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PubMed ID: 16456746BACKGROUND: To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis. METHODS: Forty Wistar-albino rats were equally divided... more
PubMed ID: 16456746BACKGROUND: To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis. METHODS: Forty Wistar-albino rats were equally divided into 4 groups. Colonic transsection and anastomosis situated at the distal left colon was performed on all animals. Animals in groups 1 and 2 received late total enteral nutrition (TEN) and in groups 3 and 4 early TEN. Glutamine was added to TEN protocol in groups 2 and 4. The colonic segment including the anastomosis was excised at the end of the 7th day postoperatively. Bursting pressure of the anastomosis and tissue hydroxyproline levels were determined. RESULTS: Bursting pressure levels were 111.6 and 95.8 centimeters of water (cmH2O) in early and late nutrition groups, respectively (p=0.022). Comparison of late TEN groups showed a significant difference in favor of group with glutamine (95.8 vs 138.5 cmH2O; p<0.0001). Highest bursting pressures (139 and 138.5 cmH2O) were measured in both early and late TEN groups with glutamine. Tissue hydroxyproline level in early TEN group (2440.3 ?g) was significantly higher than late TEN group (1509.6 ?g; p=0.024). Comparison of late TEN groups showed a considerable but not statistically significant difference (p=0.276) in favor of group with glutamine (1509.6 vs 1981.6 ?g). CONCLUSION: Postoperative early TEN significantly ameliorates the resistance of the anastomosis and collagen synthesis. Glutamine enrichment in nutritional protocol decreases and reverses the disadvantages of late TEN regarding the resistance of anastomosis. A similarly positive, albeit weaker, effect of glutamine supplementation is also seen on collagen synthesis
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We present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruction following a pancreatoduodenectomy. Treatment strategy for this type of jaundice is discussed with a review of the literature. The dilated... more
We present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruction following a pancreatoduodenectomy. Treatment strategy for this type of jaundice is discussed with a review of the literature. The dilated loop of the jejunum was drained percutaneously with 10 F abscess drainage catheter. The obstructive jaundice was improved.
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Research Interests: Comparative Study, Medicine, Prevention, Humans, Liver Transplantation, and 15 moreCyclosporine, Renal Function, Digestive System, Calcineurin, Nephrotoxicity, Long Term, Prospective Study, Creatinine, Liver function tests, Orthotopic Liver Transplantation, Postoperative Complications, Immunosuppressive Agents, Prospective Cohort Study, Cause of death, and Medical and Health Sciences
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Research Interests: Microscopy, Gastroenterology, Wound Healing, Inflammation, Immunohistochemistry, and 14 moreMedicine, Intestinal Mucosa, Female, Animals, Rats, Glutamine, Wistar Rats, Enteral Feeding, Colon, Parenteral Nutrition, Colon Anastomosis, Anastomosis, Enteral Nutrition, and Medical biochemistry and metabolomics
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Research Interests: Medicine and Gynecology
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Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to introduce an... more
Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to introduce an easy and reproducible method for measuring anal pressures in testing the effectiveness of surgical procedures. We used a Sengstaken-Blakemore tube connected to a mercury manometer. After calibration of the system by inflating the distal (gastric) balloon and filling connection lines to the mercury manometer with 0.9% NaCl solution, resting and squeezing anal pressures were measured. The system was used on 50 human subjects (35 with anal fissure and 15 normal volunteers). Left lateral internal sphincterotomy had been performed in the anal fissure cases. Anal pressures were measured preoperatively and on postoperative days (POD) 2 and 20. Preoperative resting anal pressures in the group with anal fissure (83.4 +/- 1 mmHg) were significantly higher than those in the group of normal individuals (52 +/- 1.2 mmHg; p = 0.001). Resting anal pressures after the sphincterotomy (29 +/- 1 mmHg) were found to be significantly lower on POD 2, and resting anal pressure measurements (47 +/- 1 mmHg) on POD 20 were lower than the corresponding preoperative values. These values are closer to those of normal volunteers (p = 0.016). Anal manometry can be performed with this easily constructible and inexpensive system. This reproducible method can be used in the assessment of the results of surgical treatment in patients with anal and perianal diseases.
