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Altered spontaneous contractions of the ileum by anesthetic agents in rats exposed to peritonitis
(W J G PRESS, 2009) Aydin, Cengiz; Bagcivan, Ihsan; Gursoy, Sinan; Altun, Ahmet; Topcu, Omer; Koyuncu, Ayhan
AIM: To investigate in vitro effects of propofol, midazolam and dexmedetomidine, which are commonly used anaesthesic or sedatives, on spontaneous contractions of the ileum both in normal rats and those exposed to hyperdynamic peritonitis. METHODS: Spontaneous contractions of isolated ileum muscle segments from sham operated rats and those exposed to peritonitis, were studied in vitro. The amplitude and the frequency of spontaneous contractions of ileum muscle segments were studied after adding dexmetetomidine, propofol, and midazolam to the organ bath in a cumulative manner. RESULTS: Both amplitude (85.2 +/- 6.6 vs 47.4 +/- 7.1) and frequency (32.8 +/- 4.6 vs 20.2 +/- 3.9) of spontaneous contractions in ileum smooth muscle segments were decreased significantly in the peritonitis group compared to the control group (P < 0.05). Dexmedetomidine significantly increased the amplitude of spontaneous contractions (85.2 +/- 6.6 vs 152.0 +/- 5.4, P < 0.05) whereas, propofol (85.2 +/- 6.6 vs 49.6 +/- 4.8, P < 0.05) and midazolam (85.2 +/- 6.6 vs 39.2 +/- 4.5, P < 0.05) decreased it in both control and peritonitis groups. The frequency of spontaneous contractions were significantly decreased by propofol in both control (32.8 +/- 4.6 vs 18.2 +/- 3.4, P < 0.05) and peritonitis groups 20.2 +/- 3.9 vs 11.6 +/- 3.2, P < 0.05). Dexmedetomidine and midazolam did not cause significant changes in the number of spontaneous contractions in both control and the peritonitis groups (P > 0.05). CONCLUSION: Propofol, midazolam and dexmedetomidine have various in vitro effects on spontaneous contractions of the rat ileum. While dexmedetomidine augments the spontaneous contraction of the rat ileum, propofol attenuates it. However, the effects of these compounds were parallel in both control and peritonitis groups. (C) 2009 The WIG Press and Baishideng. All rights reserved.
Effect of peritoneal lavage with chlorhexidine gluconate solution on survival and adhesion formation
(Turkish Surgical Assoc, 2005) Topcu, Omer; Duman, Mustafa; Koyuncu, Ayhan; Aydin, Cengiz; Turan, Mustafa; Sen, Metin
Purpose: In this experimental study; effects of chlorhexidine glucunate solution on peritoneal adhesion formation and perioperative mortality were investigated. Peritoneal Hydatidosis (PH) still remains the most important complication of hydatid cyst surgery. Peritoneal lavage with scolocidal agents and chemotherapy are suggested as a therapeutic approach in the peritoneal dissemination. Materials and Methods: Eighty male rats were divided into four equal groups. Group 1: 0.9% NaCl (Control), Group 2: 20% NaCl, Group 3: 0.4% Chlorhexidine Glucunate (Chx-Glu), and Grup 4: 0.04% Chx-Glu. Two ml solution in each group was instilled into the peritoneal cavity through a median laparotomy and aspirated 5 minutes later. Animals that survived the perioperative period were sacrificed at the fifteenth postoperative day. Adhesion formation were macroscopically graded by Nair criteria. Results: Mortality rate was not significantly different between groups (p > 0.05). Adhesion formation was significantly low in study groups compared to control group (p < 0.05). Adhesion formation was significantly low in Chx-Glu groups compared to 20% NaCl group (p < 0.05). There was no diffirence of adhesion formation between Chx-Glu groups (p > 0.05). Conclusion: Currently, intraabdominal adhesions are still important problems in the surgical area. We recommend the use of 0.04% Chx-Glu solution in the treatment of hydatid disease and Peritoneal Hydatidosis as a potent and non-toxic agent in addition to its ability for decreasing intrabdominal adhesion formation.
