Objective: Ischemia-reperfusion injury is thought to be the most important factor affecting the s... more Objective: Ischemia-reperfusion injury is thought to be the most important factor affecting the success of liver surgery. Pregabalin has been studied to prevent ischemic reperfusion injury in many organs. The aim of this study was to investigate the role of pregabalin in preventing liver ischemic injury. Materials and methods: 40 male Wistar-Albino rats, 6-8 weeks old, were divided into 5 groups. Four groups other than the sham group were subjected to hepatic ischemia for 1 hour, followed by 2 hours of reperfusion. Effects of 30 mg/and 60 mg/kg pregabalin were evaluated by aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor α (TNF-α), nuclear factor-kappa B (NF-кB), interleukin (IL)-6 levels, measured in blood samples collected before and after ischemia. Apoptosis was measured by caspase-3, and tissue samples were evaluated for ischemia by histopathologic examination. Results: The 60 mg pregabalin group was significantly superior (p=0.024) to the N-acetylcysteine group and the 30 mg pregabalin group for AST levels (p=0.612 and p=0.807, respectively). The difference between before and after ischemia-reperfusion blood TNF-α levels was higher in the 60 mg pregabalin group, but not significantly different from the 30 mg pregabalin and N-acetylcysteine groups (p>0.05). Tissue TNF-α levels showed that 60 mg and 30 mg pregabalin treatment was more effective than no-treatment (p=0.011, p=0.033, respectively), but not superior to N-acetylcysteine (p>0.05). Conclusions: It has been found that ischemia-reperfusion causes damage to the liver, and this damage may be irreversible if no treatment is given. Our study group, pregabalin molecule was found to be significantly effective in preventing ischemia-reperfusion injury and may have a therapeutic advantage over N-acetylcysteine.
We herein present a patient referred to our clinic with the comp- laints of flatulence and left u... more We herein present a patient referred to our clinic with the comp- laints of flatulence and left upper quadrant abdominal pain who was diagnosed to have pancreatic cystic neoplasia radiolo- gically. The septated cyst was defined to be 9x12 cm in diame- ter by abdominal computed tomography and by ultrasonog- raphy originated from the tail of the pancreas. Distal pancre- atectomy procedure with complete resection of the cystic lesion was performed in this patient. Pathologic examination revealed pancreatic cystic lymphangioma (PCL). Although PCL is very rare in adult patients, it can cause confusion due to the presen- ce of other cystic pathologies of the pancreas. Complete excision of the cyst is mandatory to prevent recurrences. In our case, no recurrence was detected after a two-year follow-up.
Introduction: Demonstration of diagnostic contribution of Papanicolaou Society of Cytopathology-s... more Introduction: Demonstration of diagnostic contribution of Papanicolaou Society of Cytopathology-standardized nomenclature for pancreaticobiliary cytology (PSC-PC) in endoscopic ultrasonography (EUS) fine-needle biopsy (FNA) biopsies is important for widespread use and further development. Methods: 179 EUS-FNA biopsies (89: solid, 90: cystic) and PSC-PC categories were compared with surgical definite histopathology and definite clinical diagnosis. Overall risk of malignancy (oROM) was calculated for each PSC-PC category. Diagnostic accuracy was evaluated. Results: The cytopathology of lesions was nondiagnostic in 27%. Ductal dilatation, lymphadenopathy, and solid characteristic (independently) were associated with diagnostic result, while lesion size was not. PSC-PC categories had 89% diagnostic consistency with surgical definite histopathology. Category mismatch was detected in 3 patients (11%), of which 2 had adenocarcinoma. oROM was 14.3% for nondiagnostic group, 46% for cat. III (atypia), and 12% for cat. IVB (neoplastic – other). In terms of malignancy, the PSC-PC system had 100% specificity; PPV, 92% sensitivity, and 81% NPV; and the diagnostic accuracy was 94%. Conclusion: Using PSC-PC in EUS-FNA biopsies, pancreatic malignancy can be diagnosed with high diagnostic accuracy. In mucinous cystic lesions, some malignancies may be missed. To predict the malignancy risk of cat. IVB, assessment of dysplasia seems important. Although PSC-PC is not the only parameter in terms of diagnosing malignancy, its contribution to the clinical decision is quite high.
