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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 Acute portal vein thrombosis secondary to donor/recipient portal vein diameter mismatch after orthotopic liver transplantation.(John Wiley & Sons Inc, 2005) Yilmaz, S; Kirimlioglu, V; Kirimliogiu, H; Kutlu, R[Abstract Not Available]Öğe An attempt to decrease ammonia levels after portacaval anastomosis in dogs - Hepatic periarterial neurectomy(Kluwer Academic/Plenum Publ, 2002) Yilmaz, S; Kirimlioglu, V; Katz, D; Basak, K; Caglikulekci, M; Kayaalp, C; Yildirim, BHepatic encephalopathy and elevated serum ammonia levels occur commonly after portacaval shunt and are hypothesized to be, in part, due to decreased hepatic blood flow. Prior work has demonstrated increased blood flow to the liver following hepatic periarterial neurectomy. In this experimental study, we investigated the functional, hemodynamic, and histopathological changes in the liver and kidney occurring after the addition of hepatic periarterial neurectomy to side-to-side portacaval shunt in dogs. It is our hypothesis that the addition of hepatic periarterial neurectomy to portacaval shunt will decrease postshunt ammonia levels. Side-to-side portacaval shunt was performed in 12 dogs (group I). Hepatic periarterial neurectomy was added to portacaval shunt in 9 dogs (group II). Serum levels of ammonia, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, albumin, and bilirubin together with hepatic blood flow were determined in both groups preoperatively and on postoperative day 21. The pre- and postoperative histopathologic changes of the liver and kidney were evaluated. There was significantly less postoperative elevation of serum ammonia and aspartate aminotransferase when hepatic periarterial neurectomy was added to the portacaval shunt procedure. Hemodynamic studies of hepatic artery and hepatic tissue indicated better blood flow in group II. The histopathologic evaluation of group II showed expansion of sinusoids, portal vessels, and portal areas and increased portal fibrosis as compared to group I. The results of this experimental study show that adding hepatic periarterial neurectomy to the portacaval shunt procedure improves postoperative serum levels of ammonia and aspartate aminotransferase and hepatic artery and tissue blood flow.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 Choledochal cyst spontaneously rupturing the hepatic artery(Springer, 2000) Kirimlioglu, V; Yilmaz, S; Katz, DA; Hilmioglu, F; Caglikulekci, M; Kayaalp, C; Akoglu, M[Abstract Not Available]Öğe Complete treatment of ruptured hepatic cyst into biliary tree by ERCP(Springer, 2001) Hilmioglu, F; Karincaoglu, M; Yilmaz, S; Yildirim, B; Kirimlioglu, V; Aladag, M; Onmus, H[Abstract Not Available]Öğe Effect of fish oil, olive oil, and vitamin E on liver pathology, cell proliferation, and antioxidant defense system in rats subjected to partial hepatectomy(Elsevier Science Inc, 2006) Kirimlioglu, V; Kirimlioglu, H; Yilmaz, S; Ozgor, D; Coban, S; Karadag, N; Yologlu, SThe high capacity of liver regeneration after partial hepatectomy (PH) is well known. This study investigated the role of the antioxidant defense system in regeneration among Wistar-albino male rats subjected to 70% partial hepatectomy after a pretreatment period of 2 weeks with eicosapentanoic acid (EPA) rich fish oil (FO), first pressed virgin olive oil (00), or vitamin E. The control group of 10 rats underwent PH only. On postoperative day 3, all rats were humanely killed. Liver sections of animals treated with FO or vitamin E showed significant increases in regeneration within both liver parenchyma and cut surface compared with the control group (P < .05). Liver sections of 00 displayed an insignificant increase in liver regeneration (P > .05), with less increase in parenchyma than of the cut surface. The enhancement of the liver parenchymal regeneration in the FO group was significantly greater than that of the vitamin E group. Concerning liver function tests (LIFT), there was no significant difference among the groups. When the treatment groups were compared to the control group glutathione (GSH) levels were increased and content of malondialdehyde (MDA), nitric oxide (NO), and superoxide dismutase (SOD) were decreased. Based on these results, we concluded that after 70% PH in rats, the liver parenchyma and cut surface regeneration were greatest with FO and least with 00 treatment. Both FO and vitamin E served to improve the antioxidant defense system more than 00 treatment.