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Öğe Arginase and Ornithine in Human Benign and Malignant Skin Tumors(Walter De Gruyter Gmbh, 2010) Gokmen, Selma Suer; Kazezoglu, Cemal; Aygit, A. Cemal; Yildiz, Reyhan; Cakir, Beyhan; Ture, Mevlut; Gulen, SendoganObjectives: Arginase activity and ornithine concentration have been shown to be elevated in experimentally-induced benign tumors in mice. The aim of the study is to investigate arginase activity and ornithine concentration in human benign and malignant skin tumors and to evaluate their role for prognosis of skin tumors. Patients and Methods: We have investigated arginase activity and ornithine concentration in supernatant of homogenates of benign tumors (nevus) of the skin from 13 patients and of malignant tumors (squamous cell or basal cell carcinomas) from 29 patients. Total arginase activity, ornithine and total protein concentration in supernatant were determined by the methods of Geyer, Chinard and Lowry, respectively. Results: Arginase activity (p=0.006) and ornithine concentration (p=0.007) in nevus were significantly higher than in adjacent normal tissue. There was no significant difference between their levels in basal cell carcinoma and in nevus (p>0.05). There was no significant difference between ornithine concentration in squamous cell carcinoma and in nevus (p>0.05). However, arginase activity in this carcinoma was significantly higher than in nevus (p=0.018). Conclusion: The significant difference between tissue arginase activities in squamous cell carcinoma and in nevus indicates that determination of arginase activity could be useful for prognosis of skin tumors.Öğe The Effects of Thermal Injury on Immature Rat Ear Cartilage(Lippincott Williams & Wilkins, 2010) Aygit, A. Cemal; Benlier, Erol; Top, Husamettin; Yalcin, Omer; Huseyinova, Gulara; Kanter, Mehmet; Cakir, BeyhanThe purpose of this study was to research regeneration and growing properties of an immature rat ear cartilage and its adjacent tissue after a thermal injury. Fifteen 30-day-old male Sprague-Dawley rats were used. Burn wounds were created by applying a heated plaque. All the rats, based on their tissue sampling day, were placed in two groups for histopathologic evaluation. In group I (n = 5), the burned right auricles were amputated on the first day, and the left auricles were amputated as a control at the same time. In group II (n = 10), the burned right auricles were amputated on the 30th day, and the left auricles were amputated as a control at the same time. Epithelization of skin was completed in period ranging between 12 and 15 days in all burned ears. The skin appendages were few throughout the affected area. Chondroid tissue regenerated from perichondrium and increased capillary vessels were observed. On the first day of the burn injury, electron microscopic findings were karyopyknosis, karyorrhexis, and karyolysis of the nucleus, and there were also signs of necrosis. New chondro-blasts were formed around the collagen fibrils in the scar tissue on the 30th day. CD-31 immunohistochemical staining showed increased capillary vessels in the burned ear. The peripheral nerve fibers decreased and regenerative signs of nerves were shown with the use of S-100 immunohistochemical staining. Differentiation of chondroblasts to chondrocytes occurs in the burned immature ear, and new cartilage tissue regenerates from perichondrium. In addition, regenerative signs of nerves appear. (J Burn Care Res 2010; 31: 803-808)Öğe The efficacy of linear polarized polychromatic light on burn wound healing: An experimental study on rats(Oxford Univ Press, 2007) Karadag, Ceyda Akci; Birtane, Murat; Aygit, A. Cemal; Uzunca, Kaan; Doganay, LatifeWe aimed to investigate the questionable effect of linear polarized polychromatic light on burn wound healing in rats. Two deep second-degree burn wounds on the backside of each of 21 Sprague-Dawley rats were created with a standard burning procedure by applying a heated plaque. Burned regions located right dorsolaterally and classified as group I lesions were treated with linear polarized polychromatic light + open dressing + antibacterial pomade, whereas group 11 lesions were located left dorsolaterally and treated with only open dressing + antibacterial pomade. Macroscopic evaluation was performed for determination of the completed wound closure rate, measurement of burn wound area, and investigation of macroscopic edema, hyperemia, and epithelialization. Histopathological evaluation included monitoring of epithelialization, vascularization, origination of granulation tissue, inflammatory cell response, and total histopathological score on days 7, 14, and 21 after burn creation. Macroscopic evaluation revealed more obvious epithelialization in group I lesions between days 6 and 15. The number of completely closed wounds was higher in group I than in group 11 on days 16 and 21. The average area of burn wounds was lower from day 5, hyperemia was less on days 2 to 17, and edema was less from day 4 to day 13 in group I lesions. Histopathological evaluation revealed a higher rate of epithelialization on day 7 and higher vascularization occurrence on day 21 in group I lesions. Linear polarized polychromatic light seems to be effective in the treatment of burn wounds and in the promotion of healing. This may be related to linear polarized polychromatic light stimulation of epithelialization and vascularization.