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The Acute Effect of Humic Acid on Iron Accumulation in Rats
(Humana Press Inc, 2016) Cagin, Yasir Furkan; Sahin, N.; Polat, A.; Erdogan, M. A.; Atayan, Y.; Eyol, E.; Bilgic, Y.
Free iron leads to the formation of pro-oxidant reactive oxygen species (ROS). Humic acids (HAs) enhance permeability of cellular wall and act as a chelator through electron transferring. This study was designed to test chelator effect of HA on iron as well as its anti-oxidant effect against the iron-induced hepatotoxicity and cardiotoxicity. The rats used were randomly divided into four groups (n = 8/group): group I (the control group); group II (the HA group), humic acid (562 mg/kg) was given over 10 days by oral gavage; group III (the iron group), iron III hydroxide polymaltose (250 mg/kg) was given over 10 days by intraperitoneal route; and group IV (the HA plus iron group), received the iron (similar to group II) plus humic acid (similar to those in groups II and III) group. Blood and two tissue samples both from liver and heart were obtained for biochemical and histopathological evaluations. Iron deposition, the iron-induced hepatotoxicity, and cardiotoxicity were demonstrated by histopathological and biochemical manner. However, no significant differences were observed in the serum biochemical values and the histopathological results among the iron and the HA plus iron groups in the liver tissue but not in the heart tissue. The protective effects of humic acid against iron-induced cardiotoxicity were shown but not against hepatotoxicity in our study.
Airway management using the ProSeal™ laryngeal mask airway in a child with Goldenhar syndrome
(Verduci Publisher, 2012) Aydogan, M. S.; Begec, Z.; Erdogan, M. A.; Yucel, A.; Ersoy, M. O.
Children with congenital anomalies such as Goldenhar syndrome affecting the airway can be a problem for the anaesthesiologist. We present the case of an 18 month-old child with Goldenhar syndrome, in whom the ProSeal (TM) Laryngeal Mask Airway was successfully used for inguinal hernia surgery.
Astronomical site selection for Turkey using GIS techniques
(Springer, 2015) Aksaker, N.; Yerli, S. K.; Erdogan, M. A.; Erdi, E.; Kaba, K.; Ak, T.; Aslan, Z.
A site selection of potential observatory locations in Turkey have been carried out by using Multi-Criteria Decision Analysis (MCDA) coupled with Geographical Information Systems (GIS) and satellite imagery which in turn reduced cost and time and increased the accuracy of the final outcome. The layers of cloud cover, digital elevation model, artificial lights, precipitable water vapor, aerosol optical thickness and wind speed were studied in the GIS system. In conclusion of MCDA, the most suitable regions were found to be located in a strip crossing from southwest to northeast including also a diverted region in southeast of Turkey. These regions are thus our prime candidate locations for future on-site testing. In addition to this major outcome, this study has also been applied to locations of major observatories sites. Since no goal is set for the best, the results of this study is limited with a list of positions. Therefore, the list has to be further confirmed with on-site tests. A national funding has been awarded to produce a prototype of an on-site test unit (to measure both astronomical and meteorological parameters) which might be used in this list of locations.
Comparison of Antioxidant Effects of Isoflurane and Propofol in Patients Undergoing Donor Hepatectomy
(Elsevier Science Inc, 2015) Ucar, M.; Ozgul, U.; Polat, A.; Toprak, H. I.; Erdogan, M. A.; Aydogan, M. S.; Durmus, M.
