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Öğe A Nationwide Assessment of Turkish Society's Knowledge and Attitudes Toward Xenotransplantation(Wiley, 2025) Akbulut, Sami; Kucukakcali, Zeynep; Ozer, Ali; Colak, CemilBackground: This study aimed to assess public perceptions, awareness, and attitudes toward xenotransplantation (XTx) and organ donation in Turkey by examining the influence of demographic, socioeconomic, and religious factors to identify barriers and facilitators to organ donation and XTx acceptance Methods: This cross-sectional survey was conducted with 10 650 participants, selected through stratified sampling to ensure national representation. Data collection was performed via Computer-Assisted Personal Interviewing (CAPI), with structured questionnaires designed to evaluate participants' perspectives on organ donation, XTx, and religious influences, and comparisons were made based on age groups, geographical region, sectarian affiliation, education level, belief categories, and economic status. ResultsOrgan donation rates were low across all demographic groups, with notable differences by geographical region, education level, income, age, and religious beliefs. The highest organ donation rate was in Central Anatolia (0.9%), while Southeastern Anatolia had the lowest (0.0%) (p = 0.014). Higher education (p = 0.001) and income levels (p = 0.01) correlated with greater organ donation support. Younger individuals (18-24 years) were less religiously observant, while older participants (65+) displayed the highest religious adherence (p = 0.022). Acceptance of XTx from halal animals was highest in the Aegean region (43.0%) (p = 0.001) and among participants with lower religious adherence (27.4%) (p = 0.004). Approval for XTx from non-halal animals was significantly lower, particularly among highly religious individuals (23.9%). Awareness of XTx-related studies was lowest among participants aged 65+ (9.4%) (p < 0.001) and highest among Maliki participants (27.3%). Conclusion: This study highlights the influence of demographic, socioeconomic, and religious factors on public attitudes toward organ donation and XTx in Turkey. These findings offer critical insights for policymakers and healthcare professionals to design culturally adaptive strategies that improve organ donation rates and foster XTx acceptance.Öğe Abdominopelvic Actinomycosis Associated With an Intrauterine Device and Presenting With a Rectal Mass and Hydronephrosis: A Troublesome Condition for the Clinician(Int College Of Surgeons, 2012) Yilmaz, Mehmet; Akbulut, Sami; Samdanci, Emine Turkmen; Yilmaz, SezaiActinomycosis is an uncommon, chronic, granulomatous disease that can be mistaken for a malignant tumor. Abdominopelvic actinomycosis constitutes about 20% of all actinomycosis cases and may mimic malignancy, tuberculosis, or other abdominopelvic inflammatory diseases. This condition is more prevalent in women who use an intrauterine device. We treated a 44-year-old woman who presented with vaginal discharge, right flank pain, dysuria, and difficulty with defecation. She had anorexia and weight loss (8 kg) during the previous 2 months and had a history of intrauterine device use for 12 years. Clinical, radiologic, and endoscopic examinations revealed a rectal mass and right hydronephrosis. Rectal biopsy showed nonspecific colitis. Laparotomy showed a mass that was invading and obstructing the pelvic orifice. Surgery included total abdominal hysterectomy, bilateral salpingo-oophorectomy, appendectomy, low anterior resection, and Hartmann colostomy. Histopathologic evaluation of surgical specimens showed actinomycosis originating from the tubo-ovarian structures and invading the rectal wall. The patient was placed on penicillin for 6 months, and then had closure of the colostomy with no complication.Öğe Accurate definition and management of idiopathic sclerosing encapsulating peritonitis(Baishideng Publishing Group Inc, 2015) Akbulut, SamiAIM: To review the literature on idiopathic sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon syndrome. METHODS: The PubMed, MEDLINE, Google Scholar, and Google databases were searched using specific key words to identify articles related to idiopathic SEP. These key words were sclerosing encapsulating peritonitis, idiopathic sclerosing encapsulating peritonitis, abdominal cocoon, and abdominal cocoon syndrome.The search included letters to the editor, case reports, review articles, original articles, and meeting presentations published in the English-language literature from January 2000 to May 2014. Articles or abstracts containing adequate information about age, sex, symptom duration, initial diagnosis, radiological tools, and surgical approaches were included in the study. Papers with missing or inadequate data were excluded. RESULTS: The literature search yielded 73 articles on idiopathic (primary) SEP published in 23 countries. The four countries that published the greatest number of articles were India (n = 21), Turkey (n = 14), China (n = 8) and Nigeria (n = 3). The four countries that reported the greatest number of cases were