Effects of contrast media on the hepato-pancreato-biliary system
(W J G PRESS, 2009) Topcu, Omer; Kurt, Atilla; Nadir, Isilay; Arici, Sema; Koyuncu, Ayhan; Aydin, Cengiz
AIM: To determine the effects of high osmolarity contrast media (HOCM) and iso-osmolar contrast. media (CM) application, with or without pressure, on hepato-pancreato-biliary (HPB) system. METHODS: Sixty rats were divided into six equal groups as follows: Group 1: (0.9% NaCl, control), Group 2: (diatrizoate meglumine Na, ionic HOCM, Urographin (R)), Group 3: (iodixanol, iso-osmolar nonionic CM, Visipaque (R)); each of which was applied without pressure, whereas the animals of the remaining three groups (1p, 2p, 3p) were subjected to the same CM with pressure. We performed a duodenal puncture and introduced a catheter into the ampulla. After the catheterization, 0.2 mL CM or 0.9% NaCl was injected with or without pressure. Blood samples were taken for biochemical evaluations. The histopathological examinations of liver, common bile duct, and pancreas were performed. RESULTS: There were no significant differences between the six groups for blood amylase, alanine aminotransferases, aspartate aminotransferases, bilirubin levels (P > 0.05). Alkaline phosphatase and gamma glutamyl transaminase levels were higher (P < 0.05) in the Urographin (R) groups (2, 2p) than the Visipaque (R) groups (3, 3p), or control groups (1, 1p). Hepatocyte necrosis, portal area inflammation, and Kupffer's cell hyperplasia were higher (P < 0.05) in the study groups than the control group. However, there were no significant differences (P > 0.05) between HOCM (2, 2p) and iso-osmolar CM (3, 3p) groups. Bile duct proliferation and regeneration in the Urographin (R) groups (2, 2p) were significantly higher (P < 0.05) than the Visipaque (R) groups (3, 3p) or the control groups (1, 1p). Although CM caused minor damage to the pancreas, there were no statistically significant differences (P > 0.05) between the groups. Application of the CM with pressure did not cause additional damage to the HPB system. CONCLUSION: Iso-osmolar, non-ionic CM could be more reliable than the ionic HOCM, whereas the application of pressure during the CM application had no effect on the HPB system. (C) 2009 The WJG Press and Baishideng. All rights reserved.
Effects of NO/L-Arginine Pathway on Gallbladder Contractility in Bile Duct Ligated Guinea Pigs
(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2009) Soylu, Sinan; Aydin, Cengiz; Bagcivan, Ihsan; Yildirim, Sahin; Koyuncu, Ayhan; Topcu, Omer; Arici, Sema
Background. Common bile duct ligation (CBDL) produces gallbladder distension and acute inflammation similar to that seen in human acute acalculous cholecystitis. CBDL in the guinea pig affects smooth muscle contractility. The aim of this study was to determine whether the nitric oxide-L-arginine pathway plays a role in the inflammatory process and abnormal gallbladder contractility that occur after CBDL. Materials and Methods. Contractility of gallbladder muscle from CBDL and sham-operated guinea pigs was studied in vitro. Animals were treated with saline, aminoguanidine (AG), or an aminoguanidine + L-arginine combination (AG + L-Arg) in vivo. Potassium chloride, carbachol, and electric field stimulation (EFS) were used for contracting the gallbladder muscle strips or activating intrinsic nerves. Hematoxylin and eosinstained slides of muscle strips were scored for inflammation. Results. Contraction responses to carbachol and EFS were decreased significantly in CBDL guinea pigs compared with those in the sham-operated group. AG partly reversed the smooth muscle contractile response to carbachol and EFS, but did not reduce the inflammation score. Treatment with AG + L-arg did not reverse either the contraction response or the inflammation score. Conclusions. These findings suggest that AG and AG + L-Arg treatments have no beneficial effect on inflammation in guinea pigs after CBDL, although AG significantly reversed the effect on muscle contractility (P < 0.05). This improvement was independent of inflammation and may be due to a decreased level of NO and its diminished relaxant effect. (C) 2009 Elsevier Inc. All rights reserved.
