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Öğe The effect of a flavonoid fractions diosmin plus hesperidin on radiation-induced acute proctitis in a rat model(Medknow Publications, 2011) Sezer, Atakan; Usta, Ufuk; Kocak, Zafer; Yagci, Mehmet AliBackground: To explore the protective effect of a flavonoid fractions diosmin + hesperidin (Daflon), against radiation-induced acute proctitis in an experimental rat model. Materials and Methods: Thirty four rats were divided into four groups. The rats in Group 1 received Daflon and underwent irradiation. The rats in Group 2 received no Daflon and underwent irradiation. The rats in Group 3 received Daflon and underwent sham irradiation. The rats in Group 4 received no Daflon and underwent sham irradiation. Daflon emulsion (100 mg/kg/day) was administered via an orogastric feeding tube to the rats in groups 1 and 3 starting from 1 day prior to irradiation until the euthanasia day (day 15 following irradiation). Radiation therapy was delivered on a cobalt-60 unit using a single fraction of 17.5 Gy defined at a depth of 1 cm through an anterior portal. Slides were examined by the same pathologist under a light microscope two times in a blinded manner. Results: When compared to group 2, the rats of Group 1 showed less glandular distortion and less mucosal inflammation with less infiltration of the crypt epithelia by the inflammatory cells (P < 0.001). A statistically significant increase in all parameters but muscular wall thickness was observed for the rats in Group 2 as compared to the group 3 and 4. Conclusions: Administration of a dose of 100 mg/kg/day of the diosmin + hesperidin resulted in decreased morphologic inflammatory changes. This drug may have protective effects against radiation-induced acute proctitis.Öğe The Effects of Apelin on Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model(Galenos Publ House, 2012) Sagiroglu, Tamer; Oguz, Serhat; Sagiroglu, Gonul; Copuroglu, Elif; Yalta, Tulin; Sayhan, Mustafa Burak; Yagci, Mehmet AliObjective: Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280 +/- 20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 mu g/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared to the I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.Öğe The Effects of Sirolimus on Target Organs During Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model(Elsevier Science Inc, 2011) Sagiroglu, Tamer; Sezer, Atakan; Altaner, Semsi; Umit, Hasan; Yalta, Tulin; Yagci, Mehmet AliBACKGROUND: Mesenteric ischemia and reperfusion (I/R) syndrome (MIRS) has been considered a clinicopathologic entity associated with a variety of clinically severe conditions with decreased intestinal blood flow and has been known to induce I/R damage in various organs. Sirolimus (SRL), a macrolide antibiotic isolated from a strain of Streptomyces hygroscopicus, is a potent and nonnephrotoxic immunosuppressant. OBJECTIVE: This study was designed to investigate the potential impact of sirolimus on MIRS-induced I/R damage in renal, intestinal, pulmonary, and hepatic tissues in an experimental rat model. METHODS: Twenty-four male Sprague-Dawley rats, aged 6 to 8 weeks and weighing 280 (+/- 20 g), were studied. Using computer-generated random numbers, rats were assigned to 1 of the following 3 groups: group 1 (I/R group, n = 8), group 2 (I/R + sirolimus group, n = 8), and group 3 (control group, n = 8). Sirolimus, in a 1 mg/mL (60 mL) solution, was administered intraperitoneally in a dose of 1.5 mg/kg/d to the rats assigned to group 2 starting from 3 days before the surgical procedure. In surgery, a laparotomy was performed to clamp the superior mesenteric artery and, thus, induce bowel ischemia in groups 1 and 2. After 60 minutes of ischemia, the microvascular clamp on the superior mesenteric artery was removed for 3 hours of reperfusion. Soon after experimental induction of MIRS, bowel, lung, kidney, and liver specimens from each animal were harvested for both biochemical and histopathologic analysis. RESULTS: There were statistically significant differences between groups 1 and 3 with regard to degrees of intestinal (P < 0.001), hepatic (P = 0.001), renal (P < 0.001), and pulmonary (P = 0.01) I/R damage. The lung