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Öğe Acute abdomen caused by brucellar hepatic abscess(Elsevier Singapore Pte Ltd, 2007) Ibis, Cem; Sezer, Atakan; Batman, Alli K.; Baydar, Serkan; Eker, Alper; Unlu, Ercument; Kuloglu, FigenBrucellosis is a zoonotic infection that is transmitted from animals to humans by ingestion of infected food products, direct contact with an infected animal, or aerosol inhalation. The disease is endemic in many countries, including the Mediterranean basin, the Middle East, India, Mexico, Central and South America and, central and southwest Asia. Human brucellosis is a systemic infection with a wide clinical spectrum. Although hepatic involvement is very common during the course of chronic brucellosis, hepatic abscess is a very rare complication of Brucella infection. We present a case of hepatic abscess caused by Brucella, which resembled the clinical presentation of surgical acute abdomen.Öğe The Amount of Comorbidities as a Single Parameter Has No Effect in Predicting the Outcome in Appendicitis Patients Older than 60 Years(Lippincott Williams & Wilkins, 2010) Ibis, Cem; Albayrak, Dogan; Hatipoglu, Ahmet R.; Turan, NesrinBackground: Retrospective analysis of acute appendicitis patients older than 60 and statistical evaluation of the association between the accompanying illnesses, severity of peritonitis, morbidity, and mortality rates. Introduction: Although acute appendicitis is not frequent among aged populations, accompanying comorbidities of the geriatric patients are always fear factors before an emergency abdominal surgery even for acute appendicitis. Methods: The data of the 27 patients older than 60 years who underwent appendectomy were retrospectively analyzed. The patients were grouped according to the total number of their comorbidities, Mannheim peritonitis index scores, and the period between the onset of abdominal pain and the admission to the hospital. Results: The mean age of the patients was 73 years. The morbidity and mortality rates were statistically significantly higher in perforated cases. The comparison of patients with <= 1 comorbidity with patients with >= 2 comorbidities did not show any statistical difference in morbidity and mortality. The sensitivity, specificity, positive predictive value, and negative predictive values for mortality in geriatric acute appendicitis patients with Mannheim peritonitis index scores greater than 26 were found to be 75%, 86%, 50%, and 95%, respectively. Discussion: Retrospective evaluation of geriatric patients with acute appendicitis, according to the total number of their comorbidities, surprisingly revealed no statistical difference between groups. We thought that a high Mannheim peritonitis index score is a more reliable criteria than the total number of comorbidities in predicting the prognosis of patients with acute appendicitis in the geriatric population.Öğe Bilateral brucellar breast abscess in a 48-year-old woman(K Faisal Spec Hosp Res Centre, 2009) Ibis, Cem; Albayrak, Dogan; Yagci, Mehmetali[Abstract Not Available]Öğe Cutaneous metastasis of epidermoid carcinoma of the larynx: a case report(Kare Publ, 2006) Ibis, Kamuran; Ibis, Cem; Yurut-Caloglu, Vuslat; Altaner, Semsi; Caloglu, Murat; Karagol, Hakan; Cosar-Alas, RusenThe frequency of distant metastasis of epidermoid carcinoma of the larynx is between 6.5-7.2%. The common sites of metastasis are lung, liver and bone. Cutaneous metastasis is very rare. A 56-year-old male with locally advanced larynx carcinoma who received curative radiochemotheraphy a year ago was presented to our department with subcutaneous nodular lesions, and fatigue. Physical examination revealed 0.5 cm sized, and 1x1cm sized subcutaneous nodular lesions in the right arm, and in the parasternal area, respectively. Histopathologic examination confirmed the skin metastasis of epidermoid carcinoma of the larynx. The patient has profound anemia, hypercalcemia, hypernatremia, and hyperglicemia with complicated diabetic foot. Although the symptomatic treatment began immediately, the patient died on the third day of hospitalisation. Cutaneous metastasis may be the first sign of local failure, of distant metastasis, or even of the undetected laryngeal carcinoma with poor prognosis.Öğe MRI Findings in Biliary Cystadenoma(Modestum Ltd, 2014) Can, Guray; Tuncel, Sedat Alpaslan; Genchallac, Hakan; Puyan, Fulya Oz; Ibis, CemBiliary cystadenoma is a rare cystic hepatic neoplasm. We herein present a 44 year-old female patient with biliary cystadenoma focusing on difficulties in diagnosis because of lack of specific findings with imaging, and the need for surgery. As biliary cystadenomas have high recurrence risks and malignant transformation potential, careful follow-up should not be underestimated. Proper surgical resection of the lesion may be considered the most suitable diagnostic and therapeutic procedure, and prognosis is generally excellent after removal of the tumor.