Effects of Proton Pump Inhibitors and H-2 Receptor Antagonists on the Ileum Motility
(HINDAWI PUBLISHING CORPORATION, 2011) Kurt, Atilla; Altun, Ahmet; Bagcivan, Ihsan; Koyuncu, Ayhan; Topcu, Omer; Aydin, Cengiz; Kaya, Tijen
Objectives. To investigate the effects of proton pump inhibitors (PPIs) and H-2 receptor antagonists on ileum motility in rats with peritonitis and compare changes with control group rats. Methods. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another of 8 rats underwent a sham operation and were accepted as controls. Twenty-four hours later after the operation, the rats were killed, and their ileum smooth muscle was excised and placed in circular muscle direction in a 10mL organ bath. Changes in amplitude and frequency of contractions were analyzed before and after PPIs and H-2 receptor blockers. Results. PPI agents decreased the motility in a dose-dependent manner in ileum in both control and intraabdominal sepsis groups. While famotidine had no significant effect on ileum motility, ranitidine and nizatidine enhanced motility in ileum in both control and intraabdominal sepsis groups. This excitatory effect of H-2 receptor antagonists and inhibitor effects of PPIs were significantly high in control group when compared to the peritonitis group. The inhibitor effect of pantoprazole on ileum motility was significantly higher than the other two PPI agents. Conclusions. It was concluded that H-2 receptor antagonists may be more effective than PPIs for recovering the bowel motility in the intraabdominal sepsis situation.
Effects of Triclosan-Impregnated Suture Materials on Colonic Anastomosis
(Erciyes Univ Sch Medicine, 2020) Atabey, Mustafa; Tas, Ayca; Topcu, Omer; Silig, Yavuz
Objective: Symptomatic anastomotic leakage observed after colorectal surgery is one of the major complications. One of the factors affecting the anastomosis healing is the type of suture material used. This study aims to investigate the effects of the suture material polydioxanone (PDS, Ethicon), which is late absorbable and has a monofilament structure, and the suture material polyglactin 910 (Vicryl, Ethicon), which is absorbable and has a multifilament structure, on the healing of colonic anastomosis, and to compare the traditional forms of these sutures with their antibacterial effective triclosan-impregnated forms (PDS Plus, Ethicon and Vicryl Plus, Ethicon). Materials and Methods: The rats were divided into four equal groups consisting of 10 subjects each: Group I: Vicryl; Group II: Vicryl Plus; Group III: PDS; and Group IV: PDS Plus. The presence of wound infection, whether the integrity of the abdominal wall was maintained, intra-abdominal adhesion scoring, the presence of intra-abdominal abscess, and whether the macroscopic integrity of anastomosis was maintained were evaluated. Results: According to the results of this experimental study, while the highest ABP and hydroxyproline levels were observed in the PDS Plus group, the lowest values were observed in the Vicryl group. However, the difference was not statistically significant. Conclusion: Slowly absorbable and monofilament PDS suture material causes less tissue reaction and inflammatory response compared to the Vicryl suture material that is absorbable in the colonic anastomosis line and multifilament.
The effects of various scolicidal agents on the hepatopancreatic biliary system
(KARGER, 2006) Topcu, Omer; Aydin, Cengiz; Arici, Sema; Duman, Mustafa; Koyuncu, Ayhan; Sen, Metin
Background: Sclerosing cholangitis is a rare but dreadful complication of liver hydatid surgery. Almost all scolicidal agents were shown to be potentially associated with this complication clinically or experimentally. This experimental study was designed to examine the effects of 0.04% chlorhexidine gluconate and 95% ethanol on the hepatobiliary system and pancreas and also to compare their effects with 10% povidone iodine and hypertonic 20% saline. Materials and Methods: 50 Wistar rats were divided into equal five groups identified as: 0.9% NaCl ( control group), 0.04% chlorhexidine gluconate, hypertonic 20% saline, 10% povidone iodine, and 95% ethanol. Scolicidal agents were injected into the biliary tract through a duodenal puncture. The animals were kept for 3 months. The animals were sacrificed, and histopathological examinations of the liver, biliary tract, and pancreas were performed. Results: The most severe histopathological changes of the liver, biliary tract, and pancreas were found in the ethanol group, and the least changes were detected in the chlorhexidine gluconate group. Conclusion: This experimental study confirms the deleterious effect of 95% ethanol on hepatopancreatic biliary system when used for the percutaneous drainage of hydatid diseases. For treatment of hydatid cysts in the hepatobiliary system, 0.04% chlorhexidine gluconate should be used as scolicidal agent.