specimens from group 2 had less inflammation and perivascular edema formation compared with specimens from group 1, but no statistical significance was observed between the groups (P < 0.33). There were statistically significant differences between groups 1 and 2 with regard to degrees of intestinal, hepatic, and renal I/R damage (P = 0.001 for all). CONCLUSION: The findings of the present study demonstrate the attenuating effects of sirolimus on I/R damage in the intestine and remote organs, including the liver and kidney in the setting of MIRS in an experimental rat model. As a therapeutic implication, the utility of sirolimus may be of clinical value in procedures associated with a high likelihood of I/R damage, including major abdominal operations and renal transplantation. However, whether these results apply to humans is unclear. Additional experimental and clinical studies are warranted to confirm the clinical utility of sirolimus in conditions potentially associated with I/R damage. (Curr T her Res Clin Exp. 2011;72:79-93) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.Öğe Hemodynamic Instability due to Intratumoral Hemorrhage in Retroperitoneal Alveolar Rhabdomyosarcoma in Adult(Drunpp-Sarajevo, 2010) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Calta, Fedai; Cicin, Irfan; Usta, UfukBackground: Rhabdomyosarcomas are the most common soft tissue sarcomas in pediatric age and rare in adults. Case Report: A 37-year-old male admitted with abdominal discomfort and mass during the previous 9 months. The patient was hospitalized for the diagnosis of abdominal mass. Initial hemodynamic parameters were stabile. During diagnosis course, hemoglobin level decreased and hemodynamic instability occurred. Abdominal computed tomography revealed a 30x20 cm mass in left retroperitoneal space. The physical examination revealed the enlargement of the mass. The surgical resection of tumor and the adjacent abdominal wall resection were performed. Alveolar rhabdomyosarcoma was diagnosed. The patient received adjuvant chemotherapy and radiotherapy. The patient had 8 mouths follow up without signs of recurrence. Conclusion: The clinical presentation of this tumor with haemodynamic instability due to intra tumoral hemorrhage is a challenging course for physicians and this rare entity must be kept in mind for accurate and urgent treatment.Öğe Hepatic hydatid cyst cases(Aves Yayincilik, Ibrahim Kara, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, IrfanObjectives: Hydatid cyst is presently a prevalent health problem in our area and country. This study retrospectively reviewed medical records of four patients who underwent urgent surgery due to intraperitoneal rupture and the records of all patients treated for hepatic hydatidosis in the same period. Patients and Methods: Medical records of the 44 patients (24 females, 20 males; mean age 47.5 years; range 16 to 83 years) who were treated in our clinic for hepatic hydatidosis between January 2004 and June 2007 were reviewed retrospectively. The patients were evaluated with respect to age, sex, location of the cyst, surgical method applied, hospital stay duration, pre- and postoperative complications, and treatment methods applied for the complications. Results: Four patients (9%) underwent emergency surgery due to intraperitoneal rupture. Postoperative biliary leakage into the cyst cavity was observed in 15 patients (34%). It was closed spontaneously in 6 patients (40%) without further intervention. In 8 patients (53%) the biliary leakage continued for about 10 days and the daily median drainage was over 100 cc. Endoscopic sphincterotomy was performed in these cases. Mortality rate was 4% (n=2). Conclusion: Rupture of hydatid cyst should be suspected in trauma patients who had hepatic cyst and intraperitoneal free fluid concomitantly. In these patients therapeutic intervention should be quick because of the risk of any anaflactic reaction. Endoscopic sphincterotomy is an effective treatment method for biliary fistula after hydatid cyst surgery.