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Öğe A rare reason of mechanical intestinal obstruction; phytobezoar images for clinicians(TIP ARASTIRMALARI DERNEGI, 2014) Cıkman, Oztekin; Ozkan, Omer Faruk; Adam, Gürhan; Tas, Sukru; Ademoglu, Serkan; Karaayvaz, MuammerMechanical intestinal obstruction is defined as the partial or total blockage of the passage of digested food in gastrointestinal system towards the distal. If intestinal obstruction is not treated properly it can cause high incidences of morbidity and mortality. The most frequent cause is adhesion after surgery but etiological cause changes frequently with age. Known symptoms of intestinal obstructions are nausea, vomiting, abdominal ache and distention in the abdomen. In our study we aimed to present a 70 year old patient with intestinal obstruction due to phytobezoar who developed sepsis, with the help of current literature. © 2014, TIP ARASTIRMALARI DERNEGI. All rights reserved.Öğe A Rare Reason of Mechanical Intestinal Obstruction; Phytobezoar Images for Clinicians(Modestum Ltd, 2014) Cikman, Oztekin; Ozkan, Omer Faruk; Adam, Gurhan; Tas, Sukru; Ademoglu, Serkan; Karaayvaz, MuammerMechanical intestinal obstruction is defined as the partial or total blockage of the passage of digested food in gastrointestinal system towards the distal. If intestinal obstruction is not treated properly it can cause high incidences of morbidity and mortality. The most frequent cause is adhesion after surgery but etiological cause changes frequently with age. Known symptoms of intestinal obstructions are nausea, vomiting, abdominal ache and distention in the abdomen. In our study we aimed to present a 70 year old patient with intestinal obstruction due to phytobezoar who developed sepsis, with the help of current literature.Öğe A rare reason/cause of esophageal obstruction: Steakhouse syndrome(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Çıkman, Öztekin; Taş, Şükrü; Kiraz, Hasan Ali; Özkan, Ömer Faruk; Adam, Gürhan; Karaayvaz, MuammerSteakhouse syndrome is an esophageal acute obstruction, due to improperly chewed meat. In most cases the etiology cannot be exactly shown, it is seen more frequently in patients with motility disorders in the lower esophageal sphincter and in alcoholics. Medical history and endoscopic examination are the first to be done for diagnosis. The endoscopic removal of foreign body after the diagnosis of obstruction is the most effective treatment method. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Öğe Agenesis of Isthmus of the Thyroid Gland in a Patient with Graves-Basedow Disease and a Solitary Nodule(Hindawi Ltd, 2013) Ozkan, Omer Faruk; Asik, Mehmet; Toman, Huseyin; Ozkul, Faruk; Cikman, Oztekin; Karaayvaz, MuammerThe thyroid is a vascular endocrine gland with two lateral lobes connected by a narrow, median isthmus. Although a wide range of congenital anomalies of the thyroid gland has been reported in the literature, agenesis of the thyroid isthmus is a very rare congenital anomaly Thyroid isthmus agenesis does not manifest clinical symptoms, and it can be confused with other thyroid pathologies. We describe a patient with no isthmus of the thyroid, associated with Graves-Basedow disease. Thyroid isthmus agenesis should be kept in mind in order for surgical procedures involving thyroid pathologies to be carried out safely.Öğe AKUT PANKREATİTTE ERKEN LAPARASKOPİK KOLESİSTEKTOMİ; SONUÇLARIMIZ(2016) Çıkman, Öztekin; Taş, Şükrü; Kiraz, Hasan Ali; Şekerci, Berkin; Karaayvaz, Muammer; Akgün, YılmazAmaç: Bu çalışmada, akut bilier pankreatit nedeniyle tedavi edilen hastaların, erken dönemde laparoskopik kolesistektomi sonuçlarının değerlendirilmesi amaçlanmıştır.Materyal ve Metod: Ocak 2012 - Temmuz 2015 tarihleri arasında akut biliyer pankreatit nedeniyle yatırılan, klinik ve laboratuar bulguları düzeldikten sonra taburcu edilmeden laparoskopik kolesistektomi yapılan 37 hastanın kayıtları retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, laboratuar bulguları, ultrasonografi, MRCP ve ERCP sonuçları ameliyat süresi, açığa geçme, morbidite, mortalite ve postoperatif hastanede yatış süreleri kaydedildi.Bulgular: Akut biliyer pankreatit nedeniyle yatan 37 hastadan 16'sı erkek, 21'i kadın olup hastaların yaş ortalaması 58,1'di. Ranson skor ortalaması 1.38 olarak hesaplandı. Ultrasonografik açıdan değerlendirildiğinde 26 (%70,27) hastada multipl kalkül, 5 (% 13,51) hastada safra çamuru, 6 (16,22) hastada ise tek kalkül saptandı. Laboratuar ve klinik olarak safra yollarında patoloji olduğu düşünülen 19 hastaya MRCP çekildi. MRCP'de koledokta kalkül saptanan 6 hasta ERCP sonrası opere edildi. Tüm hastalarda standard laparoskopik kolesistektomi işlemi 4 portla başlandı. 