E Tekin

Gazi University, Engüri, Ankara, Turkey

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Publications (18)12.47 Total impact

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    ABSTRACT: In the present study we aimed to determine the effect of an AT-II antagonist candesartan on pancreatic microcirculation in an experimental model of acute necrotizing pancreatitis. There were five study groups with 10 animals in each. Pancreatitis was induced by intravenous infusion of cerulein and coadministration of glycodeoxycholate into biliopancreatic canal. Candesartan is given at 6th and 18th hour to the 24th and 48th hour groups, respectively. At 24th and 48th hours; following anaesthesia laparotomy was performed and laser Doppler flowmetry was performed in the pancreatic tissue of the animals. Following scarification blood samples were obtained for amylase, myeloperoxidase, IL-6 and tumour necrosis factor alpha. Tissue samples from the pancreas were obtained for histopathological analysis, endothelial cell apoptosis (TUNEL assay) and matrix metalloproteinase-9 immunohistochemistry. Pancreatic microcirculation was higher in the candesartan treated groups (p < 0.05). Myeloperoxidase, IL-6 and tumour necrosis factor alpha was found to be lower in the candesartan treated groups (p < 0.05). The pancreatic edema and inflammation were found to be reduced in the candesartan treated groups (p < 0.05). Endothelial apoptosis was found to be reduced by cadesartan treatment but it did not reach statistical significance (p > 0.05). Tissue matrix metalloproteinase -9 levels were found to be reduced with candesartan treatment (p < 0.05). Treatment with candesartan in the early phases of acute necrotizing pancreatitis effective on microcirculation of pancreatic tissue (Tab. 3, Fig. 6, Ref. 28).
    Bratislavske lekarske listy 01/2015; 116(4):270-5. · 0.45 Impact Factor
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    ABSTRACT: Biopterin as a stable metabolite is produced by oxidation of 5,6,7,8-tetrahydrobiopterin (BH4). It is known that many diseases may cause changes in BH4 concentration and/or dihydropteridine reductase (DHPR) enzyme activity. There is only a limited number of studies correlating DHPR activity in malignancies. The main goal of the present study was to evaluate alterations in the DHPR activity and biopterin levels in patients with breast and thyroid cancers. The breast cancer patients (n=24) were compared to patients with benign breast diseases (n=19) and controls (n=30). In addition; the patients with thyroid cancer (n=17) were compared to patients with benign thyroid diseases (n=42) and the control group. We did not observe any significant difference between the benign disorders and the malignancies. Biopterin concentrations in patients with benign and malign thyroid and breast diseases were lower than the controls (all p <0.05). DHPR activities in thyroid diseases were significantly higher than the controls while insignificant decreases in DHPR activities in breast patients were detected. Our results suggested significant alterations in unconjugated pteridine pathway in thyroid and breast disorders.
    PTERIDINES 01/2010; 21(1):72-78. DOI:10.1515/pteridines.2010.21.1.72 · 0.96 Impact Factor
  • Toxicology Letters 10/2008; 180. DOI:10.1016/j.toxlet.2008.06.683 · 3.36 Impact Factor
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    ABSTRACT: Hyperthyroidism apparently does not protect the patients from thyroid cancer as believed before. In contrast, hyperthyroidism with concurrent thyroid cancer can be diagnosed after pathological examination of unsuspect nodules. The aim of this study was to evaluate the coexistence of hyperthyroidism and thyroid carcinoma and to discuss the advantages of total thyroidectomy in such cases. Between January 2002 and October 2004, 120 hyperthyroid patients underwent surgical treatment in our clinic. All patients with hyperthyroidism in this study underwent fine-needle aspiration biopsy and cytologic examination. Frozen section evaluation was performed in all of these patients during the operation. Among these patients 10 had concurrent thyroid cancer. Only one of these patients was examined by fine needle aspiration biopsy prior to operation, while the rest of malignancies was diagnosed from unsuspect nodules. The selection of appropriate operation procedure appears very important to find out and treat concurrent thyroid cancers. We diagnosed 90 % of thyroid cancers incidentally. If there are no technical difficulties, we prefer total thyroidectomy for the patients with toxic multinodular goiter and Graves' disease with nodules.
    Endocrine regulations 10/2005; 39(3):91-6.