Efficacy of Chlorhexidine Gluconate During Surgery for Hydatid Cyst
(SPRINGER, 2009) Topcu, Omer; Sumer, Zeynep; Tuncer, Ersin; Aydin, Cengiz; Koyuncu, Ayhan
Dissemination of protoscolices-rich fluid during surgery for hydatid cyst disease is a major cause of recurrence. Instillation of a scolicidal agent into a hepatic hydatid cyst before opening is the most commonly employed measure to prevent this serious complication. In this clinical study, the efficacy of 0.04% chlorhexidine gluconate (Chx-Glu) during hydatid cyst surgery was tested, and early-term results were evaluated. A total of 30 consecutive patients with 45 liver cysts were studied. Only type I and type II cysts were included. Cysts were punctured, and fluid was aspirated. The viability of protoscolices in this fluid was determined. Chx-Glu 0.04% was instilled into the cyst cavity. After 5 minutes of exposure, the cyst fluid was reaspirated and evaluated for the viability of protoscolices. Imprints of the germinative membranes were determined for protoscolices viability. All protoscolices in 45 cysts evaluated were killed by 5 minutes of exposure to 0.04% Chx-Glu. The whole of the germinative membrane imprints contained dead protoscolices. Chx-Glu 0.04% did not cause any adverse effect on biliary tracts in communication with cysts. There was no recurrence during the 2-year follow-up period. There were also no mortality and no cavity-related complications. This study shows that intracystic injection of 0.04% Chx-Glu is an effective measure against the dissemination of viable protoscolices. In addition, Chx-Glu is the most convenient scolicidal agent as per the criteria defined by the World Health Organization. Therefore, it can be used safely during hydatid cyst surgery. However, there remains the need to perform advanced comparative clinical studies on the efficacy of Chx-Glu and other scolicidal agents.
Expression of FHIT, p16, p53 and EGFR as prognostic markers in thyroid tumors of uncertain malignant potential
(ZERBINIS MEDICAL PUBL, 2015) Koc, Mustafa; Aktimur, Recep; Gokakin, Ali Kagan; Atabey, Mustafa; Koyuncu, Ayhan; Elagoz, Sahende; Topcu, Omer
Purpose: Thyroid tumors of uncertain malignant potential (TT-UMP) constitute a relatively new diagnosis. The purpose of this study was to analyze the relationship between immunohistochemical panels, prognostic parameters and TT-UMP. Methods: Group I was composed of patients diagnosed as differentiated thyroid carcinoma (DTC) and Group II of patients diagnosed as TT-UMR The prognostic scores of patients were calculated using data according to the well-known prognostic scoring systems MACIS, AMES, AGES. Evaluations of antibodies were based on the presence of nuclear staining for p16 and p.53, membranous and cytoplasmic staining for epidermal growth factor receptor (EGFR) and cytoplasmic staining for fragile histidine triad (FHIT). Results: Statistically significant difference was noted (p< 0.05) between Group I and Group II according to MACIS and AMES. No statistical difference was found in terms of immunostaining between groups when stained with p16, p.53 and FHIT. On the other hand, in Group II a moderate positive correlation was detected between MACIS and EGFR. Conclusion: According to our findings p53 was not important in tumor genesis at early stages in well-differentiated thyroid carcinomas and p16 loss of expression could be used as a finding to help in difficult microscopic diagnosis. TT-UMP is a gray zone of lesions requiring specific therapeutic procedures and postoperative follow-up. A positive correlation was detected between EGFR and TT-UMP, leading to assume that this situation could be used as a new tool in the follow-up of these patients in the future.
The impact of Ramadan on peptic ulcer perforation
(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2012) Gokakin, Ali Kagan; Kurt, Atilla; Atabey, Mustafa; Koyuncu, Ayhan; Topcu, Omer; Aydin, Cengiz; Sen, Metin; Akgol, Gunduz
BACKGROUND Medical treatment has played an important role in the reduction of peptic ulcer perforation (PUP). The goal of this study was to evaluate the effect of fasting on PUP. METHODS A retrospective analysis of 229 patients who were operated due to PUP between 1999-2009 was made. Patients were divided into two groups. Group I (n=188) included the patients who were operated in other periods of the year, while Group II (n=41) included the patients who were operated during Ramadan, the Muslim period of fasting. Patients in Group II were analyzed in terms of duration of fasting. RESULTS The increase in surgeries per group was higher in Group II than Group I (p<0.05). Predisposing factors, anti-ulcer drug usage and demographic variables were seen to have no role in this difference. Duration of fasting may have a minimal effect on the perforation. CONCLUSION The results of this study demonstrate that PUP is detected as relatively higher during Ramadan among those who are fasting for more than 12 hours daily. We suggest that people with predisposing factors should be informed before making a decision to fast.
