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  • Küçük Resim Yok
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    Amyand hernia
    (2018) Dirican, Abuzer; Ateş, Mustafa; Koç, Süleyman; Özgör, Dinçer; Kocaaslan, Hüseyin
    [Abstract Not Acailable]
  • Küçük Resim
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    Balık yağı, zeytin yağı ve vitamin e’nin karaciğer üzerindeki patolojik etkileri; parsiyel hepatektomi yapılan ratlardaki hücre proliferasyonu ve antioksidan savunma sistemi
    (İnönü Üniversitesi, 2005) Özgör, Dinçer
    Bugün split karaciğer greftleri çocuklarda kullanılmamaktadır ancak erişkinlerdeki kullanımı artmaktadır. Parsiyel hepatektomi (PH) sonrasında karaciğer rejenerasyonunun yüksek kapasitede olduğu iyi bilinmektedir. Bu çalışmada %70 parsiyel hepatektomi yapılan ratlarda balık yağı, zeytinyağı ve vitamin E tedavileri sonrasında gelişen karaciğer rejenerasyonu ve antioksidan savunma sistemi araştırılmaktadır. Çalışmada 35 adet erkek swiss albino sıçan kullanılmıştır. Grup A’ya (n=10) balık yağı 4mL/kg/gün po, Grup B’ye (n=10) zeytin yağı 4mL/kg/gün po, Grup C’ye (n=10) vit E lOOmg/kg/gün İM Grup D’ye (n=5) %70 PH uygulandığı halde tedavi uygulanmamıştır. 2 haftalık tedavi periyodu sonrasında %70 PH uygulandı. Postoperatif 3. gün denekler sakrifiye edildi ve karaciğer fonksiyonlarının değerlendirilmesi için vena kava inferiordan kan örneği ve histopatolojk ve biyokimyasal çalışmalar için karaciğer dokusu alndı. Grup A ve C’den alınan örneklerde karaciğer parankiminde ve kesim alanında kontrol gruplarına göre istatistiksel olarak belirgin anlamlı karaciğer rejenerasyonu gösterildi (p=0,045). Diğer taraftan, Grup B’de karaciğer rejenerasyonu kesim yüzeyinden ziyade parankimde daha belirgindi, ancak hem parankim hem de yüzey kesim alanı kontrol grubuna göre istatistiksel olarak farklılık göstermedi (p=0,l). Balık yağı grubundaki karaciğer parankim rejenerasyon artışı istatistiksel olarak vitamin E grubundan daha fazla idi (p=0,035). Karaciğer fonksiyon testleri açısından %70 PH istatistiksel olarak tüm gruplarda farklılık gözlenmedi. MDA seviyesi kontrol grubuna göre daha düşük olarak belirlendi ( p=0,001). Kontrol grubu ile karşılaştırıldığında GSH düzeyi zeytin yağı grubunda daha belirgin olarak istatistiksel olarak, belirgin anlamlı artmış gözlendi (p=0,025,p=0,01ve göreceli p=0,96).
  • Küçük Resim
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    Can an extended right lobe be harvested from a donor with gilbert’s syndrome for living-donor liver transplantation? Case report
    (Transplantation Proceedings, 2012) Yılmaz, Mehmet; Ünal, Bülent; Işık, Burak; Özgör, Dinçer; Pişkin, Turgut; Ersan, Veysel; Gönültaş, Fatih; Yılmaz, Sezai
    Gilbert’s syndrome (GS) is a common cause of inherited benign unconjugated hyperbilirubinemia that occurs in the absence of overt hemolysis, other liver function test abnormalities, and structural liver disease. GS may not affect a patient’s selection for living-donor liver transplantation (LDLT). Between February 2005 and April 2011, 446 LDLT procedures were performed at our institution. Two of the 446 living liver donors were diagnosed with GS. Both donors underwent extended right hepatectomies, and donors and recipients experienced no problem in the postoperative period. Their serum bilirubin levels returned to the normal range within 1–2 weeks postoperatively. In our opinion, extended right hepatectomy can be performed safely in living liver donors with GS if appropriate conditions are met and remnant volume is 30%. Livers with GS can be used successfully as grafts in LDLT recipients.