Öğe Hepatic Hydatid Cyst Cases Reply(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan[Abstract Not Available]Öğe Inflammatory myofibroblastic tumor presenting as an abdominal wall mass in an adult patient(Wolters Kluwer Medknow Publications, 2010) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Coskun, Irfan; Usta, Ufuk; Cicin, Irfan; Temizoz, OsmanInflammatory myofibroblastic tumor of the abdominal wall is a rare soft-tissue tumor presentation in adults. A 50-year-old woman was referred with abdominal pain and a palpable mass in the left lower quadrant. Computed tomography scan and magnetic resonance investigation revealed an 8-cm heterogeneous abdominal wall mass. Tumor markers were within normal limits. Fine-needle aspiration cytology and tru-cut biopsies yielded necrotic material. A preoperative diagnosis of a resectable rhabdomyosarcoma was suggested. On exploration a tumor measuring 8 x 8 x 6 cm was resected along with the involved structures. Histopathologic examination of specimen revealed an inflammatory myofibroblastic tumor of the abdominal wall. The patient has been followed up for the last 12 months without clinical or radiographic evidence of recurrence. Inflammatory myofibroblastic tumor arising from the anterior abdominal wall in adults is an unusual manifestation of soft-tissue tumors, which can be managed by a multidisciplinary team of surgeons, oncologists, radiologists and pathologists.Öğe Lymphangiomatosis of the colon mimicking acute appendicitis(Wolters Kluwer Medknow Publications, 2011) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Coskun, I; Hatipoglu, Ahmet Rahmi; Altaner, Semsi; Umit, Hasan[Abstract Not Available]Öğe The management of gastric perforation in a girl with Rett syndrome: Report of a case(Elsevier Science Bv, 2011) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet RahmiIntroduction: Rett syndrome is a neurologically disorder that affects approximately one in 10,000 females. Case report: A 21-year-old girl with Rett syndrome was hospitalized for abdominal distention and pain. Physical examination revealed abdominal tenderness. Radiology investigation revealed bilateral free air in subdiaphragmatic area. Gastric perforation observed at laparotomy. Primary suturing and omentoplasty were performed. In the follow-up, the symptoms of intestinal obstruction occurred. Conservative treatment failed and second intervention was performed. At laparotomy severe gastric and intestinal dilatation and bowel adhesions were detected. Adhesiolysis, tube gastrostomy, and feeding jejunostomy performed. Discussion: Rett syndrome and associated gastric complications are uncommon. These pathologic disorders may cause gastric, intestinal necrosis, intestinal obstructions. Because of the late occurring of physical findings and insidious presentation of the gastrointestinal perforations in Rett syndrome, physicians should keep in mind this rare entity to reduce morbidity and mortality. (C) 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.Öğe A New Tube Gastrostomy Model in Animal Experiments(Derman Medical Publ, 2013) Sezer, Atakan; Sagiroglu, Tamer; Copuroglu, Elif; Yagci, Mehmet Ali; Oltulu, Cagatay; Sut, NecdetAim: The orogastric route is the most preferred application method in the vast majority of the animal experiments in which application can be achieved by adding the material to the water of the experiment animal, through an orogastric tube or with a surgically managed ostomy. Material and Method: This experiment was constructed with twelve male Sprague-Dawley rats which were randomly assigned to one of two groups consist of control group (group C, n:6) and tube gastrostomy group (group TG, n:6). A novel and simple gastrostomy tube was derivated from a silicone foley catheter. Tube gastrostomy apparatus was constituted with a silicone foley catheter (6 French). In the group TG an incision was performed, and the stomach was visualized. A 1 cm incision was made in the midline and opening of the peritoneum. Anchoring sutures were placed and anterior gastric wall was lifted. The gastric wall is then opened. The apparatus was placed into the stomach and pulled through from a tunnel under the skin and fixed to the lateral abdominal wall with a 2/0 silk suture. Result: The procedure was ended in the 10th day of experiment. No mortality was observed in group C. The rats were monitored daily and no abnormal behavior consists of self