Ahmet Ender Demirkiran

Adnan Menderes University, Güsel Hissar, Aydın, Turkey

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Publications (11)12.24 Total impact

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    Fatma Demirkiran · Hedef Ozgun · Mehmet Eskin · Gulengun Turk · Rahsan Cam · Ozlem Ozgun · Ahmet Ender Demirkiran ·
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    ABSTRACT: The aim of the study is to describe the cognition of breast cancer with respect to knowledge, beliefs, attitudes and behavior in a group of gestational age Turkish women. A questionnaire survey was therefore performed on 201 randomly selected women registered to the health database in Aydin. In age, marital status, and occupation were found to significantly impact on breast self-examination (BSE) performance, which should still be considered as an important tool for early diagnosis, although it does not substitute clinical examination and education. As delayed diagnosis is the leading problem in the management of disease, well-structured education should be supported to increase awareness of breast cancer. Given to the remarkable role of nurses in the community on women's health, a more focused approach on education of young female populations by nurses in Turkey should be considered.
    Asian Pacific journal of cancer prevention: APJCP 01/2011; 12(1):277-82. · 2.51 Impact Factor
  • A E Demirkiran · M Balkaya · P Tuncyurek · M H Cevikel · N Culhaci · M Iyigor · H Ozgun · N Aydin · S Boylu ·
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    ABSTRACT: Obstructive jaundice promotes bacterial translocation from the gut, but the role of nitric oxide is controversial in this process. We studied the effects of nitric oxide synthase substrate, L-arginine, and nitric oxide synthase inhibitor, N(G)-nitro-L-arginine methyl ester, on bacterial translocation in bile duct ligated rats. The animals were randomized into five groups; control, sham, common bile duct ligation alone, nitric oxide inhibition, and nitric oxide supplementation. Obstructive jaundice was performed with common bile duct ligation. L-arginine or N(G)-nitro-L-arginine methyl ester was injected once daily for 14 days. Blood bilirubin level, liver histology, and bacterial translocation to the mesenteric lymph nodes as well as to the liver were assessed. The L-arginine supplemented group had the lowest bacterial translocation rate, but the most prominent hepatic fibrosis. Nitric oxide inhibition increased bacterial translocation to the mesenteric lymph nodes. Therefore, the administration of nitric oxide donor or inhibitor acts as a significant regulatory factor for bacterial translocation in obstructive jaundice.
    Acta chirurgica Belgica 04/2006; 106(2):202-5. · 0.41 Impact Factor
  • S Boylu · H Ozgun · P Tuncyurek · C Yenisey · N Culhaci · H Erpek · A E Demirkiran ·
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    ABSTRACT: In this study, we investigated the effects of synchronous anastomosis on intestinal healing in experimental colonic resection. Sprague-Dawley rats were randomized into 3 groups; control (group I), single anastomosis (group II) and synchronous (double) anastomosis (group III). Single and proximal anastomoses were located 3 cm distal to caecum, and distal anastomoses were done 3 cm distal to them. On the 7th postoperative day, bursting pressure, hydroxyproline level and histology of the anastomotic site were assessed. Bursting pressures and hydroxyproline levels indicated that impaired healing of proximal anastomoses in group III was evident. Proximal anastomoses in group III had the lowest hydroxyproline value and bursting pressure level. Significant fibrosis was observed in the histological examination of distal anastomoses in group III. Double colonic anastomoses is not as safe as single anastomoses and involves additional risk. The healing of proximal anastomosis is significantly altered after experimental synchronous resection.
    Acta chirurgica Belgica 12/2005; 105(6):649-52. · 0.41 Impact Factor
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    ABSTRACT: C-reactive protein (CRP) is used as a marker of intestinal ischaemia. This study evaluated whether CRP levels can be used to detect ischaemia-induced (strangulated) intestinal obstruction and subsequent bacterial translocation. Forty-eight rats, divided into four groups underwent the following procedures: anaesthesia alone (native controls), laparotomy (sham-operated controls), or surgical induction of simple or strangulated intestinal obstruction (simple and strangulated obstruction groups, respectively). Blood samples were collected for culture and serum CRP analysis. In addition, liver and mesenteric lymph node (MLN) specimens were collected for culture, to determine the presence of bacterial translocation; and ileal segments, for histopathological investigation. CRP levels and rates of bacterial translocation, expressed as colony forming units (cfu) per gram wet tissue, were higher in both intestinal obstruction groups than in the native and sham-operated control groups (P < 0.001 for both). The increases in CRP levels paralleled increases in the number of cfu in the MLN and liver cultures (P < 0.01). Compared to controls, animals in the obstruction groups also had a higher incidence of positive blood cultures (P < 0.005) and greater histopathologic evidence of inflammatory infiltration of the lamina propria (P < 0.01). However, no significant difference between the simple and strangulated obstruction groups was observed. CRP levels increase with the severity of bacterial translocation in acute intestinal obstruction but do not permit discrimination between simple and strangulated intestinal obstruction.