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The effect of Diosmin Hesperidin on intestinal ischaemia reperfusion injury was evaluated in an experimental model in rats. Forty Spraque-Dawley rats were divided into 4 groups of (n = 10) (sham, sham + Diosmin Hesperidin, Reperfusion,... more
The effect of Diosmin Hesperidin on intestinal ischaemia reperfusion injury was evaluated in an experimental model in rats. Forty Spraque-Dawley rats were divided into 4 groups of (n = 10) (sham, sham + Diosmin Hesperidin, Reperfusion, Reperfusion + Diosmin Hesperidin). Diosmin Hesperidin oral gavage was administrated at a dose of 50 mg/kg to rats 14 and 2 hours before the operation and 30 minutes of ischaemia and 30 minutes of reperfusion was performed in the groups when appropriate. Ileum samples were resected for histopathological evaluation and tissue malondialdehyde (MDA) and myeloperoxidase (MPA) level determination. Mean mucosal injury score of IR group (4,50+/-0,23) was significantly higher than the other groups (p < 0.05). Although mean mucosal injury score of IR + DH group was higher than sham and sham + DH groups, difference was not statistically significant (p > 0.05). Tissue MDA and MPO activities of IR group were 45,55+/-2.61 nmol/g/wet tissue and 1.68+/-0.25 U/g/wet tissue respectively and were significantly higher than the other groups (p < 0.008). Although tissue MDA and MPO activities of IR + DH group was higher than sham and sham + DH groups, differences were not statistically significant (p > 0.008). Diosmin Hesperidin seems to be effective in the prevention of intestinal reperfusion injury.
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Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology and biochemistry of gastrointestinal mucosal cells and wound healing. The aim of this study is to determine the effect of L-Thyroxin on... more
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology and biochemistry of gastrointestinal mucosal cells and wound healing. The aim of this study is to determine the effect of L-Thyroxin on colonic anastomosis healing. Method: Thirty male Wistar Albino rats were equally divided (n=10) in to three groups. Group 1 was the sham group whereas groups 2 and 3 were made hypothyroid by administration of propylthiouracil 10mg/kg/day per oral for four weeks. Hypothyrodism was confirmed with measurement of free-T3 and free T4 levels. All groups were subjected to left colonic transection and anastomosis. Group 3 rats have taken L-thyroxin therapy intraperitoneally 5g in 1cc saline daily for seven days. Anastomosis bursting pressure, hydroxyproline and IGF-I Ab-1 measurements were done on postoperative 7th day. Results: The anastomosis bursting pressure levels of group 3 were significantly higher than both group1 (p=0,03) and group2 (p=0,002). Hydroxy...
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The safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and embryological variations of the inferior laryngeal nerve (ILN), of the thyroid gland itself and unusual relations between ILN and the gland... more
The safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and embryological variations of the inferior laryngeal nerve (ILN), of the thyroid gland itself and unusual relations between ILN and the gland threaten operation security are discussed. The patient with toxic multinodular goiter is treated with total thyroidectomy. During dissection of the right lobe, the right ILN which has nonrecurrent course arising directly from cervical vagus nerve is identified and fully isolated until its laryngeal entry. At the operation, we observe bilateral Zuckerkandl's tubercles (ZTs) as posterior extension of both lateral lobes. The left ILN has usual recurrent course in the trachea-esophageal groove. The right ZT is placed between upper and middle third of the lobe points the nonrecurrent ILN. The coincidence of non-recurrent ILN pointed by a ZT is rare anatomical and embryological feature of this case. Based on anatomical and embryological variations, we ...
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Türkçe. İyot Eksikliğine Bağlı Endemik Guatr Bölgesinde A-meliyat Edilen Nodüler Guatr Olgularında Düşük Tiroid Kanseri İnsidansı. LOW INCIDENCE OF THYROID CARCINOMA IN SURGICALLY TREATED PATIENTS WITH ...
Toxic adenoma is one of the main causes of hyperthyroidism. We investigated the efficacy of surgery in the treatment of toxic adenoma. Serum thyroid stimulating hormone (TSH) measurement, ultrasound and scintigraphy of the thyroid were... more
Toxic adenoma is one of the main causes of hyperthyroidism. We investigated the efficacy of surgery in the treatment of toxic adenoma. Serum thyroid stimulating hormone (TSH) measurement, ultrasound and scintigraphy of the thyroid were made for diagnostic purpose. The safety of surgery was evaluated by postoperative clinical course of patients. The efficacy of surgery was determined by the function of the remaining thyroid tissue. The incidence of hyperthyroidism was 53% in surgically treated patients with nodular goitre in our iodine deficient region. The cause of thyrotoxicosis was toxic adenoma in 15 patients (14%). Suppressed serum TSH levels indicated the hyperthyroidism in all of 15 patients. Solitary solid adenoma was found by ultrasonographic examination, and solitary autonomous hot nodule by thyroid scintigraphy. Surgical treatment consisted of unilateral total lobectomy. It was the primary treatment in 13 patients. Two patients had surgery as secondary treatment after unsu...
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Aneurysms of the coeliac axis are rare. Up to 1997, 137 cases had been reported. Here we present a coeliac aneurysm which involved the origin of the splenic, left gastric, and common hepatic arteries. After making a midline incision,... more
Aneurysms of the coeliac axis are rare. Up to 1997, 137 cases had been reported. Here we present a coeliac aneurysm which involved the origin of the splenic, left gastric, and common hepatic arteries. After making a midline incision, infra-diaphragmatic control of the aorta was obtained. The aorta was clamped for 25 minutes to resect the aneurysm. The defect at the origin of the coeliac axis was closed with 1.5 cm PTFE patch. The distal segments of the splenic and left gastric arteries were ligated. A 6-mm ringed PTFE graft was interposed between the infra-renal aorta and the proper hepatic artery. The control arteriogram showed a good arterial flow. The patient recovered uneventfully after surgery with normalisation of hepatic function.
