Mevlut Pehlivan - Academia.edu (original) (raw)
Papers by Mevlut Pehlivan
Zenodo (CERN European Organization for Nuclear Research), Mar 15, 2022
Medical Network Klinik Bilimler ve Doktor, 2000
Konuralp Tip Dergisi, Dec 1, 2014
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology... 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). Hydroxyproline levels were significantly higher in group 3 than both group1 and group 2 (Group3 versus group1 p=0,003 and group 3 versus group 2 p=0,002). The IGF-1 Ab-1 staining integrity were higher in group3 versus group1 (P=0,008) and group2 (P=0,005) respectively. Conclusions: Thyroid hormones improve anastomosis healing as documented increased hydroxiproline levels and anastomotic bursting pressure.
Turkish journal of trauma & emergency surgery, 2006
PubMed ID: 16456746BACKGROUND: To investigate the effects of postoperative early enteral and glut... 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
Arquivos Brasileiros de Oftalmologia, 2019
Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mec... more Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] ≥40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 μm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-μm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 μm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 μm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 μm, and nasal 500, 1000, and 1500 μm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2003
We present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruct... 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.
Transplantation Proceedings, 2002
Turkish journal of trauma & emergency surgery, 2006
Acta histochemica, Apr 1, 2007
Problems related to colonic anastomosis healing constitute the major morbidity in colorectal surg... more Problems related to colonic anastomosis healing constitute the major morbidity in colorectal surgery. Patients without appropriate nutritional support are at higher risk of postsurgical complications, mainly due to reduced wound healing. Therefore, we investigated the effect of early and late postoperative total enteral nutrition (TEN) and glutamine addition on colon anastomosis healing using light microscopy and immunohistochemistry (IGF-I immunolabelling). In this study, 40 Wistar-albino rats underwent distal left colonic transection and anastomosis. The rats were then divided into four groups given different diets: delayed total enteral nutrition (dTEN; beginning 3 days postoperatively), delayed TEN with added glutamine (dTEN+ Glutamine), early TEN (eTEN; beginning within 6 h postoperatively), and early TEN with added glutamine (eTEN+Glutamine). Colon segments, including the anastomosis, were excised 7 days postoperatively and evaluated histopathologically for inflammation, mucosal healing, submucosal-muscular layer repair, the amounts of necrosis and vascularisation and immunohistochemically for IGF-I labelling. The inflammation and necrosis scores in the dTEN and dTEN+Glutamine groups were significantly greater than in the eTEN and eTEN+Glutamine groups. The IGF-I immunoreactivity increased in the eTEN, eTEN+Glutamine, and dTEN+Glutamine groups compared to dTEN (po0.05). We concluded that early TEN and glutamine enrichment in the postoperative period improve anastomosis healing via IGF-I.
Turkish Journal of Medical Sciences, 2009
We sought to evaluate the effect of L-carnitine administration on the levels of IGF-1, TNF-α, and... more We sought to evaluate the effect of L-carnitine administration on the levels of IGF-1, TNF-α, and lipid peroxidation during hepatic regeneration for up to 72 h in an experimental partial hepatic resection rat model. Materials and methods: Sixty rats were divided into 3 groups: control and low-dose (100 mg/kg) and high-dose (200 mg/kg) L-carnitine. Each group was divided into 2 sub groups (24 and 72 h after partial hepatectomy). Partial (70%) hepatectomy was performed after 7 days of intra-peritoneal administration of L-carnitine. After partial hepatectomy, L-carnitine was also administered to rats until sacrifice. Serum IGF-1, TNF-α, and tissue malondialdehyde levels were determined in all groups before and at 24 and 72 h after surgery. Results: Serum TNF-α increased significantly in the control group during the regeneration period. The low dose of L-carnitine (100 mg/kg) decreased the elevation of TNF-α whereas the high dose (200 mg/kg) increased it. In the control group, the IGF-1 level decreased in the first 24 h after surgery and then increased. The IGF-1 level behaved similarly in the L-carnitine groups. The malondialdehyde level in the control group increased during the first 24 h and then decreased. Similarly in the L carnitine groups, the malondialdehyde level increased during the first 24 h and then decreased significantly in a dose-dependent manner. Conclusion: Three types of biochemical pathways are essential in liver regeneration: cytokine, growth factor, and metabolic pathways. We conclude that, in addition to its effects on energy metabolism, high-dose L-carnitine may promote liver regeneration by increasing IGF-1, TNF-α, and decreasing malondialdehyde.
Case Reports in Medicine, 2012
The safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and ... 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 suggest identification and full exposure of ILN before attempting excision of adjacent structures, like the ZT which has surgical importance for completeness of thyroidectomy.
