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T Colak

Publications and source records attributed to T Colak.

68 records · Page 4Linked to original sources
PubMed1999

The effect of pneumoperitoneum on bacterial clearance and RES functions in a model of E. coli peritonitis.

The use of laparoscopic surgery in peritonitis has increased rapidly. The present study examined the effects of pneumoperitoneum on bacterial clearance. Spraque-Dawley rats were divided into six groups of seven animals. In groups 1 and 4, laparotomy with a midline incision was performed and 10(9) E. coli in a volume of 1 ml inserted into the peritoneal cavity. Groups 2, 3, 5, 6 received an identical quantity of E. coli by intraperitoneal injection. Groups 3 and 6 received carbon dioxide pneumoperitoneum at a constant pressure of 5 mmHg for 60 minutes after intraperitoneal injection of E. coli. In one hour groups; the mean bacterial counts per lung from the E. coli injection with laparotomy group was significantly higher than for the E. coli injection with pneumoperitoneum group (p < 0.05). The mean bacterial counts per kidney in the E. coli injection with laparotomy group was higher compared with the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.0001). There was statistically significant difference in quantitative bacteraemia between the E. coli injection with laparotomy group and the E. coli injection or E. coli injection with pneumoperitoneum groups (p < 0.05). In four-hour groups; the mean bacterial counts of lungs and liver-spleen were significantly higher in the E. coli injection with laparotomy group than in the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.05 and p < 0.001 respectively). The quantitative bacteria was significantly higher in the E. coli injection with laparotomy group than in the E. coli injection and E. coli injection with pneumoperitoneum groups (p < 0.05). This study demonstrates that pneumoperitoneum impairs the clearance of bacteria from the peritoneal cavity in an experimental model of peritonitis. However, we could not detect the deleterious effects of pneumoperitoneum compared with laparotomy.

Animals↗
PubMed1998

Effect of carbon dioxide pneumoperitoneum on bacteremia and severity of peritonitis in an experimental model.

BACKGROUND: Laparoscopy is increasingly used in conditions complicated by peritonitis. A theoretical concern is that carbon dioxide pneumoperitoneum may increase bacteremia. METHOD: In 60 rats peritonitis was induced by cecostomy. Animals were randomly allocated to pneumoperitoneum (PP) and control groups. Blood cultures and intraabdominal swabs were assessed. A peritonitis severity score (PSS) was computed based on histology from peritoneal biopsy. RESULTS: One hour after cecostomy neither in abdominal swabs nor in blood samples bacteria were reproduced in PP and control groups. Three hours after cecostomy the frequency of positive blood cultures was 80% and 20% in PP and control groups, respectively (p < 0.0001). Six hours after cecostomy the frequency of positive blood cultures was 100% in each group (p > 0.05). One hour after cecostomy the mean peritoneal severity score was significantly higher in the PP group than in the control group, but there was not any significant difference between groups 3 and 6 h after cecostomy. The mean peritoneal severity scores were found to be significantly increased with time when the PP groups compared with each other. CONCLUSION: In rats, pneumoperitoneum can't cause a more severe peritonitis but it does induce an increase in the rate of bacteremia within the early 6-h period of peritonitis.

Acute Disease↗
PubMed1997

Non-Hodgkin's lymphoma presenting as thyroid and adrenal gland involvement.

We report an unusual case of non-Hodgkin's lymphoma involving both the thyroid and adrenal glands. Malignant infiltration of the glands by B-cell immunoblastic type lymphoma were demonstrated by cytologic findings in needle biopsy. Staging studies showed minor nodal involvement. The patient was treated with combination chemotherapy. Simultaneous involvement of the thyroid and adrenal glands with non-Hodgkin's lymphoma is very rare. In this report, while presenting this rare coexistence, we also want to emphasize that fine-needle aspiration biopsy was useful in the diagnosis.

Adrenal Gland Neoplasms↗
PubMed1995

Two unusual cases of wandering spleen requiring splenectomy.

The occurrence of wandering spleen is rarely referred to in the pediatric surgical literature. We treated two unusual cases with this anomaly. The first case had an acute abdominal problem associated to a wandering spleen and a diaphragmatic eventration. Splenectomy was performed because of splenic infarction. In the second case the wandering spleen was associated with gastric bleeding due to left-sided portal hypertension, and splenectomy was inevitable.

Abdomen, Acute↗
PubMedDate not supplied

Quality of life and mood in renal transplantation recipients, donors, and controls: preliminary report.

Currently, living related donors are involved in approximately 85% of all kidney transplantations performed at our institution. Health-related quality of life (HRQL) is an important outcome factor in chronic disease. Quality of life may be diminished by prolonged illness or certain treatment modalities and by negative, disabling effects on mood. We investigated HRQL and mood in renal transplant recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. Recipient depression scores were significantly higher (indicating more serious depression) than those of donors (P <.05), but similar to those of the controls. There was no significant difference between the donor and the control subjects' depression scores. The anxiety scores of the recipients and donors were similar; and recipient anxiety scores were significantly higher than those of the control subjects (P <.05). The recipient scores indicated significantly poorer physical functioning (P <.001), significantly greater physical limitation on roles (P <.01), and lower levels of general health (P <.01) compared to controls. The recipient scores for vitality, pain, social functioning, and emotional limitations on roles were similar to those of the controls. Our results indicate that most recipients and donors experience anxiety after renal transplantation. This study confirms that recipients have favorable outcomes with respect to social functioning and emotional well-being. Overall, the results of this preliminary study are positive, encouraging us to continue to perform living donor kidney transplantation.

