Publications (21)38.1 Total impact
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Article: The impact of preoperative immunonutrition and other nutrition models on tumor infiltrative lymphocytes in colorectal cancer patients.
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ABSTRACT: The importance of the alteration of tumor infiltrative lymphocytes (CD4(+), CD8(+), CD16(+), and CD56(+)) in colorectal cancer prognosis is well known. In this study, we analyzed the effect of preoperative immunonutrition and different nutritional models on the clinical condition of colorectal cancer patients. Twenty-eight colorectal cancer patients were grouped into 4 groups according to their nutrition regimens randomly and were given immunonutrition (IMN), standard enteral (SE), total parental nutrition (TPN), and normal nutrition (NN) regimens, all of which contained the same calorie-nitrogen content within a 7-day preoperative period. All patients had an endoscopic biopsy before and after the regimen, and the lymphocyte population infiltrating mucosal parts of the resected tumor tissue were evaluated. Immunohistochemical analysis of the tissue specimens was performed by staining with antihuman CD4(+), CD8(+), CD16(+), and CD56(+) antibodies. After nutrition, there were significant increases in each of the 4 groups of CD4(+) and CD8(+) cells within the tumor. Comparing the rates of augmentation, the increased rates of the CD8(+) cells infiltrating the tumor after nutrition in the patients who were fed with IMN were significantly more than the ones in other groups (P = .01). CD16(+) cell infiltration was significantly higher in all groups except the SE and IMN groups. The SE group had increased CD56(+) cell infiltration compared with the other groups. In the colorectal cancer patients who had nutrition in the 7-day preoperative period, except for the SE nutrition group, there were significant increases of infiltration of CD56(+) cells at the mucosal part of the tumor tissue within the CD4(+) and CD8(+) cell population. When postnutrition values were compared, there was a marked increase of CD8(+) cells in the IMN group.American journal of surgery 10/2012; 204(4):416-21. · 2.36 Impact Factor -
Article: Left gastric and right hepatic artery anomalies in a patient with gastric cancer: images for surgeons.
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ABSTRACT: Surgical resection remains the principal treatment for advanced gastric cancer, but one of the difficulties in a curative or extended gastrectomy is the identification of the vascular supply of the stomach. A patient had gastric cancer hospitalized for planning and performing his surgical therapy. A multidetector-row computed tomography scan showed us a large tumor mass and numerous lymph nodes invading perigastric and second tiers of stomach and revealed a left gastric artery and right hepatic artery in which branched directly from aorta. A 3-dimensional construction showed a demonstrative vascular anomaly as well during operation. We were able to perform total gastrectomy and D2 lymph node dissection as surgical therapy for patient. The patient's postoperative clinical course was uneventful, and after postoperative 36 months, there was no evidence of recurrence. We recommend that a multidetector-row computed tomography scan is very useful for the preoperative staging in gastric cancer patients because of its diagnostic value for showing any vascular anomaly and aiding in decision making on the appropriate surgical strategy.American journal of surgery 08/2011; 202(2):e13-6. · 2.36 Impact Factor -
Article: Impact of herniorraphy technique on testicular perfusion: results of a prospective study.
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ABSTRACT: Inguinal hernia repair is one of the most frequently performed operations. The Lichtenstein hernia repair is the most popular hernia repair technique in general surgical practice. However, totally extraperitoneal-preperitoneal hernia repair technique has been frequently used technique recently. The aim of this prospective, randomized, clinical study was to evaluate testicular perfusion after these 2 procedures. In our prospective randomized study, 32 male patients, aged 33 to 72 years who fulfilled the inclusion criteria underwent elective herniorraphy for groin hernia. The patients were randomly assigned into either Lichtenstein hernia repair (n=16) or totally extraperitoneal-preperitoneal hernia repair (n=16) group according to their admittance. Color Doppler ultrasonography of the testes was performed on all patients 1 day before the operation, 3 days and 6 months after the operation. The results of the resistive index of the both groups; Lichtenstein hernia repair and totally extraperitoneal-preperitoneal hernia repair are statistically insignificant in all preoperative, early and late postoperative periods (P>0.05). Either Lichtenstein hernia repair or totally extraperitoneal-preperitoneal hernia repair does not effect the testicular perfusion.Surgical laparoscopy, endoscopy & percutaneous techniques 06/2010; 20(3):186-9. · 1.23 Impact Factor -
Article: Gastric duplication cyst in an adult.