1(%) hastada preop saptanamayan kolesistoduodenal fistül nedeniyle operasyonda açığa geçilerek bitirildi. Pos-toperatif hastaların ortalama yatış süresi iki bulundu.Sonuç: Erken dönem laparoskopik kolesi-tektomilerde operasyon süresi ve anatomik yapılarınortayakonmasındakizorluklararağmen, akut biliyer pankreatit sonrası erken dönemde kolesistektominin rekürren pankre-atit ataklarını önleyen, daha etkin bir tedavi seçeneği olduğunu düşünmekteyiz.Öğe AN EXTREMELY RARE COMPLICATION OF MECKEL'S DIVERTICULUM: ENTEROCUTANEOUS FISTULIZATION OF UMBILICAL HERNIA(Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2015) Cikman, Oztekin; Kiraz, Hasan Ali; Ozkan, Omer Faruk; Adam, Gurhan; Celik, Ahmet; Karaayvaz, Muammer[Anstract Not Available]Öğe Determination of the prognostic importance of ostrogen and progesteron receptors on gastric cancer(2013) Çikman, Öztekin; Söylemez, Ömer; Sayar, Ilyas; Karaayvaz, MuammerPresently, gastric cancers solution to early diagnose and resection is surgery. In local-regional-advanced stage (Stage 3A and especially stage 3B) cases, it's quite difficult to decide absolute indication of surgery. In our study, we aimed to show the importance of the prognosis by investigating the presence of ostrogen and progesteron receptors and their effects on the survival of stage 3A and 3B gastric cancers patiens. The survivability rates of 20 cases with Stage 3A and 3B gastric cancer have been analyzed. In the course of our clinical research we prepared the cancerous and the normal tissue samples in paraphine blocks with immunohistochemical methods and analyzed under photomicroscope ER and PR were evaluated being based on the stain of breast cancers. Of the 20 patients 2 (10%) of them were observed to have had ER possitive 5 (25%) of them PR possitive and 2 (10%) of them were observed to had both ER and PR possitive. Of the 16 patients who were in Stage 3B 7 of them produced receptor possitive results both in proximal and distal tumours (in proximal tumours, 1 case was ER possitive 1 PR possitive; in distal tumours 1 case was ER possitive 4 cases were PR possitive). Life expectancy in these cases who produced receptor possitive results was determined to be approximately 3 years. Although the same surgical procedures are applied to all of the cases the increase in life expectancy in those cases with possitive receptors brings to mind that prognosis would also be better in such cases. we found in the course of our study that the life expectancy was remarkably higher in those cases of Stage 3B, that are ER and/or PR possitive. Therefore we are of the conviction that such procedures as total gastrectomy and DII dissection would be beneficial in increasing the survivability in such cases.Öğe Diagnosing between papillary carcinoma and reactive papillary changes in an infarcted thyroid nodule after fine needle aspiration and accompanied by a synchronous brain stem astrocytoma(Kare Publ, 2018) Goret, Ceren Canbey; Goret, Nuri Emrah; Ozkan, Omer Faruk; Karaayvaz, MuammerA 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing. In addition, we examined the case along with a literature review because an accompanying synchronous brain stem astrocytoma was detected in the patient after thyroidectomy.Öğe ENDOMETRIOMA LOCALIZED IN THE RECTUS ABDOMINIS MUSCLE: A CASE REPORT AND REVIEW OF LITERATURE(Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2014) Ozkan, Omer F.; Cikman, Oztekin; Kidraz, Hasan Ali; Roach, Emir C.; Karacaer, Mehmet Ali; Karaayvaz, Muammer[Anstract Not Available]Öğe Endometrioma localized in the rectus abdominis muscle: a case report and review of literature(2014) Ozkan, Omer F.; Cikman, Oztekin; Kiraz, Hasan A.li; Roach, Emir C.; Karacaer, Mehmet A.li; Karaayvaz, Muammer[No abstract available]Öğe Isolated omental panniculitis: two case reports and review of literature(Modestum Ltd, 2017) Tas, Sukru; Cikman, Oztekin; Ozdil, Asli; Akgun, Yilmaz; Karaayvaz, MuammerIsolated omental panniculitis (IOP), a rare form of acute abdominal syndrome, is defined as intraabdominal