  • Küçük Resim
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    Carcinoma erysipeloides from breast cancer mimicking as radiodermatitis: Report of a case
    (Meme Sağlığı Dergisi, 2009) Söğütlü, Gökhan; Aydın, Cemalettin; Karadağ, Neşe; Ölmez, Aydemir; Özgör, Dinçer; Deniz, Sümer
    Öz: Erizipel karsinom, visseral kanserlerin nadir bir metastazıdır. Lenfatik blokaj sonucu erizipel benzeri bir görünüm oluşmaktadır Bu da erizipel ve diğer inflamatuar lenfödem durumlarıyla karışabilmektedir. Biz bu olgu sunumunda, lokal ileri meme kanseri nedeniyle mastektomi yapılmış ve sonrasında erizipel karsinom gelişmiş bir kadın hastayı sunmayı amaçladık. Lezyon, klinik olarak radyasyon dermatitini andırmakta idi.
  • Küçük Resim
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    A case of acute small bowel obstruction due to metastasis of undiagnosed primary carcinoma of the lung
    (Turk J Gastroenterol., 0–0., 2009) Ara, Cengiz; Dirican, Abuzer; Özgör, Dinçer; Pişkin, Turgut
    A 75-year-old man was admitted to our department with abdominal pain, nausea and vomiting. He was a heavy smoker (a packet/day/60 years) with chronic obstructive pulmonary disease.
  • Küçük Resim
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    Conversion to stoppa procedure in laparoscopic totally extraperitoneal inguinal hernia repair
    (JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2012) Ateş, Mustafa; Dirican, Abuzer; Özgör, Dinçer; Gönültaş, Fatih; Işık, Burak
    Background and Objectives: Conversion to open surgery is an important problem, especially during the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Methods: Here, we discuss conversion to the Stoppa procedure during laparoscopic TEP inguinal hernia repair. Outcomes of patients who underwent conversion to an open approach during laparoscopic TEP inguinal hernia repair between September 2004 and May 2010 were evaluated. Results: In total, 259 consecutive patients with 281 inguinal hernias underwent laparoscopic TEP inguinal hernia repair. Thirty-one hernia repairs (11%) were converted to open conventional surgical procedures. Twenty-eight of 31 laparoscopic TEP hernia repairs were converted to modified Stoppa procedures, because of technical difficulties. Three of these patients underwent Lichtenstein hernia repairs, because they had undergone previous surgeries. Conclusion: Stoppa is an easy and successful procedure used to solve problems during TEP hernia repair. The Lichtenstein procedure may be a suitable option in patients who have undergone previous operations, such as a radical prostatectomy.
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    Delici-kesici alete bağlı diyafragma yaralanmaları: 18 olgunun analizi
    (Ulusal Cerrahi Dergisi, 2010) Dirican, Abuzer; Ateş, Mustafa; Ünal, Bülent; Yılmaz, Mehmet; Özgör, Dinçer; Yılmaz, Sezai
    Öz: Amaç: Tüm delici-kesici alete bağlı diyafragma yaralanmaları onarım gerektirmesine karşın, ameliyat öncesi tanı koymak zordur. Bu çalışmanın amacı, DKA bağlı diyafragma yaralanmaları konusunda bir genel cerrahi kliniği olarak deneyimlerimizi aktarmaktır. Hastalar ve Yöntem: Mart 2000- Haziran 2009 tarihleri arasında, İnönü Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda tedavi edilen, delici-kesici alete bağlı diyafragma yaralanmalı 18 hastanın kayıtları retrospektif olarak incelendi. Bulgular: Hastaların 3'ü kadın, 15'i erkek ve yaş ortalamaları 33 (20–69) yıl idi. En sık şikâyetler solunum güçlüğü, karın ve göğüs ağrısıydı. Onbir (%66) hastada diyafragmanın sol tarafında, 6 (%33) hastada sağ tarafında, 1 (%6) hastada ise her iki tarafında yaralanma vardı. On yedi hastaya hastaneye başvurduktan sonra ilk 24 saat içinde orta hat karın insizyonuyla, bir hastaya ise 10 gün sonra lateral torakotomiyle cerrahi müdahale yapıldı. Mortalite, 2 hastada eşlik eden ek organ yaralanmalarına bağlı kanama, bir hastada ise postoperatif gelişen sepsise bağlı olmak üzere 3 (%17) hastada oluştu. Sonuç: Delici-kesici alete bağlı diyafragma yaralanmalarında ameliyat öncesi tanı koymak zordur. Bu hastalarda yüksek oranda yandaş visseral organ yaralanması mevcuttur. Gövdenin umbilikus ile ksifoid arası seviyesinde karına nafiz bıçaklanmalarda diyafragma yaralanması akılda tutulmalıdır. Bu hastaların karın ameliyatları esnasında her iki hemidiyafragma dikkatlice eksplore edilmelidir.
