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    Ameliorative Effects of Larazotide Acetate on Intestinal Permeability and Bacterial Translocation in Acute Pancreatitis Model in Rats
    (Springer, 2024) Karahan, Dogu; Harputluoglu, Muhsin Murat Muhip; Gul, Mehmet; Gunduz, Ayten; Ozyalin, Fatma; Inceoglu, Feyza; Tikici, Deniz
    Background Intestinal barrier dysfunction in acute pancreatitis (AP) may progress to systemic inflammatory response syndrome (SIRS) and multi-organ failures by causing bacterial translocation. Larazotide acetate (LA) is a molecule that acts as a tight junction (TJ) regulator by blocking zonulin (Zo) receptors in the intestine. Aims In our study, we aimed to investigate the effects of LA on intestinal barrier dysfunction and bacterial translocation in the AP model in rats. Methods Thirty-two male Sprague-Dawley rats were divided into 4 groups; control, larazotide (LAR), AP, and AP + LAR. The AP model was created by administering 250 mg/100 g bm L-Arginine intraperitoneally 2 times with an hour interval. AP + LAR group received prophylactic 0.01 mg/mL LA orally for 7 days before the first dose of L-Arginine. For intestinal permeability analysis, fluorescein isothiocyanate-dextran (FITC-Dextran) was applied to rats by gavage. The positivity of any of the liver, small intestine mesentery, and spleen cultures were defined as bacterial translocation. Histopathologically damage and zonulin immunoreactivity in the intestine were investigated. Results Compared to the control group, the intestinal damage scores, anti-Zo-1 immunoreactivity H-Score, serum FITC-Dextran levels and bacterial translocation frequency (100% versus 0%) in the AP group were significantly higher (all p < 0.01). Intestinal damage scores, anti-Zo-1 immunoreactivity H-score, serum FITC-Dextran levels, and bacterial translocation frequency (50% versus 100%) were significantly lower in the AP + LAR group compared to the AP group (all p < 0.01). Conclusions Our findings show that LA reduces the increased intestinal permeability and intestinal damage by its effect on Zo in the AP model in rats, and decreases the frequency of bacterial translocation as a result of these positive effects.
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    An Evaluation of the Factors Affecting Failure of the Procedure in reoperated Thyroidectomies: A Retrospective Analysis
    (Sage Publications Inc, 2022) Comcali, Bulent; Ozdemir, Buket A.; Atas, Hakan; Ozdemir, Egemen; Tikici, Deniz; Saylam, Baris
    Background The aim of this study was to determine the factors affecting procedure failure in revision thyroidectomy surgery. Methods A total of 148 patients applied with revision surgery were separated into 2 groups according to the surgical success status. Comparisons were made of the 2 groups of patients where residual tissue was totally excised (Group 1, n:132) and patients where residual tissue could not be completely excised (Group 2, n:16). The patients were examined in respect of factors affecting the success of the procedure. Results The patients comprised 133 (89.9%) females and 15 (10.1%) males with a mean age of 49.68 +/- 12.02 years. Surgical failure was observed in 7 patients as the lesion could not be determined despite the use of intraoperative USG, and in 9 patients because of weak signal or signal loss. The determination of residual tissue <= 25mm on preoperative USG examination was seen to have a significant negative effect on surgical success (r=-0.329, p0.001). The patient having undergone >= 3 previous operations was determined to have a negative effect on surgical success (r=-0.229, p=0.005), and nerve damage on the opposite side to the lesion in a previous surgical procedure was determined to be the most important factor with a negative effect on surgical success (r=-0.571, p<0.001). In multinomial logistic regression analysis of the factors affecting success, the preoperative presence of nerve damage in the contralateral lobe to the lesion (OR: 33.11, 95% CI: 4.22-192.28, p<0.001) and lesion size <= 25 mm (OR: 10.10, 95% CI: 3.54-75.01, p=0.001) were determined to contribute significantly to surgical failure. Conclusion The results of this study clearly showed that as residual tissue size <= 25mm and contralateral nerve damage in the preoperative ultrasonographic evaluation are associated with surgical failure, alternative treatment methods such as radioactive iodine ablation may be preferred in these patients.
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    Outcomes of patients with primary sclerosing cholangitis after liver transplantation in a predominantly living donor liver transplant center
    (Elsevier Masson s.r.l., 2023) Harputluoglu, Murat; Calgin, Mehmet Zeki; Ataman, Engin; Tikici, Deniz; Kutluturk, Koray; Kutlu, Ramazan; Efe, Cumali Savas
    Background and aim: The number of studies reporting in detail the complications that occur after liver transplantation in patients with primary sclerosing cholangitis (PSC), especially after living donor liver transplantation (LDLT), is limited. In this study we present the complications and outcomes of PSC patients after liver transplantation in a predominantly LDLT center. Materials and methods: Adult and pediatric patients who underwent liver transplantation for PSC between February 2008 and October 2020 were included in the study. The demographic characteristics, presence of co-existing diseases, indications for transplantation, type of transplantation, and immunosuppressive treatments used were recorded. Patient survival, survival times, cause of death, recurrences, rejection, and biliary complications were recorded. Results: Thirty patients who underwent liver transplantation for PSC were included in the study. Twenty-seven patients (90 %) were living donor transplants. The 1-, 3-, and 5-year survival rates after transplantation were 75.9 %, 74.9 %, and 74.9 %, respectively. Biliary complications occurred in 15 patients (50 %). All patients with biliary complications were successfully treated with endoscopic and percutaneous interventional treatments. Chronic rejection occurred in three patients (10 %) and acute rejection occurred in five patients (13.3 %). PSC recurrence developed in five patients (18.5 %). Conclusion: Biliary complications are the most common complication after liver transplantation in patients with PSC in our center, where LDLT is used extensively and PSC patients are followed closely with respect to biliary complications after transplantation. © 2023 The Author(s)