Biomedical subjects

T Yilmazlar

Publications and source records attributed to T Yilmazlar.

17 recordsLinked to original sources

PubMed2001

Laparoscopic management of malfunctioning peritoneal dialysis catheters.

BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an established alternative method to hemodialysis for treating end-stage renal disease patients. However, this method is associated with a significant number of complications, such as catheter malposition, omental wrapping, and infection. The purpose of this study was to determine the efficacy of laparoscopy in the treatment of malfunctioning CAPD catheters. METHODS: Between November 1994 and June 1999, a total of 16 patients with CAPD underwent laparoscopy for the evaluation and management of CAPD catheter dysfunction. Two trocars (10-mm and 5-mm) were used. Recorded data included patient demographics, catheter implantation method, date of malfunction, cause of dysfunction, procedure performed, complications, and catheter outcome. RESULTS: The primary etiology of dysfunction was omentum and/or small bowel wrapping with adhesions in eight cases, malpositioning in five cases, and infection in the remaining three cases. Adhesiolysis was performed in the eight cases with adhesions. In the five cases with malpositioning but no adhesions, the catheters were repositioned in the pelvic cavity. Two catheters had to be withdrawn because of infection. In one case with tunnel infection, the catheters were exchanged simultaneously. There was only one perioperative complication, consisting of temporary dialysate leakage. There were no mechanical or infection problems. The overall success rate of catheter function (>30 days after laparoscopy) was 100%, except for two cases in which the catheters had to be removed. CONCLUSION: Laparoscopy is a highly effective and successful method for the evaluation and management of peritoneal dialysis catheter dysfunction.

Adult↗

PubMed2000

The expression of fragile sites in lymphocytes of patients with rectum cancer and their first-degree relatives.

Fragile sites are non-staining gaps and breaks in specific points of chromosomes. These sites also include acentric fragments, triradial figures and several rearrangements. Although this issue has been controversial recently, they may be related to structural chromosomal rearrangement in some neoplasms. In this study, the expression of fragile sites induced by aphidicolin (Apc), 5-bromodeoxyuridine (BrdU) and caffeine was investigated on prometaphase chromosomes obtained from the peripheral blood lymphocytes of 36 patients with rectum cancer, 30 first-degree relatives and 30 normal healthy controls. The results of the structural chromosome aberrations determined in patients and their first-degree relatives were significantly higher than those in control subjects (P<0.001). We determined aphidicolin type common fragile sites (1p36, 1p31, 1p21, 1q21, 1q25, 1q44, 2p24, 2q21, 2q33, 2q37, 3p14, 5q21, 5q33, 13q13, 14q24, 16q23 and 18q21). When the rates of sites such as 1p21, 1q25, 2q33, 3p14, 5q21 and 14q24 in patients and in their first-degree relatives were compared with the control group, the difference was statistically significant. Our results indicated an increased genetic instability in patients with rectum cancer and their first-degree relatives. Therefore, the increase of fragile site expression may be an important marker showing genetic predisposition to rectum cancer.

Adult↗

PubMed2000

The expression frequency of common fragile sites and genetic predisposition to colon cancer.

The expression frequency of common fragile sites induced by aphidicolin (Apc), bromodeoxyuridine (BrdU), and caffeine was evaluated on prometaphase chromosomes obtained from the peripheral blood lymphocytes of 32 patients with colon cancer, 30 of their clinically healthy family members and 30 age-matched normal controls. The proportion of damaged cells (P < 0.001), the mean number of chromosomal aberrations and the expression frequencies of fragile sites were significantly higher in the patient and relative groups compared to the control group. Our findings show an increased genetic instability in patients with colon cancer and their first-degree relatives. In addition, common fragile sites can be used as a suitable marker for determining genetic predisposition to cancer.

Adenocarcinoma↗

PubMed2000

Vasopressin, renin, and adrenocorticotropic hormone levels during the resuscitation of hemorrhagic shock in dogs.