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    ABSTRACT: Detection of a breast mass accompanied by a contralateral axillary lymphadenopathy presents a dilemma because of the possible presence of an occult breast cancer on the same side as the axillary lymphadenopathy. A patient presented with an axillary lymphadenopathy from an occult breast cancer and a synchronous contralateral breast cancer, for which the differential diagnosis was established through a significant difference in estrogen and progesterone receptor levels. The patient was treated with neoadjuvant chemotherapy followed by bilateral modified radical mastectomy, adjuvant chemotherapy, and adjuvant radiation therapy. She is alive and free of disease 1.5 years after the diagnosis.
    The Breast 05/2005; 14(2):157-62. DOI:10.1016/j.breast.2004.05.006 · 2.58 Impact Factor
  • A Ziya Anadol, Emin Ersoy, Ferit Taneri, Ercüment H Tekin
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    ABSTRACT: Mesenteric ischemia is a major cause of mortality in surgery. Despite the advances in medicine, considerable number of patients undergoes reoperations for a better assessment of intestinal viability. Although great majority of these second-look operations are "negative explorations," progressive nature of this devastating disease pushes surgeons to re-explore the abdomen. This study compares open and laparoscopic "second-look" procedures in patients with mesenteric ischemia. In the first group (n = 41), abdomen was closed and second-look laparotomy was performed to 23 patients. In the second group (n = 36), a 10-mm trocar was inserted before closing the abdomen and second-look intervention was performed by a telescope to 23 patients. Sixteen of relaparotomies in the first group (70%) revealed nothing and were unnecessary. Two patients (8%) in the laparoscopy group needed re-resection while 20 patients (87%) were rescued from unnecessary laparotomies. Conclusively, patients with mesenteric ischemia are "ill enough" to deserve the "minimal invasion" spirit of laparoscopic surgery.
    Surgical laparoscopy, endoscopy & percutaneous techniques 09/2004; 14(4):191-3. DOI:10.1097/01.sle.0000136677.39377.62 · 0.94 Impact Factor
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    ABSTRACT: Laparoscopic hernia repair has all the advantages of a tension free repair. This study compares the laparoscopic transabdominal preperitoneal (TAPP) approach with tension-free open hernia repair in terms of operative time, postoperative pain, hospital stay, complications, and cost. Open and TAPP repairs using polypropylene mesh were performed in two groups of 25 male patients. The difference in operative times between the groups was not significant. Mean pain scores (0-100) for the open group were 54.12 +/- 13.06 at 12 hours and 37.24 +/- 11.38 at 24 hours, significantly higher than the corresponding scores of 38.36 +/- 8.21 at 12 hours and 20.92 +/- 8.73 at 24 hours for the TAPP group (P < 0.05). The mean postoperative analgesic dose was 6.72 +/- 2.72 in the TAPP group, which was insignificantly lower than 7.52 +/- 2.00 in the open group. Mean hospital stay was 2.24 +/- 0.97 days in the open group and 1.52 +/- 0.51 in the TAPP group, which was significant (P < 0.05). Twenty patients (80%) in the TAPP group rated themselves highly satisfied with the surgery as compared to 11 patients (44%) in the open group (P < 0.05). There was no recurrence in either group during a mean followup period of 13.5 months (range, 8-28 months). Laparoscopic hernia repair was significantly more expensive than open (1100 US dollars versus 629 US dollars). TAPP repair is superior to open repair in terms of shorter hospital stay, lower postoperative pain, and better patient satisfaction. It is also safe, with no recurrence in a short-term period. This technique will be the operation of choice for the treatment of groin hernia after long-term results have been established in our center.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 07/2004; 14(3):159-63. DOI:10.1089/1092642041255414 · 1.19 Impact Factor
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    ABSTRACT: To compare the diagnosis of thyroid pathological findings by using frozen section and preoperative imprint. From January 1998 to December 1999, one hundred and three consecutive patients admitted to Department of Surgery, Gazi University Medical Faculty for thyroid operation, were prospectively included into the study. In all patients, imprint and frozen section were carried out from their suspected nodules and the results were compared with the permanent biopsy. Those findings used to find out sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of frozen section and imprint. Because of the definitive differentiation of malignant or benign lesions could not be done, three patient were excluded from the study. In our study; sensitivity, specificity, PPV, NPV and accuracy for imprints was found as 83.3%, 97.7%, 83.3%, 97.7% and 96% (respectively), while respective corresponding data for frozen section were 81.8%, 96.6%, 75%, 97.7% and 95%. In one patient, the pathological finding of follicular carcinoma as found by permanent section was accurately diagnosed by imprint, but missed by frozen section. Both the imprint and frozen section failed to diagnose two papillary carcinoma. Overall cancer rate among 103 patients was 12 % (nine papillary carcinoma, one Hürthle cell carcinoma and two follicular carcinoma). Both the frozen sections and imprints showed high sensitivity rate and similar accuracy rates. So, if there is no opportunity for frozen section, the imprints could be used. Furthermore, the use of imprints is less time consuming and less expensive than that of frozen sections.
