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Öğe The effect of ethyl pyruvate on oxidative stress in intestine and bacterial translocation after thermal injury(J Surg Res, 2008) Karabeyoğlu, Melih; Ünal, Bülent; Bozkurt, Betül; Dolapçı, İştar; Bilgihan, Ayşe; Karabeyoğlu, Işıl; Cengiz, ÖmerBackground. Thermal injury causes a breakdown in the intestinal mucosal barrier due to ischemia reperfusion injury, which can induce bacterial translocation (BT), sepsis, and multiple organ failure in burn patients. The aim of this study was to investigate the effect of ethyl pyruvate (EP) on intestinal oxidant damage and BT in burn injury. Materials and methods. Thirty-two rats were randomly divided into four groups. The sham group was exposed to 21°C water and injected intraperitoneal with saline (1 mL/100 g). The sham EP group received EP (40 mg/kg) intraperitoneally 6 h after the sham procedure. The burn group was exposed to thermal injury and given intraperitoneal saline injection (1 mL/100 g). The burn EP group received EP (40 mg/kg) intraperitoneally 6 h after thermal injury. Twenty-four hours later, tissue samples were obtained from mesenteric lymph nodes, spleen, and liver for microbiological analysis and ileum samples were harvested for biochemical analysis. Results. Thermal injury caused severe BT in burn group. EP supplementation decreased BT in mesenteric lymph nodes and spleen in the burn EP group compared with the burn group (P < 0.05). Also, burn caused BT in liver, but this finding was not statistically signifi- cant among all groups. Thermal injury caused a statistically significant increase in malondialdehyde and myeloperoxidase levels, and EP prevented this effects in the burn EP group compared with the burn group (P < 0.05). Conclusion. Our data suggested that EP can inhibit the BT and myeloperoxidase and malondialdehyde production in intestine following thermal injury, suggesting anti-inflammatory and anti-oxidant properties of EP.Öğe Factors affecting mortality and morbidity in patients with peptic ulcer perforation(Journal of Gastroenterology and Hepatology, 2007) Koçer, Havva Belma; Sürmeli, Süleyman; Solak, Cem; Ünal, Bülent; Bozkurt, Betül; Yıldırım, Osman; Dolapcı, Mete; Cengiz, ÖmerBackground and Aim: With the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer (PU) diseases has decreased, although complications of PU such as perforation and bleeding have remained fairly constant. The purpose of this study was to identify the risk factors that predict morbidity and mortality in patients with perforated PU. Methods: The records of 269 patients who were operated on for perforated PU were reviewed retrospectively. The following factors were analyzed in terms of morbidity and mortality: age >65 years; gender; associated medical illness; chronic ingestion of nonsteroidal anti-inflammatory drugs, aspirin, corticosteroids or immunosuppressants; alcohol ingestion and smoking habits; American Society of Anesthesiologist (ASA) status; season; delayed operation; site of ulcer perforation; and shock on admission and type of operation. Results: There were 30 female (11.16%) and 239 male (88.84%) patients. Seventy-one (26.4%) patients had associated diseases. Simple closure was performed in 257 (95.5%) patients; 12 patients (4.5%) underwent definitive operations. A total of 108 postoperative complications were present in 65 (24.2%) patients. Twenty-three patients died (8.55%). Multivariate analysis showed that only age, ASA score, treatment delay, presence of shock and definitive operation were independent predictors of mortality. Significant risk factors that led to morbidity were ASA status, time of surgery, season, presence of shock and type of surgery. There was a significant difference concerning morbidity and mortality between simple closure of the perforation and definitive surgery. Conclusions: Age, delayed surgery, presence of shock, ASA risk and definitive surgery are factors significantly associated with fatal outcomes in patients undergoing emergency surgery for perforated PU. Therefore, proper resuscitation from shock, improving ASA grade, decreasing delay and reserving definitive surgery for selected patients is needed to improve overall results.