We aimed to detect EBV/Hp (Epstein-Barr Virus/Helicobacter pylori) co-infection by determining th... more We aimed to detect EBV/Hp (Epstein-Barr Virus/Helicobacter pylori) co-infection by determining the number of copies of EBV/EBER-1 in the gastric biopsy samples of the Hp (+) GC, peptic ulcer (PU), and non-ulcer dyspepsia (NUD) cases. The patient group (PG), with 34 patients (34 GC and 30 PU patients) and a control group with 40 NUD cases were included. All patients and controls were Hp positive. EBV/EBNA-1 IgG were measured by the Anti-EBNA-1 ELISA IgG kit. Determination and quantification of EBV/EBER-1 gene region was performed by qPCR. EBV/EBER-1 positivity was 35.29% (12/34), 6.6% (2/30) and 2.5% (1/40) in GC, PU and 40 NUD cases, respectively. A significant difference was found between the GC and NUD cases (p=0.001). A significant difference was found between the groups for mean EBV/EBER-1 copy numbers (p=0.019). No significant difference was found between GC and the NUD cases (p=0.1455) for EBV/EBNA-1 IgG antibody positivity. EBV/EBER-1 positivity (OR=3.319), and age ≥55 years old (OR=2.331) were found to be a significant in multivariate logistic regression. In conclusion, our data suggest that the GC risk by EBVand Hp co-infection increased 3.3 times.
Background: Non-steroidal anti-inflammatory drug (NSAID) use may cause diaphragm-like lesions in ... more Background: Non-steroidal anti-inflammatory drug (NSAID) use may cause diaphragm-like lesions in the bowel. Although NSAID-enteropathy is among the causes of protein-losing enteropathy (PLE), intractable hypoalbuminemia is rare. Case report: Here, we discuss a case of NSAID-enteropathy with a diaphragm-like disease that presented with Protein Losing Enteropathy (PLE) rather than obstruction. The hypoalbuminemia recovered immediately after resection of the obstructive segment, despite ongoing annular ulcerations in the early postoperative period. Thus, it was not clear whether obstructive mechanisms influenced resistant hypoalbuminemia besides the ulcers. We also reviewed the English-written literature for "diaphragm-type lesion, NSAID-enteropathy, obstruction, and protein-losing enteropathy". We noted that the role of obstruction in the pathophysiology of PLE was not clear. Conclusions: As our case and a couple of cases reported in literature, slow-onset obstructive pathology seems to contribute to well-known factors: inflammatory response, exudation, tight-junction dysfunction, and increase in permeability in the physiopathology of NSAID-induced PLE. Factors such as distention-induced low-flow ischemia and reperfusion, cholecystectomy-related continuous bile flow, bacterial overgrowth-related bile deconjugation and concomitant inflammation are among other potential influencers. The possible role of a slow-onset obstructive pathology in the physiopathology of NSAID-induced and other PLE needs to be further elucidated.
Aim: Esophageal cancer is a fatal disease where the majority of patients are diagnosed at an adva... more Aim: Esophageal cancer is a fatal disease where the majority of patients are diagnosed at an advanced stage. In this study, we aimed to present the demographic and clinicopathological characteristics of patients who were operated for esophageal cancer. Materials and Methods: A total of 847 patients who underwent surgery, chemoradiotherapy, or palliative procedures for esophageal pathology between the years of 1985 and 2018 were retrospectively analyzed. Age, gender, tumor location, histopathology, surgical technique, and chemoradiotherapy history of patients were analyzed. Results: In the study, 488 patients were male (60.5%) and 319 were female (39.5%). The ratio of males and females was 1.52. The average age was 58.6 years, and 80.1% were older than 50 years. The most common pathological material obtained was squamous cell carcinoma (67.5%), followed by adenocarcinoma (27.7%). Total esophagectomy was performed in 435 patients; distal esophagectomy was performed in 38 patients. Tra...