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ABSTRACT: Gastric duplication cyst which is a rare anomaly can also be observed in adulthood. Abdominal pain is the most common complaint in adults and most cases are discovered incidentally by radiological examination or gastric endoscopy. Preoperative diagnosis of gastric duplication is difficult and definitive diagnosis requires findings on laparatomy together with histopathological examination of the lesion. Gastric duplication cyst is primarily managed by complete excision. Gastric duplication cyst was suspected on gastric endoscopy and magnetic resonance imaging (MRI) of the abdomen in a 52-year-old woman presented with abdominal pain. She was treated by complete excision of the cyst and the diagnosis was confirmed with the operative findings and histopathological examination of the removed specimen.Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 05/2010; 20(5):335-6. · 0.34 Impact Factor -
Article: Ectopic breast carcinoma.
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ABSTRACT: A 47-year-old premenopausal woman had a swelling in right axilla which had been diagnosed as "ectopic breast tissue" with an incisional biopsy. A subcutaneous nodule appeared two years ago. The ectopic breast containing the mass was excised with axillary dissection. It was an invasive ductal carcinoma and metastasis was detected in one lymph node. She received local radiotherapy after 6 cycles of chemotherapy and has now been taking hormonotherapy. Ectopic breast tissue has potential for malignant transformation. As its carcinoma has a worse prognosis and a higher incidence of metastasis because of delayed diagnosis, prophylactic excision may be recommended.Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2009; 19(11):734-6. · 0.34 Impact Factor -
Article: The shrinking rates of different meshes placed intraperitoneally: a long-term comparison of the TiMesh, VYPRO II, Sepramesh, and DynaMesh.
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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. · 1.23 Impact Factor -
Article: The effect of ursodeoxycholic acid on liver regeneration after partial hepatectomy in rats with non-alcoholic fatty liver disease.
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ABSTRACT: Aim: To investigate the effect of ursodeoxycholic acid (UDCA) on liver regeneration following partial hepatectomy in rats with non-alcoholic fatty liver disease (NAFLD). Methods: UDCA was administered to seven rats (group 1) and physiological saline was administered both to seven rats (group 2) with NAFLD and to seven rats with normal livers (group 3). All rats underwent two-thirds hepatectomy and the remnant liver tissues were removed 48 h later. Mitotic index (MI) and levels of proliferating cell nuclear antigen (PCNA), glutathione (GSH) and malondialdehyde (MDA) were assayed. Results: MI and PCNA levels in group 2 were significantly lower than in groups 1 and 3, but the values in groups 1 and 3 were similar. The GSH levels of group 2 were significantly lower than those of group 3 in the hepatectomy tissues, and lower than those of groups 1 and 3 in the remnant tissues. The differences between GSH levels in groups 1 and 3 were not significant. MDA levels in hepatectomy and remnant tissues were significantly higher in group 2 compared to groups 1 and 3; values in groups 1 and 3 were similar. Conclusion: UDCA increases regeneration after partial hepatectomy in rats with NAFLD, possibly due to an attenuating effect on oxidative stress.Hepatology Research 05/2009; 39(8):814-21. · 2.20 Impact Factor -
Article: A rare case of duodenal duplication treated surgically.
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ABSTRACT: Duodenal duplication, a rare congenital malformation, can also be observed in adulthood. Although it can be cystic or tubular, communicating or non-communicating, cystic and non-communicating forms are the most common. Several complications, such as obstruction, bleeding, perforation and pancreatitis, may result. Optimal treatment is total excision, although endoscopic procedures have also been described in appropriate cases. If total excision is not possible, subtotal excision and internal derivation can be performed. The 38-year-old woman presented here had occasional attacks of abdominal pain and obstruction, and we considered the diagnosis of duodenal duplication by abdominal computerized tomography. As we confirmed the diagnosis with operative findings and histopathological signs, we treated her with subtotal excision and intraduodenal cystoduodenostomy.World Journal of Gastroenterology 03/2009; 15(7):882-4. · 2.47 Impact Factor -
Article: Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters.