Investigation of the association between the MDM2 T309G polymorphism and gastric cancer
(SPANDIDOS PUBL LTD, 2017) Tas, Ayca; Atabey, Mustafa; Caglayan, Gulcin; Bostanci, Meric Emre; Bolukbasi, Serap Sahin; Topcu, Omer; Silig, Yavuz
Murine double minute clone 2 oncoprotein (MDM2) is a key component in the regulation of the tumour suppressor p53. The association between the MDM2 polymorphism and gastric cancer (GC) has been investigated in Turkish population. In the present case-control study, the aim was to investigate the association between genetic polymorphisms of the MDM2 gene (a major regulator of p53 function) and primary GC risk in a Turkish population. The polymorphism, T309G (rs2279744) in the MDM2 gene was determined in patients with GC (n=65) and in healthy control subjects (n=67) using the polymerase chain reaction-restriction fragment length polymorphism method. The findings were evaluated using logistic regression and.2 tests. No statistically significant differences were observed between the control subjects and patients with GC regarding smoking status. A comparison between GC cases and control subjects indicated a statistically significant difference for family history of cancer [odds ratio (OR)=0.17; 95% confidence interval (CI), 0.05-0.56;.2=0.19; P=0.01]. A significant difference was identified in the GG genotype distribution between GC patients and control subjects (OR=4.58; 95% CI, 1.18-17.79; P=0.022). Thus, the results of the present study indicate that the MDM2 gene T309G intron (GG) genotype may be an important risk factor for GC development in the Turkish population.
Isolated ICC hyperplasia: Precursor or unusual form of GIST?
(SPRINGER, 2007) Ozer, Hatice; Arici, D. Sema; Ensari, Arzu; Elagoz, Sahande; Topcu, Omer
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Leptin/Melanocortin Pathway in Cholelithiasis Patients: A Diagnostic Perspective
(Bentham Science Publ Ltd, 2025) Agbektas, Tugba; Guclu, Gulsen; Tas, Ayca; Ozmen, Esma; Topcu, Omer; Aydin, Suleyman; Silig, Yavuz
Background: Cholelithiasis is the most prevalent inflammatory condition of the gallbladder. The regulation of biological processes, including energy homeostasis, and control of body weight are key mechanisms that the leptin and melanocortin pathways play a role in Cholelithiasis is the most prevalent inflammatory condition of the gallbladder. There are various risk factors for the development of gallstone disease, especially weight gain, and obesity is just one of them. This risk factor can be minimized by maintaining appetite and energy balance. Here, leptin and melanocortin pathways are the key mechanisms in maintaining appetite and energy homeostasis. Objectives: The aim of this study was to investigate the relationship between the levels of LEP, LEPR, TrkB, BDNF, POMC, and MC4R proteins in patients with Cholelithiasis. This study aims to determine the relationship between LEP, LEPR, TrkB, BDNF, POMC, and MC4R protein levels, which play a role in maintaining appetite and energy homeostasis, and cholelithiasis. Methods This study examined 44 patients diagnosed with Cholelithiasis and 44 healthy control subjects who had not previously been diagnosed with any form of Cholelithiasis. The levels of leptin (LEP), Leptin Binds To Leptin Receptors (LEPR), Tropomyosin Receptor Kinase B (TrkB), Brain-Derived Neurotrophic Factor (BDNF), Pro-OpioMelanoCortin (POMC), and Melanocortin-4 Receptors (MC4R) molecules were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The results were analyzed using the SPSS Software (Version 22.0) program and GraphPad Prism 8.0.1 software. Results: The study found a statistically significant decrease (p < 0.05) in MC4R, TrkB, BDNF, and POMC protein levels in Cholelithiasis patients compared to the control group. There was no statistically significant difference in LEP and LEPR concentration values between the two groups (p = 0.247, p = 0.674). Conclusion: The proteins MC4R, TrkB, BDNF, and POMC, which are involved in the leptin and melanocortin pathways may play a significant role in Cholelithiasis disease. However, more detailed research on the relevant proteins is needed. Nevertheless, this research will guide new studies.
A new variant of bile duct duplication with coexistence of distal cholangiocarcinoma
(NATURE PUBLISHING GROUP, 2010) Kosar, Ilkay; Ataseven, Hilmi; Yonem, Ozlem; Cakmak, Erol; Ozer, Oezdemir; Ozer, Hatice; Topcu, Omer
Background. A 72-year-old hypertensive woman presented with a 2-month history of right upper quadrant abdominal pain. She had a 15-day history of jaundice, fever with chills and shivering, nausea, vomiting, weight loss and generalized pruritus. Investigations. Physical examination, laboratory evaluation, transabdominal ultrasonography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, brush cytology, laparotomy and histopathology. Diagnosis. Bile duct duplication with coexistence of distal cholangiocarcinoma. Management. En bloc resection (including the duodenum, pancreatic head and adjacent lymph nodes), hepaticojejunostomy and pylorus-saving Whipple operation.