Öğe Effect of steroid on mitochondrial oxidative stress enzymes, intestinal microflora, and bacterial translocation in rats subjected to temporary liver inflow occlusion(Elsevier Science Inc, 2006) Kirimlioglu, V; Kirimlioglu, H; Yilmaz, S; Piskin, T; Tekerekoglu, S; Bayindir, YProtective effects of steroids against ischemia-reperfusion (I/R) injury are well known, but there is little information about the influence of temporary inflow occlusion on intestinal barrier function or bacterial translocation. The aim of this experimental study was to investigate the effects on liver, kidney, spleen, Heal mitochondrial stress enzymes, and bacterial translocation of methylprednisolone (MP) in rats undergoing temporary liver inflow occlussion. Twenty-seven pathogen-free Wistar albino rats were randomized into three groups: group A: I/R (n = 10); group B: I/R + MP (n = 10); and group C: sham (n = 7). Rats in groups A and B were subjected to 20 minutes of portal vein and hepatic artery occlusion with 3 mg/kg MP injected into group B animals intraperitoneally during the occlusion. Twenty-two hours later, all rats were sacrificed to measure mitochondrial oxidative stress enzymes in liver, kidney, spleen, and ileum. We evaluated intestinal bacterial counts, intestinal mucosal histopathology, bacterial translocation to mesenteric lymph nodes (MLN), liver, spleen, and kidney. Decreased levels of malondialdehyde and increased levels of glutathione were observed in all examined tissues of group B compared to those of group A rats. Statistically significant increases in the intestinal counts of Klebsiella spp and Proteus spp and of bacterial translocation to liver, kidney, spleen, and MLN were measured in group B with respect to group A.Öğe Effects of nucleoside analogues on liver regeneration 70% partially hepatectomized rats(Elsevier Science Inc, 2006) Yilmaz, S; Kirimlioglu, V; Kirimlioglu, H; Coban, S; Kayaalp, C; Yilmaz, M; Karakoc, YThe alternatives for prophlaxis and treatment of recurrent hepatitis B virus infection have increased since new oral nucleoside analogues have become available. We conducted this experimental study to investigate the effect in the liver of these agents on the expression of transforming growth factor alpha (TGF-alpha) and on proliferation index, estimated by Ki-67. Thirty male Wistar albino rats were randomized into three groups: group A (n = 10) received adefovir dipivoxil (40 mg/kg/d per gavage); group B (n = 10), lamivudine (L; 30 mg/kg/d per gavage); and group C (n = 10) did not receive any treatment and were the control group. Groups A and B were treated for 3 days. Animal treatment began on day -1. After performing 70% partial hepatectomy on day 0, all rats were sacrificed on postoperative day 2 to harvest liver tissues for histopathological examination. We stained and indexed Ki-67 and TGF-alpha immunohistochemically on the hepatectomy surface and in the parenchyma, Ki-67 and TGF-a indices were significantly higher in group A compared with group B (P = .001 and P = .004, respectively, and P = .003 and P = .001, respectively). When the L group was compared with the control group for results on the hepatectomy surface and the parenchyma, Ki-67 and TGF-a indexes were insignificantly different (P = .6 and P = .3, respectively, and P = .1 and P = .6, respectively). Based on the results of this experimental study, we concluded that Adefovir dipivoxil has greater proliferative effect on liver parenchyma and in the cut surface than does lamivudine.Öğe Expression of matrix metalloproteinases MMP-2 and MMP-9 in donor liver. Cirrhotic liver and acute rejection after human liver transplantation.(John Wiley & Sons Inc, 2006) Kirimlioglu, H; Kirimlioglu, V; Yilmaz, S; Karadag, N[Abstract Not Available]Öğe Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy(Springer, 2000) Yilmaz, S; Kirimlioglu, V; Ertas, E; Hilmioglu, F; Yildirim, B; Katz, D; Mizrak, B[Abstract Not Available]Öğe Hypertonic saline in hydatid disease(Springer, 2001) Kayaalp, C; Balkan, M; Aydin, C; Ozgurtas, T; Tanyuksel, M; Kirimlioglu, V; Akoglu, MThe objective of this study was to determine the scolicidal effects of saline in different concentrations using different exposure times and to examine whether hypertonic saline can be used to irrigate the abdomen when there is a free intraperitoneal perforation of hydatid disease. Various concentrations of saline solutions (0.09%, 3.0%, 6.5%, 10%, 15%, 20%, 25%, 30%) were added to concentrated echinococcus granulosus sediments for the following times: 1, 2, 3, 4, 5, 10, 15, 30, 45, and 60 minutes. Normal (0.09%), 3.0%, and 6.5% saline resulted in high viability ratios after 60 minutes' exposure. Complete lethality for 10%, 15%, 20%, 25%, and 30% saline occurred at the end of 75, 10, 6, 3, and 3 minutes, respectively. During the second part of the study, 20 Sprague-Dawley rats were used for abdominal saline irrigation in four groups: 30% NaCl for 3 minutes; 20% NaCl for 6 minutes; intravenous isotonic dextrose water and furosemide plus 30% NaCl irrigation for 3 minutes; the same prophylactic therapy plus 20% NaCl irrigation for 6 minutes. Sodium and chloride values rose significantly (20-30%) shortly after hypertonic saline irrigation in each group (p < 0.01). Support with isotonic dextrose and furosemide before irrigation did not have any beneficial effect on biochemical values or mortality. The 24- and 48-hour mortality rates were 70% and 90%, respectively. These studies illustrate that the scolicidal effect of hypertonic saline is limited in low concentrations, but an increase in the concentration can augment its adverse effects. Peritoneal irrigation with hypertonic saline should be avoided for intraabdominal perforated hydatid disease. Therefore, we concluded that hypertonic saline is not a good scolicidal agent to prevent recurrence of hydatid disease.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 Liver patholology and cell proliferation after calcineurin inhibitors and antiproliferative drugs following partial hepatectomy in rat.