China (n = 104; 53.88%), India (n = 35; 18.13%), Turkey (n = 17; 8.80%) and Nigeria (n = 5; 2.59%). The present study included 193 patients. Data on age could be obtained for 184 patients (range: 7-87 years; mean +/- SD, 34.7 +/- 19.2 years), but were unavailable for nine patients. Of the 184 patients, 122 were male and 62 were female; sex data could not be accessed in the remaining nine patients. Of the 149 patients whose preoperative diagnosis information could be obtained, 65 (43.6%) underwent operations for abdominal cocoon, while the majority of the remaining patients underwent operations for a presumed diagnosis of intestinal obstruction and/or abdominal mass. Management information could be retrieved for 115 patients. Of these, 68 underwent excision + adhesiolysis (one laparoscopic); 24 underwent prophylactic appendectomy in addition to excision + adhesiolysis. Twenty patients underwent various resection and repair techniques along with excision + adhesiolysis. The remaining three patients were managed with antituberculosis therapy (n = 2) and immunosuppressive therapy (n = 1). CONCLUSION: Idiopathic SEP is a rare disorder characterized by frequently recurring bouts of intestinal obstruction. Surgical therapy is the gold standard management strategy.Öğe Adipose-derived stem cells in the treatment of hepatobiliary diseases and sepsis(Baishideng Publishing Group Inc, 2022) Satilmis, Basri; Cicek, Gizem Selen; Cicek, Egemen; Akbulut, Sami; Sahin, Tevfik Tolga; Yilmaz, SezaiDetermination of the mesenchymal stem cells is one of the greatest and most exciting achievements that tissue engineering and regenerative medicine have achieved. Adipose-derived mesenchymal stem cells (AD-MSC) are easily isolated and cultured for a long time before losing their stem cell characteristics, which are self-renewal and pluripotency. AD-MSC are mesenchymal stem cells that have pluripotent lineage characteristics. They are easily accessible, and the fraction of stem cells in the adipose tissue lysates is highest among all other sources of mesenchymal stem cells. It is also HLA-DR negative and can be transplanted allogenically without the need for immunosuppression. These advantages have popularized its use in many fields including plastic reconstructive surgery. However, in the field of hepatology and liver transplantation, the progress is slower. AD-MSC have the potential to modulate inflammation, ameliorate ischemia-reperfusion injury, and support liver and biliary tract regeneration. These are very important for the treatment of various hepatobiliary diseases. Furthermore, the anti-inflammatory potential of these cells has paramount importance in the treatment of sepsis. We need alternative therapeutic approaches to treat end-stage liver failure. AD-MSC can provide a means of therapy to bridge to definitive therapeutic alternatives such as liver transplantation. Here we propose to review theoretic applications of AD-MSC in the treatment of hepatobiliary diseases and sepsis.Öğe Amebic Acute Appendicitis: Systematic Review of 174 Cases(Springer, 2013) Otan, Emrah; Akbulut, Sami; Kayaalp, CuneytThis study aimed to determine the clinical and demographic features of acute amebic appendicitis by reviewing the reported cases. The PubMed and MEDLINE databases were searched to identify articles related to amebic appendicitis using key words. The search included all articles published between 1935 and 2012 without restricting language, journal, or country. A total of 174 cases of amebic appendicitis reported in 42 articles were analyzed. The mean age of the patients was 23.5 years (range 2 months-83 years). The majority of patients were male (74.0 %), and the majority of cases were reported from countries with high/moderate risk for amebiasis (76.5 %). A history of traveling to a high/moderate-risk country was cited in 64.0 % of the overall cases. The interval between travel and onset of clinical symptoms ranged from months to years. History of or coexisting dysenteric diarrhea was present in only 7.0 and 14.0 % of overall cases, respectively. A preoperative diagnosis of amebiasis was cited for only five cases (3.0 %). Complicated appendicitis was present in 30.7 % of cases, some of which required colon resection. Severe postoperative intraabdominal complications (e.g., liver abscess, abdominal sepsis, gastrointestinal fistula, hemorrhage) occurred in 19.4 % of surgery-treated patients. The overall mortality rate was 3.2 %. Appendectomy specimens should be routinely sent for histopathologic examination. In the case of suspected amebic acute appendicitis, extra precautions-early appendectomy, metronidazole for antibiotic prophylaxis, wet-preparation examination, obtaining a timely pathology result, increasing the awareness of uncommon complications of appendectomy-can hasten appropriate therapeutic intervention and improve outcome.