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Mesut Tez

Publications and source records attributed to Mesut Tez.

At least 19 recordsLinked to original sources
PubMed2007

Comparison and validation of scoring systems in a cohort of patients treated for biliary acute pancreatitis.

OBJECTIVES: There are a few prospective studies assessing the severity of acute pancreatitis with exclusive criteria for biliary etiology. The aim of this study was to assess the reliability of prediction of the severity and mortality of acute biliary pancreatitis by using the Ranson, Acute Physiology And Chronic Health Evaluation II and III, Simplified Acute Physiology Score II, and Mortality Probability Model (MPM) II systems. METHODS: Fifty-eight patients with acute biliary pancreatitis were studied prospectively. Disease severity scores and mortality predictions were calculated using the collected data in the first 24 hours of admission and for Ranson score in the first 48 hours. Discrimination and calibration characteristics of each system were determined by using area under receiver operating characteristics curve and Hosmer-Lemeshow goodness-of-fit test, respectively. RESULTS: Among 58 patients included, there were 4 mortalities (6.8%). Fifteen patients (25.8%) had severe disease, and 5 patients (8.6%) had systemic and local complications. All systems had reliable power of discrimination and calibration. Among systems tested MPM II was the best performing as far as discrimination, and calibration characteristics are considered. The items of MPM II that were positive in patients with severe pancreatitis were those related to systemic perfusion. CONCLUSIONS: Mortality Probability Model II predicted mortality at admission is better than the other systems in predicting the severity of pancreatitis. Results also indicate the important role of systemic perfusion at the early phases of acute pancreatitis in the progression of disease.

APACHE↗
PubMed2006

Reprogramming of replicative senescence in hepatocellular carcinoma-derived cells.

Tumor cells have the capacity to proliferate indefinitely that is qualified as replicative immortality. This ability contrasts with the intrinsic control of the number of cell divisions in human somatic tissues by a mechanism called replicative senescence. Replicative immortality is acquired by inactivation of p53 and p16INK4a genes and reactivation of hTERT gene expression. It is unknown whether the cancer cell replicative immortality is reversible. Here, we show the spontaneous induction of replicative senescence in p53-and p16INK4a-deficient hepatocellular carcinoma cells. This phenomenon is characterized with hTERT repression, telomere shortening, senescence arrest, and tumor suppression. SIP1 gene (ZFHX1B) is partly responsible for replicative senescence, because short hairpin RNA-mediated SIP1 inactivation released hTERT repression and rescued clonal hepatocellular carcinoma cells from senescence arrest.

Animals↗
PubMed2006

Evaluation of P-POSSUM and CR-POSSUM scores in patients with colorectal cancer undergoing resection.

INTRODUCTION: The aim of this study was to evaluate the predictive accuracy of P-POSSUM and CR-POSSUM models on patients undergoing colorectal resection. METHODS: P-POSSUM and CR-POSSUM predictor equations for mortality were applied retrospectively to 321 patients who had undergone colorectal resection for cancer. P-POSSUM and CR-POSSUM scores were validated by assessing their calibration and discrimination. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and the corresponding calibration curves. Evaluation of the discriminative capability of both models was performed using receiver-operating characteristic (ROC) curve analysis. RESULTS: Overall, 22 deaths were observed. CR-POSSUM predicted 25 deaths (chi2 = 12.20, P = 0.13), and P-POSSUM predicted 29 deaths (chi2 =18.85, P = 0.002). ROC curves analysis revealed that CR-POSSUM has reasonable discriminatory power for mortality. CONCLUSIONS: These data suggest that CR-POSSUM may provide a better estimate of the risk of mortality for patients who undergoing colorectal resection.

Adolescent↗
PubMed2006

Value of preoperative serum CA 19-9 levels in predicting resectability for pancreatic cancer.

BACKGROUND: Pancreatic cancer carries a poor prognosis; at operation approximately 25% of patients will be found to have unresectable tumours even though CT has demonstrated that they are resectable. At our tertiary care centre, we wished to find out if there is an optimum cut-off value for the CA 19-9 level preoperatively that will indicate that the pancreatic cancer is unresectable despite radiologic imaging that suggests otherwise according to receiver operating characteristic (ROC) curve analysis. METHODS: Preoperative demographic data, clinical features and serum CA 19-9 levels were reviewed for 51 patients with pancreatic cancer who underwent laparotomy between 1998 and 2003. Preoperatively, resectability was determined from a complete history, physical examination and radiologic imaging. An ROC curve was constructed for the CA 19-9 levels. The sensitivity, specificity, positive and negative predictive values of CA 19-9 were calculated with several cut-off points. RESULTS: There were 18 (36%) resectable and 33 (64%) unresectable pancreatic cancers. The mean CA 19-9 level was 68.8 U/mL in the resectable group and 622 U/mL in unresectable group. When a CA 19-9 level of 256.4 U/mL was used as a cutoff point, the specificity and sensitivity was 92.3% and 82.4% respectively. CONCLUSION: Preoperative CA 19-9 levels may be a useful marker for determining preoperatively which patients have unresectable disease despite the demonstration on CT of resectable disease.