Journal of surgery and medicine, Feb 28, 2023
A 33-year-old female patient was admitted to our clinic with complaints of nausea and vomiting fo... more A 33-year-old female patient was admitted to our clinic with complaints of nausea and vomiting for two days and the inability to tolerate food. The patient had a Nissen fundoplication three years ago. Computed tomography (CT) showed a bezoar image in the distal esophagus. The patient stated that the symptoms began after he ate a persimmon two days ago. The patient underwent esophagogastroduodenoscopy. A bezoar was observed in the distal esophagus at the esophagogastric junction. No pathology was observed in the stomach and duodenum. After the bezoar was shredded with a snare and removed with a retrieval snare. Here, we further describe this case of a bezoar that caused ileus in the distal esophagus after a fundoplication operation.
Turkiye Klinikleri Journal of Surgery, 2003
Obesity Surgery, Jan 17, 2020
Background Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for treating obes... more Background Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for treating obesity. Excessive residual gastric volume (RGV) may be one cause of insufficient weight loss following this surgery. The purpose of this study was to investigate the relationship between weight loss and the RGV measured during surgery over a 2-year follow-up period. Methods All patients undergoing LSG at our university surgery department were included in this prospective observational study. During the operation, the pylorus was grasped with a laparoscopic clamp, and saline solution dyed with methylene blue was introduced using an intraluminal glass-tipped injector when the residual stomach became fully visible. The amount of fluid given when the remaining gastric tissue ceased expanding was noted. The patients were divided into three groups depending on the volume of the residual gastric tissue. Percentages of excess weight loss (EWL%) were also evaluated 6, 12, and 24 months after the LSG. Results Sixty-two patients (50 females and 12 males) with a mean age of 36 (17-56) years were included in the study. There was no significant difference between the preoperative and postoperative body mass index values (p = 0.407 and p = 0.337, respectively) or between the preoperative and postoperative weight (p = 0.081 and p = 0.517, respectively) among the groups. A comparison of the participants' weight losses and EWL% values after 6, 12, and 24 months of follow-up revealed no significant difference among the groups at any time point (p > 0.005). Conclusion Greater weight loss was observed as the RGV decreased over the 24-month follow-up period. However, that weight loss was not statistically significant.
World Journal of Surgery, Jan 5, 2007
Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, mos... 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.
Acta Chirurgica Belgica, 2004
The effect of Diosmin Hesperidin on intestinal ischaemia reperfusion injury was evaluated in an e... 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 &amp;lt; 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 &amp;gt; 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 &amp;lt; 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 &amp;gt; 0.008). Diosmin Hesperidin seems to be effective in the prevention of intestinal reperfusion injury.
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology... 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...
Zenodo (CERN European Organization for Nuclear Research), Mar 15, 2022
Medical Network Klinik Bilimler ve Doktor, 2000
Konuralp Tip Dergisi, Dec 1, 2014
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology... 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). Hydroxyproline levels were significantly higher in group 3 than both group1 and group 2 (Group3 versus group1 p=0,003 and group 3 versus group 2 p=0,002). The IGF-1 Ab-1 staining integrity were higher in group3 versus group1 (P=0,008) and group2 (P=0,005) respectively. Conclusions: Thyroid hormones improve anastomosis healing as documented increased hydroxiproline levels and anastomotic bursting pressure.
Turkish journal of trauma & emergency surgery, 2006
PubMed ID: 16456746BACKGROUND: To investigate the effects of postoperative early enteral and glut... 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
Arquivos Brasileiros de Oftalmologia, 2019
Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mec... more Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] ≥40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 μm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-μm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 μm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 μm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 μm, and nasal 500, 1000, and 1500 μm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.
Tanısal ve girişimsel radyoloji : Tıbbi Görüntüleme ve Girişimsel Radyoloji Derneği yayın organı, 2003
We present percutaneous biliary drainage in a patient with jaundice due to afferent loop obstruct... 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.
Transplantation Proceedings, 2002
Turkish journal of trauma & emergency surgery, 2006
Acta histochemica, Apr 1, 2007
Problems related to colonic anastomosis healing constitute the major morbidity in colorectal surg... more Problems related to colonic anastomosis healing constitute the major morbidity in colorectal surgery. Patients without appropriate nutritional support are at higher risk of postsurgical complications, mainly due to reduced wound healing. Therefore, we investigated the effect of early and late postoperative total enteral nutrition (TEN) and glutamine addition on colon anastomosis healing using light microscopy and immunohistochemistry (IGF-I immunolabelling). In this study, 40 Wistar-albino rats underwent distal left colonic transection and anastomosis. The rats were then divided into four groups given different diets: delayed total enteral nutrition (dTEN; beginning 3 days postoperatively), delayed TEN with added glutamine (dTEN+ Glutamine), early TEN (eTEN; beginning within 6 h postoperatively), and early TEN with added glutamine (eTEN+Glutamine). Colon segments, including the anastomosis, were excised 7 days postoperatively and evaluated histopathologically for inflammation, mucosal healing, submucosal-muscular layer repair, the amounts of necrosis and vascularisation and immunohistochemically for IGF-I labelling. The inflammation and necrosis scores in the dTEN and dTEN+Glutamine groups were significantly greater than in the eTEN and eTEN+Glutamine groups. The IGF-I immunoreactivity increased in the eTEN, eTEN+Glutamine, and dTEN+Glutamine groups compared to dTEN (po0.05). We concluded that early TEN and glutamine enrichment in the postoperative period improve anastomosis healing via IGF-I.