(John Wiley & Sons Inc, 2005) Kirimlioglu, V; Kirimlioglu, H; Yilmaz, S; Coban, S; Turkmen, E[Abstract Not Available]Öğe Maxillary brown tumor and uremic leontiasis ossea in a patient with chronic renal insufficiency(Dustri-Verlag Dr Karl Feistle, 2004) Taskapan, H; Taskapan, C; Baysal, T; Sahin, I; Ulu, R; Karadag, N; Kirimlioglu, VFindings of renal osteodystrophy in cranial bones are not uncommon and include osteomalacia, osteosclerosis, erosion of the cortical bone, brown tumors and resorption of the lamina dura. However, massive thickening of the cranial vault and facial bones, called uremic leontiasis ossea, have been reported very rare. In the present article, we describe the case of an uncooperative female patient with a brown tumor, involving the left maxillary sinus and massive thickening of the cranial vault and facial bones, secondary to severe secondary hyperparathyroidism during 8 years of regular hemodialysis treatment.Öğe Palliative decompression of obstructive hilar malignancies utilizing an extrahilar biliary approach(Springer, 2000) Yilmaz, S; Kirimlioglu, V; Katz, DA; Caglikulekci, M; Yilmaz, MHilar cancers carry a dismal prognosis. Palliation of obstructive jaundice in patients with hilar cancer can be achieved by either surgical or nonsurgical means. Selection of the appropriate palliative measures is a challenging problem. Segmental bilioenteric anastomosis procedures were performed on 19 patients with hilar cancer. Seventeen of the bypasses were done to the segment III duct, known as the ligamentum teres approach, and two bypasses were to the segment V duct. Five patients, who had already been stented percutaneously or endoscopically, were operated on after the stents were clogged and a duodenal obstruction ensued. There were two postoperative deaths (10.5%) and four postoperative complications (21%). All of the 17 surviving patients experienced improvement in the level of jaundice postoperatively and the levels of serum total and direct bilirubin decreased by 78.9% and 84.2%, respectively. Two patients developed late cholangitis before death and were treated by external biliary drainage; one developed duodenal obstruction and was treated by gastrointestinal anastomosis. The mean length of hospital stay was 15.2 days. Mean survival was 8.2 months and the mean period of well-being was 7.8 months. Median survival was 7 months and median period of well being was 7 months. Three patients are still alive at 8, 8, and 24 months. These data suggest that the ligamentum teres approach offers effective palliation for patients with unresectable hilar cancer.Öğe Percutaneous right portal vein embolization with polyvinyl alcohol particles in gastric cancer metastasis: Report of a case(Springer, 2005) Kutlu, R; Sarac, K; Yilmaz, S; Kirimlioglu, V; Baysal, T; Alkan, A; Sigirci, APolyvinyl alcohol (PVA) particles are used for the embolization of various vascular tumors. They are also used before hepatic resection to embolize the ipsilateral portal vein, causing hypertrophy of the remaining liver. We report our first experience with portal vein embolization (PVE) with PVA particles to treat gastric cancer metastasis to the liver. PVE with PVA is a safe interventional radiologic procedure, which does not cause problems during surgery and can improve the outcome of hepatic resection.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 effects of resveratrol on spleen and ileum in rats subjected to ischemia-reperfusion(Elsevier Science Inc, 2006) Karabulut, AB; Kirimlioglu, V; Kirimlioglu, H; Yilmaz, S; Isik, B; Isikgil, OResveratrol is as an antioxidant with free radical-scavenging activity and finds its clinical application in the prevention of postischernic tissue injury following solid organ transplantation. This study investigates the effect of Resveratrol on spleen and ileum tissues subjected to hepatic ischemia-reperfusion (I/R) in rats. Twenty-four rats were recruited in the study as follows: group A: I/R (n = 8), group B: I/R + Resveratrol (it = 8), and group C: sham operation (n = 8). After intraperitonealy pretreatment of eight rats with resveratrol (15 mg/kg/d) for 5 days, 16 rats were subjected to 45 minutes of hepatic ischemia followed by 30 minutes reperfusion period. Resveratrol was given 15 minutes prior to ischemia and just before the reperfusion in rats. After reperfusion period all rats were sacrified. Spleen and ileum tissues were examined spectrophotometrically to measure malondialdehyde (MDA), glutathione (GSH), and total nitrite, nitrate as an end product of nitric oxide (NO) levels. Concerning the spleen, statistically significant decrease of GSH and increase of MDA and NO levels were found group A when compared to groups B and C (P = .040, P = .004, and P = .001 group A vs group B; P = .05, P = .003, and P = .001 group A vs group C, respectively). Parallel results were obtained in ileum. A statistically significant decrease in GSH and an increase in MDA and NO levels in group A in respect to group B and group C was obtained (P = .048, P = .034, and P = .00.1 group A vs group B; P = .004, P = .001, and P = .003 group A vs group C, respectively). The result of this study shows that resveratrol has a protective effect on spleen and ileal mitochondrial oxidative stress in rats subjected to I/R.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.