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ABSTRACT: To evaluate the effects of preoperative immunonutrition and other nutrition models on the cellular immunity parameters of patients with gastrointestinal tumors before surgical intervention. In addition, effects on postoperative complications were examined. Patients with gastrointestinal tumors were randomized into 3 groups. The immunonutrition group received a combination of arginine, fatty acids and nucleotides. The second and third group received normal nutrition and standard enteral nutrition, respectively. Nutrition protocols were administered for 7 d prior to the operation. Nutritional parameters, in particular prealbumin levels and lymphocyte subpopulations (CD4+, CD8+, CD16+/56+, and CD69 cells) were evaluated before and after the nutrition protocols. Groups were compared in terms of postoperative complications and duration of hospital stay. Of the 42 patients who completed the study, 16 received immunonutrition, 13 received normal nutrition and 13 received standard enteral nutrition. prealbumin values were low in every group, but this parameter was improved after the nutritional protocol only in the immunonutrition group (13.64+/-8.83 vs 15.98+/-8.66, P=0.037). Groups were similar in terms of CD4+, CD16+/56, and CD69+ prior to the nutritional protocol; whereas CD8+ was higher in the standard nutrition group compared to the immunonutrition group. After nutritional protocols, none of the groups had an increase in their lymphocyte subpopulations. Also, groups did not differ in terms of postoperative complications and postoperative durations of hospital stay. Preoperative immunonutrition provided a significant increase in prealbumin levels, while it did not significantly alter T lymphocyte subpopulation counts, the rate of postoperative complications and the duration of hospital stay.World Journal of Gastroenterology 02/2009; 15(4):467-72. · 2.47 Impact Factor -
Article: Carcinosarcoma of the gallbladder: report of a case.
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ABSTRACT: Gallbladder carcinosarcoma is one of the rarest subsets of gallbladder malignancies. To date, only 34 cases have been reported in the English literature. Therefore the knowledge and experience regarding this disease is limited. This report describes a 70-year-old male patient who was diagnosed by documenting the epithelial and mesenchymal components with histopathological and immunohistochemical methods, and treated by a radical cholecystectomy. The pediculated polypoid tumor had filled the lumen, originating from the gallbladder fundus. The tumor infiltrated the surrounding connective and adipose tissue overlapping the muscular layer of its primary site, but had not perforated the serosa nor invaded the liver. The patient, who was treated only surgically, has remained healthy after 54 months of follow-up, which is the longest documented survival for this disease. This case indicates that curative treatment of a tumor confined to the gallbladder without liver or serosa invasion, or lymph node involvement, is therefore possible.Surgery Today 02/2009; 39(2):168-71. · 1.22 Impact Factor -
Article: Effects of N-acetylcysteine on regeneration following partial hepatectomy in rats with nonalcoholic fatty liver disease.
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ABSTRACT: To investigate the effect of N-acetylcysteine on regeneration following partial hepatectomy in rats with nonalcoholic fatty liver disease (NAFLD). N-Acetylcysteine was given to seven rats with NAFLD (group 1); physiological saline was given to seven rats with NAFLD (group 2); and physiological saline was given to seven rats with a normal liver (group 3). We performed two-thirds hepatectomy in all rats and removed the remnant liver tissue 48 h later to measure the mitotic index (MI), proliferating cell nuclear antigen, glutathione (GSH), and malondialdehyde (MDA) levels. Mitotic index values were significantly higher in group 1 than in groups 2 and 3, and higher in group 3 than in group 2. Proliferating cell nuclear antigen values were significantly higher in group 1 than in group 2, but no significant difference was found in comparison with group 3. Glutathione values in group 1 were significantly higher than in group 2 and MDA values in group 1 were lower than in group 2. There was no significant difference between groups 1 and 3 in GSH and MDA values, in both the two-thirds hepatectomy and 48-h tissues. N-Acetylcysteine enhanced regeneration after partial hepatectomy in rats with NAFLD. We believe that it exerted this effect through its influence on oxidative stress.Surgery Today 02/2009; 39(7):592-7. · 1.22 Impact Factor -
Article: Diagnostic value of plasminogen activity level in acute mesenteric ischemia.