Öğe Pancreas is an Unusual Initial Metastatic Site of Intracranial Hemangiopericytoma(Kare Publ, 2016) Ibis, Kamuran; Saynak, Mert; Yalta, Tulin; Ibis, Cem; Kocak, Zafer; Karadeniz, AhmetIntracranial hemangiopericytoma (HPC) is rare and aggressive tumor with local recurrences as well as distant metastases. The majority of metastases are encountered in bone, lung, and liver. Pancreatic metastasis is extremely rare. Described in the present report is the case of a 41-year-old woman who had undergone surgical resection of intracranial HPC 16 years earlier. The tumor recurred 3 years after the operation and was successfully managed with surgery followed by adjuvant radiotherapy. Thirteen years later, an isolated pancreatic metastasis developed. Patient underwent Whipple procedure for pancreatic head lesion and received adjuvant radiotherapy. Patient died of extensive disease in lungs, bones, mediastinum, cranium and peritoneal carcinomatosis in abdomen 17 months after pancreatic surgery.Öğe Primary Hydatid Disease of Pancreas Mimicldng Cystic Neoplasm(Lippincott Williams & Wilkins, 2009) Ibis, Cem; Albayrak, Dogan; Altan, AydinPrimary hydatid disease of the pancreas is very rare. We report a 33-year-old female who was admitted to the hospital with abdominal discomfort due to the pancreatic mass. A diagnosis of a pancreatic cystic mass was established through abdominal ultrasonography and computed tomography scan. Hydatid disease as well as a cystic neoplasm of the pancreas were both thought in the differential diagnosis. Distal pancreatectomy with splenectomy was performed. The histopathologic evaluation of the specimen revealed a hydatid cyst affecting the tail of the pancreas. Hydatid disease Should be considered in the differential diagnosis of all cystic masses of the pancreas, especially in endemic regions.Öğe The prognostic significance of p21 and Her-2 gene expression and mutation/polymorphism in patients with gastric adenocarcinoma(Humana Press Inc, 2013) Ozen, Alaattin; Kocak, Zafer; Sipahi, Tammam; Oz-Puyan, Fulya; Cakina, Suat; Saynak, Mert; Ibis, CemAnalyses of gene expression status and genetic polymorphisms are methods to identify novel histopathological prognostic factors. In patients with gastric cancer, some cell cycle regulators p53, p21, p27 and Her-2 oncogene have been proposed as prognostic factors. We aimed to investigate the expression and mutation/polymorphism of p21 and Her-2 and also relationship between that genes status and histopathological factors and prognosis in patients with gastric cancer. Forty-four patients with locally advanced gastric cancer were analyzed in this study from January 2000 to December 2008. Clinicopathological parameters, expression and mutation/polymorphism of p21 and Her-2 results were used to predict disease-free survival and overall survival. The positive expression of p21 and Her-2 was observed in 61.4 % (n = 27) and 9.1 % (n = 4) of all 44 tumors, respectively. p21 gene mutation and Her-2 gene polymorphism were detected in 20 % (n = 11) and 2.3 % (n = 1, II phenotype) of cases, respectively. The negative expression of p21 was correlated significantly with diffuse and undifferential type histologies, whole gastric involvement and positive vascular/neural invasion. The median survival rate of patients with negative expression was significantly poorer than that of patients with positive expression of p21 (17 vs. 27 months, p = 0.01, cox regression). p21 mutation was significantly higher in patients with diffuse (p = 0.03) and undifferential (p = 0.02) type histologies. There was no statistically significant association between histopathological parameters and Her-2 gene polymorphism/expression. The negative expression of p21 correlates with disease survival and may be a poor prognostic factor in patients with resected gastric cancer treated with adjuvant chemotherapy.Öğe THE PROGNOSTIC SIGNIFICANCE OF P21 AND HER-2 GENE EXPRESSION AND MUTATION/POLYMORPHISM IN PATIENTS WITH GASTRIC CARCINOMA(Oxford Univ Press, 2011) Ozen, Alaattin; Kocak, Zafer; Sipahi, Tammam; Oz-Puyan, Fulya; Cakina, Suat; Saynak, Mert; Ibis, Cem[Abstract Not Available]Öğe Protective effect of Urtica dioica on liver damage induced by biliary obstruction in rats(Sage Publications Inc, 2013) Oguz, Serhat; Kanter, Mehmet; Erboga, Mustafa; Ibis, CemThe aim of this study was to evaluate the possible protective effects of Urtica dioica (UD) against liver damage in the common bile duct-ligated rats. A total of 24 male Sprague Dawley rats were divided into three groups, namely, control, bile duct ligation (BDL) and BDL+received UD groups, containing eight animals in each group. The rats in UD-treated groups were given UD oils (2ml/kg) once a day intraperitoneally for 2weeks starting 3days prior to BDL operation. The change demonstrating the bile duct proliferation and fibrosis in expanded portal tracts includes the extension of proliferated bile ducts into the lobules; inflammatory cell infiltration into the widened portal areas were observed in BDL group. Treatment of BDL with UD attenuated alterations in liver histology. The -smooth muscle actin, cytokeratin-positive ductular proliferation and the activity of terminal deoxynucleotidyl transferase dUTP nick end labeling in the BDL were observed to be reduced with the UD treatment. The data indicate that UD attenuates BDL-induced cholestatic liver injury, bile duct proliferation and fibrosis.