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Öğe Correlation between histopathological results and BI-RADS classification in breast masses(2019) Kutluer, Nizamettin; Aksu, Ali; Bozan, Mehmet Bugra; Kanat, Burhan Hakan; Kargici, Hulagu; Cay, Ferhat; Azak Bozan, AyseAim: The aim of this study was to determine the reliability of BI-RADS Classification by evaluating the correlation between BI-RADS Classification System and pathology results of patients admitted to the general surgery outpatient clinic of our hospital with the complaints of breast lump, breast pain and nipple discharge.Material and Methods: This retrospective study was conducted between 2009 and 2011. The study included a total of 150 female patients, who applied to the Research and Training Hospital General Surgery Polyclinics with the complaints of breast lump, pain and discharge which were classified as BIRADS-3, BIRADS-4 (4a, 4b, 4c) subcategories and BIRADS-5 category, and were evaluated using the epicrisis forms, test results (radiological imaging and tumor markers) and pathology reports.Results: The study included a total of 150 patients; 21 of which were classified as BI-RADS 3, 44 as BI-RADS 4a, 35 as BI-RADS 4b, 22 as BI-RADS 4c and 28 as BI-RADS 5. Of the masses determined to be benign, 21 cases (100%) were classified as BI-RADS 3, 43 cases (97.72%) as BI-RADS 4a, 34 cases (97.14%) as BI-RADS 4b, 8 cases (36.36%) as BI-RADS 4 and 1 case as BI-RADS 5 (3.57%). Of the malignant masses, 1 case (2.28%) was classified as BI-RADS 4a, 1 (2.86%) as BI-RADS 4b, 14 cases (63.64%) as BI-RADS 4c and 27 cases (96.43%) as BI-RADS 5.Conclusion: In the light of these data, we believe that the division of BI-RADS category 4 into sub-categories play an important role in management of breast masses.Öğe Does apocynin increase liver regeneration in the partial hepatectomy model?(Tubitak Scientific & Technological Research Council Turkey, 2023) Bilgic, Yilmaz; Kanat, Burhan Hakan; Ozhan, Onural; Yildiz, Azibe; Aksungur, Zeynep; Erdemli, Mehmet Erman; Vardi, NigarBackground/aim: Hepayocyte loss may develop secondary to liver surgery and at this point liver regeneration plays a significant act in terms of liver reserve. The purpose of this research was to investigate the efficacy of apocynin on liver regeneration and preservation after partial hepatectomy in rats.Materials and methods: A total of 32 rats, have been divided into 4 groups (n: 8) for hepatectomy model. Inflammatory and antiinflammatory parameters were measured from blood and liver tissue samples. In addition, the effects of apocynin were examined immunohistochemically and histopathologically from liver tissue. Results: In liver tissue samples, a significant difference has been found in glutathione peroxidase, total nitrite, catalase, oxidative stress index, total antioxidant and total oxidant status between sham and hepatectomy groups. A significant difference has been achieved between hepatectomy and posthepatectomy-Apocynin in terms of glutathione peroxidase and oxidative stress index. Total antioxidant status, oxidative stress index, and total oxidant status were significantly different only between the sham and the hepatectomy groups. Statistical differences were found between sham and hepatectomy groups and between hepatectomy and pre+post-hepatectomy-Apocynin groups in terms of serum glutathione, malondialdehyde, total nitrite, and L-Arginine. There were significant differences between the sham and hepatectomy groups, between hepatectomy and posthepatectomy-apocynin groups, between posthepatctomy-apocynin and pre+posthepatectomy-apocynin groups in terms of sinusoidal dilatation, intracytoplasmic vacuolization and glycogen loss (p < 0.001), in all histopathologic parameters except sinusoidal dilatation (p < 0.05). However, significant Ki-67 increases have been elaborated in hepatectomy, posthepatectomy-apocynin, and pre+posthepatectomy-apocynin groups compared to sham group (p < 0.001), in pre+posthepatectomy apocynin group compared to hepatectomy and posthepatectomy-apocynin groups (p < 0.001). Conclusion: Histopathology, immunohistochemistry, and biochemistry results of this study revealed that apocynin has a protective effect on enhancing liver regeneration in partial hepatectomy cases in rats.