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Öğe Abdominal actinomycosis simulating malignancy of the right colon(Springer, 2005) Isik, B; Aydin, E; Sogutlu, G; Ara, C; Yilmaz, S; Kirimlioglu, V[Abstract Not Available]Öğe Bilhaemia: An unexpected complication of liver trauma(Taylor & Francis As, 2001) Yilmaz, S; Kirimlioglu, V; Katz, D; Caglikulekci, M; Ara, C; Hilmioglu, F[Abstract Not Available]Öğe Liver pathology and cell proliferation after calcineurin inhibitors and anti proliferative drugs following partial hepatectomy in rats(Elsevier Science Inc, 2006) Kirimlioglu, H; Kirimlioglu, V; Yilmaz, S; Coban, S; Turkmen, E; Ara, CImmunosuppressants are the cornerstones of treatment after solid organ transplantation. This study investigated the pathology and cell proliferation following partial hepatectomy (PH) in rats undergoing immunosuppressive treatment. After I day, all rats were subjected to 70% PH. Groups A and B (n = 10) received calcineurin inhibitors subcutaneously: either FK506 or cyclosporine (CyA). Groups C and D (n = 10) received antiproliferative drugs: either mycophenolate mofetil (MMF) or sirolimus (SRL) by gavage. A control group (n = 5) received 1 mL of tap water daily. On postoperative day 2, all rats were sacrificed to obtain liver tissue for pathologic examination. Using immunohistochemistry we separately examined the hepatectomy surface and the liver parenchyma. In the parenchyma, the Ki-67 indices were higher in the CyA and FK506 groups and lower in the SRL and MMF groups compared with controls (P < .01). CyA had the highest and MMF the lowest values. On the hepatectomy surface, Ki-67 indices and TGF-alpha expressions were higher in the CyA group and lower in the SRL and MMF groups compared with the control group (P < .01). Slightly higher values in the FK506 group were not significantly different compared with the control group (P > .05). All groups other than FK506 showed prominent cholangiolar epithelial phenotypes compared with the control group. In the CyA and SRL groups, the number of cholangiolar cells was higher (P < .01), and in the MMF group lower than in the control group (P < .01). Among all groups, SRL had the highest values.Öğe Protective effect of melatonin against oxidative stress on adhesion formation in the rat cecum and uterine horn model(Pergamon-Elsevier Science Ltd, 2005) Ara, C; Kirimlioglu, H; Karabulut, AB; Coban, S; Hascalik, S; Celik, O; Yilmaz, SThis experimental study was designed to evaluate the degree of adhesion formation and peritoneal tissue levels of malondialdehyde (MDA), reduced glutathione (GSH) and nitric oxide (NO) and the effect of melatonin on these metabolites in a postoperative intraperitoneal adhesion formation model in rats. Thirty adult female Wistar albino rats were subjected to standardized lesions by cecal and uterine horn abrasion and were randomly divided into three groups. Control rats were treated with 5% ethanol. Melatonin treated rats received 4 mg/kg melatonin before closure and for 10 consecutive days intraperitoneally after surgery. Rats in the sham operation group underwent a surgical procedure similar to the other groups however the peritoneal abrasion was not performed. On postoperative day 10 relaparatomy was performed. After the assessment of the adhesions, the rats in each group were sacrificed and peritoneal tissues were harvested to determine the tissue levels of MDA, GSH and NO activity. Adhesion formation scores in the melatonin group were significantly lower than that of control and sham group (p < 0.01 and p < 0.02, respectively). Tissue levels of MDA and NO were significantly lower in the melatonin treated rats when compared with control and sham groups. The levels of GSH in the melatonin treated rats were significantly higher than those of control and sham groups (p < 0.01). The results demonstrate that in this experimental model, intraperitoneal administration of melatonin decreases the extent of peritoneal adhesions and causes a decrease in MDA and NO and an increase in GSH levels. (c) 2005 Elsevier Inc. All rights reserved.Öğe Protective effect of resveratrol against oxidative stress in cholestasis(Academic Press Inc Elsevier Science, 2005) Ara, C; Kirimlioglu, H; Karabulut, AB; Coban, S; Ay, S; Harputluoglu, M; Kirimlioglu, VBackground. We investigated the protective role of resveratrol in rat liver injuries induced by chronic biliary obstruction. Materials and methods. Secondary biliary cirrhosis was induced by bile duct ligation for 28 days. Swiss albino rats were divided into the three following groups: group 1: sham (n = 7); group 2: bile duct ligation (n = 7); group 3: bile duct ligation plus resveratrol (n = 7). Bile duct ligation plus resveratrol group received 10 mg(kg dose of resveratrol intraperitoneally daily for 28 days. Liver damage and cholestasis were determined by the biochemical and the pathologic examination. Results. The present data showed a decrease in both plasma bilirubin levels and aspartate aminotransferase and alanine aminotransferase levels in the resveratrol-treated rats, when compared with bile duct ligation group (P < 0.05). In the resveratrol-treated rats, tissue levels of malondialdehyde and nitric oxide were significantly lower than that of the bile duct ligation (P < 0.002). The levels of glutathione in resveratrol-treated rats were significantly higher than that in bile duct ligation group (P < 0.004). The levels of interleukin-1 alpha, interleukin-6, and tumor necrosis factor-alpha in resveratrol group were significantly lower than that in bile duct ligation group (P < 0.004, P < 0.001, P < 0.001, respectively). Administration of resveratrol in the rats with biliary obstruction resulted in inhibition of ductular proliferation and lymphocytic inflammation. Conclusion. The present study demonstrates that intraperitoneal administration of resveratrol in bile duct ligated rats maintained antioxidant defenses and reduces liver oxidative damage and ductular proliferation. This effect of resveratrol may be useful in the preservation of liver function in cholestasis. (c) 2005 Elsevier Inc. All rights reserved.