital, İstanbul, Istanbul, Turkey

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Publications (10)21.03 Total impact

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    ABSTRACT: Acute and chronic humoral injuries in renal transplant recipients are the main reasons for graft rejection and failure. Histological and clinical characteristics of humoral rejection and symptoms are variable and not always helpful for differential diagnosis. Clinical monitoring of the allograft, an elevated serum panel-reactive antibody (PRA), and the presence of donor-specific antibody (DSA) during immune monitoring as well as C4d staining of biopsy material can establish the differential diagnosis. Even without a cellular component, humoral rejection reaction is serious because the target tissue is the graft endothelium. Because the kidney graft has a rich vascular structure this attack causes permanent injury to the kidney in the long term. Graft dysfunction in this setting is usually more severe, requiring dialysis therapy, compared with acute cellular reactions. Positive C4d staining of peritubular capillaries in biopsy material represent a hallmark of complement-dependent cytotoxicity, supporting the diagnosis of humoral rejection. We analyzed C4d staining as a hallmark of humoral rejection. From 2009 to 2011, we analyzed the relationship between pathological findings of C4d immunohistochemistry staining and the clinical outcomes of 45 kidney transplant recipients who underwent a kidney biopsy because of graft dysfunction due to possible humoral rejection. Biopsy specimens of 15 patients stained C4d positive; the remaining 30 showed negative results. Intravenous steroids, PP + IVIG with or without antithymocyte globulin (ATG), was administered for treatment. Sixty six percent (n = 10) of patients were C4d positive with 16% (n = 5) of those showing C4d-negative biopsy results, losing their grafts, and returning to hemodialysis. C4d staining refractory humoral rejection injury was related to poor graft outcomes.
    Transplantation Proceedings 07/2012; 44(6):1694-6. · 0.95 Impact Factor
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    ABSTRACT: Anastomotic dehiscence is a serious complication of colorectal surgery that causes death in up to 40% of cases in which it occurs. Edema and inflammation due to abdominal sepsis can prevent the use of standard management (i.e., colostomy, ileostomy or Hartmann's procedure), in which case alternative salvage repair methods are required. The present report describes the treatment of a 73-year-old female patient at high risk of mortality because of intraabdominal sepsis due to suture dehiscence following a right hemicolectomy and ileo-transversostomy. Several surgical repair procedures were tried, but all failed. We then used an expanded polytetrafluoroethylene (ePTFE) graft in salvage repair, and this approach proved successful. This is the first report to describe clinical, macroscopic and histopathological findings, following use of an ePTFE graft in colorectal repair in humans.
    Techniques in Coloproctology 08/2010; 16(2):169-73. · 1.54 Impact Factor
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    ABSTRACT: The aim of our study was to determine and compare the shrinking rates of different prosthetic materials used in ventral hernia repair and to establish a possible correlation with macroscopic adhesions, histopathologic inflammation, and fibrosis. Thirty-six Wistar albino rats were divided into 4 groups (T, V, S, and D). A midline laparotomy was performed under general anesthesia. A 30x40 mm-sized mesh was placed intraperitoneally and fixed with an interrupted 4/0 polypropylene suture to the anterior abdominal wall. In group T, TiMesh; group V, Vypro II; group S, Sepramesh; and group D, DynaMesh-IPOM were used. All rats were killed at the 90th day postoperatively and the mesh area and the shrinking rate were calculated. Each group was evaluated in correlation with shrinking, adhesion, histopathologic inflammation, and fibrosis, and compared with each other. The mean area was 1013.33 mm2 in the T group, 930.44 mm2 in the V group, 1024.44 mm2 in the S group, and 1073.8 mm2 in the D group. The shrinking areas were found as 186.67 mm2, 269.55 mm2, 177.55 mm2, and 126.2 mm2, respectively. The shrinking rates were statistically significant in each group. The lowest shrinking rate was found in group D and highest in group V, but the results were statistically insignificant. In terms of macroscopic adhesion, histopathologic inflammation, and fibrosis no statistically significant differences were found among all the groups in comparison with each other. Although the shrinking rate of DynaMesh is lowest among all the groups, the results are statistically insignificant. The results of our experimental study revealed no superiority in the means of mesh shrinkage among TiMesh, Vypro II, Sepramesh, and DynaMesh in the rats.
    Surgical laparoscopy, endoscopy & percutaneous techniques 09/2009; 19(4):e130-4. · 0.88 Impact Factor
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    ABSTRACT: Although asymptomatic prostatitis is the most common noncancer diagnosis as demonstrated histologically by biopsies, screening and identification before biopsy remain unclear. In this study we prospectively evaluate the efficacy of examination of post-prostatic massage urine for prediction of asymptomatic prostatitis in biopsies. A total of 161 consecutive men 50 to 80 years old with serum prostate specific antigen 4.1 to 10.0 ng/ml, normal digital rectal examination, no evidence of clinical prostatitis or urinary tract infection, who underwent 8 or 10-core prostate biopsies under transrectal ultrasonography guidance were included in the study. Immediate pre-biopsy leukocyte count in post-prostatic massage urine was determined per high power field (400 x). We selected 5, 7 and 10 leukocytes per high power field as cutoffs, and urine was examined for prediction of histological prostatitis. Histological diagnosis was prostatitis, benign prostatic hyperplasia and prostate cancer in 66 (41.0%), 63 (39.1%) and 32 (19.9%) patients, respectively. The mean number of leukocytes and percentage of positive post-prostatic massage urine microscopy for all cutoffs were significantly higher in subjects with prostatitis than in those without prostatitis (p <0.0001). Histological prostatitis was predicted most accurately by the 5 leukocyte cutoff (sensitivity 68.2%, specificity 82.1% and area under the receiver operating characteristics curve 0.75). In asymptomatic men with mild increases of prostate specific antigen histological evidence of prostatic inflammation is common. The leukocyte count in post-prostatic massage urine appears to be useful for screening of this condition before biopsy. Our data suggest that 10 leukocytes per high power field in post-prostatic massage urine, the usually applied cutoff, may be too high for the definition of prostatic inflammation.
