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    196 Genel Cerrahi Uzmanının Kasık Fıtığına Yaklaşımları ile İlgili Anket Çalışması
    (2008) Kartal, Adil; Tekin, Ahmet; Vatansev, Celalttin; Tekin, Şakir; Belviranlı, Metin; Yol, Serdar; Aksoy, Faruk
    Amaç: Anket çalışması kasık fıtıklarının onarımında Türkiye’deki genel cerrahların tecrübelerini analiz etmek için planlandı. Durum De?erlendirilmesi: Anket çalışmaları geri bildirimdeki yetersizlik nedeniyle araştırmacılar için zor yürütülmektedir. Bu konuda hekimlerin daha duyarlı olması bilime önemli katkılar sağlayacaktır. Yöntem: 2002 yılında Türkiye’deki 250 genel cerraha posta yoluyla bir anket (örneğin Lichtenstein veya diğer tekniklerin uygulanması ve kullanılan anestezi türünü içeren) gönderildi. Bulgular: 250 katılımcının 196’sından (%78) geri bildirim elde edildi. Bunlardan 128 cerrah (%65.3) kasık fıtığı onarımı için ilk tercih olarak Lichtenstein tekniğini kullanmaktaydı. Rutkow tekniği ve Bassini onarımı bunu takip etmekteydi. Cerrahların çoğunluğu genel anestezi kullanmaktaydı. Seroma ve hematom en sık bildirilen komplikasyonlardı. Sonuç: Özellikle Lichtenstein olmak üzere gerilimsiz meş tekniği primer ve nüks fıtıkların her ikisinde de tercih edilen tedavi yöntemiydi. Kasık fıtıklarının onarımında cerrahların yarıdan fazlası genel anesteziyi tercih etmekteydi. Hastaların çoğu ameliyat sonrası birinci günde hastaneden çıkartıldı.
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    Akut Kolesistit İçin Erken Laparoskopik Kolesistektomi
    (2009) Tekin, Ahmet; Küçükkartallar, Tevfik; Belviranlı, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; Kartal, Adil
    BACKGROUND The aim of this study was to assess the clinical results of treatment by laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. METHODS Between 1994 and 2006, LC was performed in 3876 patients in Selcuk University Meram Medicine Faculty. The clinical, biochemical, radiologic, and operative data of 182 (101 F, 81 M) consecutive patients with acute cholecystitis operated 3 days after the onset of symptoms were analyzed retrospectively to determine the complications and morbidity after operation. RESULTS The conversion rate was 31 (17.03%) in acute cholecystitis. Postoperative length of stay was found as 4 days in the successful LC group and 7 days in the conversion group. For acute cholecystitis, we found a statistical difference between the successful LC group and the conversion group in terms of length of postoperative hospitalization time and gallbladder wall thickness. We identified the following factors as associated with conversion: male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm. CONCLUSION LC is a safe approach in selected patients with acute cholecystitis. Male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.
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    Akut kolesistit için erken laparoskopik kolesistektomi
    (2009) Tekin, Ahmet; Küçükkartallar, Tevfik; Belviranlı, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; Kartal, Adil
    AMAÇ: Bu çalışmada, erken laparoskopik kolesistektomi (LK) ile tedavi edilen akut kolesistitli (AK) hastaların klinik sonuçları değerlendirildi. GEREÇ VE YÖNTEM: Selçuk Üniversitesi Meram Tıp Fakültesi’nde Ocak 1994 ile Aralık 2006 yılları arasında 3876 hastaya LK yapıldı. Bunlardan 182 hastaya (101 kadın, 81 erkek) semptomların başlamasından itibaren ilk üç gün içinde kolesistektomi uygulandı. Hastaların dosyaları klinik, biyokimyasal, radyolojik ve ameliyat bulguları, ameliyat sonrası komplikasyon ve morbiditeye etkisini saptamak için geriye dönük olarak değerlendirildi. BULGULAR: Akut kolesistli olgularda açığa geçme oranı 31 (%17,03) idi. Ameliyat sonrası hastanede kalış süresi başarılı LK grubunda 4, açık kolesistektomiye geçilen grupta 7 gün olarak saptandı. Laparoskopik tamamlanan ve açığa geçilen kolesistektomi grupları arasında hastanede yatış süresi ve safra kesesi duvar kalınlığı yönünden istatistiksel olarak anlamlı fark bulundu. Çalışmamızda açığa geçme ile ilgili faktörler; erkek cinsiyeti, ultrasonografide perikolesistik sıvı gözlenmesi, gangrenöz tip kolesistit ve safra kesesi duvar kalınlığının 1 cm ve üzerinde olması idi. SONUÇ: LK, seçilmiş AK’li hastalarda güvenli bir yaklaşımdır. Erkek cinsiyeti, ultrasonografide perikolesistik sıvı gözlenmesi, gangrenöz kolesistitler ve safra kesesi duvar kalınlığının 1 cm ve üzerinde olması yüksek açık cerrahiye dönme riski ile beraberdir.