Hemorrhage is a potent stimulus for the release of vasopressin (VP), renin, and adrenocorticotropic hormone (ACTH). The goal of this study was to analyze changes in plasma VP, renin, and ACTH levels during hemorrhagic shock and resuscitation with two different solutions: hypertonic acetate dextran (HAD) and lactated Ringer's (LR) solution. Eight randomized dogs were shocked by removing 37 +/- 9 mL/kg of blood while maintaining the mean arterial pressure (MAP) at 45 +/- 5 mmHg for 1 h. Test solutions were randomized and infused as needed with the hemorrhaged blood to restore the MAP and cardiac index to baseline. Blood samples for hormone analyses were taken in baseline, shock, and resuscitation periods. For each experiment, all hormone levels increased in the postshock period and then returned to baseline values after resuscitation with both solutions. VP and renin levels rapidly returned to baseline values after resuscitation in the LR dogs compared with the HAD dogs (p < 0.05). By contrast, there was no significant difference in ACTH levels between the two solutions. High-volume infusion with LR achieves more rapid restoration than small-volume infusion with HAD for VP and renin levels.

Adrenocorticotropic Hormone↗

PubMed1997

Is it necessary to retrieve dropped gallstones during laparoscopic cholecystectomy?

BACKGROUND: An experimental study was planned to evaluate the effect of bile alone and bile in combination with gallstones on intraperitoneal adhesion and abscess formation in the peritoneal cavity of the rat. METHODS: One hundred Sprague-Dawley rats were assigned to ten groups (n: 10). Groups 1-3 received a 1-ml intraperitoneal injection of saline, sterile bile, and infected bile. Groups 4-10 underwent a lower 5-mm midline abdominal incision. In groups 5, 7, and 9, a single gallstone (3-mm diameter) was placed in the right upper quadrant and injected with sterile saline, sterile bile, and infected bile, respectively. In groups 6, 8, and 10, four gallstones (3-mm diameter) were placed in the right upper quadrant together with sterile saline, sterile bile, and infected bile, respectively. Group 4 only underwent a 5-mm midline incision. All animals were sacrificed at the end of 4 weeks and the peritoneal cavity was carefully examined to investigate adhesions and abscess formation. The adhesions were graded according to Nair's gross pathologic grading of adhesions. The Kruskal-Wallis nonparametric test (KW) was used for statistical analysis. RESULTS: No intraabdominal lesions were noted in groups 1-3. The adhesion score was increased by number of stone and infected bile (G4: 3, G5: 3, G6: 11, G7: 7, G8: 10, G9: 15, G10: 18). But there was only a significant difference between the groups that received sterile saline+single stone (G5) and that receiving infected bile+four stones (G10) (KW: 24.3 P < 0.05). There was abscess formation in three rats in group 9 and two in group 10. CONCLUSIONS: In conclusion, infected bile in combination with multiple stones increases the gross grading of adhesion and intraabdominal abscess formation. Thus, in cases with multiple stones and infected bile, the dropped stones should be retrieved and the peritoneal cavity should be copiously irrigated during laparoscopic cholecystectomy.

Abdominal Abscess↗

PubMed1996

Effect of CO2 pneumoperitoneum on bacteremia in experimental peritonitis.

Bacteria transfer to the blood from the peritoneum is thought to be augmented when the diaphragmatic stomata are activated by an increased intra-abdominal pressure. Therefore, it may be expected that the increase in intra-abdominal pressure during laparoscopic surgery can augment the absorption of bacteria from the peritoneum to the blood. The present study examines the effect of pneumoperitoneum on bacteremia in experimental Escherichia coli peritonitis in rabbits. Twenty-four rabbits were divided into three groups. 10(9) colony forming units of E. coli were inoculated intraperitoneally into group 1 (n = 8). Group 2 (n = 8) received an identical bacterial inoculum and underwent a midline laparotomy at the 2nd hour. Group 3 (n = 8) also had an identical bacterial inoculum which was followed by 15 mm Hg CO2 pneumoperitoneum for 1 h at the 2nd hour. In all groups, the growth value (GV) was measured in the 3rd- and 6th-hour blood cultures using the Bactec NR 730 system. There was no difference in the 3rd- and 6th-hour GVs (p > 0.05) among the three groups. In conclusion, pneumoperitoneum with 15 mm Hg CO2 in experimental E. coli peritonitis did not increase the bacteremia when compared with the control and laparotomy groups.

Animals↗

PubMed1996

The value of herniography in football players with obscure groin pain.