Background. The safety of healthy volunteer donors is one of the most important issues in living-donor liver transplantation. Use of the Pringle maneuver during donor hepatectomy can result in liver ischemia-reperfusion (IR) injury. The objective of this study was to examine the effects of isoflurane and propofol on IR injury caused by the Pringle maneuver during donor hepatectomy. Methods. A total of 70 American Society of Anesthesiology I-II donors aged 18-65 years who underwent hepatectomy were included in the study. The patients were randomly divided into 2 groups: propofol and isoflurane. Plasma superoxide dismutase (SOD), malondialdehyde (MDA), total oxidative status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) were measured before surgery (to) and after surgery (t(1)). Results. There were no statistically significant differences in demographic features, anesthesia, and times of surgery between the groups (P > .05). Plasma TAC levels at to and t(1) were significantly lower in the propofol group than in the isoflurane group (P < .05). OSI at t(1) was significantly higher in the propofol group than in the isoflurane group (P < .05). MDA levels were significantly higher in the propofol group than in the isoflurane group at to (P < .05). MDA levels level were significantly higher in the isoflurane group than in the propofol group at t(1) (P < .05). Conclusions. Propofol may have protective effects against IR injury caused by the Pringle maneuver during donor hepatectomy in living-donor transplantations. However, the effectiveness of propofol for clinical use needs to be investigated further.
Comparison of hemoglobin levels via measured with pulse co-oximeter and with lab test during living donor hepatectomy
(Lippincott Williams & Wilkins, 2018) Colak, Y. Z.; Bicakcioglu, M.; Erdogan, M. A.; Toprak, H. I.; Yilmaz, S.
[Abstract Not Available]
Effect of alkalinisation of lignocaine for propofol injection pain: a prospective, randomised, double-blind study
(Australian Soc Anaesthetists, 2013) Ozgul, U.; Begec, Z.; Erdogan, M. A.; Aydogan, M. S.; Sanli, M.; Colak, C.; Durmus, M.
The aim of this study was to determine whether pretreatment with alkalinised lignocaine reduced the incidence and severity of pain during propofol injection. This prospective, randomised, double-blind study included 300 adult, American Society of Anesthesiologists physcial status I to II patients undergoing elective surgery. Patients were randomly allocated to one of three groups: Group L received 0.05 ml/kg of 1% lignocaine (5 ml normal saline + 5 ml 2% lignocaine), Group A received 0.05 ml/kg alkalinised lignocaine (5 ml 2% lignocaine + 1 ml 8.4% NaHCO3 + 4 ml normal saline), and Group S, the control group, was given the same amount of normal saline (NaCl 0.9%). All drugs were given as a bolus over 20 seconds before propofol administration. A blinded researcher assessed the patient's pain level using a four-point scale. The pain score [median (range)] and the incidence of pain in Group A (6%) was significantly lower than in groups L (41%) and S (88%, P <0.001). In addition, the pain score and the incidence of pain were found to be significantly different between Group L and Group S (P <0.001). The incidence of moderate and severe pain were greater in Group S when compared with groups A and L (P <0.001). Intravenous pretreatment with alkalinised lignocaine appears to be effective in reducing the pain during propofol injection.
Effect of Preoperative Iron Deficiency in Liver Transplant Recipients on Length of Intensive Care Unit Stay
(Elsevier Science Inc, 2013) Aydogan, M. S.; Ozgul, U.; Erdogan, M. A.; Yucel, A.; Toprak, H. I.; Durmus, M.; Colak, C.
Liver transplant (LT) recipients often display iron deficiency preoperatively, which significantly increases the quantity of blood that needs to be transfused intraoperatively, A risk factor for a prolonged intensive care unit (ICU) stay. The aim of this retrospective study was to determine whether there was a clinically significant association between iron deficiency and the length of ICU stay, among 153 patients scheduled for OLT from September 2011 to June 2012. Patients were divided into 2 groups according to their baseline iron status: iron- deficient (ID) and non-ID (normal iron profile) cohorts. Iron deficiency was assessed on the basis of several parameters; transferrin saturation as well as serum iron, ferritin, soluble transferrin receptor, and C-reactive protein levels. We retrospectively analyzed the data regarding demographic and clinical features, preoperative laboratory values, intraoperative transfusions, and length of ICU stay. Patient demographic features and preoperative values were similar between the groups. Preoperative iron deficiency, which was diagnosed in 72 patients (58.6%), was associated with a greater intraoperative use of fresh frozen plasma and red blood cell transfusions (P = .0001). The median length of ICU stay after LT was longer among the ID versus the non-ID group (5 and 3 days per patient, respectively; P = .0001). Therefore, we have suggested that preoperative iron deficiency may be a prognostic factor for the length of ICU stay after LT.