Öğe Operative approach in traumatic injuries of the duodenum(Acta Chir Belg, 2006) Bozkurt, Betül; Özdemir, Buket Altun; Koçer, Havva Belma; Ünal, Bülent; Dolapçı, Mete; Cengiz, ÖmerAbstract. Background : The management of duodenal traumas remains controversial. The experience of Ankara Numune Training and Research Hospital Emergency Surgery Department with duodenal injuries during a 10-year period was analyzed to identify trends in operative management and sources of duodenum-related morbidity and mortality. Methods and Results : Between 1994 and 2003, 1799 patients with blunt abdominal trauma were operated on and the incidence of duodenal trauma was 2.8% (50 patients). The injuries were penetrating in 31 (62%) patients and blunt in 19 (38%). Primary repair (PR) of injury was performed in 24 (48%) patients, primary repair and tube duodenostomy (PRTd) in 8 (16%) patients, complex repair (CR) in 11 (22%) patients, and exploration only without a duodenal procedure in 5 (10%) patients. Two of the patients died during laparotomy. The mortality rate was 12% and the incidence of duodenum-related morbidity was 12%. The overall morbidity rate was 40% (20 patients). The most commonly injured portion of the duodenum was DII (58%), and the most frequent cause of duodenum-related and overall morbidity in our series was Grade III duodenal injury. Conclusion : Our experience suggests that the use of primary repair in grade III injury may be associated with higher duodenum-related morbidity. Our recommendation is to use complex repair for grade III duodenal injuries.Öğe The relationship between prognostic factors of breast cancer and thyroid disorders in Turkish women(Journal of Surgical Oncology, 2004) Cengiz, Ömer; Bozkurt, Betül; Ünal, Bülent; Yıldırım, Osman; Karabeyoğlu, Melih; Eroğlu, Abdullah; Koçer, Havva Belma; Ulaş, MuratBackground: Breast carcinoma is a frequent disease that affects the female population. As for other malignant diseases, several studies have been carried out in an attempt to identify its etiology, yet the etiological agent has not been clearly defined. The etiological relationship between thyroid disease and breast cancer is still being investigated. However, most of the studies in this field are conflicting and discussions on this relationship still continue. Patients and Method: Our prospective open study was conducted on 136 consecutive patients operated for breast carcinoma. As a control group, 68 individuals with normal breast examination, who did not have any known malignancy and/or thyroid disease, living in the same geographical region and with matching socio-cultural and economical status, were included in the study. We aimed to identify the occurrence and frequency of thyroid pathologies in both groups to compare the clinical and the laboratory features of thyroid disease and breast carcinoma in an attempt to contribute to the studies investigating the relationship between these two entities. Results: We found thyroid pathology in 77.9% of breast cancer patients while this was 47.1% in the control group. Breast cancer patients had higher levels of free-T3 and more frequent diffuse and nodular enlargement of thyroid gland in ultrasonography when compared to the control group. Furthermore, in the presence of thyroid disease, breast cancer patients had statistically significant increases in the number of metastatic lymph nodes, vascular invasion, and tumor size. Conclusion: In conclusion, the frequency of thyroid pathology is higher in breast cancer patients compared to controls indicating a relationship between breast carcinoma and thyroid pathology. Our study shows that the presence of thyroid pathology in breast cancer patients can be influential on the spread of cancer and adversely affect its prognosis. We thought further studies are needed to confirm these findings and to explain the reason for co-occurrence of breast cancer and thyroid disease and furthermore to investigate the prognosis and survival of breast cancer patients in the presence of thyroid pathology.Öğe Tiroid hastalıklarında sık kullanılan preoperatif testlerin patolojik inceleme ile korelasyonu(Endokrinolojide Diyalog Dergisi, 2009) Ünal, Bülent; Işık, Burak; Bozkurt, Betül; Dirican, Abuzer; Karabeyoğlu, Melih; Kahraman, Latif; Aydın, Cemalettin; Cengiz, Ömer[Abstract Not Acailable]