Oxidative stress markers in laparoscopic vs. open appendectomy for acute appendicitis: A double-blind randomized study
(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) Aktimur, Recep; Gokakin, Ali Kagan; Deveci, Koksal; Atabey, Mustafa; Topcu, Omer
Background: Oxidative stress is a complicated process, which was defined as an increase in prooxidants and decrease in antioxidants caused by various mechanisms, including inflammation and surgical trauma. The association between acute appendicitis and oxidative stress has been showed in previous studies. However, comparison of oxidative stress in laparoscopic or open appendectomy (OA) has not been established. Patients and Methods: Patients who were diagnosed as acute appendicitis between October 2012 and January 2013 were randomized to open (OA, n = 50) and laparoscopic appendectomy (LA, n = 50). Blood samples for oxidative stress markers (total oxidant status [TOS] and total antioxidant status [TAS]), C-reactive protein (CRP) and white blood cells (WBC's) were collected just before the surgery and 24 h after surgery. Results: There were no differences in preoperative values of WBC and CRP between LA and OA groups (P = 0.523 and 0.424), however, in postoperative 24(th) h, CRP was reduced in LA group (P = 0.031). There were no differences in preoperative levels of TOS, TAS, and oxidative stress index (OSI) between LA and OA groups. In the postoperative 24(th) h, TOS and OSI were found to be significantly higher in OA group when compared to LA group (P = 0.017 and 0.002) whereas no difference was detected in TAS level in the postoperative 24(th) h (P = 0.172). Conclusions: This double-blind, randomized clinical trial provides evidence that LA for uncomplicated appendicitis is associated with significantly lower oxidative stress compared with OA. Some of the advantages of LA may be attributed to the significant reduction of oxidative stress in these patients.
Peptic Ulcer Perforation in Elderly: 10 years' Experience of a Single Institution
(ELSEVIER TAIWAN, 2016) Gokakin, Ali K.; Atabey, Mustafa; Koyuncu, Ayhan; Topcu, Omer
Background: Peptic ulcer perforation (PUP) constitutes a unique situation characterized by severe pain, leading almost every patient with this complication to seek help in the hospital. However, clinical features of PUP in elderly patients are different from those of young or in adult patients; indeed, symptoms of PUP may be atypical in old age. Materials and methods: This was a retrospective study of patients who underwent emergency surgery for PUP between 2002 and 2012. The patients were divided into two age groups. Medical conditions of the patients that may have had an effect on the perforation, such as age, gender, concomitant disease, use of drugs, presence of Helicobacter pylori infection, characteristic of pain (vague abdominal pain or severe epigastric pain), smoking status, and duration symptoms at the time of admission, were evaluated. Results: A total of 261 patients were included in this retrospective study. Group I (n = 202) was composed of adults (age < 65 years), Group II (n = 59) was composed of geriatric patients (age >= 65 years). Male dominancy was observed in both groups. Primary closure of the perforation was the most common procedure performed. Hypertension (18.3 % and 52.5%, respectively), and diabetes mellitus (11.9% and 15.3%, respectively) were the most frequent comorbidities in both groups, whereas mortality and morbidity rates were higher in elderly group. Conclusions: PUP is a serious condition, particularly in geriatric age requiring emergency surgical management. Primary closure of the perforation was the most common procedure performed in our series. Copyright (C) 2013, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC.