    Endocrine regulations 07/2001; 35(2):71-4.
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    ABSTRACT: Assessment of malignancy criteria in Huerthle cell neoplasm. This study intends to review retrospectively the patients who were operated for Huerthle cell neoplasia at Gazi University, Department of General Surgery between January 1986 and October 1999. Pathological specimens from 63 patients (20 males and 43 females) were investigated in this study, 48 of which revealed Huerthle cell adenoma and 15 revealed Huerthle cell carcinoma. The mean age of the patients with Huerthle cell adenoma was 40.7+/-1.59 yr while it was 51.3+/-1.83 yr in patients with Huerthle cell carcinoma. Mann-Whitney U and Chi-square tests were used for statistical analysis. . Fifty-two of the 63 patients had fine needle aspiration (FNA) biopsy prior to operation, 49 of those were reported to have suspected Huerthle cell neoplasia (HCN) and three had suspected Huerthle cell carcinoma (HCC). The sensitivity of FNA for HCN was 20 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 76 %. For all patients, peroperative frozen section (FS) biopsy was examined. Fifty-nine of the FS specimens revealed HCN and four revealed HCC. The sensitivity, specificity, positive predictive value and negative predictive value of FS biopsy were 27 %, 79 %, 28.5 % and 77.5 %, respectively. In this retrospective study, there was a statistically significant correlation between malignancy and the size of the tumor (P<0.05) according to Chi-square test, and also a statistically significant correlation between malignancy and the age of the patient (P<0.05) according to Mann-Whitney U test. In cases where FS and FNA biopsies cannot adequately define the benign or malignant behaviour of the tumor, the age of the patient and the diameter of the tumor must be taken into consideration for accurate surgical strategy. Particularly for 50 year-old and elderly, incidence of malignancy is statistically significant without considering sex of the patient.
    Endocrine regulations 03/2000; 34(1):19-21.
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    ABSTRACT: The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor alpha (TNF-alpha) and serum triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting pressure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-alpha release from macrophages and monocytes, and the stabilizing effect on the neutrophils.
    Surgery Today 02/2000; 30(10):896-902. DOI:10.1007/s005950070041 · 1.21 Impact Factor
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    ABSTRACT: Glutamine (Gln), which is the most abundant free amino acid in the circulation, and also a primary fuel for rapidly dividing cells, was used to determine its effects on incisional healing. The effect of Gln-enriched feeding was investigated using tensile strength measurement, which reflects the quality and speed of regeneration, and by the measurement of tissue hydroxyproline level which correlate directly with the collagen content of wounds. Forty albino Wistar rats in four equal groups received a special diet 7 days prior to surgery and 7 days after surgery. On the 7th day of study a 5-cm dorsal midline skin incision was made and then closed by interrupted sutures. Group 1 received a normal diet for all 14 days; group 2 received a Gln-enriched diet 7 days prior to surgery and a normal diet 7 days after surgery; group 3 received a normal diet prior to surgery and a Gln-enriched diet after surgery; group 4 received a constant Gln-enriched diet. On the 7th postoperative day, tensile strength measurements and hydroxyproline level analyses were done. A preoperative Gln-enriched diet did not show any significant improvement in the tensile strength and hydroxyproline levels on the 7th postoperative day, but a pre- and postoperative, and a postoperative Gln-enriched diet significantly improved the tensile strength and hydroxyproline levels when compared with the normal diet group (P<0.0001). These findings show that wound healing is better when Gln was added in the postoperative, or both pre- and postoperative periods, but not when only added in the preoperative period.
