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Öğe Apendico-ileal fistula in an acute ileus patient(2012) Yaşar, Mehmet; Aslaner, Arif; Bat, OrhanAppendiko-ileal fistül akut ileus tablosu ile nadir görülür. Bu yazıda mekanik barsak tıkanıklığı nedeni ile laparatomi uygulanan apendikoileal fistüllü 46 yaşında erkek olgu sunuldu. Cerrahi sırasında apendiks lümeni ile terminal ileum arasında bir fistül olduğu gözlendi. Ayrıca proksimal ileal ve jejunal ansların gergin olduğu da saptandı. Apendektomi, segmental ileum rezeksiyonu ve uçuca anastomoz cerrahi işlem olarak uygulandı. İnce barsak tıkanıklığı ile akut ileus tablosu gelişen hastalarda, apendiko-ileal fistülün akılda bulunması gerektiğini düşünmekteyiz.Öğe Appendico-ileal fistula in an acute ileus patient [Bİr Akut İleus Olgusunda Apendİko-İleal Fİstül](2012) Yaşar, Mehmet; Aslaner, Arif; Bat, OrhanAppendico-ileal fistula is a rare condition with acute ileus. We report a case of appendico-ileal fistule in a 46-year-old man patient who has undergone laparatomy for intestinal mechanical obstruction. Intraoperatively, an appendix with a lumen was found with a fistula to the terminal ileum. It has been observed that proximal ileal and jejunal intestinal anses were distended. Appendectomy, segmental ileum resection and end-to-end anastomoses were performed as a surgical procedure. This case describes an elderly man with acute ileus presenting with small bowel obstruction. We conclude that, appendico-ileal fistula should be kept in mind in cases with acute ileus presenting with small bowel obstruction.Öğe Clinical importance of solitary solid nodule of the thyroid in endemic goiter region(Medknow Publications, 2005) Gürleyik, Emin; Coşkun, Özgür; Aslaner, ArifContext: Endemic area and iodine supplementation may affect the pathogenesis of the nodule which commonly occurs in endemic thyroid enlargement due to iodine deficiency. Aims: To establish pathological changes in solitary solid and larger nodule of the thyroid in endemic area. Setting and Design: Retrospective study in Surgical Department of University Hospital. Methods and Material: We determined 44 surgically treated patients with solitary solid nodule in endemic goiter area in which the population routinely receives iodinated salt. The thyroid nodule was preoperatively evaluated with blood chemistry, ultrasound, nuclear scanning and FNAC. The results of preoperative evaluation, surgical interventions, and histopathological examination were analyzed. Statistical analysis: Student t test and Fisher's exact test. Results: Twenty (45%;20/44) patients with hot (autonomous) nodule have received the diagnosis of toxic adenoma. Twenty four patients had solitary solid and cold nodule. Total thyroidectomy was performed on two patients with papillary cancer (PTC) diagnosed by FNAC from cold nodules. Forty two patients have been treated with total excision of the lobe including hyper or hypoactive solitary solid nodule. Pathological examination has reported two more cases of PTC and one case of insular cancer arising from cold nodules. Completion thyroidectomy was performed on these 3 patients. Conclusions: Solitary solid and large nodule is a common indication for thyroid surgery in endemic goiter area. High incidence of hyperthyroidism due to single autonomous nodule, and high rate of malignant change (mainly papillary cancer) in solitary hypoactive nodule arises from this series in endemic thyroid enlargement.Öğe Does L-carnitine have any effect on cold preservation injury of non-fatty liver in the University of Wisconsin solution?