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    Axillary Lymph Node Status in Multicentric Breast Tumors and Breast Tumors with Nipple Involvement
    (KARGER, 2012) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Vatansev, Celalettin; Aksoy, Faruk; Kartal, Adil; Tuncer, Fatma B.
    Background: Axillary lymph node dissection plays an important role in breast cancer management in terms of staging, prediction of prognosis, determination of adjuvant therapy, and local control of the primary tumor. The objective of this study was to evaluate the axillary lymph node involvement in multicentric breast tumors and breast tumors with nipple involvement in comparison with unifocal tumors. Patients and Methods: We reviewed the records of 267 patients with stage I or IIA disease. The rates of axillary lymph node metastasis (ALNM) in patients with unifocal tumors, multicentric tumors, or nipple involvement were compared. Results: 209 (78%) patients had unifocal tumors, 24 (8%) had multicentric tumors, and 34 (12%) had nipple involvement. The incidence of ALNM was 9.76% in patients with unifocal tumors, 24.84% in patients with multicentric tumors, and 36.71% in patients with nipple involvement. Hence, the incidence of ALNM was significantly higher in patients with nipple involvement or multicentric tumors than in patients with unifocal tumors. Conclusion: Our data suggest that compared to unifocal tumors, breast tumors with nipple involvement or multiple foci show a significantly higher incidence of ALNM which is a predictor of a poor prognosis.
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    Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery.
    (FIELD HOUSE PUBLISHING LLP, 2009) Apiliogullari, Seza; Duman, Ates; Tekin, Ahmet
    [Abstract not Available]
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    Comparison of Laparoscopic and Open Surgery Splenectomies Performed for Hematological Diseases
    (2012) Çakır, M.; Tekin, Ahmet; Küçükkartallar, T.; Vatansev, C.; Aksoy, Faruk; Kartal, Adil
    Aim. Today most of the splenectomies performed for non-traumatic reasons are undertaken due to hematological diseases. In our study, our aim is to present the results of splenectomy cases that were applied laparoscopic and open surgery for benign hematological malignancies. Methods. We retrospectively examined 240 cases on whom splenectomy was performed in General Surgery Clinic at Meram Faculty of Medicine, Selcuk University between June 2002 and January 2011 because of hematological diseases in terms of age, gender, diagnosis, the presence of accessory spleen, operation method and duration, need for blood transfusion, duration of hospitalization, morbidity and mortality. Results. The mean age of the patients was 39 (17-74). 142 (59%) of the patients were female and 98 (41%) were male. Hundred forty of the splenectomies were performed with laparoscopic procedure, 100 were carried out with open method. Laparoscopic splenectomies were completed in 88 (50-140) minutes and those performed with open method took 52 (34-100) minutes to complete. On average, patients who were applied open surgery were discharged 5,7 days later, and those who had laparoscopic surgery were discharged 3 days later. The cases were followed for 44 (6-72) months on average. Conclusion. In hematological diseases, splenectomy is a distinguished treatment applied after medical treatment or if this treatment is inadequate. In hematological splenectomies, laparoscopic intervention is to be the primary choice.