  • Küçük Resim
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    Donor complications among 500 living donor liver transplantations at a single center
    (Transplant Pro, 0–0., 2012) Özgör, Dinçer; Dirican, Abuzer; Ateş, Mustafa; Gönültaş ,Fatih; Ara, Cengiz; Yılmaz, Sezai
    ABSTRACT Introduction. Living donor liver transplantation (LDLT) has become necessary because of the shortage of cadaveric organs. We retrospectively analyzed 500 living donor hepatectomies using the Clavien classification system for complications to grade their severity. Materials and methods. We retrospectively identified and applied the Clavien clasification to 500 consecutive donors who underwent right for LDLT left hepatectomy between January 2007 and August 2011. Results. The 149 complications were observed in 93 of 500 (18.6%) donors who were followed for a mean 30 months. There wan no donor mortality. Complications developed in 85 (18.6%) right 5 (35.7%) left, and 3 (10%) left lateral segment hepatectomy donors. The overall incidence of reoperations was 7.2%. Seventy-seven of 149 complications were grade I (51.6%) or 9 grade II (6%). The major complications consisted of 27 (18.1%) grade IIIa, 35 (23.4%) grade IIIb, and 1 (0.6%) grade IVa. Grade IVb and grade V complications did not occur. The most common problems were biliary complications in 14 of 181 donors (7.7%). Conclusion. Donors for LDLT experienced a range of complications.
  • Küçük Resim
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    Donor complications among 500 living donor liver transplantations at a single center
    (Transplant Pro, 0–0., 2012) Özgör, Dinçer; Dirican, Abuzer; Ateş, Mustafa; Gönültaş ,Fatih; Ara, Cengiz; Yılmaz, Sezai
    Introduction. Living donor liver transplantation (LDLT) has become necessary because of the shortage of cadaveric organs. We retrospectively analyzed 500 living donor hepatectomies using the Clavien classification system for complications to grade their severity. Materials and methods. We retrospectively identified and applied the Clavien clasification to 500 consecutive donors who underwent right for LDLT left hepatectomy between January 2007 and August 2011. Results. The 149 complications were observed in 93 of 500 (18.6%) donors who were followed for a mean 30 months. There wan no donor mortality. Complications developed in 85 (18.6%) right 5 (35.7%) left, and 3 (10%) left lateral segment hepatectomy donors. The overall incidence of reoperations was 7.2%. Seventy-seven of 149 complications were grade I (51.6%) or 9 grade II (6%). The major complications consisted of 27 (18.1%) grade IIIa, 35 (23.4%) grade IIIb, and 1 (0.6%) grade IVa. Grade IVb and grade V complications did not occur. The most common problems were biliary complications in 14 of 181 donors (7.7%). Conclusion. Donors for LDLT experienced a range of complications.