Affect↗
PubMedDate not supplied

The psychosocial impact of renal transplantation on living related donors and recipients: preliminary report.

We investigated the psychosocial and demographic features of living related kidney donors and recipients during follow-up visits between August 2002 and March 2003 using two new questionnaires, one for donors and one for recipients. The surveys were distributed to 22 donors and 55 recipients, 18 (81.8%) donors and 49 (89.1%) recipients completed their questionnaires. Concerning level of satisfaction with quality of life after transplantation, 93.9% of the recipients and 72.2% of the donors were "highly satisfied". Almost all donors (94.4%) said that they would make the same decision again and would also strongly encourage others to donate. Issues related to donor dissatisfaction involved beliefs that preoperative information was inadequate and perceived negative effects of transplantation on personal health at the time the survey was conducted. Only 6.1% of the recipients said they were dissatisfied with their quality of life after the operation. The main issues were psychiatric morbidity and beliefs that preoperative information was inadequate. Overall, the vast majority of donors and recipients reported that they had a positive transplantation experience. Only a small proportion of the subjects developed psychosocial morbidity or were dissatisfied with their quality of life. These results are preliminary, but it appears that better psychological preparation for the transplantation process and close psychiatric follow-up would reduce negative outcomes.

Adolescent↗
PubMedDate not supplied

Causes of anemia in renal transplant recipients.

Iron-deficiency anemia is one of the major problems encountered in renal transplant recipients. The aim of this retrospective study was to reevaluate the causes of anemia among 100 anemic kidney recipients. Patients with serum creatinine levels greater than 2 mg/dL were excluded from the study. Female patients were considered to be anemic if the hemoglobin was <12 g/dL for males, <13 g/dL. Complete blood count, serum creatinine, serum iron, iron-binding capacity, ferritin, transferrin saturation, erythrocyte folate, and serum vitamin B(12) levels were measured in all patients. Mean hemoglobin value was 10.2 +/- 1.4 g/dL for female and 9.9 +/- 1.3 for male patients, mean corpuscular volume (MCV) 91.3 +/- 4.9 fL. We observed normocytic anemia in 60, macrocytic anemia in 30, and microcytic anemia in 10 patients. A low level of serum folate was observed in 9 (15%) and of vitamin B(12) in 5 (8.8%) of 60 patients with normocytic anemia. Folate deficiency was found in 18 (60%) and vitamin B(12) deficiency in 12 (40%) of 30 patients with macrocytic anemia. All patients with microcytic anemia had iron deficiency. Splenomegaly was seen significantly more often in patients with macrocytic than normocytic anemia (P =.008). Folate and vitamin B(12) deficiency were the major causes of nutritional anemia; oral or parenteral supplementation with these vitamins is likely to cure the anemia in the majority of cases.

Adult↗
PubMedDate not supplied

The pharmacokinetics of equoral versus neoral in stable renal transplant patients: a multinational multicenter study.

We studied the pharmacokinetics (PKs) of the new generic cyclosporine formulation, Equoral capsules, after the switch from original formulation Neoral capsules in stable renal transplant patients. The study was carried out in accordance with the basic principles defined in the US 21 CFR Part 312.20 and the principles of the Declaration of Helsinki. The study included clinically stable first renal transplant patients maintained on cyclosporine with no rejection episode during the past 6 months. Hematology, biochemistry, and urine chemistry were determined on day 7, and day 21. The patients were all switched to Neoral (lot number 416MFD0601) on day 0 when the first sparse sampling PK was performed. On day 14 a 12-hour PK profile included predose, 30 minutes; 1 hour; 1 hour 30 minutes; 2 hours; 3 hours; 4 hours; 5 hours; 6 hours; 8 hours; 10-hours and 12-hour samples. Cyclosporine levels were determined using a CYA kit (Abbott TDx). On day 15 the patients were switched from Neoral capsules to Equoral capsules (lot 5T111014) at an equivalent dosage (mg/mg). The second sparse sampling PK was performed on day 21 and a 12-hour PK was performed on day 28. On the morning of day 29 patients were switched from Equoral capsules to Neoral capsules at an equivalent dosage (mg/mg). Additional concentrations were measured on days -7, 18, and 35. Safety parameters were monitored at each visit. The pharmacokinetics of both formulations were equivalent. The mean AUC for Neoral and Equoral was 2856 and 2892, respectively. The ratios of LSM and the 90% confidence intervals for the in-transformed parameters (AUC o-t, AUC inf, and Cmax) of Equoral and Neoral SGC were 98% and 95%, respectively, suggesting that Equoral and Neoral SGC are bioequivalent.