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    Comparison of mammography sensitivity after reduction mammoplasty targeting the glandular and fat tissue
    (AVES, 2015) Cakir, Murat; Kucukkartallar, Tevfik; Tekin, Ahmet; Selimoglu, Nebil; Poyraz, Necdet; Belviranli, Mehmet Metin; Kartal, Adil
    Objective: Mammography may have some limitations in the diagnosis and screening of breast cancer for women who have previously undergone breast reduction surgery. This study aimed to investigate how the structural defects in the breast tissue formed by postoperative changes are reflected on mammography. Material and Methods: The records of patients who had previously undergone breast reduction surgery and who were requested to undergo mammography for breast cancer screening by the general surgery clinic were retrospectively studied. The patients' ages, surgical procedures, postoperative follow-up periods, amount of removed material, and histopathological and mammographic results were studied. The patients were classified into 3 groups: those older than 40 years who underwent reduction mammoplasty targeting predominantly the glandular tissue (group 1), those younger than 40 years who underwent reduction mammoplasty targeting predominantly the fat tissue (group 2), and those older than 40 years who were diagnosed with breast hypertrophy and were not operated (group 3). Results: The mean follow-up period of the patients was 6 (2-10) years. The mean value of resected tissue was 1120 g (680-2070) in group 1 and 1220 g (720-1980) in group 2. The mean age at the time of surgery was 45 (40-70) years for group 1 and 35 (24-40) years for group 2. All patients in group 1 were classified in Breast Imaging-Reporting and Data System (BI-RADS) category 1-2; 28 patients in group 2 were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 8 were classified in BI-RADS 0. In group 3, 35 patients were classified in BI-RADS 1-2, 4 were classified in BI-RADS 3, and 1 was classified in BI-RADS 0. Conclusion: We believe that breast reduction surgery targeting predominantly the glandular tissue in patients older than 40 years increases mammographic sensitivity.
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    COMPARISON OF SELECTIVE SPINAL ANESTHESIA AND LOCAL INFILTRATION ANESTHESIA UNDER MONITORED ANESTHESIA CARE TECHNIQUES IN PATIENTS UNDERGOING ANORECTAL DAY SURGERY
    (NOBEL ILAC, 2011) Duman, Ates; Apiliogullari, Seza; Tekin, Ahmet; Bodur, Said
    Objective: In this prospective, randomized study, we aimed to compare the two techniques that we employ routinely in our clinic; selective spinal anesthesia (SSA) and local infiltration anesthesia under monitored anesthesia care (MAC) in terms of patient and surgeon satisfaction, time for ambulation (AT), time to be ready for discharge (RD). Material and Method: In group I (n=30), spinal anesthesia was achieved with 2.5 mg 0.5% hyperbaric bupivacaine in the sitting position. In group II (n=30), 0.25 mg.kg-1 of hetamine followed by 1-2mg. kg-1 of propofol were administered intravenously for sedation. Local infiltration anesthesia consisting of 5ml of 0.5% isobaric bupivacaine and 5ml of 2% prilocaine. Patient and surgeon satisfaction, AT, RD and side effects were compared. Results: The mean AT and RD were 38 min and 45 min respectively in group land, 43 mm and 57 min respectively in group II (p<0.05). While the groups were similar in terms of surgeon satisfaction, patient satisfaction was better in group I (p<0.05). Conclusion: When compared to local infiltration anesthesia under MCA, SSA technique provides better patient satisfaction together with shorter AT and RD times.