From January 1985 to May 1994, herniography was performed in 60 football players with groin pain but without clinical signs of hernia. Herniographic examination revealed 62 occult inguinal hernias in 51 cases, nine cases were normal. Fifty of these 51 cases were operated on. Surgery was postponed until the end of the league in one case. There was only one false positive examination. The herniographic and operative diagnoses corresponded well in the other 49 cases. There were three minor complications which have related to the needle sigmoid colon puncture, all of them were managed conservatively. There was no technical failure. These results indicate that herniography is a safe and valuable method to identify non palpable herniations causing groin pain of unknown origin in football players.

Adolescent↗

PubMed1995

Colonic actinomycosis: report of a case and review of the literature.

Abdominal actinomycosis is a rare entity which presents some difficulty in establishing a correct preoperative diagnosis. We report herein the case of a 41-year-old woman who developed abdominal actinomycosis involving the left colon and the surrounding retroperitoneum. The patient, who had an intrauterine contraceptive device (IUCD) in situ, presented with left flank pain and the signs and symptoms of an intraabdominal mass, which was initially diagnosed as a neoplasm originating from the left colon or the retroperitoneal space. Thus, a left colectomy was performed, but the histopathological pathological diagnosis revealed abdominal actinomycosis. We evaluated the diagnosis and treatment of this disease in light of the knowledge acquired from the available literature on this rare entity.

Actinomycosis↗

PubMed1994

Scintigraphic detection of splenosis: superiority of tomographic selective spleen scintigraphy.

We used scintigraphy with sulphur colloid and heat-damaged red cells to detect splenosis after splenectomy in 19 patients 7 to 69 months after injury. We compared planar and tomographic selective spleen scintigraphy using heat-damaged red cells with subtracted planar colloid scintigraphy, and showed that the most sensitive method was tomographic selective splenic scintigraphy. The incidence of splenosis was 58% with this method, the other techniques detecting abnormalities in 21% and 26% of the patients.

Adult↗

PubMedDate not supplied

Anti-emetic efficacy of tropisetron and metoclopramide.

Post-operative vomiting, especially in ambulatory surgical patients, remains a troublesome problem. This placebo-controlled, randomized, prospective double-blind trial was designed to evaluate the efficacy of two prophylactic anti-emetic regimens on post-operative vomiting in 1-day thyroid surgery. Altogether 60 elective surgical patients were followed for 4 h post-operatively. All patients were American Society of Anesthesiologists physical status of I or II and aged between 22 and 60 years: group 1 was saline control; in groups 2 and 3, metoclopramide (0.2 mg/kg) or tropisetron (5 mg) was administered, respectively, as an intravenous single dose during induction. Patients were pre-medicated. A standardized anaesthetic technique consisting of thiopentone-succinylcholine for induction and fentanyl-nitrous oxide-halothane-pancuronium for maintenance of anaesthesia was used. A 'rescue' anti-emetic was provided in case of continued vomiting or at the patient's request. Anti-emetic inefficacy was defined as request for rescue anti-emetic and/or vomiting episode during the first 4 h post-operation. The number of patients vomiting was 12/20 (60%), 10/20 (50%) and 1/20 (5%) within the first 2 h post-operation in groups 1, 2 and 3, respectively (P > 0.05 for groups 1 and 2; P < 0.01 for groups 2 and 3; P < 0.001 for groups 1 and 3). In group 2, three patients required rescue medication during the first 2 h post-operation, but no significant difference was observed between groups 2 and 3 (P > 0.05). None of the cases in any of the groups needed any rescue medication during post-operative 2-4 h. It is concluded that tropisetron is a highly effective anti-emetic drug in the prophylaxis of post-operative vomiting.

Adult↗

PubMedDate not supplied

Efficacy of tenoxicam on intra-abdominal adhesion prevention in a rat model.