  • Küçük Resim
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    Donor complications among 500 living donor liver transplantations at a single center
    (Transplant Proc., 2012) Özgör, Dinçer; Dirican, Abuzer; Ateş, Mustafa; Gönültaş, Fatih; Ara, Cengiz; Yılmaz, Sezai
    Introduction. Living donor liver transplantation (LDLT) has become necessary because of the shortage of cadaveric organs. We retrospectively analyzed 500 living donor hepatectomies using the Clavien classification system for complications to grade their severity. Materials and methods. We retrospectively identified and applied the Clavien clasification to 500 consecutive donors who underwent right for LDLT left hepatectomy between January 2007 and August 2011. Results. The 149 complications were observed in 93 of 500 (18.6%) donors who were followed for a mean 30 months. There wan no donor mortality. Complications developed in 85 (18.6%) right 5 (35.7%) left, and 3 (10%) left lateral segment hepatectomy donors. The overall incidence of reoperations was 7.2%. Seventy-seven of 149 complications were grade I (51.6%) or 9 grade II (6%). The major complications consisted of 27 (18.1%) grade IIIa, 35 (23.4%) grade IIIb, and 1 (0.6%) grade IVa. Grade IVb and grade V complications did not occur. The most common problems were biliary complications in 14 of 181 donors (7.7%). Conclusion. Donors for LDLT experienced a range of complications.
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    The effect of caffeic acid phenethyl ester CAPE against cholestatic liver injury in rats
    (J Surg Res, 0–0., 2010) Çoban, Sacid; Yıldız, Fahrettin; Alpaslan, Terzi; Al, Behcet; Özgör, Dinçer; Ara, Cengiz; Ara, Cengiz; Polat, Alaadin; Esrefoğlu, Mukaddes
    Objectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mmol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in g glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin1alpha (IL-1a) and interleukin-6 (IL-6) were signifi- cantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation. Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necroinflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury. 2010 Elsevier Inc. All rights reserved.
  • Küçük Resim
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    The effect of caffeic acid phenethyl ester CAPE against cholestatic liver injury in rats
    (J Surg Res, 2010) Çoban, Sacid Abdussemet; Yıldız, Fahrettin; Terzi, Alparslan; Al, Behçet; Özgör, Dinçer; Ara, Cengiz; Polat, Alaadin; Eşrefoğlu, Mukaddes
    Objectives. Caffeic acid phenethyl ester (CAPE) has been subjected to considerable investigations that have revealed its antioxidant and anti-inflammatory activities in different conditions. But there is not a previous investigation about its effect on cholestatic liver injury. The aim of this study was to investigate the effect of CAPE in rat liver against cholestatic liver injury induced by bile duct ligation. Methods. Swiss-albino rats were recruited in the study as follows; Group 1 rats subjected to simple laparotomy known as the sham group; Group 2 rats subjected to bile duct ligation (BDL); Group 3 bile duct ligated rats treated with CAPE. The third group received CAPE (10 mmol/kg) intraperitoneally daily throughout 14 d. Results. Data showed a decrease in g glutamyl transferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase levels (ALT) of the CAPE treated rats, compared with BDL group (P < 0.001, P < 0.01, and P < 0.02, respectively). In the CAPE treated rats, tissue levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were significantly lower than that of the BDL group (P < 0.001). The levels of glutathione (GSH) in CAPE treated rats were significantly higher than that of BDL group (P < 0.001). In CAPE treated group, the levels of interleukin- 1alpha (IL-1a) and interleukin-6 (IL-6) were signifi- cantly lower than that of BDL group (P < 0.03, P < 0.02, respectively). Administration of CAPE in the rats with biliary obstruction resulted in inhibition of necro-inflammation.Conclusion. These results suggest that treatment of CAPE maintains antioxidant defenses, reduces oxidative liver injury, cytokine damage, and necroinflammation in bile duct ligated rats. Thus, CAPE seems to be a promising agent for the attenuation of cholestatic liver injury.