harming incision site, resistance to oral intake or attending to displace. There was statistically significant difference in increasing alanine transaminase level (p<0.05) and decrease in the total protein and body weight (p<0.05) at the group TG at the end of experiment. There was significant increase in urea levels in Group C (p<0.05) at the end of experiment. The statistically significant decrease was observed in the same period in group C between aspartate transaminase, albumin, total protein, and body weight (p<0.05). Glucose (p=0.047) and aspartate transaminase (p=0.050) level decrease changes and weight loose (p=0.034) from preoperative period to the end of the experiment between gastrostomy and laparotomy groups were statistically significantly. Discussion: Here in we presented a novel and simple tube gastrostomy model in an experimental rat model in which rats had unrestrained movements. We believe that this new constructed tube gastrostomy model may be an alternative route for the experimental models in which orogastric route is unavailable to use.Öğe Protective effect of curcumin on cyclosporin A-induced endothelial dysfunction, antioxidant capacity, and oxidative damage(Sage Publications Inc, 2014) Sagiroglu, Tamer; Kanter, Mehmet; Yagci, Mehmet Ali; Sezer, Atakan; Erboga, MustafaCyclosporin A (CsA) is the most widely used immunosuppressive drug for preventing graft rejection and autoimmune disease. However, the therapeutic treatment induces several side effects such as nephrotoxicity, cardiotoxicity, hypertension, and hepatotoxicity. Curcumin has been successfully used as a potent antioxidant against many pathophysiological states. This experimental study was performed to test, during CsA treatment, the alterations of curcumin antioxidant properties against CsA-induced endothelial dysfunction. Rats were divided into four groups: control, curcumin alone, CsA, and CsA + curcumin; each group containing eight animals. The animals in the CsA + curcumin group were treated with CsA (10 days, 25 mg/kg, orally) and curcumin (15 days, 200 mg/kg, orally, starting 5 days before CsA administration). At the end of the treatments, the animals were killed; serum and aorta tissue were treated for biochemical and morphological analyses. The results indicate that CsA-induced aortic endothelial dysfunction was characterized by morphological and ultrastructural alterations in tissue architecture, changes in malondialdehyde and ferric reducing/antioxidant power levels, and increase in endothelial nitric oxide synthase and terminal-deoxynucleotidyl-transferase mediated dUTP nick end labeling (TUNEL) expression. In conclusion, our data suggest that the imbalance between production of free oxygen radicals and antioxidant defence systems, due to CsA administration, is a mechanism responsible for oxidative stress. Moreover, we show that curcumin plays a protective action against CsA-induced endothelial dysfunction and oxidative stress, as supported by biochemical, ultrastructural, immunohistochemical, and TUNEL results.Öğe Protective effect of everolimus on renal ischemia reperfusion injury in rats(Medknow Publications & Media Pvt Ltd, 2014) Sagiroglu, Tamer; Sezer, Atakan; Torun, Nese; Yalta, Tulin; Yagci, Mehmet Ali; Sagiroglu, Gonul; Copuroglu, ElifThe aim of this study was to determine the effect of everolimus and tacrolimus pretreatments on renal morphology and function in a rat ischemia reperfusion (I/R) model. Twenty-eight male Sprague-Dawley rats were randomly assigned to saline sham operation, saline I/R (IR), tacrolimus I/R (TRL I/R) and everolimus I/R (ERL I/R) groups. Saline and active treatments were administered intraperitoneally for seven consecutive days before the surgery. The suprarenal aorta was clamped to achieve warm ischemia, except in the sham group. Right nephrectomy was performed in all animals and histology was examined. Renal function was assessed on post-operative Day 7 by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy, glomerular filtration rate (GFR) and serum biochemistry. Both everolimus and tacrolimus preserved serum creatinine and blood urea nitrogen levels, but only everolimus preserved GFR (0.74 +/- 0.36, 1.20 +/- 0.37 and 2.24 +/- 0.32 mL/min for I/R, TRL I/R and ERL I/R, respectively, P < 0.001). %ID values for sham, I/R, TRL I/R and ERL I/R were 55 +/- 3, 47 +/- 4, 45 +/- 6 and 62 +/- 7 (P < 0.001). On histologic evaluation, ERL I/R showed less tubular damage and necrosis than I/R, as well as TRL I/R. Within the confines of this rat warm ischemia model, everolimus pre-treatment was useful in preserving renal function following I/R injury. The possibility of using everolimus as a pre-conditioning agent for I/R injury in kidney transplantation should be further explored.