Öğe The Risk of Venous Thromboembolism With Thyroid Surgery(Lippincott Williams & Wilkins, 2010) Sezer, Atakan; Tuncbilek, Nermin; Gultiken, Sibel; Demir, Muzaffer; Irfanoglu, Mehmet Emin; Ibis, CemThe aim of the study is to assess preoperative risk of venous thromboembolism in thyroid surgery candidates and evaluate postoperative outcomes. This study was conducted on 116 consecutive patients between 2007 and 2008. The patients were classified by a Caprini venous thromboembolism risk assessment form in the preoperative period. The lower extremities of the patients were evaluated for deep venous thrombosis (DVT), by the same radiologist using color Doppler duplex ultrasonography, on preoperative day 1 and postoperative days 12 to 14. Venous diameter, venous wall response to compression, echogenity, thrombus within the lumen, loss of flow, and spectral wave changes were evaluated. Fifteen of the 116 patients withdrew from the study. The mortality rate was zero throughout the entire study. Eighty-seven (75.2%) patients were female and 29 patients (24.8%) were male. The mean age was 46.5 years (19-73 years). There were 18 patients in the very high risk group, 74 patients in the high risk group, and 24 patients in the moderate risk group in preoperative assessment. None of the patients had asymptomatic DVT preoperatively. All patients underwent thyroidectomy, and the average duration of hospitalization was 2.5 days (2 6 days). One (0.9%) patient with a risk score of 6 was diagnosed with asymptomatic DVT in the postoperative period with increased lumen diameter of the popliteal vein, thrombus, and lack of color flow in ultrasonography examination. Thyroid surgery may be a risk factor for developing DVT. In daily clinical practice, risk assessment should be done precisely to prevent venous thromboembolic events preoperatively in thyroid surgery.Öğe The Value of Intra-abdominal Pressure Measurement in Patients with Acute Abdomen(Elsevier Singapore Pte Ltd, 2009) Ibis, Cem; Altan, AydinAIM: To find out the potential benefit of bladder pressure (BP) measurement as a diagnostic tool for acute abdomen. BACKGROUND: Acute abdomen is one of the most important clinical entities among general Surgical clinics. The diagnosis can be achieved by considering the patient's history, physical examination, laboratory analysis or by different imaging modalities. Abdominal compartment syndrome (ACS) occurs due to elevated intra-abdominal pressure (IAP), and can be diagnosed by measurement of BP. We observed in our clinical routine elevated IAP levels in patients with acute abdomen. METHODS: Two groups were established: one containing 65 consecutive patients diagnosed as having acute abdomen in the emergency room, and the control group of 10 consecutive patients with no acute abdominal complaints elected for laparoscopic operation. IAP measurements were performed before the operations. BP was measured in the supine position with 50 mL of sterile saline instilled into the bladder after the bladder had been emptied. The catheter was connected to a water manometer with the reference point being the symphisis pubis, BP levels greater than 7 cmH(2)O were accepted as abnormal and interpreted as a diagnostic criteria for acute abdomen. RESULTS: Sensitivity, specificity, positive predictive value, negative predictive value and the accuracy are calculated 95.4%, 80%, 96.9%, 72.7%, 93.3%, respectively. CONCLUSION: We found elevated IAP may support the physician's diagnosis of acute abdomen with approximately 27.3% false negative rate. [Asian J Surg 2009;32(1):33-8]Öğe Value of Preoperative Indocyanine Green Clearance Test for Predicting Post-Hepatectomy Liver Failure in Noncirrhotic Patients(Int Scientific Literature, Inc, 2017) Ibis, Cem; Albayrak, Dogan; Sahiner, Tayfun; Soytas, Yigit; Gurtekin, Basak; Sivrikoz, NukhetBackground: Liver failure is the most feared complication following hepatectomy. Post-hepatectomy liver failure (PHLF) is closely related to the remnant liver volume, and functional reserve. There are several methods for predicting PHLF prior to liver resection. The indocyanine green (ICG) clearance test was popularized in patients with hepatocellular cancer (HCC). We aim to demonstrate the value of preoperative ICG clearance measurement via pulse spectrophotometer (LIMON (R)) in prediction of PHLF in noncirrhotic patients prior to liver resection. Material/Methods: Fifty-three noncirrhotic patients who underwent liver resection due to different pathologies were included. Retrospectively collected clinical data, including the preoperative ICG clearance measurements and remnant liver volumes of the patients, were statistically evaluated according to the PHLF criteria of the International Study Group of Liver Surgery. Results: Four (7.5%) patients with PHLF were observed. There was no significant difference between PHLF and non-PHLF groups regarding ICG clearance measurements with cut-off values of 5% and 9.5%. Conclusions: The ICG clearance test does not satisfy our expectations in noncirrhotic patients in predicting PHLF. We believe that the ICG clearance test should be reserved for patients with cirrhosis and/or HCC. This test could be an option for noncirrhotic patients with chronic active hepatitis, advanced-grade fatty livers, or for patients who received long-term preoperative chemotherapy, and also for patients who underwent single or multiple sessions of TACE or TARE prior to liver resection. If the routine selection criteria have been fulfilled, there is no further need to perform the ICG clearance test for living liver donors.