Öğe Predictive value of 99mTc-sestamibi scintigraphy for healing of extremity amputation(Springer, 2006) Sarikaya, Ali; Top, Husamettin; Aygit, A. Cemal; Benlier, Erol; Unal, YasinPurpose: Although various non-invasive procedures have been proposed to determine the optimal level of amputation of limbs in patients who have vascular disease, currently there are no consistent criteria that can be applied before surgery. The purpose of this study was to determine whether Tc-99m-sestamibi imaging can accurately predict the healing of amputation sites. Methods: In a prospective study in 26 patients ( 21 men, 5 women; age range 23 - 94 years) presenting with ulcers or gangrene of the foot and hand, Tc-99m-sestamibi imaging was performed preoperatively. The indications for amputation included gangrene ( 23 patients), electrical injury ( 2 patients) and trauma ( 1 patient) of extremities. Although the amputation levels were chosen according to clinical criteria and scintigraphic results, the final amputation level was defined by scintigraphic results. Two below-knee, one above-knee, 12 toe, 11 transmetatarsal, two phalanx, one finger and one thumb amputations and one shoulder disarticulation were performed. In four cases, the amputation defect was not suitable for coverage using a local dermal flap; rather, it was covered with free tissue transfer. Patients had clinical follow-up for 6 - 36 months ( mean 11.69 months) to assess healing of the stump. Scan results were compared with clinical outcome to assess prediction of healing. Results: There was healing in all amputations at the end of the follow-up period. When evaluated regarding preoperative Tc-99m-sestamibi uptake pattern, there was no perfusion to the lesion site in 21 patients and perfusion to an area smaller than the extent of skin necrosis in four patients; thus, in these 25 patients, Tc-99m-sestamibi scintigraphy suggested non-viable tissue in the extremities with clear-cut edges of perfused muscle tissue. Diffusely decreased uptake was seen below the left knee in one case. How scintigraphy changed management was analysed. The amputation levels proposed before scintigraphy were divided into two groups, definite (n=14) and indefinite ( n= 12), based on visual examination and Doppler findings. In nine patients in the definite group, the proposed amputation level before scintigraphy was not altered by the scintigraphic data. However, Tc-99m-sestamibi scan enabled unnecessarily high amputation levels to be avoided in 12 patients in the indefinite group and in five patients in the definite group. Therefore, there was change in management of 65% of cases based on scintigraphic findings. Conclusion: Since healing of the stump was seen in all cases, outcome was correctly predicted by scintigraphy. This preliminary study supports the use of Tc-99m-sestamibi scan in selecting the optimal amputation level consistent with subsequent stump healing.Öğe Reverse-flow retroauricular island flap in facial reconstruction(Lippincott Williams & Wilkins, 2007) Benlier, Erol; Top, Husamettin; Cinar, Can; Yazar, Sukru; Aygit, A. Cemal; Cetinkale, OguzBACKGROUND Reconstruction of facial skin defects requires good-quality skin cover to satisfy aesthetic expectations of patient, especially when the skin defect is on the uncovered area of the face. Limitations in the available local tissue and donor-site morbidity restrict the options. OBJECTIVE In an effort to solve these problems, we have begun to use a subcutaneous pedicled retroauricular reverse-flow flap. METHODS Between January 1997 and December 2005, reverse-flow subcutaneous pedicled retroauricular island flap was used to cover facial defects in 12 patients who underwent surgical excision of skin tumor. The patients ranged in age from 44 to 81 years with a mean age of 58 years. RESULTS Only one case experienced a superficial necrosis in the distal one-quarter part of the flap. The functional and aesthetic results were satisfactory for both patients and surgeons, and no tumor recurrence was observed during the 12 to 28 months (mean, 18.8 months) follow-up period. CONCLUSIONS This flap can be used reliably for the reconstruction of facial skin defects of small and medium size. The preference of frontal branch pedicled flap enables more distal facial area defects to be covered, such as dorsal nasal, nasolabial, and upper lip, than flaps based on parietal branch.