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    Dev ingunal herni onarımında ameliyat öncesi pnömoperitoneum uygulaması
    (2013) Çakır, Murat; Tekin, Ahmet; Kaynak, Adnan
    Fıtık onarımı cerrahların sık uyguladıkları ameliyatlardandır. Fıtık cerrahisinde istenmeyen problemlerden birisi dev fıtık içeriğinin karın içerisine itilmesi esnasında oluşabilecek kompartman sendromudur. Bu problemi önlemek için pnömoperitoneum (PP) yöntemini dev inguinal fıtıklarda kullandık ve tartışmaya değer bulduk. Kasıkta ağrı, şişlik ve idrar yaparken zorlanma şikâyeti olan 70 yaşında erkek hastanın dev inguinal fıtık onarımında PP uyguladık. Ultrasonografi eşliğinde intraabdominal alana yerleştirilen kateterle 15mmHg basıncında pnömoperitoneum 12 gün boyunca günde bir seans olarak uygulandı. Anterior yaklaşımla gerilimsiz mesh hernioplasti ameliyatı yapılan hasta ameliyat sonrası 5. günde taburcu edildi. PP dev inguinal fıtıkların onarımında abdominal kompartman sendromunun gelişmesini önlemede etkin bir yöntem olarak kullanılabilir.
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    Diaphragmatic rupture in abdominal trauma
    (2003) Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; Tekin, Ahmet; Belviranl, Metin; Kaynak, Adnan
    BACKGROUND: The aim of the study is to evaluate the patients with diaphragmatic rupture due to penetrating or blunt abdominal trauma. METHODS: Thirty-eight patients with diaphragmatic rupture due to penetrating or blunt abdominal trauma were investigated retrospectively. RESULTS: The average age was 41,72 and there were 31 male and seven female patients. The injury forms were penetrating trauma in 22 (58%) and blunt trauma in 16 (42%) cases. Associated abdominal organ injuries were found in 27 (71%) cases. Among 47 diaphragmatic ruptures, 27 (57%) were on the left and 20 (43%) were on the right side. The average diameter of the rupture was 5,45 (1-20) cm. Management of the diaphragmatic rupture and other associated organ injuries were accomplished through laparotomy. Morbidity was developed in 18 cases and mortality in four cases with associated abdominal organ injuries. CONCLUSION: Diaphragmatic rupture results in high morbidity and mortality due to associated organ injuries.
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    A different approach for sterilization of liver hydatid cysts
    (W J G PRESS, 2007) Tekin, Ahmet; Kucukkartallar, Tevfik; Kartal, Adil
    [Abstract not Available]
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    Early and late urological complications corrected surgically following renal transplantation
    (WILEY, 2007) Dinckan, Ayhan; Tekin, Ahmet; Turkyilmaz, Serdar; Kocak, Huseyin; Gurkan, Alihan; Erdogan, Okan; Tuncer, Murat
    The purpose of this study was to assess outcomes of urological complications after kidney transplantation operation. Nine-hundred and sixty-five patients received a kidney transplant between 2000 and 2006. In total, 58 (6.01%) developed urological complications, including urinary leakage (n = 15, 1.55%), stenosis (n = 29, 3%), vesicoureteral reflux (VUR) (n = 12, 1.2%), calculi (n = 1, 0.1%) and parenchymal fistulae (n = 1, 0.1%). Urinary leakage cases were treated by ureteroneocystostomy (UNS) via a double-J stent and stenosis cases by UNS. Fenestration was performed in patients developing lymphoceles and unresponsive to percutaneous drainage. VUR treatment was performed by ureteroneocystostomy revision or UNS. Stent usage during ureteric reimplantation was observed to reduce urinary leakage. Surgical complication rates in renal transplantation recipients according to donor type (living versus cadaveric) and the status of stent use (with stent versus without stent) were 5.53% vs. 7.27% (P = 0.064) and 5.24% vs. 20% (P < 0.01) respectively. No recurrence, graft loss or death was seen after these interventions. Comparison of recipients with and without urological complication showed that there was no difference between groups (P > 0.05) with respect to last creatinine level. No graft or patient loss was associated with urological complications. Urological complications that can be surgically corrected should be aggressively treated by experienced surgeons and graft loss avoided.