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ABSTRACT: To investigate the changes in plasminogen activity level during mesenteric ischemia. We performed laparotomy in 90 female Wistar-Albino rats (average weight 230 g). In sham groups (SL) (Groups I and II) the superior mesenteric artery (SMA) and vein (SMV) were explored, but not tied. In SMA groups (Groups III and IV) the SMA was ligated, and in SMV groups (Groups V and VI) the SMV was ligated. On re-laparatomy 2 mL of blood was drawn at 1 h in groups I, III and V, and at 3 h in groups II, IV and VI. Plasminogen levels were assessed and comparisons were made between groups and within each group. The mean plasminogen activity in the SL group was significantly higher than SMA (25.1 +/- 10.8 vs 11.8 +/- 4.6, P < 0.001) or SMV (25.1 +/- 10.8 vs 13.7 +/- 4.4, P < 0.001) groups both at 1 h and at 3 h (29.8 +/- 8.9 vs 15.1 +/- 5.7, P < 0.0001; 29.8 +/- 8.9 vs 14.2 +/- 2.9, P < 0.0001). There were no significant differences between the values of SMA and SMV groups at 1 h (P = 0.28) and at 3 h (P = 0.71). In each group, plasminogen activity levels did not change significantly between the two measurements performed at 1 h and 3 h. We conclude that blood plasminogen activities decrease during early phases of both arterial and venous mesenteric ischemia which may be a useful marker for early diagnosis.World Journal of Gastroenterology 05/2008; 14(16):2540-3. · 2.47 Impact Factor -
Article: Intestinal obstruction due to spontaneous intramural hematoma of the small intestine during warfarin use: a report of two cases.
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ABSTRACT: Warfarin-dependent spontaneous intramural hematoma of the small intestine is a rare complication. The first symptom is usually abdominal pain, frequently accompanied by nausea and vomiting. In some cases, concomitant gastrointestinal bleeding might be seen. Ultrasonography and computed tomography are the most useful radiographic methods for the diagnosis of an intramural hematoma of the intestines. Although it is usually treated conservatively, surgical intervention is required in cases involving active bleeding, intestinal obstruction, or acute abdominal symptoms. Here we present two patients who were treated surgically. Both patients had intestinal obstruction and ischemia, and one had concomitant gastrointestinal bleeding and intussusception due to an intramural hematoma.European Journal of Emergency Medicine 11/2007; 14(5):272-3. · 0.90 Impact Factor -
Article: Case 108: sclerosing encapsulating peritonitis.
Radiology 04/2007; 242(3):937-9. · 5.73 Impact Factor -
Article: Case 98: primary serous papillary carcinoma of the peritoneum.
Radiology 10/2006; 240(3):905-9. · 5.73 Impact Factor -
Article: Effects of unfractionated heparin and low-molecular-weight heparin on colonic anastomoses in the presence of experimental peritonitis.