    ANZ Journal of Surgery 11/2004; 74(10):900-4. DOI:10.1111/j.1445-1433.2003.02681.x · 1.12 Impact Factor
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    ABSTRACT: Elevated intra-abdominal pressure and colostomy have adverse effects on colonic anastomoses. The aim of the present study was to investigate the effects of laparoscopic colon surgery with and without diverting colostomy on healing of colonic anastomoses in an experimental model. Thirty-six male rats were divided into three equal groups: group 1, control (colonic anastomosis and anaesthesia for 180 min only); group 2, 180 min pneumoperitoneum and colonic anastomosis; and group 3, similar to group 2 with a proximal colostomy. On day 7, bursting pressures, tissue hydroxyproline and nitric oxide concentrations and histopathological inflammation scores were determined and compared. Mean bursting pressures were higher in the control group than the two pneumoperitoneum groups (P=0.0003). Mean tissue hydroxyproline concentrations showed no difference (P>0.05). Mean tissue nitric oxide concentrations were significantly increased in the control group (P=0.0013). Histopathological scores demonstrated increased inflammatory response in group 3 compared to the controls (P=0.0009). Pneumoperitoneum delays collagen maturation and impairs anastomotic strength in the colon. Following pneumoperitoneum, performance of a diverting loop colostomy to protect the anastomosis will not have additional detrimental effects on anastomotic healing.
    ANZ Journal of Surgery 03/2004; 74(3):158-63. DOI:10.1046/j.1445-1433.2003.02918.x · 1.12 Impact Factor
  • Mustafa Sare · Ahmet Ender Demirkiran · Nese Tastekin · Bengül Durmaz ·
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    ABSTRACT: Previous reports of recurrent intra-abdominal abcess formation after the laparoscopic treatment of perforated acute appendicitis led us to investigate the possible effects of gas insufflation on the spread of infection. We previously showed that Escherichia coli counts were significantly higher in a laparoscopy group that underwent carbon dioxide (CO2) insufflation than in control and laparotomy groups. The aim of this study is to investigate the effects of intra-abdominal CO2 and nitrous oxide (N2O) insufflation on anaerobic bacterial growth in a rat model. A standard strain of Bacteroides fragilis (ATCC 25285) was injected intraperitoneally (1 x 10(6) cfu/mL per kilogram) in 40 Wistar rats under sterile conditions. Forty rats with induced peritonitis were randomly divided into five groups: control, laparotomy, CO2 insufflation, N2O insufflation, and one group without pneumoperitoneum. Eight hours after the intraperitoneal injection of B. fragilis, peritoneal aspirates were obtained and inoculated onto Brucella agar. At the sixteenth hour of induced peritoneal infection (corresponding to hour 8 in the laparoscopy groups) all animals underwent laparotomy; peritoneal aspirates were obtained and inoculated into Brucella agar for bacterial counts. The colonies of B. fragilis were counted manually, and the results were expressed as the mean number of colony-forming units per milliliter. No significant differences in microorganism counts were noted between the study groups before the procedure (p>.05 for all comparisons). We observed a significant increase in the number of bacteria (mean +/- SD) in the CO2 insufflation group between hour 8 and hour 16 of peritoneal contamination. The results suggest that CO2 insufflation may promote the growth of intra-abdominal anaerobic bacteria. Such bacterial growth may lead to intra-abdominal abcess formation or cause localized peritonitis to develop into generalized peritonitis. We suggest that laparoscopy without pneumoperitoneum may be preferred in patients with peritonitis.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 07/2003; 13(3):175-9. DOI:10.1089/109264203766207690 · 1.34 Impact Factor
  • Ahmet Ender Demirkiran · Hedef Ozgün · Muharrem Balkaya · Hakan Cevikel · Nil Culhaci · Mehmet Gürel ·
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    ABSTRACT: This study was performed to describe a new model of strangulation obstruction mimicking the situations relevant to abdominal hernias. The strangulation obstruction was induced either by intra-abdominal ligation of an ileal segment 2 cm in length (n = 20) or by a pursestring suture around a fascial defect with a strangulated intestinal loop placed subcutaneously (n = 20). Ten animals served as sham operated controls (n = 10). All animals were euthanized at 12 h postoperatively; strangulated ileum segments were collected for histopathological examination. Microscopic injury scores were similar in both strangulation groups, which were significantly different from the control group (p <.001). The model described here seems to be appropriate for use in further experimental studies concerning strangulation obstruction injury and its consequences, with the added advantage of visualization of the strangulated intestinal loop beneath the skin.