The aim of this study was to investigate the effect of tenoxicam as a non-steroidal anti-inflammatory drug (NSAID) on intra-abdominal adhesion prevention in a rat model. Altogether 50 Wistar-Albino rats weighing 220-280 g were assigned to five groups, each of which was made up of 10 rats. All the rats were anaesthetized and prepared for sterile surgery. After a mid-line laparotomy was performed, a 1 cm area of the caecum was rubbed with gauze until subserosal haemorrhage developed, and then a 5 mm-diameter part of the peritoneum on the right side of the abdominal wall was removed. Prior to complete closure, 3 ml of the test material was placed into the abdominal cavity. On the eighth day the rats were killed and the adhesion score was determined. The groups and their mean adhesion scores were as follows: control group (normal saline), 2.5; group of dilution buffer, 1.8; tenoxicam (0.125 mg/kg), 1.3; tenoxicam (0.25 mg/kg), 1.3; and tenoxicam (0.5 mg/kg), 0.9. The differences between the adhesion scores among all the groups (P < 0.05, Kruskal-Wallis test), and those between the tenoxicam groups and control group (P < 0.05, Mann-Whitney U-test), were significant. Thus a single instillation of tenoxicam into the peritoneal cavity at the time of surgery reduced adhesion formation effectively in this model, irrespective of dosage.

Abdomen↗

PubMedDate not supplied

High expression of multidrug resistance-1 (MDR-1) and its relationship with multiple prognostic factors in gastric carcinomas in patients in Turkey.

Drug resistance remains a major problem in the treatment of gastric cancer. In Turkey, gastric carcinoma is the second most common cancer and, because the rate of early diagnosis is low, chemotherapy plays an important role in the treatment of the disease. We aimed to investigate expression of the multidrug resistance-1 gene (MDR-1) and its relationship with multiple prognostic factors in gastric cancers. Between 1996 and 1998, a total of 55 patients (37 men and 19 women; median age 55 years) were studied. Sections from specimens of gastric carcinomas were immunohistochemically stained to detect P-glycoprotein (which is associated with MDR-1 expression). We found MDR-1 expression in 48 (87%) of the patients. None of the multiple prognostic factors, including histological type of tumour, correlated with expression of MDR-1. Patients who had low MDR-1 expression had better survival. We conclude that the expression of MDR-1 in gastric cancer is high in Turkey, and this may be related to poor prognosis.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMedDate not supplied

Colorectal cancer in young adults.

The study was carried out to promote a greater awareness of the potential for colorectal cancer in young adults under 40 years of age. During the 8 years between 1986 and 1993, 237 patients with adenocarcinoma of the colon and rectum were operated at the Uludağ University Hospital. Of these 237 cases, 46 patients under 40 years old were reviewed retrospectively. They accounted for 19.4% of the total number of patients with carcinoma of the colon and rectum operated during the same period. Rectal bleeding was the most common presenting symptom. The mean duration of time from the onset of symptoms to diagnosis was 5.8 months. The rectosigmoid area was the most frequently involved site (80%). Seventy-six percent of the patients had Dukes' stage C or D tumors. Forty-eight percent of the tumors were either poorly differentiated or mucinous. The cumulative survival rate at 5 years was 43.4%. Patients under 40 years old with carcinoma of the colon and rectum are usually symptomatic and have advanced disease at the time of presentation. Although colorectal cancer is usually a disease of older patients it is becoming more common in younger populations.

Adenocarcinoma↗

PubMedDate not supplied

Comparison of the efficacy of 2 mg versus 5 mg tropisetron in the management of post-operative nausea and vomiting.

A randomized, double-blind, placebo-controlled study was carried out to investigate the efficacy of 2 mg versus 5 mg tropisetron in the prevention of post-operative nausea and vomiting. Patients between 22 and 64 years old who were undergoing surgery under general anaesthesia and who had been classified according to the American Society of Anesthesiologists criteria with physical status I or II were included in this trial. Sixty female patients were recruited and divided into three groups (n = 20 in each group). Patients in group 1 received saline solution as control, whereas in groups 2 and 3, 2 mg or 5 mg tropisetron, respectively, was administered intravenously as a single dose during the induction of anaesthesia. The number of patients vomiting within the first 2 h following the operation was significantly less in groups 2 and 3 compared with that in group 1 (one of 20 for each of the groups 2 and 3 versus 12 of 20 in group 1). Three patients required rescue anti-emetic medication in each of the groups 2 and 3. In conclusion, 2 mg tropisetron appears to be equally as efficacious as 5 mg in preventing post-operative nausea and vomiting.