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    Early laparoscopic cholecystectomy for acute cholecystitis
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2009) Tekin, Ahmet; Kucukkartallar, Tevfik; Belviranli, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Sakir; Kartal, Adil
    BACKGROUND The aim of this study, was to assess the clinical results of treatment by laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. METHODS Between 1994 and 2006, LC was performed in 3876 patients in Selcuk University Meram Medicine Faculty. The clinical, biochemical, radiologic, and operative data of 182 (101 F, 81 M) consecutive patients with acute cholecystitis operated 3 days after the onset of symptoms were analyzed retrospectively to determine the complications and morbidity after operation. RESULTS The conversion rate was 31 (17.03%) in acute cholecystitis. Postoperative length of stay was found as 4 days in the successful LC group and 7 days in the conversion group. For acute cholecystitis, we found a statistical difference between the successful LC group and the conversion group in terms of length of postoperative hospitalization time and gallbladder wall thickness. We identified the following factors as associated with conversion: male gender, pericholecystic collection L seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm. CONCLUSION LC is a safe approach in selected patients with acute cholecystitis. Male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.
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    Effect of Ascitic Media Formed by Glycerin on the Prevention of Peritoneal Adhesions
    (KARGER, 2009) Aksoy, Fatih; Vatansev, Celalettin; Tekin, Ahmet; Pamukcu, A.; Küçükkartallar, T.; Yılmaz, Hüseyin; Vatansev, Hüsamettin
    Aim: We aimed to investigate whether or not artificial ascites media formed using glycerin are effective in the prevention of intraperitoneal adhesions. Methods: Thirty-six Wistar albino male rats were used in the study. The rats were divided into 3 groups as follows. Group I: control group; group II (isotonic group): 3 ml of 0.9% NaCl was injected into the peritoneal cavity, and group III (glycerin group): 0.5 ml of liquid glycerin and 3 ml of 0.9% NaCl was injected into the peritoneal cavity. Results: There were serious adhesions in the control group. Adhesion rates were lower in the isotonic group compared with the control group, but the difference was not statistically significant (p > 0.05). When adhesion rates of the glycerin group were compared with the control and isotonic groups, significant differences were found, especially between the glycerin and control groups (p < 0.05). Conclusions: According to the results of our study, the use of isotonic solution and liquid glycerin decreases postoperative adhesions. We suggest that glycerin was more effective as it has the chemical ability to draw water to its media. As such, the formation of adhesions may be decreased by increasing the amount of physiological liquid inside the abdomen. Copyright (C) 2009 S. Karger AG, Basel
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    Effectiveness of collagenase in preventing postoperative intra-abdominal adhesions
    (ELSEVIER SCIENCE BV, 2013) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Yilmaz, Huseyin; Belviranli, Metin; Kartal, Adil
    Introduction: The purpose of this study is to investigate the effectiveness of Collagenase clastridiopeptidase an enzyme preparation used in enzymatic debridement in preventing adhesions brought about by peritoneal damage. Methods: The study covers a total of 40 rats in 4 groups each having 10 rats. Group 1: The control group. Group 2: Normal saline group. Group 3: Sterile Novuxol (R) group. Group 4: The group where the intraperitoneal and systemic effects of sterile Novuxol (R) were investigated. Adhesion frequency and grades were scored on the post-op 11th day according to Granat. Blood work including hemoglobin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, and albumin level measurements were performed. Toxicity was investigated histopathologically through samples taken from the liver and the peritoneum from Group 4. Results: Adhesion frequency was found to be 80% on the right and 90% on the left for Group 1, while it was 50% on both left and right for Group 2, and 30% on the right and 10% on the left for Group 3. Adhesion stages were found to be 1: 2.35 +/- 1.42 for Group 1, 0.31 +/- 1.15 for Group 2, and 0.20 +/- 0.41 for Group 3. Adhesion stage of the Sterile Novuxol (R) Group was lower than all the other groups (p < 0.05). Biochemical and hematological parameters were similar in all groups (p > 0.05). Histopathological analysis revealed no hepatotoxicity. Conclusions: According to the results of our study, we believe that Sterile Novuxol (R) can be a good anti-adhesive agent considering its ease of use, non-toxicity, and effectiveness. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