Öğe Amifostine enhances the antioxidant and hepatoprotective effects of UW and HTK preservation solutions(Baishideng Publishing Group Inc, 2014) Akbulut, Sami; Sevmis, Sinasi; Karakayali, Hamdi; Bayraktar, Nilufer; Unlukaplan, Muge; Oksuz, Ergun; Dagdeviren, AtillaAIM: To investigate whether amifostine contributes to the antioxidant and cytoprotective effects of histidine-tryptophan-ketoglutarate (HTK) and University of Wisconsin (UW) preservation solutions. METHODS: Forty-eight Sprague Dawley male rats were equally divided into six groups: (1) ringer Lactate (RL) group; (2) RL + amifostine (RL + A) group; (3) HTK group; (4) HTK + A group; (5) UW group; and (6) UW + A group. Rats in the RL + A, HTK + A and UW + A groups were administered amifostine intraperitoneally at a dose of 200 mg/kg prior to laparotomy. The RL group was perfused with RL into the portal vein. The RL + A group were perfused with RL into the portal vein after amifostine administration. The HTK group received an HTK perfusion while the HTK + A group received an HTK perfusion after administration of amifostine. The UW group received a perfusion of UW, while the UW + A group received a UW perfusion after amifostine administration. Liver biopsy was performed to investigate histopathological, immunochemical [transferase mediated dUTP nick end labeling (TUNEL), inducible nitric oxide syntetase (iNOS)] and ultrastructural alterations. Biochemical alterations were determined by examining levels of alanine aminotransferase, alkaline phosphatase and nitric oxide in the perfusion fluid. RESULTS: Pathological sinusoidal dilatation and centrilobular hydropic alteration were significantly lower in the groups that received amifostine prior to preservation solution perfusion. Although the best results were obtained in the UW + A group, we did not observe a statistically significant difference between the UW + A and HTK + A groups. iNOS grades were significantly lower in the amifostine groups 12 h after treatment. When the amifostine groups were compared against each other, the iNOS grades obtained from the UW + A and HTK + A groups were similar while the RL + A group had a much poorer score. TUNEL assays demonstrated a lower apoptosis ratio in the amifostine groups than in the non-amifostine groups 12 h after treatment. No statistically significant difference was observed between the UW + A and HTK + A groups for apoptosis. Cellular ultrastructure was best preserved in the UW + A and HTK + A groups. CONCLUSION: Here, we show that preoperative administration of a single dose of amifostine is sufficient to minimize the preservation damage in hepatic cells. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Öğe Analysis of Risk Factors Affecting the Development of Infection in Artificial Vascular Grafts Used for Reconstruction of Middle Hepatic Vein Tributaries in Living Donor Liver Transplantation(Lippincott Williams & Wilkins, 2019) Koc, Cemalettin; Akbulut, Sami; Ozdemir, Fatih; Kose, Adem; Isik, Burak; Yologlu, Saim; Yilmaz, SezaiBackground. To analyze the risk factors affecting the development of infection in artificial vascular grafts (AVGs) used for reconstruction of middle hepatic vein (MHV) tributaries in living donor liver transplantation (LDLT). Methods. Between January 2009 and January 2018, 1253 right lobe LDLTs were performed at our Transplant Institute, and MHV tributaries of the 640 right lobe liver grafts were reconstructed with AVG. Reconstructed MHV tributaries were removed due to AVG infection in 25 of these patients (case group; n = 25). To determine risk factors for AVG infection, right lobe LDLT patients without AVG infections were selected as control group (n = 615). Both groups were compared about demographic parameter, transcystic catheter usage, bile leakage, type of biliary anastomosis (duct-to-duct, telescopic duct-to-duct), number of graft biliary duct (=1 versus >1), number of biliary anastomosis (=1 versus >1), AVG thrombosis, AVG types (Dacron versus polytetrafluoroethylene). Univariate analyses were used for comparison of different variables, and variables with P <= 0.20 were taken into logistic regression model. Results. Univariate analysis shows that statistically significant differences were found between groups regarding bile leakage (P < 0.001), graft thrombosis (P = 0.002), transcystic catheter (P = 0.049), and AVG types (P = 0.013). Variables with P <= 0.20 were taken into logistic regression model. Multivariate analysis shows that bile leakage (odds ratio, 13.3) and AVG thrombosis (odds ratio, 9.8) were determined as independent and strong risk factors for development of AVG infection. Conclusions. This study revealed that bile leakage and graft thrombosis are independent and strong risk factors for infections of AVGs used for anterior sector drainage reconstruction.