Biomedical subjects
I Coskun
Publications and source records attributed to I Coskun.
Erythrocyte superoxide dismutase and glutathione peroxidase activities, and malondialdehyde and reduced glutathione levels in schizophrenic patients.
There is abundant evidence that free radicals are involved in membrane pathology in the central nervous system and that they may play a role in neuropsychiatric disorders, including schizophrenia. In this study, we investigated erythrocyte superoxide dismutase and glutathione peroxidase activities as antioxidant enzymes, malondialdehydes as a sign of lipid peroxidation, and reduced glutathione levels in schizophrenic patients. Activities of superoxide dismutase and levels of malondialdehyde in erythrocytes were greater in all patients (n=48) and in patients with acute (n=16) and chronic schizophrenia (n=32) (p<0.001 for all patients and chronic patient group; p<0.05 for acute patient group). The activities of glutathione peroxidase were lower in patients (p<0.05 for all patients and acute patient group; p=0.051 for chronic patient group) compared with the control group. Mean erythrocyte reduced glutathione was lower in patients than in controls (p<0.05). In the patient group, erythrocyte superoxide dismutase activity was positively correlated with scales and duration of disease and erythrocyte malondialdehyde concentration. These data reveal that antioxidative defense mechanisms might be impaired in schizophrenic patients.
Coronary artery aneurysm development after successful primary stent implantation.
This case report describes a patient who developed an aneurysmatic dilation of a coronary artery 6 months after successful primary stent implantatIon. The dilation occurred within the stented segment of the artery. To our knowledge, this is the first report of the development of an aneurysm, in the absence of angiographically visible dissection or other possible causative factors.
Laparoscopic versus open cholecystectomy: effect on pulmonary function tests.
BACKGROUND/AIMS: Operations often cause impairment in respiration due to pain. This study was designed to compare the changes in pulmonary function tests after open and laparoscopic cholecystectomy. METHODOLOGY: Two groups of 35 patients were randomly set up. Each patient had 3 pulmonary function tests performed and 2 postero-anterior grid chest roentgenograms taken. All of these data were evaluated by the same group of investigators. RESULTS: After taking into consideration the difference between pulmonary function tests, values were not significant (P < or = 0.05). All pulmonary function test values decreased significantly on the 1st postoperative day (P < or = 0.05). When postero-anterior chest roentgenograms were compared no clinically evident atelectasis except 3 lineary was seen in the laparoscopic cholecystectomy group, whereas 5 lineary, 7 focal, and 3 segmentary atelectasia were encountered in the open cholecystectomy group (P < or = 0.05). CONCLUSIONS: We believe that laparoscopic cholecystectomy has more advantages when speaking of postoperative pulmonary function tests and atelectasia.
The importance of intraoperative cholangiography during laparoscopic cholecystectomy.
Laparoscopic cholecystectomy (LC) using an electrosurgery energy source was successfully performed in 59 (95%) out of 62 selected patients. The procedures were performed by different surgical teams at Trakya University, Medical Fakulty, in the department of General Surgery and the Karl-Franzens-University School of Medicine, in the department of General Surgery. Cholangiography was routine at Karl Franzens University and selective at Trakya University. Laparoscopic intraoperative cholangiography (IOC) was performed in 48 (81.3%) patients, and open IOC was performed in 3 patients. Two patients had common duct stones; one of which was unsuspected preoperatively. These cases underwent endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic papillotomy (EP). One patient had a choledocal tumor, unsuspected preoperatively. Anatomical anomalies were not identified. Cholangiography could not be performed in one case in which there was no suspected pathology. ERCP was performed on one patient 30 days after being discharged because of acute cholangitis. In this case, residual stones were identified in the choledocus. Four patients underwent open cholecystectomy because of tumor, unidentified cystic duct or common bile duct pathology that could not be visualized on the cholangiogram. Our study suggests that cholangiography performed via the cystic duct before any structures are divided can prevent the most serious complication of laparoscopic cholecystectomy--common duct injury. We recommend that cholangiography be attempted on all patients undergoing LC.