Effects of Isoflurane and Propofol on Hepatic and Renal Functions and Coagulation Profile After Right Hepatectomy in Living Donors
(Elsevier Science Inc, 2013) Ozgul, U.; Ucar, M.; Erdogan, M. A.; Aydogan, M. S.; Toprak, H. I.; Colak, C.; Durmus, M.
We compared postoperative hepatic and renal functions and coagulation profiles in living donors undergoing right hepatectomy under isofiurane (n = 40) versus propofol (n = 40) anesthesia. After induction, anesthesia was maintained with isoflurane/air-O-2 (group I) or propofol/air-O-2 (group P) in addition to remifentanil and atracurium infusion in both groups. Aspartate aminotransferase, alanine aminotransferase, international normalized ratio (INR), activated partial thromboplastin time (aPTT), albumin, total bilirubin, blood urea nitrogen, creatinine, estimated glomerular filtration rate (GFR), platelet count, and hemoglobin levels were measured in the preoperative period, after end of the operation, and on the first, third, fifth and seventh postoperative days (PODs). INR was significantly increased on POD 3 and aPTT on POD 5 in group I compared with group P (P < .05). Albumin level was significantly lower in Group I on POD 1 and 3 (P < .05). GFR was significantly lower on POD 1 in the group I compared with group P (P < .05). The postoperative coagulation, GFR, and albumin values were superior following administration of propofol than isoflurane in donors who underwent living hepatectomy; however, both approaches were clinically safe, with no significant clinical difference.
Effects of Oral ?- Glucan on Liver Ischemia/Reperfusion Injury in Rats
(Elsevier Science Inc, 2013) Aydogan, M. S.; Yucel, A.; Erdogan, M. A.; Polat, A.; Cetin, A.; Ucar, M.; Duran, Z. R.
Aim. Ischemia/reperfusion (IR) injury (IRI) in liver transplant patients may negatively affect graft function. Although beta-glucan protects kidneys against IRI, its effect on the liver is unknown. This study sought to investigate beta-glucan effects on oxidative damage to the liver after IRI in rats. Materials and Methods. Thirty-two rats were randomly divided into 4 experimental groups n = 8 in each group: sham, IR, beta-glucan and IR + beta-glucan. beta-Glucan (50 mg kg(-1) . day(-1)) was orally administered for 10 days to rats in the beta-glucan and IR + beta-glucan groups. The rats in the IR and IR + beta-glucan groups were subjected to ischemia and reperfusion (IR) for 60 minutes each. All rats were killed on day 11 to evaluate histological changes as well as tissue levels of oxidants and antioxidants. Results. Malondialdehyde (MDA) levels were significantly higher in the IR than the sham group (P = .001). MDA level was significantly higher in the IR group than in the IR + beta-glucan group (P = .001). The levels of tissue antioxidant markers (superoxide dismutase [SOD], glutathione-peroxidase [GPx], and catalase [CAT]) were significantly lower in the IR group than in the sham group (P < .05). SOD and GPx levels did not differ significantly between the IR and IR + beta-glucan groups. CAT activity was significantly higher in the IR than the IR + beta-glucan group (P = .001). Histological tissue damage was reduced in the IR + beta-glucan than the IR group. Conclusion. Liver IRI is an inevitable problem during liver surgery. Our results suggested that beta-glucan pretreatment suppressed oxidative stress and increased antioxidant levels in an rat model of liver IRI.
Effects of Preoperative Iron Deficiency on Transfusion Requirements in Liver Transplantation Recipients: A Prospective Observational Study
(Elsevier Science Inc, 2013) Aydogan, M. S.; Erdogan, M. A.; Yucel, A.; Konur, H.; Bentli, R.; Toprak, H. I.; Durmus, M.