panniculitis that involves only omentum without extraabdominal fat necrosis, inflammatory bowel disease and pancreatitis. In the search made using PubMed English database, only 4 cases are determined with IOP. IOP is conceptually confused with idiopathic omental infarction (IOI). However, omental infarctions that are rare causes of acute abdominal syndromes were published by Bush for the first time in 1986 and less than 400 cases were reported. In this article we aimed to publish 2 IOP patients who applied with acute abdominal manifestation and were treated with laparoscopic omental resection to discuss the other 4 IOP cases comparing with IOP together with literature.Öğe L-carnitine has a protective effect on the colonic mucosa during abdominopelvic radiotherapy in rats(Acta Cirurgica Brasileira, 2016) Tas, Sukru; Ozkan, Omer Faruk; Cikman, Oztekin; Kiraz, Asli; Akgun, Yilmaz; Karaayvaz, MuammerPURPOSE: To evaluate histopathologically the radioprotective effect of L-carnitine on the colonic mucosa in rats undergoing abdominopelvic irradiation. METHODS: Thirty-two rats were randomly assigned to four experimental groups: intraperitoneal administration of normal saline (group 1) or L-carnitine (300 mL/kg; group 2), followed in groups 3 and 4, respectively, by one dose of abdominopelvic radiation (20 Gy) 30 min later. Rats were sacrificed 5 days after radiation, and their descending colons were resected for histopathological evaluation of the presence and severity of damage. RESULTS: Average damage scores did not differ significantly between groups 1 and 2 (0.13 +/- 0.35 and 0.25 +/- 0.46, respectively); the group 3 score was highest (10.25 +/- 0.71), and the group 4 score (3.63 +/- 1.41) was significantly lower than that of group 3 (both p = 0.0001). Pre-radiation L-carnitine administration significantly reduced mucosal thinning, crypt distortion, reactive atypia, inflammation, cryptitis, and reactive lymph-node hyperplasia (all p < 0.01). CONCLUSIONS: L-carnitine had a radioprotective effect on rat colonic mucosa. L-carnitine use should be explored for patients with gastrointestinal cancer, who have reduced serum L-carnitine levels.Öğe Laparoscopic Repair of Combined Right Diaphragm and Liver Injuries with a Sharp Object: A Case Report(Hindawi Ltd, 2013) Arik, M. Kasim; Tas, Sukru; Ozkul, Faruk; Sahin, Hasan; Karatag, Ozan; Karaayvaz, MuammerIntroduction. Diaphragm injuries develop following penetrating or blunt traumas. The purpose of the case report is to present a 28 year old male patient with stable hemodynamic findings treated with laparoscopic approach following a liver injury combined with a right diaphragm injury caused by a sharp penetrating object. Case. 4 cm long transverse laceration was observed near the middle axillary line in the 6th right intercostal space in the examination performed on a 28 year old male patient who applied to the emergency service due to sharp penetrating object injury. Respiratory sounds were decreased in the right side and the examination revealed sensitivity in the abdomen. Elevation in the right diaphragmand hemopneumothorax was monitored in chest X-ray and computerized tomography. Closed subaqueous thorax drain was placed and the patient was taken to the surgery with a right diaphragm injury prediagnosis. Laparoscopic exploration was performed to the patient with stable hemodynamic findings by entering through 10 mm port above the abdomen. 6 cm long injury at the right side of diaphragm and approximately 2 cm deep at the deepest point and 5 cm long linear laceration was observed in the 7th segment of the liver. The diaphragm was repaired laparoscopically with sutures that do not melt on their own. Tampon was applied to the laceration in the liver and bleeding control was performed with suture. Patient was discharged on the 3rd day because he had no problems during postoperative follow-ups. Result. No noticed right side diaphragm rupture and possible concomitant visceral organ injuries following a penetrant injury that can cause significant mortality and morbidity should be definitely kept in mind. The detection of right side diaphragm and liver injury is vital with high mortality in case of delayed diagnosis, and direct radiography and computerized tomography are helpful in the diagnosis. Surgical treatment with laparoscopic approach is a method that leads to less hospitalization duration and less pain in cases that are hemodynamically stable.