Objective: Ischemia-reperfusion injury is thought to be the most important factor affecting the s... more Objective: Ischemia-reperfusion injury is thought to be the most important factor affecting the success of liver surgery. Pregabalin has been studied to prevent ischemic reperfusion injury in many organs. The aim of this study was to investigate the role of pregabalin in preventing liver ischemic injury. Materials and methods: 40 male Wistar-Albino rats, 6-8 weeks old, were divided into 5 groups. Four groups other than the sham group were subjected to hepatic ischemia for 1 hour, followed by 2 hours of reperfusion. Effects of 30 mg/and 60 mg/kg pregabalin were evaluated by aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor α (TNF-α), nuclear factor-kappa B (NF-кB), interleukin (IL)-6 levels, measured in blood samples collected before and after ischemia. Apoptosis was measured by caspase-3, and tissue samples were evaluated for ischemia by histopathologic examination. Results: The 60 mg pregabalin group was significantly superior (p=0.024) to the N-acetylcysteine group and the 30 mg pregabalin group for AST levels (p=0.612 and p=0.807, respectively). The difference between before and after ischemia-reperfusion blood TNF-α levels was higher in the 60 mg pregabalin group, but not significantly different from the 30 mg pregabalin and N-acetylcysteine groups (p>0.05). Tissue TNF-α levels showed that 60 mg and 30 mg pregabalin treatment was more effective than no-treatment (p=0.011, p=0.033, respectively), but not superior to N-acetylcysteine (p>0.05). Conclusions: It has been found that ischemia-reperfusion causes damage to the liver, and this damage may be irreversible if no treatment is given. Our study group, pregabalin molecule was found to be significantly effective in preventing ischemia-reperfusion injury and may have a therapeutic advantage over N-acetylcysteine.
We herein present a patient referred to our clinic with the comp- laints of flatulence and left u... more We herein present a patient referred to our clinic with the comp- laints of flatulence and left upper quadrant abdominal pain who was diagnosed to have pancreatic cystic neoplasia radiolo- gically. The septated cyst was defined to be 9x12 cm in diame- ter by abdominal computed tomography and by ultrasonog- raphy originated from the tail of the pancreas. Distal pancre- atectomy procedure with complete resection of the cystic lesion was performed in this patient. Pathologic examination revealed pancreatic cystic lymphangioma (PCL). Although PCL is very rare in adult patients, it can cause confusion due to the presen- ce of other cystic pathologies of the pancreas. Complete excision of the cyst is mandatory to prevent recurrences. In our case, no recurrence was detected after a two-year follow-up.
Introduction: Demonstration of diagnostic contribution of Papanicolaou Society of Cytopathology-s... more Introduction: Demonstration of diagnostic contribution of Papanicolaou Society of Cytopathology-standardized nomenclature for pancreaticobiliary cytology (PSC-PC) in endoscopic ultrasonography (EUS) fine-needle biopsy (FNA) biopsies is important for widespread use and further development. Methods: 179 EUS-FNA biopsies (89: solid, 90: cystic) and PSC-PC categories were compared with surgical definite histopathology and definite clinical diagnosis. Overall risk of malignancy (oROM) was calculated for each PSC-PC category. Diagnostic accuracy was evaluated. Results: The cytopathology of lesions was nondiagnostic in 27%. Ductal dilatation, lymphadenopathy, and solid characteristic (independently) were associated with diagnostic result, while lesion size was not. PSC-PC categories had 89% diagnostic consistency with surgical definite histopathology. Category mismatch was detected in 3 patients (11%), of which 2 had adenocarcinoma. oROM was 14.3% for nondiagnostic group, 46% for cat. III (atypia), and 12% for cat. IVB (neoplastic – other). In terms of malignancy, the PSC-PC system had 100% specificity; PPV, 92% sensitivity, and 81% NPV; and the diagnostic accuracy was 94%. Conclusion: Using PSC-PC in EUS-FNA biopsies, pancreatic malignancy can be diagnosed with high diagnostic accuracy. In mucinous cystic lesions, some malignancies may be missed. To predict the malignancy risk of cat. IVB, assessment of dysplasia seems important. Although PSC-PC is not the only parameter in terms of diagnosing malignancy, its contribution to the clinical decision is quite high.