(Blackwell Publishing, 2007) Coşkun, Abdurrahman; Günal, Ömer; Şahin, İbrahim; Aslaner, Arif; Yıldırım, Ümran; Yavuz, ÖzlemAim: To evaluate the protective effect of L-carnitine on liver tissue preserved in University of Wisconsin (UW) solution. Methods: Twenty Wistar Albino rats were divided into two groups, a control (UW) group and a UW Plus L-carnitine group. Retrieved liver grafts were preserved in UW and UW Plus L-carnitine solutions at +4 degrees C. Preservation solution samples were assessed at 2, 24, 36, and 48 h to measure alanine aminotransferase and acid phosphatase activity. Tissue injury was scored on paraffin sections. Results: No micro or macrovacuolar fat droplets were observed in the tissue slices. L-Carnitine effectively decreased enzyme release when added to UW solution (P < 0.05). Conclusion: in addition to fatty liver, L-carnitine might be a metabolic adjunct in preservation solutions for non-fatty liver within UW solution.Öğe Does L-carnitine increase serum TNF -? and IGF-1 during liver regeneration in the rat?(2009) Pehlivan, Mevlüt; Coşkun, Abdurrahman; Zengin, Ahmet; Aslaner, Arif; Yavuz, TevfikAmaç: Rat deneysel parsiyel hepatektomi modelinde L-karnitin uygulamasının 72. saate kadar IGF- 1, TNF ? ve lipid peroksidasyonuna etkisini araştırmayı amaçladık. Yöntem ve gereç: Atmış rat kontrol, düşük (100 mg/kg) ve yüksek doz (200 mg/kg) L-karnitin olmak üzere 3 gruba ayrıldı. Her bir grup, parsiyel hepatektomiden sonra 24 ve 72. saat olmak üzere 2 alt gruba ayrıldı. Yedi gün intra-peritoneal L-karnitin uygulamasından sonra parsiyel (% 70) hepatektomi yapıldı. L-karnitin, parsiyel hepatektomiden sonra da ratlara verilmeye devam edildi. Tüm gruplarda cerrahi operasyondan önce, 24 ve 72 saat sonra serum IGF-1, TNF-? ve doku malondialdehid düzeyleri ölçüldü. Bulgular: Kontrol grubunda, serum TNF-? düzeyleri, rejenerasyon boyunca anlamlı derecede arttı. Düşük doz (100 mg/kg) L-karnitin, TNF-? düzeylerini azaltırken yüksek doz (200 mg/kg) artırdı. IGF-1 düzeyi, kontrol grubunda cerrahi operasyondan sonra ilk 24 saate azalırken daha sonra artmaya başladı. L-karnitin gruplarında IGF-1 düzeylerinde benzer değişimler gözlendi. Malondialdehid düzeyleri kontrol grubunda ilk 24 saatte artarken daha sonra azalmaya başladı. Benzer şekilde L-karnitin gruplarında malondialdehid düzeyleri ilk 24 saatte artarken daha sonra doza bağımlı olarak azaldı. Sonuç: Karaciğer rejenerasyonunda sitokinler, büyüme faktörleri ve metabolik yollar olmak üzere üç temel unsur bulunmaktadır. Enerji metabolizmasındaki etkilerine ilaveten, yüksek doz L-karnitinin, IGF-1, TNF-? düzeyini artırarak ve malondialdehid düzeyini de azaltarak karaciğer rejenerasyonunu hızlandırabileceğini düşünmekteyiz.Öğe Does L-carnitine increase serum TNF -alpha and IGF-1 during liver regeneration in the rat?(Tubitak Scientific & Technical Research Council Turkey, 2009) Pehlivan, Mevlüt; Coşkun, Abdurrahman; Zengin, Ahmet; Aslaner, Arif; Yavuz, TevfikAim: We sought to evaluate the effect of L-carnitine administration on the levels of IGF-1, TNF-alpha, and lipid peroxidation during hepatic regeneration for up to 72 h in an experimental partial hepatic resection rat model. Materials and methods: Sixty rats were divided into 3 groups: control and low-dose (100 mg/kg) and high-close (200 mg/kg) L-carnitine. Each group was divided into 2 sub groups (24 and 72 h after partial hepatectomy). Partial (70%) hepatectomy was performed after 7 days of intra-peritoneal administration of L-carnitine. After partial hepatectomy, L-carnitine was also administered to rats until sacrifice. Serum IGF-1, TNF-alpha, and tissue inalondialdehyde levels were determined in all groups before and at 24 and 72 h after surgery. Results: Serum TNF-alpha increased significantly in the control group during the regeneration period. The low close of L-carnitine (100 mg/kg) decreased the elevation of TNF-alpha whereas the high dose (200 mg/kg) increased it. In the control group, the IGF-1 level decreased in the first 24 h after surgery and then increased. The IGF-1 level behaved similarly in the L-carnitine groups. The inalondialdehyde level in the control group increased during the first 24 h and then decreased. Similarly in the L-carnitine groups, the malondialdehyde level increased during the first 24 h and then decreased significantly in a close-dependent manner. Conclusion: Three types of biochemical pathways are essential in liver regeneration: cytokine, growth factor, and metabolic pathways. We conclude that, in addition to its effects on energy metabolism, high-dose L-carnitine may promote liver regeneration by increasing IGF-1, TNF-alpha, and decreasing malondialdehyde.