Öğe LAPAROSKOPİK KOLESİSTEKTOMİDE; PREOPERATİF GASTROSKOPİ YAPILMALI MIDIR?(2016) Taş, Şükrü; Çıkman, Öztekin; Kiraz, Hasan Ali; Akgün, Yılmaz; Karaayvaz, MuammerAmaç: Çalışmamızda safra kesesi taşı nedeniyle operasyon planlanan hastalarda ek bir patoloji dışlamak amacıyla laparoskopik kolesistektomi öncesi üst GİS endoskopisi yapılan hastaların sonuçlarının sunulması amaçlanmıştır. Gereç ve Yöntem: Ocak 2012 - Haziran 2015 tarihleri arasında laparoskopik kolesistektomi planlanan ve operasyon öncesi üst GİS endoskopisi yapılan hastalar retrospektif olarak değerlendirildi. Kolelilitiazis nedeniyle yatan preoperatif endoskopi yapılan 110 hasta çalışmamıza dahil edildi. Preoperatif gastroskopi işlemi kliniğimiz bünyesindeki cerrahi endoskopi ünitesinde gerçekleştirildi. Hastalar yaş, cinsiyet, ultrasonografik bulgular ve endoskopik bulgular açısından değerlendirildi. Bulgular: Kolelilitiazis nedeniyle yatan, preoperatif endoskopi yapılan 110 hasta çalışmamıza dahil edildi. Hasta dosyalarından elde edilen ultrasonografi raporlarında; hastaların 58 ( % 52.7)' inde multipl kalkül, 12(% 10.9)'sinde safra çamuru saptanırken 40 (%36.4)'ınde tek bir taş olduğu rapor edildi. Preoperatif dönemde yapılan gastroskopi sonuçlarında ise hastaların 38 (%34.5)'inde pangastrit, 18 (%16.4)'inde alkalen reflü gastrit, 4 (%3.6)'ünde peptik ülser, 50 (%45,46)'sinde ise patoloji saptanmadıı Sonuç: Preoperatif dönemde safra taşı hastalığını taklit edebilen üst GİS patolojileri olduğu akılda tutulmalıdır. Yapılan çalışmalarda postkolesistektomi sendromlarının büyük çoğunluğunu üst GİS patolojileri oluşturduğu bilinmektedir. Bu durumda hasta ve hekim açısından postopeartif dönemde uzamış tedavilere neden olabilmektedir. . Günümüzde çoğu merkezde endoskopi üniteleri olup, laparoskopik kolesitektomi öncesi, üst GİS endoskopisi yapılmasını önermekteyizÖğe MANAGEMENT OF FLAP DEHISCENCE AFTER LIMBERG PROCEDURE FOR RECURRENT PILONIDAL DISEASE BY NEGATIVE PRESSURE WOUND THERAPY (NPWT)(Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2017) Tas, Sukru; Ozkan, Omer Faruk; Ocakli, Muzaffer Muazzez; Arslan, Emrah; Kiraz, Asli; Karaayvaz, Muammer[Anstract Not Available]Öğe Pancreatic involvement in small cell lung cancer(Walter De Gruyter Gmbh, 2014) Gonlugur, Ugur; Mirici, Arzu; Karaayvaz, MuammerBackground. Few data are available concerning incidence, clinical picture, and prognosis for pancreatic metastases of small cell lung carcinoma. In this paper we review the related literature available in English language. Conclusions. Although pancreatic metastases are generally asymptomatic, they can rarely produce clinical symptoms or functional abnormalities. The widespread use of multi-detector computerised tomography (CT) in contemporary medical practice has led to an increased detection of pancreatic metastases in oncology patients. Tissue diagnosis is imperative because radiological techniques alone are incapable of differentiating them from primary pancreatic tumours. Pancreatic metastases occur in the relative end stage of small cell lung cancer. The main complications of these lesions, although rare, are acute pancreatitis and obstructive jaundice. Early chemotherapy can provide a survival benefit even in patients with mild acute pancreatitis or extrahepatic biliary obstruction.Öğe Radioprotective effects of nigella sativa oil against oxidative stress in liver tissue of rats exposed to total head irradiation(Informa Healthcare, 2014) Cikman, Oztekin; Ozkan, Adile; Aras, Adem Bozkurt; Soylemez, Omer; Alkis, Hilal; Taysi, Seyithan; Karaayvaz, MuammerObjective: Many cancer patients treated with radiotherapy suffer severe side effects during and after their treatment. The aim of this study was to investigate the effects of irradiation and the addition of Nigella sativa oil (NSO) on the oxidant/antioxidant system in the liver tissue of irradiated rats. Methods: A total of 24 Sprague-Dawley rats were randomly distributed into three groups of equal numbers. The control group received neither NSO nor irradiation but received 1-ml saline orally. The irradiation group (IR) received total head 5 gray (Gy) of gamma irradiation as a single dose, plus 1-ml saline orally. The IR plus NSO group received both total head 5 Gy of gamma irradiation as a single dose and 1 g/kg/day NSO orally through an