Adult↗

PubMedDate not supplied

Non-traumatic colorectal perforations.

Over a 6 year period, between January 1992 and December 1997, 30 patients with non-traumatic colorectal perforations undergoing laparotomy were reviewed. The aim of this study was to evaluate predictions on the prognosis using the Mannheim Peritonitis Index (MPI) and to evaluate the risk of this complication. The mean age of the patients was 56.4 years (range 16-88 years). The male:female ratio was 19:11. All patients showed signs of peritonitis and underwent emergency operations. In 50% (15) of the patients, tumor was the cause. According to the MPI scoring, there were 18 patients with an MPI score of 26 or less and 12 patients with an MPI score of 27 or more. For patients with a score less than 27 the mortality rate was zero (0/18) and for score greater than 26, 66.6% (8/12). Overall mortality was 26.6% (8/30). Of 15 patients with perforated colorectal cancers, four patients died (26.6%). The mortality rate for benign perforations was 26.6% (4/15) also. In conclusion, colorectal cancers are the most common cause of the non-traumatic colorectal perforations. Patients with an MPI score greater than 26 represent the highest risk group.

Adolescent↗

PubMedDate not supplied

The effect of octreotide (SMS 201-995) on experimentally induced pancreatitis with 50% ethyl alcohol in rats.

Brattle-Boro type rats with average weight of 200 gms were used for the experiment. We established 5 groups with 10 rats in each. Group I was the control group, Group II pancreatic trauma group and Group III rats were the pancreatitis group induced by 50% alcohol. Groups IV and V were the groups in which Octreotide was injected in different time intervals after induction of pancreatitis by 50% alcohol. Amylase values were statistically significant between the control group in which Octreotide was injected in different time intervals after induction of pancreatitis by 50% alcohol. The amylase values were statistically significant between the control group and the experiments (t2 = 4.69 p < 0.001, t3 = 8.06 p < 0.00001, t4 = 4.23 p < 0.002, t5 = 4.3 p < 0.002), and it was also significant between Group III and Groups II, IV, V (t2 = 9.62 p < 0.0001, t4 = 10.26 p < 0.0001, t5 = 3.69 p < 0.005), but it was not found significant between Groups II and IV, V (t4 = 0.52 p < 0.6, t5 = 1.69 p < 0.1). Histopathologic examination of the trauma group showed congestion, minimal lymphomonocyte infiltration. Patchy necrosis and shrinkage of the acinar cells with ductal dilatation were seen in the SMS 201-995 injection groups which were more pronounced in Group V. As a conclusion SMS 201-995 is not effective to prevent the ongoing pathology of pancreatitis but the increasing values of amylase were limited on the level of simply induced traumatic pancreatitis. It may be useful in the suppression of the enzymatic production during the course of pancreatitis.

Acute Disease↗

PubMedDate not supplied

Total thyroidectomy or lobectomy in benign nodular disease of the thyroid: changing trends in surgery.

METHODS: Over a 23-month period (January 1994-December 1995) in the era of fine needle aspiration (FNA), 344 thyroid surgery operations were performed for benign diseases of the thyroid. Of these 55 total thyroidectomies or lobectomies were evaluated. Mean age was 43.6 + 9.7 and the female/male ratio was 47/8 (5.8). All cases were operated on with the consensus of the surgery + endocrinology + pathology council according to a protocol based on FNA, thyroid function tests, scintigraphy and ultrasound. Suspected FNA or suspected nodules during the surgery were verified by frozen section also. Of these 55 benign nodules, 7 (12.7%) had total bilateral, 48 (87.3%) unilateral lobectomies. RESULTS: Postoperatively 3 cases (5.8%) of seroma, one transient hypoparathyroidism (1.8%) and one unilateral vocal cord paralysis (1.8%) were seen as complications. CONCLUSIONS: In our center, FNA cytology has been a routine procedure since 1992. Surgery for benign thyroid disease has been reduced 50% since than. This study was started after two years of the FNA procedure. Resident nodules are the most common cause of recurrence in nodular thyroid disease, so some cases need radical surgery when it is decided to operate. Morbidity of surgery for recurrent disease is unacceptably high and is comparable to lifelong supplement therapy.

Adult↗