Öğe Protective effect of resveratrol against renal oxidative stress in cholestasis(Taylor & Francis Inc, 2005) Ara, C; Karabulut, AB; Kirimlioglu, H; Coban, S; Ugras, M; Kirimliglu, V; Yilmaz, SBackground/aims. This experimental study was designed to evaluate histological changes of the kidney and renal tissue levels of malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO) and the effect of resveratrol on these metabolites after bile duct ligation in rats. Methods. Secondary biliary cirrhosis was induced by bile duct ligation for 28 days. Swiss albino rats were divided into three groups. Group 1: Sham (n=7), Group 2: Bile duct ligation (n=7), Group 3: Bile duct ligation plus resveratrol (n=7). Bile duct ligation (BDL) plus resveratrol group received 10 mgr/kg dose of resveratrol intraperitoneally daily throughout 28 days. Kidney tissues were harvested to determine the tissue levels of MDA, GSH, and NO activity. Liver and kidney tissues were removed for light microscopic evaluation. Results. Cholestasis was determined by biochemical and pathologic examination. In the resveratrol-treated rats, levels of MDA were significantly lower than those of the BDL group (p<0.04). The levels of GSH in the resveratrol-treated rats were significantly higher than those in the BDL group (p<0.01). The levels of NO in the resveratrol group were significantly lower than those in the BDL group (p<0.01). Conclusion. The present study demonstrates that intraperitoneal administration of resveratrol in bile duct ligated rats maintains antioxidant defenses and reduces kidney oxidative damage. This effect of resveratrol may be useful in the preservation of renal oxidative stress in cholestasis.Öğe Proton magnetic resonance spectroscopy findings of a sacrococcygeal schwannoma(Lippincott Williams & Wilkins, 2006) Hascalik, S; Celik, O; Erdem, G; Ara, C; Kirimlioglu, HSchwannoma is tumor of peripheral nerves, originating from Schwann cells. It is a rare nerve sheath tumor, which frequently occurs in the intracranial acoustic nerve and spinal nerves. We report on a 28-year-old woman who suffered from a large pelvic mass that was diagnosed to be sacrococcygeal schwannoma. The features of proton magnetic resonance spectroscopy (MRS) study are discussed. The magnetic resonance imaging instrument was a 1.5T, Gyroscan Intera with a body coil as a radiofrequency transmitter and a signal receiver. T2-weighted images were obtained under the following conditions-turbo spin echo (TSE) T2: turbo spin echo repeat time (TR) = 4500 msec, echo time (TE) = 96 msec. Single voxel MRS was performed by the point-resolved spectroscopy technique with a long TE (136 msec). MRS measurement was performed on two different parts of the tumor. As well as strongly elevated choline and lipid signals, the tumor spectrum showed increased N-acetylaspartate resonances. MRS can be used effectively in the preoperative diagnosis of retroperitoneal and pelvic masses, which demonstrate unusual clinical features.Öğe Randomised clinical trial of two bypass operations for unresectable cancer of the pancreatic head(Taylor & Francis As, 2001) Yilmaz, S; Kirimlioglu, V; Katz, DA; Kayaalp, C; Caglikulekci, M; Ara, CObjective: To compare two different types of prophylactic gastric bypass in patients with cancer of the pancreatic head who were not suitable for curative resection. Design: Prospective study. Setting: University hospital, Turkey. Subjects: 44 patients with unresectable cancer of the pancreatic head without duodenal obstruction who presented between May 1995 and June 2000 who were randomised into 2 groups. Interventions: 22 patients had an antecolic, isoperistaltic gastrojejunostomy, jejunojejunostomy, and hepaticojejunostomy after cholecystectomy. The remaining 22 had a hepaticojejunostomy and antecolic, antiperistaltic gastrojejunostomy procedure after cholecystectomy. Main outcome measures: Mortality, morbidity, postoperative course, and survival. Results: There were no significant differences between the groups in the incidence of postoperative complications, time until restoration of oral diet, relaparotomy rate, late upper gastrointestinal bleeding, mortality, duration of hospital stay, and survival. The isoperistaltic operation took significantly longer than the antiperistaltic operation (p < 0.001) and there was less delayed gastric emptying in the antiperistaltic group but not significantly so. Both operations caused a significant lengthening in the postoperative gastric emptying time (p = 0.04 and p = 0.01, respectively). Conclusions: Both procedures are suitable for patients with unresectable carcinoma of the pancreatic head without impending duodenal obstruction. There was a trend towards better clinical results with the isoperistaltic procedure.