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    The Effects of 3 Different Intra-abdominal Pressures on the Thromboelastographic Profile During Laparoscopic Cholecystectomy
    (LIPPINCOTT WILLIAMS & WILKINS, 2011) Topal, Ahmet; Celik, Jale Bengi; Tekin, Ahmet; Yuceaktas, Ali; Otelcioglu, Seref
    Objective: The aim was to determine the influence of the pneumoperitoneum at 10, 13, and 16mm Hg on thromboelastograph (TEG) in laparoscopic cholecystectomy. Methods: Sixty patients were randomly allocated to 3 groups. The abdomen was insufflated with carbon dioxide to 10mm Hg (group 1), 13mm Hg (group 2), and 16mm Hg (group 3) intra-abdominal pressures. We evaluated changes in the TEG values [ reaction time (R), maximum amplitude (MA), alpha-angle, K time] preoperatively, intraoperatively, and postoperatively. Results: In the postoperative 24th hour, the R-value was significantly lower in group 3 than that in group 1 and group 2 (P< 0.05). We found increased values of MA intraoperative 30th minute and postoperative 24th hour in group 3 with respect to group 1 (P< 0.05) and postoperative 24th hour, and the MA value in group 3 was significantly higher than those of group 2 (P< 0.05). In group 3, the alpha-angle was significantly higher than that of group 1 and group 2 at intraoperative 30th minute and postoperative 24th hour (P< 0.05). In postoperative 24th hour, the K-value was significantly lower in group 3 than in group 2 and group 1 (P< 0.05). Conclusions: Laparoscopy with pneumoperitoneum at pressures of 10 and 13mm Hg did not alter the TEG values and low intra-abdominal pressure must be used for peritoneal insufflation.
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    The effects of anti-adhesion materials in preventing postoperative adhesion in abdominal cavity (Anti-Adhesion materials for postoperative adhesions)
    (SPRINGER/PLENUM PUBLISHERS, 2007) Şahin, Mustafa; Çakır, Murat; Avşar, Fatih Mehmet; Tekin, Ahmet; Küçükkartallar, Tevfik; Aköz, Mehmet
    Purpose. The purpose of this study was to compare the effects of anti-adhesion materials in postoperative adhesions. Materials and Methods. Rats were assigned to five groups: Group 1: Control. Group 2: chitin layers were used. Group 3: Na- hyaluronate / carboxymethylcellulose layers were used. Group 4: Na-hyaluronate gel was poured into the abdomen. Group 5: methylprednisolone was injected. The adhesion frequency and grade were scored according to Granat. Blood was taken for Hb, AST, BUN and albumin levels determination. Findings. The adhesion frequencies (right and left) and grades were as follow in Groups; I: 82%, 91%, 2.63 +/- 1.22; II: 8.3%, 25%, 0.58 +/- 0.66; III: 17%, 33%, 1.08 +/- 1.08; IV: 50%, 58%, 1.41 +/- 1.44; V: 50%, 42%, 1.41 +/- 1.50. The adhesion phase in all study groups was found significantly low compared to control group, p < 0.05. No difference was observed among serologic and hematological parameters in all groups. Conclusion. All the materials used significantly lowered the adhesion frequency and grade.
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    Effects of Caffeic Acid Phenethyl Ester (CAPE) on Hepatopulmonary Syndrome
    (SPRINGER/PLENUM PUBLISHERS, 2011) Tekin, Ahmet; Turkyilmaz, Serdar; Kucukkartallar, Tevfik; Cakir, Murat; Yilmaz, Huseyin; Esen, Hasan; Ates, Burhan
    The aim of this study was to investigate the effects of caffeic acid phenethyl ester (CAPE) on inflammatory and related histopathological changes in the lung and liver in experimental hepatopulmonary syndrome (HPS) model. Forty Sprague Dawley rats were used in this study. The animals were divided into four groups of ten rats each. Group 1 and 2 was subjected the common bile duct (CBD) but not ligated, Group 3; (cirrhosis + saline): the CBD was ligated and was given intraperitoneal saline infusion treatment during 5 weeks. Group 4; (cirrhosis + CAPE): the CBD was ligated and was given intraperitoneal CAPE infusion treatment during 5 weeks. A 5-week waiting period was observed for the development of cirrhosis and the rats' lungs and liver were taken for histopathological examination. The induction of HPS resulted in a significant increase in serum bilurubin, AST, ALT, and NO levels, and decrease PO2 and O-2 saturation. The use of CAPE significant decrease these parameters. Histopathological examination revealed less congestion, portal inflammation, and nodular formations of the liver, and less congestion, emphysematous and inflammatory changes and smallest perialviolar vascular diameters, in the lung in the cirrhosis + CAPE groups than in the other groups. CAPE treatment may be a potential approach for the treatment of hepatopulmonary syndrome in the future.