  • Küçük Resim Yok
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    The effect of caffeic acid phenethyl ester on bacterial translocation and intestinal damage after intestinal obstruction
    (Turkish Journal of Medical Sciences, 2010) Ara, Cengiz; Dirican, Abuzer; Erdoğan, Selim; Ateş, Burhan; Özgör, Dinçer; Tatlı, Faik; Tekerekoğlu, M. Sait; Kırımlıoğlu, Vedat
    Öz: Amaç: Obstruksiyon intestinal koruyucu bariyeri bozarak bakteriyel tranlokasyona sebep olur. Bu bakterilerin çoğalması ve yıkım ürünleri sonucu septik komplikasyonlar gelişir. Bu çalışmanın amacı cafeic acid phenethyl esterin (CAPE) ratlarda oluşturulan intestinal obstruksiyon modelinde bakteriyel translokasyon ve intestinal hasar üzerindeki etkisini araştırmaktır. Yöntem ve gereç: Ratlarda intestinal obstruksiyon (İO) distal ileumun 4/0 ipek sütürle bağlanması ile sağlandı. 21 Wistar albino rat üç gruba ayrıldı. Grup 1: Sham (n = 7), grup 2: İO (n = 7), grup 3: İO + CAPE (n = 7). Üçüncü gruba günde 10 ?mol kg-1 dozunda CAPE intestinal obstruksiyon oluşturulmadan iki gün önce başlanarak üç gün intraperitonel verildi. İntestinal obstruksiyondan 24 saat sonra ratlar sakrifiye edildi. Ratların mezenterik lenf nodu, karaciğer ve ilumundan örnek alınarak biyokimyasal analiz ve mikrobiyolojik inceleme yapıldı. Bulgular: Mezenterik lenf nodu ve karaciğerden alınan örneklerin bakteriyel kültür ortamına ekimde en sık üreyen mikroorganizmalar E. coli, Proteus mirabilis ve Enterococcus spp. idi. Grup 3’te malondialdehyde (MDA) ve adrenomedullin seviyeleri grup 2’ ye göre istatistiksel olarak anlamlı derecede düşük bulundu (P < 0,001). İleumdan alınan örnekte reduced glutathione (GSH) ve katalaz seviyeleri grup 3’te, grup 2’ye göre istatistiksel olarak anlamlı düzeyde yüksek bulundu (P < 0,001). Sonuç: Bu sonuçlar CAPE’nin mekanik intestinal obstruksiyonda oluşan bakteriyel translokasyona karşı ve barsaktakta oluşan oksidatif hasara karşı koruyucu etkisinin olabileceğini göstermektedir. Bu yararlı etkinin mekanizmasını açıklamak için daha çok deneysel çalışmaya ihtiyaç vardır.
  • Küçük Resim
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    Erişkinlerde Meckel Divertikülüne Bağlı İntestinal İntussusepsiyon : Olgu Sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Ara, Cengiz; Kahraman, Latif; Çoban, Sacit; Özgör, Dinçer
    İnverte olmuş Meckel divertükülüne bağlı intussusepsiyonlar nadir durumlardır. İleoileal intussepsiyonlarda inverte olmuş Meckel divertikülüne bağlı intestinal obstrüksyon gelişmiş 83 yaşında bir erkek hastayı sunmaktayız. Meckel divertikülü intussusepsiyonlar, akut obstrüksiyona bağlı ileal strangülasyona neden olabilir. Bundan dolayı gereksiz bağırsak rezeksiyonundan kaçınmak için erken tanı konulmalıdır.
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    Hepatic vein stenosis developed during living donor hepatectomy and corrected with peritoneal patch technique a case report
    (Transplantation Proceedings, 2012) Yılmaz, Sezai; Kayaalp, Cüneyt; Battaloğlu, Bektaş; Ersan, Veysel; Özgör, Dinçer; Pişkin, Turgut
    An 18-year-old male living donor for his father with end-stage liver cirrhosis due to hepatitis B underwent an extended right lobe donor hepatectomy. The middle hepatic vein was visualised on the cut surface of the graft and dissected up to the confluence of the middle and left hepatic veins. After vascular clamping, right and middle hepatic veins were cut to removed the graft. While starting the stump closure, the clamp over the middle hepatic vein slipped and the vein stump sutured quickly under suboptimal exposure. Soon after this closure, the remnant liver showed increasing congestion. Intraoperative Doppler ultrasound revealed obstruction of venous outflow at the remnant left liver due to stenosis in the left hepatic vein. Under total hepatic vascular occlusion, the sutures were removed from the narrowed left hepatic vein. A 2 2 cm peritoneal patch from the subcostal area that was prepared to close the defect was sutured to the edges of the left hepatic vein defect. Venous congestion of the liver disappeared when the clamps were removed. Intraoperative Doppler ultrasound confirmed normal hepatic venous flow. The postoperative course of the donor was uneventful. There was no clinical, biochemical, or radiological problems at 47 months of follow-up. An autogenous peritoneal patch may be a good option to repair vascular defects, which are not suitable for primary sutures, due to easy accessibility and size adjustment, cost effectiveness, as well as relatively low risk of infection and thrombosis. Close dissection of the left hepatic vein during parenchymal transection over the middle hepatic vein can result in narrowing, particularly at the bifurcation of the middle/left hepatic veins that can cause congestion in the remnant liver. When we include the middle hepatic vein with the right graft, we now believe that dissection away from the left hepatic vein seems much more secure for donors.