Turkish Journal of Medical Sciences, 2009
We sought to evaluate the effect of L-carnitine administration on the levels of IGF-1, TNF-α, and... more We sought to evaluate the effect of L-carnitine administration on the levels of IGF-1, TNF-α, and lipid peroxidation during hepatic regeneration for up to 72 h in an experimental partial hepatic resection rat model. Materials and methods: Sixty rats were divided into 3 groups: control and low-dose (100 mg/kg) and high-dose (200 mg/kg) L-carnitine. Each group was divided into 2 sub groups (24 and 72 h after partial hepatectomy). Partial (70%) hepatectomy was performed after 7 days of intra-peritoneal administration of L-carnitine. After partial hepatectomy, L-carnitine was also administered to rats until sacrifice. Serum IGF-1, TNF-α, and tissue malondialdehyde levels were determined in all groups before and at 24 and 72 h after surgery. Results: Serum TNF-α increased significantly in the control group during the regeneration period. The low dose of L-carnitine (100 mg/kg) decreased the elevation of TNF-α whereas the high dose (200 mg/kg) increased it. In the control group, the IGF-1 level decreased in the first 24 h after surgery and then increased. The IGF-1 level behaved similarly in the L-carnitine groups. The malondialdehyde level in the control group increased during the first 24 h and then decreased. Similarly in the L carnitine groups, the malondialdehyde level increased during the first 24 h and then decreased significantly in a dose-dependent manner. Conclusion: Three types of biochemical pathways are essential in liver regeneration: cytokine, growth factor, and metabolic pathways. We conclude that, in addition to its effects on energy metabolism, high-dose L-carnitine may promote liver regeneration by increasing IGF-1, TNF-α, and decreasing malondialdehyde.
Case Reports in Medicine, 2012
The safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and ... 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 suggest identification and full exposure of ILN before attempting excision of adjacent structures, like the ZT which has surgical importance for completeness of thyroidectomy.
Journal of surgery and medicine, Feb 28, 2023
A 33-year-old female patient was admitted to our clinic with complaints of nausea and vomiting fo... more A 33-year-old female patient was admitted to our clinic with complaints of nausea and vomiting for two days and the inability to tolerate food. The patient had a Nissen fundoplication three years ago. Computed tomography (CT) showed a bezoar image in the distal esophagus. The patient stated that the symptoms began after he ate a persimmon two days ago. The patient underwent esophagogastroduodenoscopy. A bezoar was observed in the distal esophagus at the esophagogastric junction. No pathology was observed in the stomach and duodenum. After the bezoar was shredded with a snare and removed with a retrieval snare. Here, we further describe this case of a bezoar that caused ileus in the distal esophagus after a fundoplication operation.
Turkiye Klinikleri Journal of Surgery, 2003
Obesity Surgery, Jan 17, 2020
Background Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for treating obes... more Background Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for treating obesity. Excessive residual gastric volume (RGV) may be one cause of insufficient weight loss following this surgery. The purpose of this study was to investigate the relationship between weight loss and the RGV measured during surgery over a 2-year follow-up period. Methods All patients undergoing LSG at our university surgery department were included in this prospective observational study. During the operation, the pylorus was grasped with a laparoscopic clamp, and saline solution dyed with methylene blue was introduced using an intraluminal glass-tipped injector when the residual stomach became fully visible. The amount of fluid given when the remaining gastric tissue ceased expanding was noted. The patients were divided into three groups depending on the volume of the residual gastric tissue. Percentages of excess weight loss (EWL%) were also evaluated 6, 12, and 24 months after the LSG. Results Sixty-two patients (50 females and 12 males) with a mean age of 36 (17-56) years were included in the study. There was no significant difference between the preoperative and postoperative body mass index values (p = 0.407 and p = 0.337, respectively) or between the preoperative and postoperative weight (p = 0.081 and p = 0.517, respectively) among the groups. A comparison of the participants' weight losses and EWL% values after 6, 12, and 24 months of follow-up revealed no significant difference among the groups at any time point (p > 0.005). Conclusion Greater weight loss was observed as the RGV decreased over the 24-month follow-up period. However, that weight loss was not statistically significant.
World Journal of Surgery, Jan 5, 2007
Anal manometry is a useful tool for testing the effectiveness of surgical treatment. However, mos... 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.
Acta Chirurgica Belgica, 2004
The effect of Diosmin Hesperidin on intestinal ischaemia reperfusion injury was evaluated in an e... 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 &amp;lt; 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 &amp;gt; 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 &amp;lt; 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 &amp;gt; 0.008). Diosmin Hesperidin seems to be effective in the prevention of intestinal reperfusion injury.
Backgrounds: Thyroid hormones play a critical developmental and regulatory role on the morphology... 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...