Öğe Analysis of risk factors affecting the development of peptic ulcer perforation: case-control study(Termedia Publishing House Ltd, 2021) Akbulut, Sami; Caliskan, Ali Riza; Saritas, Hasan; Demyati, Khaled; Bilgic, Yilmaz; Unsal, Selver; Koc, CemalettinAim: The aim of the to determine the risk factors associated with increased risk of peptic ulcer perforation (PUP). Material and methods: The demographic, clinic, and biochemical parameters of 65 patients (PUP group) who underwent PUP surgery at our clinic between June 2009 and September 2016 were compared with the data of 134 patients (control group) who underwent endoscopy at a gastroenterology clinic for dyspeptic complaints. The control group were matched at random in a 1 : 2 ratio with the PUP group. Univariate analyses were used to compare different variables and variables with clinical significance, and p <= 0.05 was used in the backward stepwise logistic regression model. Results: This study included 65 patients with peptic ulcer perforation aged 17 to 92 years (PUP group) and 134 patients with dyspeptic complaints aged 18 to 87 years (control group). Univariate analysis showed that statistically significant differences were found between groups in terms of non-steroidal anti-inflammatory drugs usage (p = 0.042; OR = 1.868), smoking (p < 0.001; OR = 5.124), old age (p = 0.003), low body mass index (BMI) (p < 0.001), and low hemoglobin (Hb) (p = 0.002). However multivariate analysis showed that increasing age (p = 0.004; OR = 1.035), smoking (p = 0.007; OR = 3.591), decreasing Hb (p = 0.042; OR = 1.277), and decreasing BMI (p < 0.001; OR = 1.669) were independent clinically significant risk factors for development of PUP. Conclusions: This study showed that decreased BMI, decreased Hb, increased age, and smoking were independent risk factors for development of PUP. Thus, this group of patients needs particular attention paid to suggestive symptoms with early diagnosis and optimal management of peptic ulcer disease.Öğe Appendiceal Carcinoid Tumor within Amyand's Hernia: A Case Report and Review of the Literature(Wolters Kluwer Medknow Publications, 2019) Sarici, Baris; Akbulut, Sami; Piskin, TurgutIntroduction: Amyand's hernia is defined as the herniation of the whole or a part of appendix vermiformis into an inguinal hernia sac. Amyand's hernia is very rare, constituting about 1% of all inguinal hernia patients and 0.1% of all acute appendicitis patients. In one-quarter of Amyand's hernia patients, inflammatory changes are detected in appendix vermiformis. Detecting an appendiceal tumor in an Amyand's hernia sac is extremely rare, with only eight cases having been reported so far in the English literature. Case presentation: A 64-year-old man with an appendiceal carcinoid tumor inside an incarcerated Amyand's hernia sac. As the tumor was localized to the radix of the appendix, resection was carried out with the help of a linear-cutter stapler in a way to contain a part of the cecal wall. As the pathology examination revealed a carcinoid tumor infiltrating the periappendicular fatty tissue, right hemicolectomy was performed in a second session, in compliance with the oncological principles. No metastasis was present at the 24th month. Case reports published in the English literature regarding the Amyand's hernia with an appendiceal tumor were also analyzed in this study. Conclusion: Amyand's hernia containing an appendiceal tumor is an extremely rare clinical entity. Clinical manifestations mostly mimic the incarcerated hernia and thus accurate diagnosis is made incidentally during hernia surgery. The basic oncological principles apply for the approach to tumors inside a hernia sac.Öğe Are Ki-67 and Procalcitonin Expression Levels Useful in Predicting the Biological Behavior of Hepatocellular Carcinoma After Liver Transplantation?(Mdpi, 2025) Karabulut, Ertugrul; Akbulut, Sami; Samdanci, Emine Turkmen; Akatli, Ayse Nur; Elsarawy, Ahmed; Kucukakcali, Zeynep; Ogut, ZekiBackground: Examinations of procalcitonin (PCT) and Ki-67 expression levels in hepatocellular carcinoma (HCC) patients who have undergone liver transplantation (LT) through immunohistochemical analyses of tumor tissue may reveal the biological characteristics of the tumor, thus informing the selection of HCC patients for LT. Methods: Hepatectomy specimens from 86 HCC patients who underwent LT were obtained and analyzed immunohistochemically for the expression of PCT and Ki-67. The percentage and intensity of PCT staining, as well as the percentage of Ki-67 expression, were assessed for each patient. The impacts of PCT and Ki-67 expression on disease-free survival, overall survival, and the recurrence rate were studied, as well as their correlations with other clinicopathological features. Results: The recurrent HCC group showed a higher Ki-67 level (p < 0.001), larger maximum dominant tumor diameter (p < 0.001), and higher rate of vascular invasion (p = 0.001). The pre-transplant AFP (p = 0.001), maximum dominant tumor diameter (p < 0.001), number of tumor nodules (p < 0.001), rate of vascular invasion (p = 0.001), and Ki-67 level (p = 0.044) were higher in patients beyond the Milan criteria. Similarly, the pre-transplant AFP (p < 0.001); maximum dominant tumor diameter (p < 0.001); number of tumor nodules (p < 0.001); rates of portal vein tumor thrombus (p = 0.002), poor differentiation (p = 0.021), and vascular invasion (p < 0.001); and Ki-67 level (p = 0.010) were higher in patients beyond the expanded Malatya criteria. The maximum dominant tumor diameter (p = 0.006); Ki-67 level (p = 0.003); rates of vascular invasion (p < 0.001), cases beyond the Milan criteria (p = 0.042) and