Öğe Resveratrol, a red wine constituent polyphenol, protects gastric tissue against the oxidative stress in cholestatic rats(Springer, 2006) Kirimlioglu, V; Ara, C; Yilmaz, M; Ozgor, D; Isik, B; Sogutlu, G; Kirimlioglu, HThis experimental study was designed to determine the effects of resveratrol on the level of malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO) in gastric tissue after bile duct ligation (BDL). Swiss albino rats were divided into three groups: Group 1, sham (n = 7); Group 2, BDL (BDL only group; n = 7); and Group 3, BDL plus resveratrol (n = 7). Animals in the resveratrol group were treated with 10 mg/kg resveratrol (i.p.) once a day throughout 28 days. In the resveratrol group, levels of MDA and NO in gastric tissue were significantly lower than in the BDL-only group (P < 0.001). The level of GSH in the resveratrol group was significantly higher than in the BDL-only group (P < 0.001). The present study demonstrates that intraperitoneal administration of resveratrol maintains antioxidant defenses and reduces oxidative gastric damage. This effect of resveratrol may be useful to preserve gastric tissue under oxidative stress due to cholestasis.Öğe Single or multiple perforations with varying locations as a complication of intestinal Behcet's disease: Report of three cases(Taylor & Francis As, 2005) Isik, B; Ara, C; Kirimlioglu, H; Sogutlu, G; Yilmaz, M; Yilmaz, S; Kirimlioglu, VIntestinal ulcers in Behcet's disease ( BD) tend to cause perforation with significant morbidity. The optimal surgical procedure in such cases is controversial and the postoperative period can be eventful with an unpredictable course. We report three cases of perforations with varying locations in three patients with long-standing Behcet's disease. Two patients required two and one patient required four operations. It is emphasized that the clinician must be alert in a patient with BD when abdominal symptoms accompany the clinical picture. As soon as the diagnosis is reached, surgical intervention with limited resection must be performed. Endoscopic examination and careful medication play major roles in the follow-up.Öğe Spontaneous small bowel perforations due to intestinal tuberculosis should not be repaired by simple closure(Elsevier Science Inc, 2005) Ara, C; Sogutlu, G; Yildiz, R; Kocak, O; Isik, B; Yilmaz, S; Kirimlioglu, VIntestinal tuberculosis is a major problem in marry regions of the world. The incidence of it is rising in Western countries due to immigration from Third World countries and human immunodeficiency virus infection. The difference between the simple closure and resection and anastomosis was evaluated in this study. Retrospectively, 12 patients with intestinal tuberculosis diagnosed histopathologically among 50 patients with free intestinal perforations operated on between 1995 and 2003 at Turgut Ozal Medical Center were evaluated. Each patient underwent routine laboratory tests and radiologic studies. The most common symptoms of patients were abdominal pain, night sweats, and weight loss. Sites of perforation were ileum in 10 patients (multiple perforation in 4) and jejunum in 2 patients (both had multiple perforations). The perforation was closed by primary closure in 7 patients. Resection-anastomosis was performed in 5 patients. Leaks occurred in overall 3 of 7 patients with primary closure. Three of the 7 patients with leaks due to septicemia died. The mortality rate among all patients was 25%. Intestinal tuberculosis should be kept in mind as a cause in free intestinal perforations. Because of high mortality rate, the resection of the affected area and anastomosis may be the treatment of choice rather than primary closure. (c) 2005 The Society for Surgery of the Alimentary Tract.Öğe Urgent Revascularization of a liver allograft with a saphenous vein interposition graft between the hepatic artery and the recipient splenic artery after late hepatic artery thrombosis(Springer, 2005) Yilmaz, S; Kirimlioglu, V; Isik, B; Yilmaz, M; Kirimlioglu, HS; Ara, C; Sogutlu, GHepatic artery thrombosis (HAT) after liver transplantation is a severe complication which may lead to graft infarction and subsequent graft loss. It complicates 2-12% of adult liver transplantations (1, 2) and subsequently leads to retransplantation in 50-75% of patients (3). Fortunately, innovations in Doppler ultrasonography and digital angiography technologies have provided an accurate and rapid method for detecting HAT before ischemic damage of the allograft (4). Revascularization procedures that can be performed once the diagnosis of HAT has been confirmed include thrombectomy alone, intrahepatic arterial thrombolysis with thrombolytic agents, creation of a new anastomosis between a moreproximal part of the recipient artery and a more distal part of the donor hepatic artery, and introduction of an interposition graft (3). Early diagnosis is a prerequisite for these revascularization strategies. Weeport here the case of a patient with previous orthotopic liver transplantation (OLT) and splenectomy in whom hepatic arterial reconstruction using saphenous vein graft between the splenic artery and the transplant hepatic artery following HAT was performed.