The comparison of electron microscopy and scintigraphy in determining the protective effect of dimethylsulphoxide (DMSO) on ischemia/reperfusion injury through Pringle maneuver.
BACKGROUND/AIMS: We investigated the role of the electron microscopy and hepatobiliary scintigraphy in determining the effect of DMSO (dimethysulphoxide) and ischemia/reperfusion injury in the liver after the Pringle maneuver. METHODOLOGY: Twenty-four rabbits were divided into the following groups; A: Control group, B: Pringle, C: 10 mg/kg DMSO, D: 1 g/kg DMSO + Pringle. Group A was considered as a control group and only laparotomy was applied. Group B was exposed to Pringle maneuver only. Group C was given 10 mg/kg of DMSO via the vena cava inferior. Group D was given 1 g/kg of DMSO. A clamp was fastened for the groups of B, C and D in the 30th minute of the Pringle maneuver and a biopsy was applied five minutes later. Fifteen minutes later a dynamic hepatobiliary scintigraphy was applied. From dynamic images, liver peak time and activity half time of the liver were obtained. RESULTS: It was found that liver peak time and liver activity half time values of the group B, C and D were significantly longer than group A. Liver peak time and liver activity half time values of group B was not different from group C. However, some values of group D were found to be significantly shorter than groups B and C. In the electron microscopy examination, only in group B were some specific degenerative changes observed in the sinusoids. We observed less irreversible changes in group C than in group B. On the other hand, the least irreversible changes were in group D. CONCLUSIONS: As a conclusion, while electron microscopy is regarded as the "gold standard", hepatobiliary scintigraphy may be thought of as an easily applicable method in determining the ischemic reperfusion injury in the clinical comparison of the protective agents.
Retroperitoneal localization of hydatid cyst disease.
In this study we discuss a rare case; hydatid cyst disease that is located in the retroperitoneum. Two cases were treated in our department with hydatid cyst disease located in the retroperitoneum; one of the cysts was in the minor pelvis and the other was on the left psoas muscle. Diagnosis was confirmed with blood tests, and radiological examinations. The cyst wall was excised partially and was oversewn. Following the operation both of the patients were given albendasole tablets for 10 weeks with blood count and liver enzyme monitorization. Hydatic cysts located in retroperitoneum were treated successfully. Especially in the endemic areas hydatid cyst should be remembered when evaluating cystic masses in the retroperitoneum. It can be treated successfully with surgery.
The rupture of hepatic hydatid disease into the right hepatic vein and bile ducts: a case report.
Echinococcus granulosus and Echinococcus multilocularis cause liver hydatid disease. One of its most common complications is rupture into the bile ducts; however, penetration of a cyst into a vessel is a very rare complication. We detected a defect (2 x 1 cm) on the wall of the right hepatic vein, in addition to three distinctive ruptures into the bile ducts, in our case. For systemic hypotension due to a bleeding during operation and to repair the vessel wall defect, an urgent right thoracotomy followed by a radial phrenotomy was needed. We were able to reach the operation site easily and repaired the vessel wall with polypropylene suture. Because of the occurrence of these two complications together and the difficulties of the operation, we decided to report this case.
Simultaneous operation for coexisting lung and liver hydatid cysts: a treatment modality.
BACKGROUND/AIMS: Hydatid disease is very common in our region. Whether or not coexisting cysts of lung and liver should be operated on simultaneously is a challenging question. METHODOLOGY: Of 127 patients operated on for hydatid cysts of the lung between 1990 and 1995, 23 (18%) had coexisting hydatid cysts of the right lung and liver. There were 12 male and 11 female patients with an average age of 34 years. RESULTS: All patients had simultaneous operations for both organs via right thoracotomy with an incision in the diaphragm (phrenotomy). In the lung, cystotomy and capitonnage were performed in 21 patients and wedge resection in 2; in the liver, cystotomy and capitonnage were performed in all 23 patients. No hospital mortality occurred. CONCLUSION: Coexisting hydatid cysts of the right lung and liver should be surgically treated simultaneously.