the expanded Malatya criteria (p = 0.027), and portal vein tumor thrombus (p = 0.020); and presence of recurrence (p < 0.001) were higher in HCC patients with mortality. The Kaplan-Meier estimates indicated that Ki-67 levels exceeding 5% significantly affected DFS and OS. Although the Kaplan-Meier estimates indicated that a PCT staining percentage of >= 25% did not have a statistically significant effect on DFS or OS, the outcomes may be considered clinically significant. Conclusions: This study demonstrated that the Ki-67 proliferation index can be used as a predictive biomarker of the biological behavior of HCC. Furthermore, we claim that PCT expression over a particular threshold might impact recurrence and survival, and we believe that further multicenter prospective studies focused on standardized PCT antibody staining are crucial in order to determine its potential as a biomarker for HCC.Öğe Artificial Intelligence and Decision Support Applications in Liver Hydatid Disease: Detection, Classification, and Complication Prediction(Springer Science+Business Media, 2025) Karaduman, Mucahit; Yildirim, Muhammed; Akbulut, SamiHydatid disease, caused by Echinococcus spp., is a parasitic infection commonly observed in endemic regions such as the Middle East, South America, and Central Asia. Imaging modalities like ultrasonography, computed tomography, and magnetic resonance imaging play a crucial role in diagnosing and managing this disease. However, these techniques have some limitations, particularly concerning diagnostic accuracy, operator dependency, and the inability to predict complications in advance. This chapter comprehensively addresses the use of artificial intelligence (AI) and clinical decision support systems in managing liver hydatid disease within this context. Since the disease most commonly affects the liver, the chapter specifically focuses on liver hydatid disease. AI-based technologies are increasingly utilized to overcome these challenges and optimize diagnostic processes. Deep learning algorithms (e.g., CNN, U-Net) have demonstrated high accuracy in analyzing imaging data. These algorithms enable the automated staging of liver hydatid cysts and predict the risk of complications. Notably, the automation of staging systems accelerates clinical decision-making and reduces discrepancies among expert opinions. Furthermore, surgical clinical decision support systems and complication prediction models not only enhance diagnostic processes but also make treatment planning more reliable. Despite the promising potential of AI models, their widespread clinical adoption faces obstacles such as the lack of high-quality data sets and the challenge of making model decisions interpretable. Therefore, multicenter studies and model validations based on extensive data sets are essential for integrating AI more effectively into clinical practice. In conclusion, AI-powered clinical decision support systems hold significant potential for standardizing and expediting the diagnostic and therapeutic processes in liver hydatid disease. However, further research is necessary to ensure their seamless integration into clinical practice. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.Öğe Artificial intelligence in acute appendicitis: A comprehensive review of machine learning and deep learning applications(Baishideng Publishing Group Inc, 2025) Akbulut, Sami; Kucukakcali, Zeynep; Colak, CemilAcute appendicitis (AAp) remains one of the most common abdominal emergencies, requiring rapid and accurate diagnosis to prevent complications and unnecessary surgeries. Conventional diagnostic methods, including medical history, clinical assessment, biochemical markers, and imaging techniques, often present limitations in sensitivity and specificity, especially in atypical cases. In recent years, artificial intelligence (AI) has demonstrated remarkable potential in enhancing diagnostic accuracy through machine learning (ML) and deep learning (DL) models. This review evaluates the current applications of AI in both adult and pediatric AAp, focusing on clinical data-based models, radiological imaging analysis, and AI-assisted clinical decision support systems. ML models such as random forest, support vector machines, logistic regression, and extreme gradient boosting have exhibited superior diagnostic performance compared to traditional scoring systems, achieving sensitivity and specificity rates exceeding 90% in multiple studies. Additionally, DL techniques, particularly convolutional neural networks, have been shown to outperform radiologists in interpreting ultrasound and computed tomography images, enhancing diagnostic confidence. This review synthesized findings from 65 studies, demonstrating that AI models integrating multimodal data including clinical, laboratory, and imaging parameters further improved diagnostic precision. Moreover, explainable AI approaches, such as SHapley Additive exPlanations and local interpretable model-agnostic explanations, have facilitated model transparency, fostering clinician trust in AI-driven decision-making. This review highlights the advancements in AI for AAp diagnosis, emphasizing that AI is used not only to establish the diagnosis of AAp but also to differentiate complicated from uncomplicated cases. While preliminary results are promising, further prospective, multicenter studies are required for large-scale clinical implementation, given that a great proportion of current evidence derives from retrospective designs, and existing prospective cohorts exhibit limited sample sizes or protocol variability. Future research should also focus on integrating AI-driven decision support tools into routine emergency care workflows.