The aims of this study were to determine the frequency of preoperative iron deficiency in adult living donor liver transplantation patients and to investigate its relationship with the need for intraoperative transfusion. Between September 1, 2011, and June 1, 2012, 103 patients scheduled for liver transplantation were included in this prospective study. Patients were divided into 2 groups according to baseline iron status: an iron-deficient group and a non deficient (normal iron profile) group. Iron deficiency was assessed on the basis of several parameters, including transferrin saturation, levels of ferritin, soluble transferrin receptor, C-reactive protein, and peripheral blood smear. Preoperative iron deficiency was diagnosed in 62 patients. Preoperative iron deficiency was associated with low preoperative hemoglobin levels (P = .01) and a high rate of intraoperative transfusion (P < .0001). Preoperative iron deficiency is prognostic factor for predicting intraoperative transfusion requirements. These findings have important implications for transfusion practices for liver transplant recipients.
Endoscopic treatment of biliary complications after duct-to-duct biliary anastomosis in pediatric liver transplantation
(Springer, 2019) Harputluoglu, M.; Demirel, U.; Caliskan, A. R.; Selimoglu, A.; Bilgic, Y.; Aladag, M.; Erdogan, M. A.
Background Studies reporting outcomes of endoscopic treatment methods in children who underwent liver transplantation (LT) is very limited. We present our outcomes, as a high-volume transplant center where endoscopic methods are preferred as the first choice in the treatment of biliary complications in children. Methods Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) as the first treatment approach for biliary complications after LT between 2005 and 2017 were included. Clinical data included patient demographics, ERCP indications (stricture or leak), and treatment outcomes, including the need for percutaneous and surgical intervention. Results ERCP was performed in 49 patients who had a duct-to-duct anastomosis (38 living donor liver transplantation (LDLT), 11 deceased donor liver transplantation (DDLT)). The most common biliary complication was stricture. Our endoscopic success rate was 66.7% (18/27) and 75% (6/8) in LDLT and DDLT patients with stricture (p > 0.05), respectively. While our endoscopic success rate was 75% (3/4) in patients with leak alone after LDLT, it was 25% (1/4) in patients with leak and stricture in this group. The endoscopic success rate was 50% in two patients who had leak alone after DDLT. Conclusions ERCP should be considered as a preferential treatment option for the management of biliary complications in pediatric liver transplant patients with duct-to-duct anastomosis, as in adults.
Endoscopic treatment of biliary complications after living donor liver transplantation in a high volume transplant center in Turkey; a single-center experience
(Univ Catholique Louvain-Ucl, 2018) Harputluoglu, M.; Aladag, M.; Demirel, U.; Bilgic, Y.; Dertli, R.; Erdogan, M. A.; Karincaoglu, M.
Background and aim : Biliary complications are an important cause of mortality and morbidity after living donor liver transplantation (LDLT). We present our endoscopic treatment results after LDLT as a single center with high volume. Methods : Patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) alter LDLT between 2005 and 2015 were included. Clinical data included patient demographics. ERCP indications (stricture or leak), and treatment outcomes, including need for percutaneous and surgical interventions. Results : ERCP was performed in 446 (39.2%) patients with duct-to-duct anastomosis of 1136 LDLT patients. The most common biliary complication was stricture +/- stone (70.6%, 315/446). Stricture and leak occurred in 60 (13.4%) patients. Only binary leak was found in 40 (8.9%) patients. Our endoscopic treatment success rate in patients with biliary stricture after LDLT was 65.1%. Overall endoscopic success rates in our patients were 55.0% in patients with both leak and stricture, and only leak. In all, our percutaneous transhepatic biliary interventions (P'f BI) and ERCP success rate was 90.6% in patients with biliary complications after LDLT. Conclusions : Endoscopic treatments are highly effective for biliary complications after LDLT. Effective use of percutaneous interventions in collaboration with endoscopic treatments significantly reduces the need for surgical treatment.