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ABSTRACT: We aimed at investigating the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on the healing process of colonic anastomoses in the presence of peritonitis which is known to adversely affect the healing process. Three groups of Wistar albino rats (n = 15 in each group) with experimental fecal peritonitis were studied. A 1-cm colonic segment was resected, and an end-to-end anastomosis was performed. The control group (group 1) was given no treatment; group 2 animals received 50 IU/kg s.c. UFH twice a day, and group 3 rats received LMWH at a dose of 1.5 mg/kg daily for 7 days postoperatively. Relaparotomy was done on day 7 in the surviving rats. The rats were sacrificed by resection of the colonic segment. The anastomosis bursting pressures were measured and the tissue samples from anastomosis lines were histopathologically examined. The bursting pressures were significantly higher in UFH and LMWH groups as compared with the controls (p = 0.021 and p < 0.001, respectively), while there was no statistically significant difference between UFH and LMWH groups. Positive bacterial culture results were more common in controls (90%) than in the other two groups (p = 0.029 and p = 0.002, respectively). Also the polymorphonuclear leukocyte counts were higher (p = 0.005) and the fibrin formation more common (p = 0.007) in the controls. On the other hand, the number of fibroblasts was higher (p = 0.002) and collagen formation and revascularization more frequent (p = 0.001 and p = 0.001, respectively) in the UFH and LMWH groups. UFH and LMWH may have positive effects on the healing process of colonic anastomoses in the presence of peritonitis.European Surgical Research 02/2006; 38(3):353-7. · 0.93 Impact Factor -
Article: Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis? A pilot study. Surgical method of sigmoid colon vaginoplasty in vaginal agenesis.
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ABSTRACT: The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are presented. Patients were between 18 and 37 years old. Ileum vaginoplasty and sigmoid colon vaginoplasty were carried out in two and nine cases, respectively. Ileum necrosis at donor site requiring ileum resection and bilateral ileostomy encountered in one of the cases was the major complication. Mild stenosis responsive to finger dilatation had been detected in two women with sigmoid vaginoplasty. Excess mucous production, long operation time, and shortness of mesentery of ileum led us to abandon ileum vaginoplasty, and sigmoid colon vaginoplasty was performed in the following cases with vaginal agenesis. All of the neovaginas were patent and functional. We suggest sigmoid colon vaginoplasty as the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, short recovery time compared with ileum vaginoplasties; and in patients reluctance to prolonged use of dilatators or in those who experienced previous failure of the other treatment modalities.International Urogynecology Journal 02/2006; 17(1):40-5. · 1.83 Impact Factor -
Article: Isolated duodenal rupture due to blunt abdominal trauma
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ABSTRACT: Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.Indian Journal of Critical Care Medicine. 01/2006; -
Article: Intestinal vaginoplasty: is it optimal treatment of vaginal agenesis? A pilot study
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ABSTRACT: The outcome of 11 cases with vaginal agenesis who underwent intestinal vaginoplasties are presented. Patients were between 18 and 37years old. Ileum vaginoplasty and sigmoid colon vaginoplasty were carried out in two and nine cases, respectively. Ileum necrosis at donor site requiring ileum resection and bilateral ileostomy encountered in one of the cases was the major complication. Mild stenosis responsive to finger dilatation had been detected in two women with sigmoid vaginoplasty. Excess mucous production, long operation time, and shortness of mesentery of ileum led us to abandon ileum vaginoplasty, and sigmoid colon vaginoplasty was performed in the following cases with vaginal agenesis. All of the neovaginas were patent and functional. We suggest sigmoid colon vaginoplasty as the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, short recovery time compared with ileum vaginoplasties; and in patients reluctance to prolonged use of dilatators or in those who experienced previous failure of the other treatment modalities.International Urogynecology Journal 12/2005; 17(1):40-45. · 1.83 Impact Factor -
Article: Extraperitoneal laparoscopic approach to Spigelian hernia combined with groin hernias.
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ABSTRACT: Spigelian hernia is a rare form of abdominal wall hernia. It occurs when peritoneum with or without organs or preperitoneal fat exists through a defect in the Spigelian fascia. A 63 year old male patient complaint of inguinal hernias and Spigelian hernia treated with laparoscopic approach that has been not previously reported in the literature. The use of the laparoscope has simplified the diagnosis, clarified its localization, and facilitated the subsequent repair of these hernias.Surgical laparoscopy, endoscopy & percutaneous techniques 09/2004; 14(4):204-6. · 1.23 Impact Factor
Top co-authors
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Institutions
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2004–2011
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Haydarpasa Numune Research and Teaching Hospital
İstanbul, Istanbul, Turkey
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2005–2006
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Zeynep Kamil Women's and Children's Disease Training and Research Hospital
İstanbul, Istanbul, Turkey
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