Adult↗
PubMed2005

Randomized, prospective comparison of postoperative pain in low- versus high-pressure pneumoperitoneum.

BACKGROUND: Reduced postoperative pain after laparoscopic cholecystectomy (LC) compared to open cholecystectomy (OC) may be able to be further optimized. To reduce pain, focus should be directed on the effects of individual components of pain. METHODS: A double-blind, randomized, controlled trial was carried out in a tertiary care hospital. Fifty-three elective patients with symptomatic gallstones were enrolled into the study. Patients were randomized to low- or high-pressure pneumoperitoneum groups. In all patients, gas pressure was set to 15 mmHg during placement of ports. Later on, in the low-pressure group, the rest of the procedure was performed at 10 mmHg pressure. At 6 and 24 h postoperatively, a short-form McGill Questionnaire (MPQ) was obtained from all patients. Patients were then asked to complete a 10-cm visual analogue scale (VAS) for abdominal pain. RESULTS: Pain scores were generally low for both groups. Statistical comparisons of mean cumulative McGill score and VAS abdominal pain scores in both groups did not reach statistical significance at 6 and 24 h after operation. CONCLUSION: There was no correlation between high- and low-pressure laparoscopy and postoperative pain after LC. Peritoneal stretching may be more responsible for shoulder pain but has less effect on intensity of abdominal pain or incisional pain. On the basis of these negative findings, routine use of low-pressure pneumoperitoneum for alleviation of postoperative pain following LC is not recommended.

Abdominal Pain↗
PubMed2004

External metallic circle in hepaticojejunostomy.

BACKGROUND: Biliary-enteric anastomosis especially Roux-en Y hepaticojejunostomy is frequently used for biliary diversion in benign biliary strictures. In this study, we present the results of hepaticojejunostomy with external metallic circle. METHODS: Hepaticojejunostomy with external metallic circle were performed in eight male Sprague-Dawley rats. At the end of the third month, anastomoses were analysed for patency and stability of external circles. RESULTS: Relaparotomy revealed that all the anastomoses were patent and circles were in original places. CONCLUSION: To provide the patency of narrow hepaticojejunostomy anastomoses, external metallic circle can be a good alternative to use of internal stents in suitable cases.

Anastomosis, Roux-en-Y↗
PubMedDate not supplied

Regional chemotherapy for advanced pancreatic carcinoma.

BACKGROUND/AIMS: Since 1990, 14 patients with advanced pancreatic cancer were treated by regional chemotherapy. Five patients had locally advanced unresectable cancer and 9 had locally advanced disease with liver metastasis. METHODOLOGY: Fourteen patients underwent laparotomy, splenic artery catheterization and received a mean therapy of 3.8 cycles and 3 patients had completed 6 cycles of chemotherapy. Every cycle given monthly consisted of 5-fluorouracil 600 mg/m2 3 days, mitomycin 10 mg/m2 1 day, and cisplatinum 60 mg/m2 1 day. Tumor response was evaluated on the basis of imaging methods, tumor markers and life quality marker pain relief. RESULTS: Four patients had stabilization, 4 had partial response, 5 had progression and 1 had complete response. Median survival was 8 months for the whole group. Palliation for pain was successful and 71.4% of the patients had pain palliation. One patient had complete, 1 patient had partial, 8 patients had stable pain relief. Four patients had poor response to treatment and had progressive pain. Side effects, mainly leukopenia and thrombocytopenia, occurred in 5 patients and responded to medical measures. Mild to moderate nausea and vomiting was common and they responded well to antiemetic treatment. CONCLUSIONS: Although the objective response rate of regional chemotherapy for overall survival is low, in an individual patient it may produce an adequate response and acceptable toxicity so that the patient experiences overall improvement in symptoms, and rarely as in one case in our group may be cured by this method.

Adult↗