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The effect of intraperitoneal administration of chemotherapeutic agents on colonic anastomosis are still under investigation. In this study the effects of intraperitoneally administered paclitaxel on rat colonic anastomosis was... more
The effect of intraperitoneal administration of chemotherapeutic agents on colonic anastomosis are still under investigation. In this study the effects of intraperitoneally administered paclitaxel on rat colonic anastomosis was investigated. After colonic anastomosis, 3 mL of isotonic saline was administered intraperitoneally to rats in control group (Group 1, n = 20). The study group (Group 2, n = 20), paclitaxel 3 mg/kg diluted with isotonic saline was administered intraperitoneally after colonic anastomosis. Rats were sacrificed on 14th day and mean body weight, mean anastomosis bursting pressure and the histopathology of the anastomosis site of the two groups were compared. Mean body weight was approximately the same with the preoperative values at 14th day in both groups. Anastomosis bursting pressure in paclitaxel group (127 +/- 3 mm Hg) was found to be similar to control group (133 +/- 5 mm Hg) (P > 0.05). Mucosal layer formation in the anastomosis line was complete on the...
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Background Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to... more
Background Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, most techniques for anal pressure measurement are not easily available because of high cost. The aim of the present study was to introduce an easy and reproducible method for measuring anal pressures in testing the effectiveness of surgical procedures. Materials and methods We used a Sengstaken-Blakemore tube
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Simultaneous right lung and liver dome hydatid cyst lesions is to be found as frequently. A 23-year-old female patient was operated by right thoracotomy and phrenotomy due to ruptured hydatid cyst on lateral basal segment of lower lobe of... more
Simultaneous right lung and liver dome hydatid cyst lesions is to be found as frequently. A 23-year-old female patient was operated by right thoracotomy and phrenotomy due to ruptured hydatid cyst on lateral basal segment of lower lobe of the right lung and intact hydatid cyst on right lobe of the liver. No recurrence was observed clinically and radiologically during
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The aim of this study was to determine the effect of Ginkgo Biloba (EGb 761) on reperfusion injury of the small bowel. Forty-eight male 200-250 g Spraque-Dawley rats in six groups were used to determine the biochemical and... more
The aim of this study was to determine the effect of Ginkgo Biloba (EGb 761) on reperfusion injury of the small bowel. Forty-eight male 200-250 g Spraque-Dawley rats in six groups were used to determine the biochemical and histopathological changes after a 30-min ischemia and 30-min reperfusion. Pre-treatment with 50 mg/kg EGb 761 (Tebofortan, Karlsruhe-Germany) or 10-mL/kg saline was administered intravenously in the treatment and control groups. The superior mesenteric artery was occluded distal to the right colic artery and collateral arcades were ligated to provide complete ischemia. Ischemia was determined by the existence of pulseless or pale color of the small intestine. The return of the pulses and the reestablishment of the pink color were assumed to be the reperfusion of the intestine. Rats that were administered Egb 761 and saline were subjected to laparotomy, ischemia, or ischemia-reperfusion procedures. Mucosal lesions were graded from 0 to 5 in histopathological examin...
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To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis. Forty Wistar-albino rats were equally divided into 4 groups. Colonic transsection and... more
To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis. Forty Wistar-albino rats were equally divided into 4 groups. Colonic transsection and anastomosis situated at the distal left colon was performed on all animals. Animals in groups 1 and 2 received late total enteral nutrition (TEN) and in groups 3 and 4 early TEN. Glutamine was added to TEN protocol in groups 2 and 4. The colonic segment including the anastomosis was excised at the end of the 7th day postoperatively. Bursting pressure of the anastomosis and tissue hydroxyproline levels were determined. Bursting pressure levels were 111.6 and 95.8 centimeters of water (cmH(2)O) in early and late nutrition groups, respectively (p=0.022). Comparison of late TEN groups showed a significant difference in favor of group with glutamine (95.8 vs 138.5 cmH(2)O; p<0.0001). Highest bursting pressures (139 and 138.5 cmH(2)O) were measured in bot...
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Intra-operative injuries of pelvic vessels are quite infrequent but serious complications of lumbar disc surgery. Injury may cause laceration of the vessel with acute life threatening retroperitoneal haemorrhage, formation of... more
Intra-operative injuries of pelvic vessels are quite infrequent but serious complications of lumbar disc surgery. Injury may cause laceration of the vessel with acute life threatening retroperitoneal haemorrhage, formation of pseudoaneurysms or arteriovenous fistulae in the late phase. It is important for surgeons to be aware of these potentially fatal complications. Authors reported a case of major vascular injury recognised intra-operatively during posterior lumbar discectomy and repaired immediately.