Öğe Familial Abdominal and Intestinal Lipomatosis Presenting with Upper GI Bleeding(Hindawi Ltd, 2015) Bilgic, Yilmaz; Altinsoy, Hasan Baki; Yildirim, Nezahat; Alatas, Ozkan; Kanat, Burhan Hakan; Sahin, AbdurrahmanAlthough lipomas are encapsulated benign tumors, systemic lipomatosis defines infiltrative nonencapsulated tumors resembling normal adipose tissue. Abdominal lipomatosis and intestinal lipomatosis are different clinicopathological entities with similar clinical symptoms. We describe here a case presenting with upper gastrointestinal bleeding from eroded submucosal lipoma at duodenum secondary to intestinal lipomatosis and abdominal lipomatosis.Öğe Is gastroscopy necessary before bariatric surgery?(Baishideng Publishing Group Inc, 2022) Kanat, Burhan Hakan; Dogan, SerhatObesity is the abnormal accumulation of fat or adipose tissue in the body. It has become a serious health problem in the world in the last 50 years and is considered a pandemic. Body mass index is a widely used classification. Thus, obese individuals can be easily classified and standardized. Obesity is the second cause of preventable deaths after smoking. Obesity significantly increases mortality and morbidity. We thought of preparing a publication about routine procedures for the preoperative evaluation of obesity. The question that we asked as bariatric and metabolic surgeons but which was not exactly answered in the literature was Is esophagogastroduodenoscopy (EGD) necessary before bariatric surgery? We found different answers in our literature review. The European Association of Endoscopic Surgery guidelines recommend EGD for all bariatric procedures. They strongly recommend it for Roux-en-Y gastric bypass (RYGB). As a result of a recent study by the members of the British Obesity & Metabolic Surgery Society, preoperative EGD is routinely recommended for patients undergoing sleeve gastrectomy, even if they are asymptomatic, but not recommended for RYGB. It is recommended for symptomatic patients scheduled for RYGB. According to the International Sleeve Gastrectomy Expert Panel Consensus Statement, preoperative EGD is definitely recommended for patients scheduled for sleeve gastrectomy, but its routine use for RYGB is controversial. However, a different view is that the American Society for Gastrointestinal Endoscopy recommends endoscopy only for symptomatic patients scheduled for bariatric surgery. In the literature, the primary goal of EGD recommended for sleeve gastrectomy has been interpreted as determining esophagitis caused by gastroesophageal reflux. In the light of the literature, it is stated that this procedure is not necessary in America, while it is routinely recommended in the European continent. Considering medicolegal cases that may occur in the future, we are in favor of performing EGD before bariatric surgery. In conclusion, EGD before bariatric surgery is insurance for both patients and physicians. There is a need for larger and prospective studies to reach more precise conclusions on the subject.Öğe Is phenytoin a safe agent for staple line recovery after gastric sleeve surgery in rats?(Turkish Assoc Trauma Emergency Surgery, 2023) Gay, Ferhat; Duran, Ali; Tokay, Esra; Hacioglu, Nelin; Kockar, Feray; Altun, Eren; Kanat, Burhan HakanBACKGROUND: The most challenging and mortal complication of gastric sleeve surgery (SG) is staple line leakage. Although many agents have been used for increasing tissue healing on the stapler line, there is still no consensus on its effectiveness and efficacy. The aim of study is to determine the effect of phenytoin on the healing process of gastric sleeve surgery in rats. METHODS: On the 10th post-operative day, the effects of phenytoin on bursting pressure in the stapler line were evaluated alongside pathohistological examinations. To investigate the molecular impact of phenytoin on the expression of TGF-8, VEGF, FGF2, and p53 genes, quantitative real-time polymerase chain reaction was utilized. In addition, gene expressions at the protein level were determined by immunohistochemical analysis. RESULTS: No signs of intra-abdominal leakage were observed in the resected samples. A statistically essential extend in stable bursting pressure measure was observed between the control group and the group treated with phenytoin application. Pathohistological results indicate that the mean score of collagens of the study group (3.2 +/- 0.42) was significantly higher than the control group (2.3 +/- 0.48) (P=0.003). In addition, the mean epithelization score of the study group (3.4 +/- 0.52) was significantly higher than the control group (2.1 +/- 0.57) (P=0.001). mRNA of TGF8, FGF2, VEGF, and p53 genes drastically increased phenytoin treated group. High FGF2 protein expression levels were determined from phenytoin use compared to the control group. CONCLUSION: Molecular studies suggest that phenytoin may increase the healing process of Gastric sleeve following SG in rats and may become a new agent for the prevention of human gastric leaks.