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    Intestinal intussusception in an adults due to Meckel’s diverticulum: A case report
    (2007) Ara, Cengiz; Kahraman, Latif; Çoban, Sacit; Özgör, Dinçer
    Abstract: Intussusceptions due to an inverted Meckel&#8217;s diverticulum are considered as a rare condition. We present a case of 83 year-old male with intestinal obstruction due to an inverted Meckel&#8217;s divertuculum at the base of ileoileal intussusceptions. Ileal strangulation may occur due to intussusception of a Meckel&#8217;s diverticulum. Hence the clinician should be aware of this possibility and diagnose more quickly to avoid unnecessary bowel resection.
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    Intestinal perforation in the hernia sac due to a blunt trauma: A case report
    (2009) Dirican, Abuzer; Ara, Cengiz; Ünal, Bülent; Özgör, Dinçer
    Abstract: Inguinal herni en sık görülen herni tiplerinden bir tanesidir. Herni kesesi içerisindeki ince barsak perforasyonu veya nekrozu gibi kompiikasyoniar ciddi durumlarla sonlanabilir. Olgumuzda olduğu gibi kasık bölgesine kunt travma, herni varlığında fıtık kesesi içindeki ince barsak perforasyonuna yol açabilir.
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    Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus
    (Lıver Transplantatıon 17:1286-1291, 2011., 2011) Ateş, Mustafa; Dirican, Abuzer; Özgör, Dinçer; Aydın, Cemalettin; Işık, Burak; Ara, Cengiz
    Yellow phosphorus is a protoplasmic toxicant that targets the liver. The ingestion of fireworks containing yellow phosphorus,either by children who accidentally consume them or by adults who are attempting suicide, often results in death due toacute liver failure (ALF). We present the outcomes of 10 children who ingested fireworks containing yellow phosphorus.There were 6 boys and 4 girls, and their ages ranged from 21 to 60 months. One patient remained stable without liver com-plications and was discharged. Three patients died of hepatorenal failure and cardiovascular collapse, and living donor livertransplantation (LDLT) was performed for 6 patients. The patients had grade II or III encephalopathy, a mean alanine amino-transferase level of 1148.2 IU/L, a mean aspartate aminotransferase level of 1437.5 IU/L, a mean total bilirubin level of 6.9mg/dL, a mean international normalized ratio of 6.6, a mean Pediatric End-Stage Liver Disease score of 33.7, and a meanChild-Pugh score of 11.3. Postoperatively, 2 patients had persistent encephalopathy and died on the second or third postop-erative day, and 1 patient died of cardiac arrest on the first postoperative day despite a well-functioning graft. The other 3patients were still alive at a mean of 204 days. In conclusion, the ingestion of fireworks containing yellow phosphoruscauses ALF with a high mortality rate. When signs of irreversible ALF are detected, emergency LDLT should be consideredas a lifesaving procedure; however, if yellow phosphorus toxicity affects both the brain and the heart in addition to the liver,the mortality rate remains very high despite liver transplantation. Liver Transpl 17:1286-1291, 2011.VC2011 AASLD.