The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study
(ELSEVIER SCI LTD, 2013) Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer
Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20 mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAG) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAG and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10 mg/kg could be apparently better than 20 mg/kg. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
Psychosis Association with Graves Thyrotoxicosis: A Case Report
(UNIVERSITATSVERLAG ULM GMBH, 2008) Kugu, Nesim; Dogan, Orhan; Topcu, Omer; Kavakci, Onder; Karsikaya, Sureyya
Graves disease is ail autoimmune and multifactorial disease of the thyroid gland and one of the commonest reasons of the hyperthyroidism. Most of the Graves disease patients show typical symptoms of the disease such as fatique, irritability, weight loss, palpitations and heat intolerance. Mental abnormalities are also known to be present in case of Graves thyrotoxicosis. These mental abnormalities are composed of irritability, emotional lability, anxiety, depression, mania, and psychotic manifestations with paranoid and persecutive delusions. Here we presented a 38 year old woman having Graves thyrotoxicosis who had no psychiatric disorder or a history of any medical illness before Graves thyrotoxicosis but whenever the disease had started acutely patient presented some psychotic symptoms such as hallucinations, paranoid and persecutive delusions, a state of confusion, agitation and hyperactivity. In the first thyroid function test (TFT) blood thyroid hormone levels were found as follows: free T(3) (FT(3))= 8.07 pg/ml (normal value: 1.71-3.71), free T(4) (FT(4))= 1.46 ng/dL (normal value: 0.70-1.48) and TSH<0.0008 (normal value: 0.35-4.94). Patient was diagnosed as Graves thyrotoxicosis after the results of her past history, physical examination, laboratory and clinical findings and patient was given antithyroid treatment. Additionally patient was also given antipsychotic treatment to control her psychotic symptoms. After the treatment psychotic and clinical symptoms of the patient relieved significantly. The case presented here showed that Graves thyrotoxicosis may start with acute psychotic symptoms and this condition may frequently be misdiagnosed with major psychiatric disorders. So, in the presence of the clinical cases which starts with acute psychotic symptoms, it is very important to get detailed medical and psychiatric past history, to make carefull physical examination and to make detailed medical investigations including thyroid function tests.
Significant association between MDM2 T309G polymorphism and colorectal cancer
(IMPRIMATUR PUBLICATIONS, 2019) Atabey, Mustafa; Tas, Ayca; Sari, Ismail; Bostanci, Meric Emre; Topcu, Omer; Silig, Yavuz
Purpose: The Murine double minute 2 (MDM2) gene plays a crucial role in regulating and suppressing the function of apoptotic pathway. We investigated the relationship between MDM2 gene SNP309 (T309G) (rs2279744) polymorphism and colorectal cancer (CRC) in a Turkish population. Methods: The polymorphism T309G (rs2279744) in the MDM2 gene was studied in patients with colorectal cancer (n=135) and healthy control subjects (n=145) using the polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method The findings were evaluated using logistic regression and x(2) tests. Results: When CRC cases and controls were evaluated based on different habits and family cancer histories, a statistically significant relationship was found between CRC and alcohol consumption (x(2) =4.07, p=0.044). Cancer cases and controls had statistically significant different family histories of cancer (x(2) =6.82, p =0.009). There was also significant difference in TG genotype distribution in the MDM2 T309G polymorphism between those with and without cancer (OR=1.98, 95% CI =1.98-3.91, x(2) =4.00, p =0.045). Conclusions: The SNP309 polymorphism of the MDM2 gene is associated with increased CRC risk in the Turkish population.
The effects of sildenafil in liver and kidney injury in a rat model of severe scald burn: A biochemical and histopathological study
(Turkish Association of Trauma and Emergency Surgery, 2014) Gökakin, Ali Kağan; Atabey, Mustafa; Deveci, Koksal; Sancakdar, Enver; Tuzcu, Mehmet; Duger, Cevdet; Topcu, Omer
Background: Severe burn induces systemic inflammation and reactive oxygen species leading to lipid peroxidation which may play role in remote organs injury. Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase- 5. Sildenafil reduces oxidative stress and inflammation in distant organs. The aim of the present study was to evaluate the effects of different dosages of sildenafil in remote organs injury.; Methods: A total of thirty-two rats were randomly divided into four equal groups. The groups were designated as follows: Sham, Control, 10, and T20 mg/kg sildenafil treatment groups. Levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), VEGF receptor (Flt-1), activities of glutathione peroxidase (Gpx), levels of total antioxidative capacity (TAC), and total oxidant status (TOS) were measured in both tissues and serum, and a semi-quantitative scoring system was used for the evaluation of histopathological findings.; Results: Sildenafil increased levels of Gpx, and Flt-1, and decreased MDA and VEGF levels in tissues. Sildenafil also increased serum levels of TAC and Flt-1 and decreased TOS, OSI, and VEGF.; Conclusion: Sildenafil decreased inflammation scores in remote organs in histopathological evaluation. It has protective effects in severe burn-related remote organ injuries by decreasing oxidative stress and inflammation. © 2014, TJTES.

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