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Nermin Karahan

Publications and source records attributed to Nermin Karahan.

11 recordsLinked to original sources

New microvenous anastomosis model for microsurgical training: external jugular vein.

In microsurgical training, the femoral vein is used frequently for a microvenous anastomosis model. But the femoral vein in the rat does not completely simulate the human vein because of its thin wall, fragility, and tendency to collapse. These anatomic characteristics cause some difficulty in carrying out anastomoses in microsurgery training particularly for beginners. The authors propose the external jugular vein of the rat for microsurgical training in microvenous anastomoses. In 10 Wistar rats, the anatomy of the external jugular vein was studied by dissection and histology. Anatomic dissections demonstrate that the external jugular vein has an average diameter of 1.9 mm (range: 1.6 to 2.1 mm) without tendency to collapse. The vein is easily dissected without any accompanying anatomic structure for an average segment of 45 mm, allowing effortless approximator clamp placement. Comparison of its cross section with that of the femoral vein and other previously described models by light microscopy and scanning electron microscopy reveals a larger diameter and much thicker vessel wall with a prominent tunica media and adventitia. Based on the anatomic findings in 20 rats, the external jugular vein was anastomosed with end-to-end standard microsurgical technique using 8-0 (n = 10) and 10-0 (n = 10) nylon sutures. Results indicate a 100 percent patency rate immediately after the anastomosis for the two subgroups and 100 percent and 90 percent patency rates 1 week after the procedure for the 10-0 and 8-0 nylon suture groups, respectively. This model presents some advantages: the vein is easily dissected with the naked eye without using the operating microscope because it is the largest vein among the superficially located veins in the rat, and has a thick vessel wall without tendency to collapse. The operative area allows for training inbilateral microsurgical anastomoses using a single skin incision and is safe from autocannibalization. The model simulates clinical microvenous anastomosis better because of its similarities to human large diameter flap veins.

Anastomosis, Surgical↗

CD10 expression in urothelial bladder carcinomas: a pilot study.

OBJECTIVES: The aims of this study were to investigate the expression of CD10 in normal bladder tissue and urothelial bladder carcinomas and to clarify its association with histopathological variables. MATERIALS AND METHODS: A total of 79 urothelial bladder carcinomas were selected from routine archival material. All cases were reevaluated histopathologically and graded according to the World Health Organization (WHO) 1973, WHO/ISUP 1998, and WHO 1999 systems. The TNM system was used for their pathological staging. CD10 immunohistochemical staining was performed in selected slides. RESULTS: Tumoral cases consisted of 74 men (93.7%) and 5 women (6.3%). According to the pathological stage, 25 (31.6%), 33 (41.8%), and 21 (26.6%) cases had pTa, pT1, and pT2-3 carcinomas, respectively. 34 of 79 (43%) urothelial carcinomas and only 1 of 11 (9.1%) nontumoral cases showed positive CD10 immunostaining. It was a cytoplasmic diffuse or granular immunostaining pattern both in nontumoral and tumoral urothelia. There was no statistically significant difference between tumoral and nontumoral cases with respect to CD10 reactivity (p = 0.051), but there was a trend toward significance. In urothelial tumors, there was a significant inverse correlation between pathological stages and CD10 immunoreactivity (p = 0.036, r = -0,237). There was also a statistically significant difference between pTa and pT2-3 urothelial tumors in relation to the CD10 expression (p = 0.034). No association was detected between CD10 expression and grades according to all systems used (p > 0.05). CONCLUSIONS: According to our findings, the CD10 expression in noninvasive carcinomas showed a higher level than that in invasive carcinomas, and it is inversely correlated with the pathological stage. CD10 may play an important role in the progression of urothelial bladder carcinomas, and downregulation probably facilitates invasion, especially muscle invasion.

Adult↗

The proportions of the white and red pulps of the human fetal spleen.