Öğe Meme Kanserinde Geç Dönem Lokal Nüksü Taklit Eden Ksantogranülomatöz İnflamasyon(Causapedia, 2016) Bayraktar, Hüsamettin; Kanat, Burhan Hakan; Erdem, Ceyhun; Karabulut, Ertuğrul; Ünal, BülentAbstract: Xanthogranulomatous inflammation (XGI) containscommon lipid-laden macrophages in the microscopicstructure. It can be seen in various parts of the body.Macroscopically, it is characterized by common brightyellow abscesses, and it may mimic a tumor. A sixtyyear-old woman, who had a mastectomy for breastcancer 10 years ago, referred to our polyclinic with apalpable mass under the incision line. The patient hasbeen initially considered to have a local recurrenceafter the investigations and operated for the secondtime. However, pathology results were reported asXGI. This situation has supported the tumorimmitating ability of XGIÖğe Memede Nekrotizan Fasiit(Causapedia, 2017) Karabulut, Ertuğrul; Bayraktar, Hüsamettin; Erdem, Ceyhun; Kanat, Burhan Hakan; Ünal, BülentÖz: Nekrotizan fasiit progresif bir yumuşak dokuenfeksiyonudur. İdiyopatik olabileceği gibi travma,yabancı cisim reaksiyonu veya cerrahiye sekonderolabilir. Sıklıkla ileri yaş diyabetik hastalarda görülür.Obezite,immunsüpresyon, kronik böbrek yetmezliği nekrotizanfasiit gelişimini kolaylaştıran faktörlerdir. Kutanoz ,subkutanöz dokuları ya da fasyayı tutabilir. Literatürdememe tutulumu nadirdir. Acil şartlarda nekrozektomi vedebridman yaptığımız hastada mevcut patoloji cok hızlıilerlemiştir.Toraks duvarına invaze olabilecek bu durumvarlığındakaçınılmazdır Başlık (İngilizce): Necrotizing Fasciitis of The Breast Öz (İngilizce): Necrotizing fasciitis is a progressive infection of thesoft tissue. As it can be idiopathic, it also can besecondery after a trauma, foreign body reaction orsurgery. It often seen in older age patients with diabet.Obesity, smoking, alcoholism, use of steriods,immunsuppression, chronic kidney failure are thepredisposing factors of the evolution of disease. It cankeep the cutaneous and subcutaneous tissues or fascia.Breast involvement is rare on the literatüre. On ourcase which is required urgent necrosectomy anddebridement , the patology has progressed quiterapidly. In case of probability of chest wallinvolvement, urgent necrosectomy and debridement isanavoidableÖğe Use of Silver Nitrate Application as Mini-Invasive Treatment of Pilonidal Sinus Disease(Editura Celsius, 2020) Kanat, Burhan Hakan; Yazar, Fatih Mehmet; Kutluer, Nizamettin; Solmaz, Ozgen Arslan; Bozan, Mehmet Bugra; Cay, Ferhat; Eroz, ErhanObjective: To investigate the cure rate and adverse effects of silver nitrate application for treatment of pilonidal sinus disease (PSD). Methods: Number of sinus pit orifices, and complications with silver nitrate application and debridement for sacrococcygeal PSD between January 2015 and July 2018 were analyzed in this retrospective study. Data were obtained from surgical, discharge, and outpatient follow-up records. Among 56 patients who were treated with silver nitrate stick, 11 patients with incomplete hospital records were excluded from the study. Demographic data including age, gender, length of follow-up, number of silver nitrate applications, number of involved sinuses and recurrence and complication rates were recorded. Results were expressed as frequencies, means, and range of values. The Mann Whitney U and chi square tests were used to evaluate significance. Results: Mean age was 24.3 +/- 5.18 (range, 14-36) years, and recurrence occurred in 4 (8.9%) patients. Complications developed in 10 (22.2%) patients and included abscess, erythema, and necrosis in 5 (11.1%), 2 (4.4%), and 3 (6.6%) patients, respectively. The recurrence rate was significantly higher in patients who developed abscesses during the follow-up period (p=0.001) than those who did not. There was no statistically significant correlation between the recurrence rate and number of sinuses or the number of silver nitrate applications. Conclusion: Low morbidity and high healing rates achieved with silver nitrate provide support for this application as a feasible and effective conservative outpatient treatment for PSD in certain patients.