    European Journal of Plastic Surgery 01/2000; 23(2):78-81. DOI:10.1007/s002380050019
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    ABSTRACT: Breast cancer refractory to known effective agents is one of the major clinical problems frequently encountered in practice. Cisplatin and vinorelbine are known to be active drugs in anthracycline-refractory cases. In this phase II study, the effectiveness and tolerability of cisplatin and vinorelbine was investigated when used in combination as a salvage regimen in the treatment of metastatic refractory breast cancer. Twenty-four patients with advanced refractory breast cancer who had been previously treated with a regimen containing doxorubicin were included in the study. Six of the 24 patients also received taxanes after failure of doxorubicin. Cisplatin at 80 mg/m2 on day 1 and vinorelbine at 25 mg/m2 on days 1 and 8 were given every 3 weeks. A total of 98 cycles of chemotherapy was given, with a median of 4/patient. The response rate was 25% (2 [8.3%] complete and 4 [16.7%] partial responses). The median survival rates were 14 months in responders and 5.5 months in nonresponders (P = 0.0282). One complete and one partial response were observed in patients previously treated with paclitaxel (overall response rate, 33%). The median response duration was 12.5 mo (range, 4-21) in complete and 4.5 mo (range, 1.5-13) in the partial response group. Grade 3 and 4 neutropenia occurred in 9 patients, with no toxic deaths. Grade 2-3 nausea and vomiting in 6 patients and grade 1 neuropathy in 1 patient were noted. Although the number of cases is insufficient to indicate that the combination will be effective, it is noteworthy in consideration of anthracycline and taxane refractory cases. A combination of cisplatin and vinorelbine seems to be a reasonable and acceptable choice as an alternative salvage regimen in such cases.
    Tumori 01/2000; 86(4):283-5. · 1.09 Impact Factor
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    ABSTRACT: In a double blind prospective clinical study to evaluate the diagnostic potential of peroperative fine needle aspiration cytology as compared to peroperative frozen section in thyroid surgery. The diagnostic value of one hundred consecutive preoperative (FNA) and peroperative fine needle aspiration (p-FNA), frozen section (FS) and permanent section (PS) examination for thyroid nodules were studied prospectively in order to assess and compare the accuracy, sensitivity and specificity. Out of 100 patients PS showed 11 % of malignancies, while p-FNA showed 5 % and FS showed 6% of malignant cases with no false positive, but with 6 and 5 false negative results, respectively. Thus, as compared with FS, one false negative finding was obtained by p-FNA in a case of malignant tumor which could be definitely ascertained by frozen section technique. However, concerning the benign nodules no differences were found between p-FNA and FS. Peroperative fine needle aspiration seems to be a useful method which can be properly performed because the nodule can be easily seen during the surgical procedure. However, further clinical observations of large numbers of patients are needed.
    Endocrine regulations 10/1999; 33(3):141-4.
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    ABSTRACT: The aim of the present study was to investigate the effect of endothelin-1 on the isolated distal ileum and proximal colon in an experimentally induced ileus in rats. Ileal and colonic contractions by endothelin-1, acetylcholine alone and with endothelin-1 were recorded both in normal and experimentally induced paralytic ileus in rats. In the control group, all the responses to acetylcholine were found to be potentiated significantly when used together with endothelin-1 but in paralytic ileus group, no detectable change was observed in the responses of the amine after administration of acetylcholine together with endothelin-1. This study indicates that endothelin-1 might have an effect on gastrointestinal motility and postoperative paralytic ileus.
    General Pharmacology 07/1999; 32(6):631-5. DOI:10.1016/S0306-3623(98)00264-X
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    ABSTRACT: OBJECTIVE: In the retrospective study to review the records of patients who had undergone thyroid surgery between 1986-1995 and to determine the need of frozen section (FS) following FNA biopsy. METHODS: The records of 2083 patients who had thyroid surgery in Gazi University Medical Faculty Department of General Surgery between 1986-1995 were retrospectively reviewed to determine and compare the accuracy and significance of fine-needle aspiration (FNA) cytology and intraoperative frozen section (FS). Results. In 61 patients, both FNA and FS diagnosis were available for the comparison with the final pathologic diagnosis. In 196 patients, FNA diagnosis was available for the comparison with the final pathological diagnosis by permanent section and in 377 patients FS diagnosis was available for the comparison with the final pathological diagnosis. The sensitivity value for detection of malignancy by means of FNA was 57.1 % compared to 82.2 % by means of FS, and FS diagnosis was more specific (99 %) than FNA diagnosis (90.9 %). FNA diagnosis of benign conditions was correct in 141 of 150 (94 %) patients. FS diagnosis of benign conditions was correct in 313 of 321 (97.5 %) patients. Nine patients had the FNA findings that were positive for malignancy and FS confirmed this diagnosis in 8 patients. Conclusions. FNA is an important diagnostic tool for eliminating benign nodules, but it is not perfect. FS is very important for determining the surgical procedure, and because of direct observation of suspicious nodule, it is even more accurate. Using these tools together is more reliable, since the number of false positive and false negative values is lower than if only the individuals methods are used.
    Endocrine regulations 01/1999; 32(4):187-191.