    Journal of Investigative Surgery 03/2003; 16(2):93-7. DOI:10.1080/713829592 · 1.16 Impact Factor
  • Mehmet Hakan Cevikel · Hedef Ozgün · Sükrü Boylu · Ahmet Ender Demirkiran · Serhan Sakarya · Nil Culhaci ·
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    ABSTRACT: The role of nitric oxide (NO) in bacterial translocation (BT) associated with acute pancreatitis is controversial. We investigated the effects of the NO synthase substrate, L-arginine, and the NO synthase inhibitor, N-nitro-L-arginine methyl ester (L-NAME), on BT in caerulein-induced acute pancreatitis in rats. Acute pancreatitis was induced by subcutaneous injections of caerulein (12 microg/kg) at 6-hour intervals for 2 days. Subcutaneous injections of L-arginine (100 mg/kg) or L-NAME (10 mg/kg) were administeredonce daily for 2 days. At 48 h, pancreatic injury and BT to the mesenteric lymph nodes (MLN), liver, and peritoneum were assessed. Compared with controls, rats that received caerulein injections alone had increased BT to the MLN and pancreatic inflammatory changes. L-Arginine significantly reduced the inflammation and BT caused by caerulein. L-NAME did not significantly alter pancreatic inflammation. Although caerulein + L-NAME-treated rats had increased BT to the peritoneum, MLN, and liver compared with controls, rates of BT did not significantly differ between caerulein alone- and caerulein + L-NAME-treated rats. In acute edematous pancreatitis, BT is increased and is regulated by NO. NO substrates limit BT and pancreatic inflammation associated with acute pancreatitis, probably by their bactericidal actions and ability to improve pancreatic blood flow.
    Pancreatology 02/2003; 3(4):329-35. DOI:10.1159/000071772 · 2.84 Impact Factor
  • Ahmet Ender Demirkiran · Hedef Ozgun · Serdar Mustafa Ozbas · Ali Dogan Bozdag · Alev Akdilli ·
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    ABSTRACT: Behcet' s Disease (BD ) is a complex multisystemic disease, which is characterized by recurrent oral and genital aphteous ulcers and iritis in which vasculitis can also be one of the possible clinical manifestations. A thirty seven year-old female patient with incomplete BD was admitted to emergency service, with intra-abdominal hemorrhage more severe than that would be expected, with the degree of related trauma. We decided to manage the patient conservatively, observing vital signs, haemogram, computed tomography (CT) and angiography instead. Subcapsular hematomas were detected in the right and left lobes of the liver. No data was encountered in the literature and textbooks referring to liver trauma with BD, except a case of fatal hemobilia. H ere in we present a liver trauma case with hemorrhage and hepatic fragility due to vasculitis in Behcet' s disease and review the literature. Key words: liver trauma, incomplete Behcet' s disease
    Ulusal travma dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2002; 8(4):253-5.
  • H. Özgün · Ş. Boylu · A.E. Demírkiran · M.H. Çevíkel · Ç. Yenísey · H. Erpek ·
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    ABSTRACT: Diverting colostomy reduces collagen accumulation, and decreases or delays the gain in anastomotic strength due to absence of intraluminal transit. As for loop colostomy, intact mesenteric side maintains the integrity of myoelectric activity, which in turn promotes to collagen synthesis. With these background information, the healing of colon anastomosis following loop colostomy comparing with diverting colostomy was investigated. Thirty rats were divided into three equal groups. Following colon resection, Group I had colon anastomosis only, Group II had colon anastomosis and diverting colostomy,and Group III colon anastomosis and loop colostomy. On the seventh postoperative day, anastomotic bursting pressures and tissue hydroxyproline levels in anastomotic segments of all subjects were determined. Bursting pressures of anastomoses in Group I was higher than in Group II and III (p=0,0024, one-way ANOVA). Tissue hydroxyproline levels in Group II were lower than in Group I and III (p<0,0001, one-way ANOVA). Although anastomotic strength decreases in loop colostomy, collagen accumulation similar to the levels of anastomoses without colostomy may be due to a delay in collagen maturation. Loop colostomy may be preferred to prevent anastomoses with minimal effects on healing.
  • Mustafa Sare · Ahmet Ender Demirkiran · Esra Alibey · Bengül Durmaz ·
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    ABSTRACT: Perforated appendicitis can be treated laparoscopically, but this approach is associated with a higher rate of intra-abdominal abscess. Pneumoperitoneum impairs the clearance of bacteria from the peritoneal cavity in experimental models of peritonitis. The aim of this study was to investigate the effects of intra-abdominal gas insufflation on bacterial growth in a rat model. The effects of intraperitoneal insufflation with different gases and a gasless model on bacterial proliferation in a setting of Escherichia coli-induced experimental peritonitis were studied in a rat model. Saline (0.25 mL) was given intraperitoneally to six Wistar male rats as the sham group. Escherichia coli (1.5 x 10(9) cfu/mL per kilogram) was injected intraperitoneally into to 24 rats. Microorganism counts were taken after 8 hours, and rats were divided into three groups: group 1, CO2 insufflation; group 2, N2O insufflation; and group 3, no insufflation. Microorganism counts were repeated 8 hours after the procedure (at 16 hours postinjection). The difference in microorganism counts between 8 and 16 hours were significant in the CO2 and N2O insufflation groups (P < 0.05) but not in the group without pneumoperitoneum. Abdominal insufflation may promote intra-abdominal bacterial growth or decrease intra-abdominal bacterial clearance.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 11/2001; 11(5):285-9. DOI:10.1089/109264201317054573 · 1.34 Impact Factor