Öğe Artificial intelligence-based prediction of molecular and genetic markers for hepatitis C-related hepatocellular carcinoma(Lippincott Williams & Wilkins, 2023) Colak, Cemil; Kucukakcali, Zeynep; Akbulut, SamiBackground:Hepatocellular carcinoma (HCC) is the main cause of mortality from cancer globally. This paper intends to classify public gene expression data of patients with Hepatitis C virus-related HCC (HCV+HCC) and chronic HCV without HCC (HCV alone) through the XGboost approach and to identify key genes that may be responsible for HCC.Methods:The current research is a retrospective case-control study. Public data from 17 patients with HCV+HCC and 35 patients with HCV-alone samples were used in this study. An XGboost model was established for the classification by 10-fold cross-validation. Accuracy (AC), balanced accuracy (BAC), sensitivity, specificity, positive predictive value, negative predictive value, and F1 score were utilized for performance assessment.Results:AC, BAC, sensitivity, specificity, positive predictive value, negative predictive value, and F1 scores from the XGboost model were 98.1, 97.1, 100, 94.1, 97.2, 100, and 98.6%, respectively. According to the variable importance values from the XGboost, the HAO2, TOMM20, GPC3, and PSMB4 genes can be considered potential biomarkers for HCV-related HCC.Conclusion:A machine learning-based prediction method discovered genes that potentially serve as biomarkers for HCV-related HCC. After clinical confirmation of the acquired genes in the following medical study, their therapeutic use can be established. Additionally, more detailed clinical works are needed to substantiate the significant conclusions in the current study.Öğe Artificial vascular graft migration into hollow viscus organs in patients who underwent right lobe living donor liver transplantation(Taylor & Francis Ltd, 2020) Koc, Cemalettin; Akbulut, Sami; Bilgic, Yilmaz; Otan, Emrah; Sarici, Baris; Isik, Burak; Bayindir, YasarBackground:To share our experience with hollow viscus migration of artificial vascular grafts (AVG) used for venous reconstruction of the right anterior sector in living donor liver transplantations (LDLT). Methods:Clinical, radiological, and endoscopic data of 13 right lobe LDLT patients (range: 26-67 years) with a diagnosis of postoperative AVG migration into adjacent hollow viscus were analyzed. Results:Biliary complications were detected in 12 patients. A median of four times endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in 11 patients prior to AVG migration diagnosis. A median of 2.5 times various percutaneous radiological interventional procedures were performed in eight patients prior to AVG migration diagnosis. The site of migration was the duodenum in eight patients, gastric antrum in four, and Roux limb in the remaining one patient. The migrated AVS were made of polytetrafluoroethylene (PTFE) in 10 patients and polyethylene terephthalate (Dacron) in three. The migrated AVGs were endoscopically removed in seven patients and surgically removed in six. Only one patient died due to sepsis unrelated to AVG migration. Conclusion:AVG migration into the adjacent hollow viscus following right lobe LDLT is a rare and serious complication. Repetitive ERCP, interventional radiological procedures, infection related to biliary leakage, and thrombosis of AVGs are among the possible risk factors.Öğe Assessment of clinical and pathological features of patients who underwent thyroid surgery: A retrospective clinical study(Baishideng Publishing Group Inc, 2018) Emre, Arif; Akbulut, Sami; Sertkaya, Mehmet; Bitiren, Muharrem; Kale, Ilhami Taner; Bulbuloglu, Ertan; Colak, CemilAIM To evaluate whether there was any correlation between the clinical parameters and final pathological results among patients who underwent thyroid surgery. METHODS We retrospectively analyzed parameters, including age, sex, complete blood cell count parameters, nodule diameter, nodule localization, thyroid function testing, and pathology reports, in patients who underwent thyroid surgery. The patients were divided into malignant (n = 92) and benign (n = 413) groups depending on the final pathological results. Both groups were compared for demographic and clinical parameters. The Kolmogorov-Smirnov normality test was used to determine if the quantitative variables had a normal distribution. The nonparametric Mann-Whitney U test was used to compare quantitative data that were not normally distributed, and Pearson's chi-squared test was used