Endoscopic treatment of biliary complications after pediatric liver transplantation in a high volume transplant center in Turkey
(Lippincott Williams & Wilkins, 2018) Harputluoglu, M. M. M.; Aladag, M.; Bilgic, Y.; Erdogan, M. A.; Caliskan, A. R.; Selimoglu, A.; Demirel, U.
[Abstract Not Available]
Endosopic treatment of biliary complications after living donor liver transplantation
(Lippincott Williams & Wilkins, 2022) Ataman, E.; Harputluoglu, M. M.; Bilgic, Y.; Erdogan, M. A.; Cagin, Y. F.; Saglam, O.; Orman, I.
[Abstract Not Available]
Four wavelengths cerebral oximetry was not affected by hyperbilirubinemia
(Lippincott Williams & Wilkins, 2019) Toprak, H., I; Colak, Y. Z.; Erdogan, M. A.; Yilmaz, S.
[Abstract Not Available]
Predictive factors in the differential diagnosis of benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasis
(Verduci Publisher, 2023) Yildirim, O.; Erdogan, M. A.
OBJECTIVE: Diagnosing benign vs. malignant extrahepatic cholestasis is challenging despite the currently available advanced imaging and endoscopic techniques. This study aims to determine the predictive accuracy of initial biochemical data and bile duct dilatation findings in transabdominal ultrasound (US) to differentiate between benign and malignant disease in patients with extrahepatic cholestasis. PATIENTS AND METHODS: We reviewed the case records of 814 patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (in cases of unsuccessful ERCP) for extrahepatic cholestasis. The etiology of biliary obstruction was determined based on ERCP, endoscopic ultrasonography, radiology, cytology, biopsy, and/or clinical follow-up at one year. The patients were divided into benign and malignant groups according to the underlying etiology of biliary obstruction. A complete biochemical profile, transabdominal ultrasonography at presentation, and other demographic data were recorded. RESULTS: Alkaline phosphatase (p = 0.002), aspartate aminotransferase (p = 0.038), and bilirubin levels were significantly higher in malignant patients. The mean age of patients with malignancy was 69.5 years, vs. 60.6 years in benign patients (p < 0.001). The likelihood of malignancy increased with the increased bilirubin levels (> 200 mu mol/l: 30.0% sensitivity, 97.6% specificity). The total bilirubin level predicting malignancy as the best cut-off value was 111 mmol/L with optimum sensitivity and specificity (61.8% and 83.8%, respectively) and area under the curve = 0.756, (p < 0.001). Intrahepatic bile duct (IHBD) dilatation was significantly higher in malignant patients (p < 0.001). CONCLUSIONS: A serum bilirubin level of 111 mu mol/L or higher and the detection of IHBD dilatation on abdominal ultrasonography are important predictors in the differential diagnosis of benign and malignant causes of extrahepatic cholestasis
Protective effect of benfotiamine on methotrexate induced gastric damage in rats
(Taylor & Francis Ltd, 2021) Koc, S.; Erdogan, M. A.; Erdogan, E.; Yalcin, A.; Turk, A.; Erdogan, M. M.
Methotrexate (MTX) is widely used for treating cancers and inflammatory diseases; it is a potential anti-metabolite and folate antagonist. We investigated potential protective effects of benfotiamine on MTX damage. We used a rat model of MTX induced gastric injury to assess changes in gastric histopathology, oxidative stress and visfatin levels due to MTX treatment. Rats were divided into four groups: an untreated control group, an MTX group treated with a single dose of MTX, a benfotiamine group treated with benfotiamine daily for two weeks, and a benfotiamine + MTX group treated with a single dose of MTX followed by benfotiamine daily for two weeks. Total serum antioxidant status (TAS), total oxidant status (TOS) and visfatin levels were measured at the end of the experiment. At the end of the experiment, we investigated both visfatin expression and the histopathology of gastric tissues. The mean visfatin level was lower in the MTX group than in the benfotiamine group. The mean serum TOS levels were higher in MTX group than in the control, benfotiamine or benfotiamine + MTX groups. Significant gastric gland dilation, and erosion and loss of mucosa were found on the gastric surface in the MTX group compared to the control group. The dilation, erosion and mucosal loss were decreased significantly in the benfotiamine + MTX group compared to the MTX group. Compared to the control group, visfatin immunoreactivity was reduced significantly in the MTX group. Decreased visfatin levels appear to play a role in the mechanism of gastric damage. Benfotiamine may be useful for preventing MTX induced gastric injuries.