OBJECTIVE: To compare the proportions of white and red pulps of the human spleen during the fetal period. METHODS: We performed this study in the Department of Anatomy and Pathology of Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey, from the period between 2002-2003. Spleens from 137 dead fetuses aged between 9 and 40 weeks were embedded into paraffin blocks following classical histological steps and stained with hematoxylin and eosin. White and red pulps could be differentiated only in 25 cases (13 males, 12 females). The proportions of the areas of white and red pulps (the trabeculae were included into the red pulp and the groups of lymphocytes were included into the white pulp) were estimated by point counting method on the sections taken from different parts of the spleens by systematic randomized sampling technique. RESULTS: It has been ascertained that the white pulp has been distinguished from 20th week onwards during the fetal period. The proportion of the white pulp area has been found to be 22.3% (of total white and red pulp areas) at the 20th week and has come to 37.6% at the 40th week. Concerning the trimesters, the proportion of the white pulp area has been found to be 30% (of total white and red pulp areas) at the 2nd trimester and has come to 36% at full term. While the white pulp area had a positive correlation with the gestational age (r: 0.34), the red pulp area had a negative one (r: -0.34). No difference has been found among gender. CONCLUSION: Reference values have been obtained about the proportions of white and red pulp areas of human fetal spleen.

Female↗

Vascular wall damage in rats induced by organophosphorus insecticide methidathion.

We have examined the effect of subchronic methidathion (MD) administration on vascular wall damage. The experimental groups were: control group and rats treated with 5 mg/kg MD. The MD group was given MD by gavage for 5 days a week for 4 weeks at a dose level of 5 mg/kg per day by using corn oil as the vehicle. The levels of malondialdehyde (MDA) were determined in the vascular tissue. Histopathological examination was examined in the thoracic aortic tissue. The levels of MDA were increased in the MD group compared with the control group (P < 0.01). In the MD group, subchronic MD administration led to the irregulation, prominent breaks and fragmentation of the elastic fibers were located in the media of aortic wall. In conclusion, it is likely that subchronic MD administration caused vascular wall damage and, in addition, lipid peroxidation may be one of the molecular mechanisms involved in MD-induced vascular toxicity.

Animals↗

Hypercalcemia syndrome. Coexisting hyperthyroidism, primary hyperparathyroidism and cancer of the gallbladder.

Hypercalcemia is a frequent finding in clinical practice. All possible causes must be considered in a patient with hypercalcemia. The association between both benign or malignant thyroid disease and primary hyperparathyroidism is well recognized. Up to 65% with primary hyperparathyroidism have associated thyroid abnormality. Hypercalcemia has also been associated with many malignant conditions. But, it is rarely seen in digestive tract cancer, such as carcinoma of gallbladder. Hypercalcemia syndrome is an absolutely rare entity. It is coexisting with hyperthyroidism, primary hyperparathyroidism and cancer of the gallbladder.

Adenocarcinoma↗

Development of the liver during the fetal period.

OBJECTIVE: To investigate the development of the liver in human fetuses aged between 9-40 weeks. METHODS: We studied 121 human fetuses (62 males, 59 females) with no external anomalies aged between 9-40 postmenstrual weeks during 2003-2004 in Suleyman Demirel University, Isparta, Turkey. The fetuses were divided into four groups as 1st, 2nd and 3rd trimesters and full term fetuses. We measured fetal weight, length, width, thickness, and volume of the liver. We established localization of the liver and its relation with the neighboring structures, its ligaments, and size of itself and its lobes, shapes of the liver and the localization of the porta hepatis on the visceral surface of the liver. RESULTS: We found significant correlations between the size, weight, volume of the liver, sizes of its lobe and gestational age (p<0.001). Group comparisons disclosed significant differences between groups in all parameters except between 3rd and 4th groups with respect to the heights of the liver and the caudate lobe (p<0.05). During the fetal period, the proportion of the distance between the porta hepatis and the right margin of the liver to the distance between the porta hepatis and the left margin of the liver did not change significantly (p>0.05). However, the proportion of the distance between the porta hepatis and the upper margin to the distance between the porta hepatis and the lower margin decreased significantly with gestational age (p<0.05). Type 3 liver (square) was the most commonly observed type of fetal liver (53%). CONCLUSION: Our opinion is that the parameters obtained can be useful to diagnose pathologies of liver development and anomalies concerning several branches of medicine such as anatomy, pathologic anatomy (fetopathology), forensic medicine, medical imaging, obstetrics and pediatrics.