to compare the qualitative data. The correlation between the final pathological results and fine-needle aspiration biopsy findings was calculated using the cross-tabulation method. RESULTS This study included 406 women and 99 men aged between 15 and 85 years. No significant differences were found between the groups with respect to age, sex, white blood cell count, neutrophil count, lymphocyte count, thrombocyte count, red cell distribution width, platelet distribution width, mean platelet volume, platecrit, nodule localization, and thyroid function testing. On the other hand, there were significant differences between the groups with respect to nodule size (P = 0.001), cervical lymphadenopathy (P = 0.0001) and nodular calcification (P = 0.0001). Compared with the malignant group, the benign group had a significantly greater nodule size (35.4 mm vs 27.6 mm). The best cut-off point (<= 28 mm) for nodule size, as determined by the receiver operating characteristic curve, had a sensitivity and specificity of 67.7% and 64.4%, respectively. The correlation between fine-needle aspiration biopsy and the final pathological results was assessed using the cross-table method. The sensitivity and specificity of fine-needle aspiration biopsy were 60% and 98%, respectively. CONCLUSION This study showed that significant differences existed between the malignant and benign groups with regard to nodule size, cervical lymphadenopathy, and nodular calcification.Öğe Assessment of clinical and pathological features of patients who underwent thyroid surgery: A retrospective clinical study(BAISHIDENG PUBLISHING GROUP INC, 8226 REGENCY DR, PLEASANTON, CA 94588 USA, 2018) Akbulut, Sami; Çolak, CemilTo evaluate whether there was any correlation between the clinical parameters and final pathological results among patients who underwent thyroid surgery. METHODS We retrospectively analyzed parameters, including age, sex, complete blood cell count parameters, nodule diameter, nodule localization, thyroid function testing, and pathology reports, in patients who underwent thyroid surgery. The patients were divided into malignant (n = 92) and benign (n = 413) groups depending on the final pathological results. Both groups were compared for demographic and clinical parameters. The Kolmogorov-Smirnov normality test was used to determine if the quantitative variables had a normal distribution. The nonparametric Mann-Whitney U test was used to compare quantitative data that were not normally distributed, and Pearson's chi-squared test was used to compare the qualitative data. The correlation between the final pathological results and fine-needle aspiration biopsy findings was calculated using the cross-tabulation method. RESULTS This study included 406 women and 99 men aged between 15 and 85 years. No significant differences were found between the groups with respect to age, sex, white blood cell count, neutrophil count, lymphocyte count, thrombocyte count, red cell distribution width, platelet distribution width, mean platelet volume, platecrit, nodule localization, and thyroid function testing. On the other hand, there were significant differences between the groups with respect to nodule size (P = 0.001), cervical lymphadenopathy (P = 0.0001) and nodular calcification (P = 0.0001). Compared with the malignant group, the benign group had a significantly greater nodule size (35.4 mm vs 27.6 mm). The best cut-off point (<= 28 mm) for nodule size, as determined by the receiver operating characteristic curve, had a sensitivity and specificity of 67.7% and 64.4%, respectively. The correlation between fine-needle aspiration biopsy and the final pathological results was assessed using the cross-table method. The sensitivity and specificity of fine-needle aspiration biopsy were 60% and 98%, respectively. CONCLUSION This study showed that significant differences existed between the malignant and benign groups with regard to nodule size, cervical lymphadenopathy, and nodular calcification.Öğe Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis(Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat KaanBACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.Öğe Assessment of Knowledge and Attitudes Toward Organ Donation Among School Teachers: First National Survey Study(Elsevier Science Inc, 2022) Akbulut, Sami; Ozer, Ali; Firinci, Betul; Demyati, Khaled; Saritas, Hasan; Yilmaz, SezaiBackground and aim. The most important factors affecting organ donation are socioeconomic, educational, and cultural factors. The aim of this study was to evaluate the attitudes, knowledge levels, and behaviors of school teachers toward organ donation Methods. This study surveyed 2400 school teachers working in official public schools. Turkey was divided into 26 regions based on the similarity of social, economic, and geographic factors identified by the Turkish Statistical Institute. Teachers were distributed equally in the city center and towns based on population. The survey procedures were carried out using computer-assisted personal interviewing. Results. Among teachers, 89.6% had a bachelor's degree and 8.5% had