We aimed to detect EBV/Hp (Epstein-Barr Virus/Helicobacter pylori) co-infection by determining th... more We aimed to detect EBV/Hp (Epstein-Barr Virus/Helicobacter pylori) co-infection by determining the number of copies of EBV/EBER-1 in the gastric biopsy samples of the Hp (+) GC, peptic ulcer (PU), and non-ulcer dyspepsia (NUD) cases. The patient group (PG), with 34 patients (34 GC and 30 PU patients) and a control group with 40 NUD cases were included. All patients and controls were Hp positive. EBV/EBNA-1 IgG were measured by the Anti-EBNA-1 ELISA IgG kit. Determination and quantification of EBV/EBER-1 gene region was performed by qPCR. EBV/EBER-1 positivity was 35.29% (12/34), 6.6% (2/30) and 2.5% (1/40) in GC, PU and 40 NUD cases, respectively. A significant difference was found between the GC and NUD cases (p=0.001). A significant difference was found between the groups for mean EBV/EBER-1 copy numbers (p=0.019). No significant difference was found between GC and the NUD cases (p=0.1455) for EBV/EBNA-1 IgG antibody positivity. EBV/EBER-1 positivity (OR=3.319), and age ≥55 years old (OR=2.331) were found to be a significant in multivariate logistic regression. In conclusion, our data suggest that the GC risk by EBVand Hp co-infection increased 3.3 times.
Background: Non-steroidal anti-inflammatory drug (NSAID) use may cause diaphragm-like lesions in ... more Background: Non-steroidal anti-inflammatory drug (NSAID) use may cause diaphragm-like lesions in the bowel. Although NSAID-enteropathy is among the causes of protein-losing enteropathy (PLE), intractable hypoalbuminemia is rare. Case report: Here, we discuss a case of NSAID-enteropathy with a diaphragm-like disease that presented with Protein Losing Enteropathy (PLE) rather than obstruction. The hypoalbuminemia recovered immediately after resection of the obstructive segment, despite ongoing annular ulcerations in the early postoperative period. Thus, it was not clear whether obstructive mechanisms influenced resistant hypoalbuminemia besides the ulcers. We also reviewed the English-written literature for "diaphragm-type lesion, NSAID-enteropathy, obstruction, and protein-losing enteropathy". We noted that the role of obstruction in the pathophysiology of PLE was not clear. Conclusions: As our case and a couple of cases reported in literature, slow-onset obstructive pathology seems to contribute to well-known factors: inflammatory response, exudation, tight-junction dysfunction, and increase in permeability in the physiopathology of NSAID-induced PLE. Factors such as distention-induced low-flow ischemia and reperfusion, cholecystectomy-related continuous bile flow, bacterial overgrowth-related bile deconjugation and concomitant inflammation are among other potential influencers. The possible role of a slow-onset obstructive pathology in the physiopathology of NSAID-induced and other PLE needs to be further elucidated.
Aim: Esophageal cancer is a fatal disease where the majority of patients are diagnosed at an adva... more Aim: Esophageal cancer is a fatal disease where the majority of patients are diagnosed at an advanced stage. In this study, we aimed to present the demographic and clinicopathological characteristics of patients who were operated for esophageal cancer. Materials and Methods: A total of 847 patients who underwent surgery, chemoradiotherapy, or palliative procedures for esophageal pathology between the years of 1985 and 2018 were retrospectively analyzed. Age, gender, tumor location, histopathology, surgical technique, and chemoradiotherapy history of patients were analyzed. Results: In the study, 488 patients were male (60.5%) and 319 were female (39.5%). The ratio of males and females was 1.52. The average age was 58.6 years, and 80.1% were older than 50 years. The most common pathological material obtained was squamous cell carcinoma (67.5%), followed by adenocarcinoma (27.7%). Total esophagectomy was performed in 435 patients; distal esophagectomy was performed in 38 patients. Tra...
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