orogastric tube starting one hour before irradiation and continuing for 10 days. Results: While liver tissue total oxidant status (TOS), lipid hydroperoxide (LOOH) level, and oxidative stress index (OSI) were significantly increased in the IR group compared to the control group, total antioxidant status (TAS), sulfhydryl (-SH) levels, and PON activity were significantly decreased. Cp activity in the IR plus NSO and IR groups was higher than in the control group. ARYL activity in the IR plus NSO supplemented group was higher than that in other groups. Conclusions: NSO reduces oxidative stress markers and has antioxidant effects, which also augments the antioxidant capacity in the liver tissue of rats. © 2014 Informa Healthcare USA, Inc.Öğe The activity of topical coenzyme Q10 (Ubiquinol) in burned rats: Results from an experimental study(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Göret, Ceren Canbey; Kiraz, Aslı; Göret, Nuri Emrah; Kılıç, Sevilay Oğuz; Özkan, Ömer Faruk; Karaayvaz, MuammerThe objective of this study was to investigate the effectiveness of topically applied coenzyme Q10 (CoQ10) (ubiquinol) for wound healing in rats with experimentally induced burn injuries. A total of 27 rats were divided into three groups, and administered general anesthesia. No further intervention was performed for Group 1 (Control). Hot water (95°C) was applied to rats in Groups 2 and 3 for 10 seconds. The rats in Group 2 received silver sulfadiazine, whereas those in Group 3 received topical CoQ10. Biopsy samples were obtained at days 3 and 10. In the group treated with CoQ10 (Group 3), there was no statistically significant difference among between Days 3 and 10 in terms of inflammation and epidermal/vascular/collagen damage. In terms of edema, there was a statistically significant distinction among the CoQ10 group (Group 3) at Day 10 and the silver sulfadiazine group (Group 2) at Day 3. In terms of oxygen radicals, there was a statistically meaningful difference among the CoQ10 group and the silver sulfadiazine group at Day 10. This investigation did not demonstrate a beneficial role of treatment with CoQ10 for the healing of burn wounds for most parameters. But in the long term (10 day); immunohistochemical analysis performed to determine edema and oxidative stress showed that treatment with CoQ10 reduced the levels of oxygen radicals in biopsies. The limitation of our study is that the duration is limited to 10 days. For this reason longer term studies were required. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All Rights Reserved.Öğe The effect of pycnogenol on lymphatic nodes and adhesion during in a peritoneal adhesion model in rats(Acta Cirurgica Brasileira, 2018) Goret, Ceren Canbey; Goret, Nuri Emrah; Kiraz, Asli; Ozkan, Omer Faruk; Karaayvaz, MuammerPurpose: To investigate the effects of pycnogenol on peritoneal adhesions and additionally to investigate the immunohistochemical effects of free oxygen radicals and reactive lymph nodes detected in the adhesive tissue that was sampled surrounding the cecum on intra-abdominal adhesions. Methods: Twenty-seven Wistar Albino rats were divided into three groups. In group 1 (sham), laparotomy was performed and stitched up. In group 2 (control), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered 2 cc of saline. In group 3 (experimental), after laparotomy was performed, punctate hemorrhage was induced by cecal abrasion in the cecum and each rat was intraperitoneally administered a sterile Pycnogenol derivative. The rats in all groups were re-laparotomized on postoperative day 7; samples were obtained from the peritoneal tissue surrounding the cecum, and the rats were sacrificed. Results: In group 3, there was a statistically significant difference in terms of inflammation, lymph node size, and free oxygen radicals; these parameters tended to increase. In terms of fibrosis evaluated using H&E and MT, there was no significant difference between groups 2 and 3. Conclusions: No positive outcomes indicating that pycnogenol reduces intra-abdominal adhesions were obtained. However, it caused severe inflammation in the tissue. Moreover, a significant increase in lymph node size was detected secondary to inflammation. Additionally, in immunohistochemical analyses conducted to detect oxidative stress, pycnogenol increased the production of free oxygen radicals in the tissue.