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    ABSTRACT: Diethyl maleate (DEM) which binds and thus depletes tissue glutathione levels was used to aggravate the injury and to determine its effect on incisional healing. A 5 cm dorsal midline skin incision was performed on 40 albino Wistar rats in two groups and then closed by interrupted sutures. Groups received 0.9% NaCl and DEM at a dosage of 1 mg/kg/day intraperitoneally for seven days, respectively. On postoperative days 7 and 14, histopathological assessment and tensile strengths were measured. The DEM treated group had a marked inflammation with poorly defined collagen formation and the tensile strength measurements revealed a significant decrease (p p
    European Journal of Plastic Surgery 01/1997; 20(6):306-309. DOI:10.1007/BF01387856
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    ABSTRACT: To investigate the efficacy and safety of neoadjuvant chemotherapy with docetaxel plus epirubicin with granulocyte colony-stimulating factor (G-CSF) support in locally advanced breast cancer patients. We retrospectively evaluated the records of 39 patients with locally advanced breast cancer. All of them received neoadjuvant epirubicin 75 mg/m(2) plus docetaxel 75 mg/m(2) every 3 weeks with G-CSF support. Responding patients were subjected to breast-conserving or modified radical mastectomy. Four (10.3%) patients achieved clinical complete response (cCR) and 25 (64.1%) clinical partial response (cPR). Pathologic complete response (pCR) was observed in 4 patients with cCR. Ten (25.6%) patients achieved stable disease (SD), while no patient had progressive disease (PD). Grade 3 and 4 neutropenia was observed in 6 (15.3%) and 4 cases (10.3%), respectively. Febrile neutropenia was observed in 2 (5.1%) cases and anemia in 7 (17.9%) cases. Grade 1/2 mucositis was observed in 12 (30.7%) patients and grade 1/2 peripheral neuropathy in 7 (17.9%) patients. Dose reduction was necessary in 4 patients with grade 4 neutropenia. The median disease-free survival was 60 months (95% CI: 41-79 months). Median overall survival was not reached. Five-year overall survival was 64.2%. The combination of docetaxel plus epirubicin was active and tolerable in neoadjuvant treatment of locally advanced breast cancer.
    Journal of B.U.ON.: official journal of the Balkan Union of Oncology 15(2):248-54. · 0.71 Impact Factor
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    ABSTRACT: Breast is the second most common site of cancer formation. It has been found that in patients with breast cancer DNA instability was enhanced and together with this enhanced damage, the DNA repair capacity which was estimated to contribute to the neoplastic transformation in the breast was decreased. The aim of the present study was to investigate the possible DNA damage in the peripheral lymphocytes among the patients with benign and malignant breast disorders in comparison to healthy controls by using the single cell gel electrophoresis (comet) assay. In this study, DNA damage of 28 patients with benign and 23 patients with malignant breast disorders operated in Gazi University, Medical Faculty, Department of Surgery were compared with 30 healthy controls comparable in sex, socioeconomic status and smoking habits with no history of any breast disease. Significant increases were observed in DNA damage in patients with benign and malignant breast disorders compared to the healthy controls. No significant difference was found between benign and malignant breast disorders. Beniğn ve maliğn meme tümörlü hastalarda DNA hasarının değerlendirilmesi Özet Meme, en sık kanser gelişen ikinci bölgedir. Meme kanseri hastalarında DNAda değişikliklerin arttığı ve bu hasar artışıyla birlikte memede neoplastik dönüşüme katkıda bulunan DNA onarım kapasitesinin de azaldığı bildirilmektedir. Bu çalışmanın amacı, beniğn ve maliğn meme rahatsızlığı bulunan hastaların sağlıklı kontrollerle karşılaştırmalı olarak olası DNA hasarlarını, tek hücre jel elektroforez (comet) yöntemi ile araştırmaktır. Bu çalışmada, Gazi Üniversitesi, Tıp Fakültesi, Cerrahi Anabilim Dalı'nda operasyon uygulanan 28 beniğn, 23 maliğn meme hastası ile cinsiyet, sosyoekonomik sınıf ve sigara içme alışkanlığı açısından eşleştirilmiş meme hastalık hikayesi bulunmayan 30 sağlıklı kontrolün DNA hasarı karşılaştırılmıştır. Beniğn ve maliğn meme hastalarında sağlıklı kontrollere kıyasla DNA hasarının arttığı gözlenmiştir. Beniğn ve maliğn meme hastaları arasında önemli fark bulunmamıştır. Anahtar Kelimeler: Meme kanseri, Beniğn meme hastalığı, Tek hücre jel elektroforez yöntemi, DNA hasarı, Comet yöntemi.