Öğe Does melatonin alleviate cold preservation injury of the liver?(Tubitak Scientific & Technical Research Council Turkey, 2010) Günal, Ömer; Coşkun, Abdurrahman; Aslaner, Arif; Yıldırım, ÜmranAim: To investigate the effect of melatonin added to preservation solution on liver cold ischemia Materials and methods: Twenty male Wistar albino rats were divided equally into groups treated with University of Wisconsin (UW) solution with and without melatonin The LDH, AST, and ACP activities of the preservation solutions were determined in samples collected at 2, 24, 36, and 48 h Tissue malondialdehyde and heat shock protein (HSP 70) levels were also measured and a histological examination was performed at 48 h Results: Melatonin prevented enzyme elevation, induced heat shock protein (HSP 70), and decreased lipid peroxidation effectively in comparison to the control group (P < 0.05) The histological examination revealed that UW solution containing melatonin prevented Kupffer cell activation and inflammation significantly (P < 0.05) Conclusion: Melatonin in preservation solutions such as UW solution may protect tissue effectively from damage during cold ischemia for up to 48 hÖğe Early enteral and glutamine enriched enteral feeding ameliorates healing of colonic anastomosis: Experimental study(Turkish Association of Trauma and Emergency Surgery, 2006) Gökpınar, İbrahim; Gürleyik, Emin; Pehlivan, Mevlüt; Özcan, Ömer; Özaydın, İsmet; Aslaner, Arif; Gültepe, MustafaBACKGROUND: To investigate the effects of postoperative early enteral and glutamine enriched enteral feeding on the healing of experimental colonic anastomosis. METHODS: Forty Wistar-albino rats were equally divided into 4 groups. Colonic transsection and anastomosis situated at the distal left colon was performed on all animals. Animals in groups 1 and 2 received late total enteral nutrition (TEN) and in groups 3 and 4 early TEN. Glutamine was added to TEN protocol in groups 2 and 4. The colonic segment including the anastomosis was excised at the end of the 7th day postoperatively. Bursting pressure of the anastomosis and tissue hydroxyproline levels were determined. RESULTS: Bursting pressure levels were 111.6 and 95.8 centimeters of water (cmH2O) in early and late nutrition groups, respectively (p=0.022). Comparison of late TEN groups showed a significant difference in favor of group with glutamine (95.8 vs 138.5 cmH2O; p<0.0001). Highest bursting pressures (139 and 138.5 cmH2O) were measured in both early and late TEN groups with glutamine. Tissue hydroxyproline level in early TEN group (2440.3 ?g) was significantly higher than late TEN group (1509.6 ?g; p=0.024). Comparison of late TEN groups showed a considerable but not statistically significant difference (p=0.276) in favor of group with glutamine (1509.6 vs 1981.6 ?g). CONCLUSION: Postoperative early TEN significantly ameliorates the resistance of the anastomosis and collagen synthesis. Glutamine enrichment in nutritional protocol decreases and reverses the disadvantages of late TEN regarding the resistance of anastomosis. A similarly positive, albeit weaker, effect of glutamine supplementation is also seen on collagen synthesis.Öğe Effect of melatonin on kidney cold ischemic preservation injury(E-Century Publishing Corp, 2013) Aslaner, Arif; Günal, Ömer; Turgut, Hamdi Taner; Çelik, Erdal; Yıldırım, Ümran; Demirci, Rojbin Karakoyun; Doğan, SamiMelatonin is a potent free radical scavenger of reactive oxygen species, nitric oxide synthase inhibitor and a well-known antioxidant secreted from pineal gland. This hormone has been reported to protect tissue from oxidative damage. In this study, we aim to investigate the effect of melatonin on kidney cold ischemia time when added to preservation solution. Thirty male Wistar albino rats were divided equally into three groups; Ringer Lactate (RL) solution, University of Wisconsin (UW) solution with and without melatonin. The serum Lactate Dehydrogenase (LDH) activities of the preservation solutions at 2nd, 24th, 36th, and 48th hours were determined. Tissue malondialdehyde (MDA) levels were also measured and a histological examination was performed at 48th hour. Melatonin that added to preservation solution prevented enzyme elevation and decreased lipid peroxidation in preservation solution when compared to the control group (p<0.05). The histological examination revealed that UW solution containing melatonin significantly prevented the kidney from pathological injury (p<0.05). Melatonin added to preservation solutions such as UW solution seemed to protect the tissue preserved effectively from cold ischemic injury for up to 48 hour.Öğe Inflammatory fibrosarcoma: A rare tumor involving retroperitoneum, ileum and colon(2007) Yaşar, Mehmet; Aslaner, Arif; Zengin, Ahmet; Turgut, TanerAn inflammatory fibrosarcoma is a rare tumor with a varied biological behavior, from benign to locally aggressive and occasionally malignant. It generally involves mesentery and retroperitoneal structures, but it rarely can involve the hollow viscera and commonly affects children and young adults. We report a case of inflammatory fibrosarcoma affecting an unusual age group, involving the ileum and descending colon (a rare site) causing subacute intestinal obstruction. We also discuss its surgical management, differential diagnosis and review of current literature.Öğe The influence of colon anastomosis levels on liquid phase gastric emptying rate(2004) Günal, Ömer; Deniz, Mustafa; Aslaner, Arif; Sungur, MustafaThe aim of this study was to investigate the effect of colonic anastomoses at different levels on liquid phase gastric emptying rate. Initiation of oral feeding after colorectal surgical procedures depends on the beginning of bowel movements. We hypothesize that surgical procedures which are performed at different colonic levels, may affect gastric motility and may alter the oral feeding starting time. Liquid phase gastric emptying rates of 49 adult male Wistar Albino rats were measured with methyl cellulose phenol red test. Two groups of 14 rats underwent ascending colon or colorectal anastomosis. We also studied a sham-op group (n=14) with laparotomy only and a control group (n=7) with no surgery. Half of each group underwent gastric emptying test on postoperative first (n=7) or tenth (n=7) days. The gastric emptying rates on the first postoperative day were (34.9±1.5%), (50.9±5.2%), and (58.3±4.5%) in colorectal anastomosis, ascending colon anastomosis, and sham-op groups, respectively. While gastric emptying rates returned to the control group levels (71.5±5.7%) on postoperative tenth day, in ascending colon anastomosis (72.5±2.1%) group and sham-op (69±1.8) group, it was still significantly lower in colorectal anastomosis (49.9±7.8%) group compared to the control group level. This study shows that colorectal anastomosis causes a delay in liquid phase gastric emptying rate compared to ascending colon anastomosis. Our findings also imply that the influence of colonic anastomosis on gastric emptying rate appears to be related to the site of colonic anastomosis.Öğe Intestinal blood flow alterations in postoperative intraabdominal adhesion formation and the role of endothelin-1 blockade(2006) Günal, Ömer; Ghandour, S.; Deniz, Melike; Aslaner, ArifBACKGROUND: The current study was planned to investigate intestinal blood flow alterations and the role of ET-1 receptor blockade in the formation of postoperative intraperitoneal adhesion formation. METHODS: Twenty-eight adult Wistar Albino rats weighing between 250 g and 300 g were divided into four groups. Control group (group 1; n=7) did not undergo any operation. Sham group (group 2; n=7) had only laparotomy. In the adhesion group (group 3; n=7), peritoneal patch (1x1 cm) excision from the right abdominal wall and cecal abrasion were done as "adhesion model operation". One week following this, treatment group (group 4; n=7) received a