    The Journal of urology 07/2009; 182(2):564-8; discussion 568-9. · 3.75 Impact Factor
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    ABSTRACT: Histopathological changes in nasal mucosa, trachea, and pulmonary system with exposure to chronic thinner inhalation have been studied in the literature. However, the possible changes in larynx mucosa, which is a part of the upper airway tract, have not been studied yet. The aim of this study is to determine the histopathological changes of rat larynx mucosa with exposure to chronic thinner inhalation. Randomized trial. The study was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. Fifty-one Sprague-Dawley rats were used throughout the experiment. Four groups of rats inhaled thinner in a glass cage for 2, 4, 8, and 12 weeks respectively. Seven rats inhaled only the air in the room as the control group. The comparison of inflammation and exocytosis in the control and 2 week groups revealed no significant difference (P>0.05), but from the beginning of 4 weeks of thinner inhalation, statistically significant differences were observed (P<0.05). From the beginning of 8 weeks of thinner inhalation, statistically significant differences were observed in larynx mucosa when we assessed metaplasia and cilia loss distribution among groups (P<0.05). On the basis of histopathological evaluations, it was shown that the harmful effect of inhalation of thinner in high concentrations to larynx mucosa is similar to the effect on other organs of the respiratory system.
    Otolaryngology Head and Neck Surgery 07/2009; 141(1):75-80. · 1.73 Impact Factor
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    ABSTRACT: We investigated whether Tempol, a water-soluble antioxidant, prevents the harmful effects of superior mesenteric ischemia/reperfusion on intestinal tissues in rats. The rats were divided into three groups of 10. In group 1, the superior mesenteric artery (SMA) was isolated but not occluded, and in groups 2 and 3 the superior mesenteric artery was occluded for 60 min. After that, the clamp was removed and reperfusion began. In group 3, 5 min before the start of reperfusion, a bolus dose of 30 mg/kg Tempol was administered intravenously and continued at a dose of 30 mg/kg for 60 min. All animals were euthanized after 24 h and tissue samples were collected for analysis. There was a significant increase in myeloperoxidase activity, malondialdehyde levels, and the incidence of bacterial translocation in group 2, with a decrease in glutathione levels. These parameters were found to be normalized in group 3. The intestinal mucosal injury score in group 2 was significantly higher than those in groups 1 and 3. Tempol prevents bacterial translocation while precluding the harmful effects of ischemia/reperfusion injury on intestinal tissues in a rat model of superior mesenteric artery occlusion.
    Surgery Today 02/2009; 39(5):407-13. · 0.96 Impact Factor
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    ABSTRACT: Summary Aim of this study is to investigate the impact of carboxymetylcellulose about adhesion formation, fibrosis and inflamation after thyroid region surgery in an animal model. Forty rats were grouped into four and a cervical midline skin incision was made. Both thyroid lobe were seen and they were sutured two times per lobe with silk suture in group I, II, III and IV. In addition this procesure a sheet of the Carboxymethylcellulose (CMC) membrane was placed on thyroid glands before closing in goup III and IV. Rats were sacrified at seventh day in groups I, III and at twenty-eighth day in groups II, IV. In all groups adhesion formation, fibrosis and inflamation were evaluated and compared statistically. The comparison of groups in terms of macroscopic adhesion, fibrosis and inflammation scores revealed a statistically significant difference between Group I and Group III, and Group II and Group IV. (P
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    ABSTRACT: Rupture of the mitral papillary muscle due to infective endocarditis is a very rare complication. There is no report regarding anterolateral papillary muscle rupture as a complication of infective endocarditis in the literature. We decided to report a case of anterolateral papillary muscle rupture due to infective endocarditis. Our case, which will be discussed later on, differs also in many ways from that in the literature.
    Echocardiography 10/2008; 25(8):901-3. · 1.26 Impact Factor
  • Transplantation 01/2008; 86. · 3.78 Impact Factor
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    ABSTRACT: Intracavitary tumors such as angiosarcomas are prone to embolize, and occlude valves and vessels. Intramyocardial tumors cause cardiac failure and arrhythmias. Pericardial tumors cause effusions which result in tamponade. It is very rare that an intracavitary tumor presents itself with a cardiac tamponade. A 32-year old woman presented to the emergency room with palpitation and shortness of breath. Her physical examination revealed pulsus paradoxus and jugular venous distention. The transthoracic echocardiography showed normal left ventricular function, and an intracavitary right atrial mass. As the patients clinical status deteriorated an emergency operation was performed. The hemorrhagic pericardial fluid was cytologically positive for malignant cells. Histopathological findings were indicative of an angiosarcoma.
    International journal of cardiology 10/2006; 112(2):e20-2. · 6.18 Impact Factor

Publication Stats

25 Citations
21.03 Total Impact Points


  • 2008–2010
    • Haydarpasa Numune Research and Teaching Hospital
      İstanbul, Istanbul, Turkey
    • Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center
      İstanbul, Istanbul, Turkey
  • 2009
    • Kafkas University
      Cars, Kars, Turkey