Chi-Square Distribution↗

Multiple loose bodies in the joints: from snowstorm to hailstones.

We report the cases of 2 young-adult patients with multiple loose bodies, one in the knee and the other in the elbow joint. Loose bodies were composed of hundreds of brilliant white particles up to 5 mm in the first patient, who had a history of pain and swelling. From the right elbow joint of the second patient, arthroscopic removal of about 25 osteocartilaginous loose bodies, ranging from 5 to 14 mm in diameter, was performed. This patient also had the effects of poliomyelitis, which had required him to use a crutch since childhood for right lower limb length discrepancy. Arthroscopic removal provided elimination of symptoms in both patients. Histopathologic examination of the specimens and clinical evidence supported the previously proposed pathogenic mechanisms on development of loose bodies. Mechanisms that could affect the natural history of loose bodies in these particular patients are discussed and speculated on in this report. We suggest that some of the numerous cartilaginous multiple loose bodies in the joints (snowstorm appearance) are attached and incorporated into synovium and the total number decreases with time, while the remaining grow with nutritional effects of synovial fluid medium, resulting in larger loose bodies with osteocartilaginous characteristics. The term "hailstone" is used to describe the ultimate situation of the previous arthroscopically defined snowstorm loose bodies.

Adult↗

Cardiotoxicity in rats induced by methidathion and ameliorating effect of vitamins E and C.

We have examined the effect of subchronic methidathion (MD) administration on heart damage, and have evaluated possible ameliorating effects of a combination of vitamins E and C against MD toxicity. The experimental groups were: control group, rats treated with 5 mg/kg MD and rats treated with 5 mg/kg body weight MD plus vitamin E and vitamin C (MD+Vit). The groups were given MD by gavage 5 days a week for four weeks at a dose level of 5 mg/kg/day (MD and MD+Vit) by using corn oil as the vehicle. Vitamin E and vitamin C were injected at doses of 50 mg/kg i.m. and 20 mg/kg i.p., respectively, after the treatment with MD in the MD+ Vit group. The levels of malondialdehyde (MDA) were determined in the heart tissue, and the levels of cardiac troponin I (TnI) in serum. An autoanalyser was used to determine the serum activities of cholinesterase (ChE). Histopathological examination was carried out in the heart tissue. MDA significantly increased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the increase in MDA was significantly less (P <0.01). ChE activity significantly decreased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the decrease in ChE activity was significantly higher (P <0.05). The serum TnI levels significantly increased in the MD group as compared to controls (P <0.01). When MD was given concurrently with vitamins E and C, the increase in the serum TnI was significantly less (P <0.01). MD caused the diffuse loss of striation and myocytolysis of the cardiomyocytes, whereas the combination of vitamins E and C caused a significant decrease in these effects of MD. In conclusion, subchronic MD administration caused heart damage and, in addition, treatment with a combination of vitamins E and C after the administration of MD reduced heart damage caused by MD.

Animals↗

Synchronous primary adenocarcinoma and gastrointestinal stromal tumor in the stomach: a report of two cases.

Synchronous occurrence of epithelial and gastrointestinal stromal tumors (GISTs) in the stomach is uncommon. This association has often been detected incidentally on gastric mucosa or serosa, or occasionally intramurally, at surgery or gastroscopy for other reasons. Various hypotheses have been proposed regarding this simultaneous development, and it is not known whether or not such an association is a simple incidental coexistence or whether the two lesions are connected by a causal relationship. In this article, we report two cases of synchronous development of stromal tumor and adenocarcinoma incidentally detected in the stomach in two elderly patients.

Adenocarcinoma↗