The protective effects of apocynin on ionizing radiation-induced intestinal damage in rats
(Taylor & Francis Ltd, 2016) Cagin, Y. F.; Parlakpinar, H.; Polat, A.; Vardi, N.; Atayan, Y.; Erdogan, M. A.; Ekici, K.
Background and aims: Radiation colitis typically emerges during radiotherapy of intra-abdominal malignancies. While the underlying mechanism remains unclear, it is considered that free oxygen radicals act like cellular mediators to cause colonic damage. Apocynin (APO) prevents oxidative stress and apoptotic cell death by inhibiting NADPH oxidase, and preventing the formation of free oxygen radicals. The aim of the present study was to investigate the protective effect of APO, a strong antioxidant and antiinflammatory agent, on radiation induced colonic oxidative damage in rats.Materials and methods: Rats were randomly divided into four groups (n=8/group). Group I (control group); Group II (Group RAD) received a single dose of 800 cGy ionizing radiation to the whole abdomen with a linear accelerator (LINAC); Group III (Group APO) received a single dose of 20mg/kg of APO intraperitoneally for five days; Group IV (Group APO+RAD) received APO for five days before radiation exposure (similar to Group III), (similar to Group II).Results: APO treatment prior to radiation led to protection in the biochemical and histopathological parameters.Conclusions: Our study shows that APO treatment before radiation improves radiation induced colonic injury in rats, by decreasing oxidative stress and apoptosis.
Single intrathecal fentanyl for combined spinal epidural anesthesia confers no advantage over hemodynamic effects in elderly patients
(Verduci Publisher, 2012) Yucel, A.; Gulhas, N.; Aydogan, M. S.; Erdogan, M. A.; Beytur, A.; Tasdemir, C.; Ersoy, M. O.
Background: Neuroaxial blockade for ambulatory transurethral resection of the prostate is a well established technique. Patients in this group are often at high risk for perioperative complications from concurrent diseases. The purpose of this study was to compare the elderly patients who received intrathecal fentanyl alone or intrathecal fentanyl plus bupivacaine or epidural anesthesia for transurethral resection of prostate surgery. Material and Methods: Ninety-nine patients were prospectively randomized to receive fentanyl 25 mu g (Group F), fentanyl 25 mu g plus hyperbaric bupivacaine 2.5 mg (Group BF), or epidural anesthesia adding fentanyl 50 mu g (Group E) by combined spinal epidural anesthesia technique. Results: The amount of local anesthetics used until when the sensorial block reached the level of T10 was significantly lower in the Group BF than in the Group E and the Group F (p < 0.001). Maximum level of sensory block was significantly lower in the Group BF than in the Group E and the Group F (p = 0.01). The time elapsed until the sensory block reached T10, the regression of sensory block to L5 level were significantly lower in the Group BF than in the Group E and the Group F (p = 0.005, p < 0.001, respectively). Compared to the basal values, mean arterial pressures were significantly lower in the Group BF than in the Group E and the Group F (p < 0.05). The occurrence of hypotension was significantly lower in the Group BF (9.4%) than in the Group E (18.2%) and the Group F (24.2%). Conclusions: Intrathecal hyperbaric bupivacaine 2.5 mg plus fentanyl 25 mu g administration provides shorter motor block onset time, less local anesthetic usage and adequate hemodynamic stability in elderly patients.

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