non-selective ET-1 receptor blocking agent bosentan (30 mg/kg, IP) intra-abdominally, once a day for four days. Intestinal blood flow through the superior mesenteric artery was measured, on postoperative seventh day. Adhesion severity and extension as well as myeloperoxidase activity in the adhesion were calculated. RESULTS: Mean intestinal blood flow significantly increased in adhesion group (81.9±5.6 ml/100 g) when compared to group 1 (65.5±1.2 ml/100 g). Bosentan caused a significant decrease (44.3±6.9 ml/100 g) in intestinal blood flow when compared to group 1 and group 2. Sham group (62.2±1 ml/100 g) had similar blood flow level with the control group (65.5±1.2 ml/100g). Adhesion scores were similar in adhesion and Bosentan groups. Sham group had almost no adhesions. Myeloperoxidase activity in adhesion tissue was significantly higher in bosentan group. CONCLUSION: Non-selective ET-1 receptor blockade has no effect on prevention of the formation of intra-abdominal adhesion, but causes a decrease in intestinal blood flow. Adhesion formation increases intestinal blood flow. Adhesion formation is accompanied by increased polymorphonuclear infiltration despite bosentan treatment.Öğe Karnitinin böbrek soğuk iskemi hasarında koruyucu etkisi(Düzce Üniversitesi, 2008) Aslaner, Arif; Günal, ÖmerAmaç: University of Wisconsin solüsyonunun soguk iskemiye karsı korumadaaltın standart olarak kabul edilmesine ragmen, soguk iskemi zamanının arttırılmasınıamaçlayan çalısmalar devam etmektedir. Bu deneysel çalısma, böbrek sogukiskemisinde karnitinin koruyuculugunu arastırmak için planlandı.Yöntem: Yirmi dört Wistar-Albino sıçan kontrol grubu (n=6; Ringer Laktat),karnitin ilave edilmis Ringer Laktat (n=6), University of Wisconsin (n=6) ve karnitinilave edilmis University of Wisconsin (n=6) grubu olmak üzere dörde ayrıldı.Böbreklerin saklama solüsyonuyla perfüzyonu sonrasında organlar 10ml'lik saklamasolüsyonlarına konuldu. 0,24,48,72. saatlerde saklama solüsyonunda Laktatdehidrogenaz aktiviteleri ölçüldü. Aynı zamanda 72. saatte alınan doku örneklerindeMalondialdehid degerleri çalısıldı. Doku zedelenmesi histopatolojik olarakHemotoksilen-eosinle boyanmıs parafin bloklardan alına kesitlerin(0.4?m)incelenmesi ile degerlendirilip skorlandı.Bulgular: Karnitin+ University of Wisconsin grubunda ortalama dokuMalondialdehid degeri belirgin olarak düsük bulundu (15,79±5,15'e karsı9,60±2,59nMol/mg, p=0,001) Saklama sıvılarındaki Laktat Dehirogenaz seviyelerindebelirgin bir farklılık izlenmedi. Histopatolojik incelemede karnitin ilave edilmis RingerLaktat grubunun toplam zedelenme skoru düsük olarak bulundu.Sonuçlar: University of Wisconsin solüsyonuna karnitinin eklenmesi böbreksoguk iskemisinde hasarı azaltıcı etkiyi artırmaktadır.Öğe Multiple bowel perforations in systemic lupus erythematosus(2005) Aydın, Mesut; Başer, Murat; Kösem, Mustafa; Aslaner, ArifSystemic lupus erythematosus (SLE) is a connective tissue disorder that has rarely been seen with acute surgical manifestations. Intestinal perforation is one of the most devastating complications of SLE which necessitates prompt surgical intervention. We report a case having multiple intestinal perforations on exploration and has undergone primary repair. SLE should be taken into account as a diagnosis of choice in patients with bowel perforation.Öğe Volvulated paraoesophageal gastric herniation with perforation into bursa omentalis: Report of a case(Acta Medical Belgica, 2006) Aydın, Mesut; Yaşar, Mehmet; Aslaner, Arif; Yazıcı, Burhan; Ertaş, ErtuğrulAlthough paraoesophageal hernias remain 30% asymptomatic, when diagnosed they have to be operated because of their fatal complications such as ischaemia, bleeding and perforation. The mortality rate increases to twenty times in emergency cases when it is compared with elective ones. Site of gastric perforation may be directed towards bursa omentalis as well as to peritoneal cavity. A case of a volvulated paraoesophageal gastric herniation ruptured to bursa omentalis is discussed with the review of the literature.