Area Under Curve↗
PubMedDate not supplied

Angiotensin-converting enzyme gene polymorphism significantly affects renal posttransplantation erythrocytosis.

Posttransplantation erythrocytosis (PE) is a frequent problem in renal transplant patients. The pathogenesis and mechanisms of both the problem and therapy strategy are unknown. Since ACE and angiotensin 2 receptor inhibitors have been used to successfully manage PE, we speculated a relation between gene polymorphisms and this complication. Ninety-six ( 30 women, 66 men, age 34.4 +/- 11.0 years) renal transplant patients evaluated retrospectively, for gene polymorphisms of ACE, angiotensinogen, angiotensin 1 and 2 receptors (ATR1 and ATR2), as well as endothelial nitric oxide synthase (ecNOS). They were divided into two groups; patients with versus without PE, which was defined as >15 g/dL hemoglobin levels during the first year after renal transplantation. PE was found to be significantly more prevalent among D/D than I/I gene polymorphism of ACE genes (P <.04). The distribution of D/D, I/D, and I/I polymorphisms were 39.1%, 45.9%, and 7.6%, respectively. There was no difference between D/D and I/D polymorphisms. Comparing the I/D and I/I polymorphisms showed PE to be statistically more prevalent in the I/D polymorphism (P <.01). Logistic regression analysis revealed that D/D and I/D polymorphisms were significant risk factors for PE (P <.05, RR = 7.714 and P <.03, RR = 10.199, respectively). While previous studies revealed a relation between angiotensin II and PE, our study discovered the contribution of ACE gene polymorphism.

Adult↗
PubMedDate not supplied

The renin-angiotensin system and endothelial nitric oxide synthase gene polymorphisms and cyclosporine toxicity in renal transplant patients.

Although cyclosporine has improved graft survival, the toxicity of the drug frequently causes problem for renal transplant patients. Cyclosporine displays deleterious effects due to direct toxicity to the nephrons and vasoconstriction of afferent arterioles, effects that may be due to increased angiotensin II and decreased nitric oxide activity. We sought to examine the relation between cyclosporine toxicity and the RAS (angiotensin-converting enzyme, angiotesinogen, angiotensin 1 and 2 receptors, and ecNOS) gene polymorphisms in 111 renal transplant patients. Retrospectively, we correlated the results of graft biopsies from these 111 patients, with the cumulative drug doses (mg), mean blood levels (mg/mL), mean daily doses (mg), and mean doses (mg/kg/d) of cyclosporine. Overall 125 patients (38 women, 87 men) were enrolled in the study. Their mean age was 34.47 +/- 11.04 years. Twenty patients displayed cyclosporine toxicity on graft biopsy; 91 showed no evidence of the disorder. We could not find any relation between cyclosporine toxicity and gene polymorphisms (P >.05), although the mean mg/kg/d dose was significantly high among cyclosporine toxicity group (P =.028, RR = 1.42). In recent studies angiotensin II and nitric oxide have been suggested to be related to cyclosporine toxicity; however, our results failed to reveal an association between cyclosporine toxicity and angiotensin II or nitric oxide-related gene polymorphisms.

Angiotensinogen↗
PubMedDate not supplied

Carcinoid tmour of the common bile duct: report of a case and a review of the literature.

Carcinoid tumours of the common bile duct are extremely rare lesions. In this article we report a case with an extrahepatic bile duct carcinoid tumour. A 40-year-old woman suffered from biliary colic and jaundice. Pre-operative computed tomography demonstrated a tumour in the biliary tract. At laparotomy there was a tumour invading the common bile duct. Common bile duct resection was performed. Carcinoid tumour of the common bile duct was diagnosed histopathologically. For extrahepatic bile duct carcinoid tumours surgical resection is the only treatment modality that offers a chance to provide a cure and prolonged disease-free survival. The favourable histopathological and biological features of these tumours encouraged the surgeons to use more aggressive approaches for advanced disease.

Adenocarcinoma↗
PubMedDate not supplied

Expression of c-erbB-2 and p53 in breast carcinoma patients: comparison with traditional prognostic factors and survival.

We aimed to determine the correlations between standard clinicopathological factors and expression of c-erbB-2 and p53 proteins, and to investigate the significance of these variables in relapse and disease-free survival (DFS) in breast carcinoma patients. Data from 200 patients who had undergone mastectomy for breast carcinoma were evaluated. Significant correlations were found between c-erbB-2 positivity and high histological grade (grade 3) tumour, p53 positivity and high grade tumour, and age < 60 years and oestrogen receptor negativity. Twenty-six patients (13%) developed a recurrence. Disease relapse was more frequent in patients who had axillary lymph node (ALN) metastasis, high grade tumour, c-erbB-2 positivity and p53 positivity; these variables were also associated with a shorter DFS. The effects of ALN metastasis and p53 positivity were significant. In conclusion, ALN metastasis and p53 positivity were important factors for predicting disease relapse in mastectomy-treated breast carcinoma patients; other clinicopathological criteria and c-erbB-2 positivity were not predictive.

Adult↗