a master's degree. In addition, 32.5% worked in primary schools, 33.1% worked in secondary schools, and 34.4% worked in high schools. Furthermore, 0.7% had donated an organ; 66.5% were not considering organ donation in the future, of whom 9.0% indicated religion as the reason for not donating an organ, and 34.8% did not indicate any reason. In addition, 96.6% considered organ donation to be proper behavior for humanity and 68% believed that organ donation is appropriate in religious terms. Conclusions. This study showed that school teachers have inadequate knowledge and attitudes toward organ donation. Encouraging children and adolescents to make a well-informed decision about organ donation and to register this choice will depend largely on preparing school teachers with adequate knowledge and motivation toward creating generations with a positive attitude toward organ donation.Öğe Assessment of Liver Regeneration in Patients Who Have Undergone Living Donor Hepatectomy for Living Donor Liver Transplantation(Mdpi, 2023) Satilmis, Basri; Akbulut, Sami; Sahin, Tevfik Tolga; Dalda, Yasin; Tuncer, Adem; Kucukakcali, Zeynep; Ogut, ZekiBackground: Inflammation and the associated immune pathways are among the most important factors in liver regeneration after living donor hepatectomy. Various biomarkers, especially liver function tests, are used to show liver regeneration. The aim of this study was to evaluate the course of liver regeneration following donor hepatectomy (LDH) by routine and regeneration-related biomarkers. Method: Data from 63 living liver donors (LLDs) who underwent LDH in Inonu University Liver Transplant Institute were prospectively analyzed. Serum samples were obtained on the preoperative day and postoperative days (POD) 1, 3, 5, 10, and 21. Regenerative markers including alfa-fetoprotein (AFP), des carboxy prothrombin (DCP), ornithine decarboxylase (ODC), retinol-binding protein 4 (RBP4), and angiotensin-converting enzyme isotype II (ACEII) and liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and total bilirubin levels were all analyzed. Results: The median age of the LLDs was 29.7 years and 28 LLDs were female. Eight LLDs developed postoperative complications requiring relaparotomy. The routine laboratory parameters including AST (<0.001), ALT (<0.001), ALP (<0.001), and total bilirubin (<0.001) showed a significant increase over time until postoperative day (POD) 3. For the regeneration-related parameters, except for the RBP4, all parameters including ACEII (p = 0.006), AFP (p = 0.002), DCP (p = 0.007), and ODC (p = 0.002) showed a significant increase in POD3. The regeneration parameters showed a different pattern of change. In right-lobe liver grafts, ACEII (p = 0.002), AFP (p = 0.035), and ODC (p = 0.001) showed a significant increase over time. DCP (p = 0.129) and RBP4 (p = 0.335) showed no significant changes in right-lobe liver grafts. Conclusions: Regenerative markers are increased in a sustained fashion following LDH. This is more prominent following right-lobe grafts which are indicative of progenitor-associated liver regeneration.Öğe Assessment of Patient Safety Attitude Levels Among Healthcare Professionals Working in the Operating Room(Erciyes Univ Sch Medicine, 2023) Tamer, Murat; Akbulut, Sami; Cicek, Ipek Balikci; Saritas, Hasan; Akbulut, Mehmet Serdar; Ozer, Ali; Colak, CemilObjective: This study aims to determine the factors affecting the perception levels of operating room (OR) nurses and nurse anesthetists working in the OR regarding patient safety attitudes. Materials and Methods: This study was conducted using face-to-face interviews with 117 healthcare professionals working as OR nurses (n=60) and nurse anesthetists (n=57). The patient safety attitude questionnaire (SAQ), where the reliability analysis was also performed for the SAQ scale. and sociodemographic characteristics were used for this study. Qualitative variables were given as numbers and percentages (%), and the dataset belonging to quantitative variables that met the normal distribution criteria was given as mean (standard deviation), and data of quantitative variables that did not comply with nor-mality were given as median, IQR, and 95% CI of the median.Results: There were significant differences between OR nurses and nurse anesthetists regarding job satisfaction (p=0.015) and total SAQ score (p=0.040). Significant differences were detected between men and women participants regarding smoking (p=0.020) and stress recognition (p=0.040). The reliability analysis of the scale was as follows: total (alpha: 0.791), job satisfaction (alpha: 0.883), teamwork climate (alpha: 0.856), safety climate (alpha: 0.864), perceptions of management (alpha: 0.881), stress recognition (alpha: 0.791), and working conditions (alpha: 0.530).Conclusion: It was shown that the patient safety attitudes of the healthcare professionals participating in this study are above average, although it is still insufficient, where the stress identification score of the female participant was higher, and it was also found that the nurses' job satisfaction and SAQ score were higher.