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    Effects of caffeic acid phenethyl ester (CAPE) on sepsis in rats
    (SPRINGER/PLENUM PUBLISHERS, 2008) Tekin, Ahmet; Kuecuekkartallar, Tevfik; Tuerkyilmaz, Serdar; Dinckan, Ayhan; Esen, Hasan; Ates, Burhan; Yilmaz, Hueseyin
    Sepsis is still a major cause of the high mortality rate in the intensive care unit. Many studies have been published about the severity of sepsis, but the cause of mortality in sepsis and multiorgan failure is still obscure. This study investigated the effects of caffeic acid phenethyl ester (CAPE) particularly on the inflammatory and related histopathological changes in the lung, liver and kidney in an experimental sepsis model. Forty Sprague Dawley rats were used in this study, and were divided into four groups of ten rats each, as follows: Group I was given intraperitoneal saline infusion treatment. Group II was given intraperitoneal CAPE infusion treatment. Sepsis was induced in the animals in Group III (sepsis with saline infusion), while Group IV rats underwent induced sepsis plus CAPE infusion treatment (sepsis with CAPE infusion). Sampling was performed 48 h after treatment. The induction of sepsis resulted in a significant increase in serum glucose, leukocytes, urea, creatinine, LDH levels in BAL, plasma MDA, AST and ALT levels in the sepsis+saline group. The use of CAPE significantly decreased these parameters. Histopathological examination revealed less congestion, portal inflammation, and focal necrosis of the liver, and less congestion, edema, and emphysematous and inflammatory changes in the lung in the sepsis+CAPE group than in the other groups. These results support that CAPE may be used for the treatment of organ failure during sepsis.
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    The effects of oral liquid and intravenous glutamine on bowel adaptation in a rabbit short bowel syndrome model
    (TURKISH SOC GASTROENTEROLOGY, 2010) Tekin, Ahmet; Yemis, Mustafa; Kucukkartallar, Tevfik; Vatansever, Celalettin; Cakir, Murat; Yilmaz, Huseyin; Toy, Hatice
    Background/aims: The aim of this study was to examine whether liquid glutamine given to rabbits after resection is as effective as intravenous (iv) glutamine and to study the positive effects of glutamine on mucosal atrophy that occurs after bowel resection. Methods: Thirty rabbits with an average weight of 2500 g were used. On the third day, 30 rabbits were divided into three groups as follows: Group I (controls): bowel resection + oral total parenteral nutrition, Group II (oral liquid L-glutamine): Bowel resection + oral total paranteral nutrition + oral liquid L-glutamine, and Group III (iv L-glutamine): bowel resection + oral total paranteral nutrition + iv L-glutamine. On the postoperative 7(th) day, all subjects were sacrificed to examine intestinal adaptation indicators. Results: There was an increase in average villas height and crypt depth in Group III compared to the other groups (p=0.0001). In Group II, the villus height and crypt depth increased more than in Group I, but the difference was less significant (p=0.038). There was no significant difference between groups in terms of average goblet cell proliferation. Conclusions: In our experimental study, it was observed that the orally given L-glutamine liquid in the rabbit intestinal adaptation model prevented mucosal atrophy after 50% bowel resection and even increased mucosa mass. However, iv glutamine led to similar and even better results. Neither route of glutamine administration was determined to have an effect on goblet cell proliferation.