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    Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus
    (Liver Transplantation, 2011) Ateş, Mustafa; Dirican, Abuzer; Özgör, Dinçer; Aydın, Cemalettin; Işık, Burak; Ara, Cengiz; Yılmaz, Mehmet; Selimoğlu, Mukadder Ayşe; Kayaalp, Cüneyt; Yılmaz, Sezai
    Yellow phosphorus is a protoplasmic toxicant that targets the liver. The ingestion of fireworks containing yellow phosphorus, either by children who accidentally consume them or by adults who are attempting suicide, often results in death due to acute liver failure (ALF). We present the outcomes of 10 children who ingested fireworks containing yellow phosphorus. There were 6 boys and 4 girls, and their ages ranged from 21 to 60 months. One patient remained stable without liver complications and was discharged. Three patients died of hepatorenal failure and cardiovascular collapse, and living donor liver transplantation (LDLT) was performed for 6 patients. The patients had grade II or III encephalopathy, a mean alanine aminotransferase level of 1148.2 IU/L, a mean aspartate aminotransferase level of 1437.5 IU/L, a mean total bilirubin level of 6.9 mg/dL, a mean international normalized ratio of 6.6, a mean Pediatric End-Stage Liver Disease score of 33.7, and a mean Child-Pugh score of 11.3. Postoperatively, 2 patients had persistent encephalopathy and died on the second or third postoperative day, and 1 patient died of cardiac arrest on the first postoperative day despite a well-functioning graft. The other 3 patients were still alive at a mean of 204 days. In conclusion, the ingestion of fireworks containing yellow phosphorus causes ALF with a high mortality rate. When signs of irreversible ALF are detected, emergency LDLT should be considered as a lifesaving procedure; however, if yellow phosphorus toxicity affects both the brain and the heart in addition to the liver, the mortality rate remains very high despite liver transplantation.
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    Mekanik barsak obstrüksiyonu nedeniyle laparotomi yapılan hastalarda flukonazol proflaksisinin lipid peroksidasyonu ve nitrik oksit üzerine etkisi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2006) Düzova, Halil; Işık, Burak; Özgör, Dinçer; Bayındır, Yaşar; Tekerekoğlu, M.Sait; Yılmaz, Sezai
    Amaç: Mekanik barsak obstrüksiyonu nedeni ile opere edilen hastalarda ortaya çıkan enfeksiyonlarda, giderek artan sıklıkta Candida albicans izole edilmektedir. Bu çalışmada, kandidial enfeksiyonlar, nitrik oksit (NO) ve tiobarbiturik asit türevi aktif ürünlerin (TBARS) yapım cevabı üzerine flukonazol profilaksisin, etkisini incelemek için yapıldı. Gereç ve Yöntem: Temmuz 2003 ile Aralık 2004 tarihleri arasında mekanik barsak obstrüksiyonu nedeniyle laparotomi yapılan 52 hasta çalışmaya alındı. Bu randomize (plasebo- kontrol), çift-kör klinik çalışmada, belirtilen hasta grubunda kandidial translokasyon sıklığı ve bu durumun klinik bulgulara etkisi ile rutin antibakteriyel tedavi ile birlikte preopertaif tek doz flukonazol (400 mg) proflaksisinn etkisi araştırıldı. Aynı zamanda, flukonazol proflaksisinin preoperatif, postoperatif 2., 6. ve 24. saatlerde alınan kan örneklerinde kandidial translokasyonda NO ve TBARS düzeyleri üzerine etkisi spektrofotometrik yöntem ile ölçüldü. Sonuçlar: Malign nedenlerden mekanik barsak tıkanması olan hastalarda ameliyat öncesi tek doz flukonazol verildiğinde, postoperatif 2’inci saat plazma NO düzeyinde artış (p<0.003), ameliyat anında alınan kan ve doku kültürlerinde gram negatif üreme gösteren hastaların postoperatif 24’üncü saatinde plazma NO düzeylerinde istatistiksel olarak artış bulundu (p<0.05). Fakat NO plazma seviyesi, postoperatif kültüründe gram negatif üremesi olan hastalarda 6’ıncı. saatte 2’ıncı saatte ki düzeye göre azalma saptandı (p<0,05). Çıkarımlar: Malign nedenlerden dolayı barsak tıkanması olanlarda, fungal translokasyonu engelleme özelliği gösteren flukonazol, aynı zamanda NO metabolizmasını etkiler. Kültürlerinde gram negatif üremesi olan olgularda ise NO metabolizmasının daha geniş kapsamlı araştırılması gerekmektedir.