Öğe A RARE BREAST TUMOR: SECRETORY BREAST CARCINOMA(Aves, 2011) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Hoscoskun, Zeki; Hatipoglu, Ahmet; Altaner, Semsi; Cicin, IrfanSecretory breast carcinoma is a rare type of invasive breast cancer. The tumor was first reported in pediatric patients, but actual incidence among pediatric and adult decades is similar. We present the case of a 50-year-old woman with a secretory breast carcinoma treated by breast conserving surgery and sentinel node dissection followed by chemotherapy and radiotherapy. The patient has meanwhile completed 3 years of follow-up with no evidence of recurrence. Secretory breast carcinoma usually has a low progression rate, and the prognosis is usually favorable. The choice of treatment should be patient based and minimal invasive procedures consist of breast conserving surgeries and sentinel node biopsies should be favoured. Systemic treatment and radiotherapy are points still awaiting for further investigation.Öğe A rare cause of intestinal obstruction due to an exophytic gastrointestinal stromal tumor of the small bowel(Pharmamed Mado Ltd, 2009) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Cicin, Irfan; Usta, Ufuk; Temizoz, OsmanIntroduction: Gastrointestinal stromal tumors constitute a distinct group of rare gastrointestinal tract tumors that originate from the interstitial cells of Cajal. These jejunoileal lesions are a rare cause of obstruction but can be associated with substantial morbidity. Case: A 59-year-old woman presented to the emergency department with abdominal pain and distention. Physical examination revealed tenderness and rebound in right lower quadrant. Computed tomography revealed a mass in lower right quadrant. A 9x9x4 cm exophytic ileal mass was observed at exploration. Preoperative diagnose was a small bowel tumor and then segmental resection and primary anastomosis were performed. Histopathological investigation revealed spindle cells that stained strongly for C-117, consistent with a diagnosis of a malign gastrointestinal stromal tumor. Conclusion: We conclude that exophytic small bowel gastrointestinal stromal tumors are rare lesions, which should be kept in mind by physicians among the diagnosis of small bowel obstructions in order to reduce substantial morbidity and mortality.Öğe Spontaneous Fistulization of a Pancreatic Abscess to Colon and Duodenum Treated With Percutaneous Drainage(Lippincott Williams & Wilkins, 2011) Sezer, Atakan; Sagiroglu, Tamer; Temizoz, Osman; Yagci, Mehmet Ali; Umit, Gulsum Elif; Umit, HasanPancreatic fistulas are rare clinical entities associated with severe pancreatitis. A 39-year-old man who had been diagnosed and treated for severe pancreatitis 2 months ago presented with abdominal pain, fever, and vomiting. The abdominal computed tomography (CT) demonstrated a peripancreatic abscess and a duodenal fistula communicating the first part of duodenum, which was also verified with fluoroscopy. A size 14-French catheter with pig-tail tip was inserted primarily with a Seldinger 2-step technique through percutaneous route under CT-guidance to avoid intervening bowels or solid organs. The patient's clinic improved and treatment was stopped on the 18th day. On the 26th day of the first intervention, the patient had fever and abdominal pain and his clinic was deteriorated. A second fluoroscopic examination revealed that the duodeno pancreatic fistula was closed while a new 1 has developed into the ascending colon. With aggressive nutrition support, antibiotics and repeated drainage of the abscess pouch a dramatic clinical improvement was observed. Control abdominal CT demonstrated the resolution of pancreatic abscess on the 62nd day.
