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Öğe Comparing the effects of nebivolol and dexpanthenol on wound healing: an experimental study(Wiley, 2016) Ulger, Burak V.; Kapan, Murat; Uslukaya, Omer; Bozdag, Zubeyir; Turkoglu, Ahmet; Alabalik, Ulas; Onder, AkinWound healing is a dynamic, interactive process that is initiated in response to injury. A number of investigations and clinical studies have been performed to determine new approaches for the improvement ofwound healing. The aim of this studywas to compare the effects of dexpanthenol, a molecule that is widely used for improvingwound healing, and nebivolol, a molecule that increases nitric oxide release, on wound healing. A total of 30 rats were divided into three equal groups (n = 10). A linear 2 cm incision was made in the rats' skin. No treatment was administered in the first (control) group. Dexpanthenol cream was administered to the rats in the second group and 5% nebivolol cream was administered to the rats in the third group. The wound areas of all of the rats were measured on certain days. On the 21st day, all wounds were excised and histologically evaluated. The wound healing rates of the dexpanthenol and nebivolol groups were higher than those of the control group (P < 0.05). However, the wound healing rates of the dexpanthenol and nebivolol groups were not significantly different. Nebivolol and dexpanthenol have comparable effects on wound healing.Öğe Effects of ellagic acid on experimental acute pancreatitis in rats(Wiley-Blackwell, 2015) Bozdag, Zubeyir; Yilmaz, Edip Erdal; Yazgan, Umit Can; Kaplan, Ibrahim; Arikanoglu, Zulfu; Ibiloglu, Ibrahim; Atamanalp, Sabri Selcuk[Abstract Not Available]Öğe Factors affecting mortality in patients with splenic injuries(Edizioni Luigi Pozzi, 2018) Uslukaya, Omer; Bozdag, Zubeyir; Gumus, Metehan; Turkoglu, Ahmet; Boyuk, Abdullah; Yilmaz, Edip Erdal; Gunduz, ErcanAIM: Mortality in splenic injuries can create medico-legal problems. Though many studies exist regarding splenic injuries, there are not a sufficient number investigating the factors in splenic injuries influencing mortality. In this study, we aimed to investigate the factors affecting mortality in splenic injuries. MATERIALS AND METHODS: All 237 patients with splenic injury between 2005 to 2014 were retrospectively analyzed. The patients were divided into two groups, survivors and non-survivors. Age, gender, mechanism of injury, grade of splenic injury, pulse, respiratory rate, systolic blood pressure, hemoglobin levels, number of transfusions, surgical procedure, ISS, RTS and hospitalization period were recorded. Univariate and multivariate analysis were used to compare survivors and non-survivors. RESULTS: The average age of the patients was 32 and most (82.7%) were male. Mortality was observed in 18 patients (7.6%). Mortality was found significantly lower in patients who had isolated splenic injury (p=0.048). In univariate analyses, decreased RTS (p<0.001), increased number of blood transfusion (p<0.001), decreased hemoglobin level (p=0, 025) and increased ISS (p<0.001) were found significant in non-survivors. In multivariate analysis; number of transfusions, ISS and RTS were found as independent risk factors for mortality. CONCLUSIONS: We found high number of transfusions, high ISS and low RTS as independent risk factors for mortality in patients with splenic injury.Öğe Factors that Affect Drain Indwelling Time after Breast Cancer Surgery(Aves, 2016) Uslukaya, Omer; Turkoglu, Ahmet; Gumus, Metehan; Bozdag, Zubeyir; Yilmaz, Ahmet; Gumus, Hatice; Kaya, SeyhmusObjective: The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). Materials and Methods: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. Results: The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. Conclusion: DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.Öğe Fasciola hepatica infection at a University Clinic in Turkey(J Infection Developing Countries, 2014) Ulger, Burak Veli; Kapan, Murat; Boyuk, Abdullah; Uslukaya, Omer; Oguz, Abdullah; Bozdag, Zubeyir; Girgin, SadullahIntroduction: We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis in light of current literature. Methodology: Thirty-nine patients with fascioliasis admitted to the Surgery Clinic of Dicle Medical Faculty (Turkey) were included in this study. The demographic, clinical, diagnostic, treatment and outcome data were analyzed retrospectively. Results: Abdominal pain (n = 37; 95%) and eosinophilia (n = 31; 79%) were the most common findings. Twenty-seven patients were diagnosed by clinical and radiological findings. Patients were treated with triclabendazole. Thirty-six (92.4%) of the patients improved after medical treatment. Conclusions: The presence of typical clinical, laboratory and radiological findings is sufficient for diagnosis. Triclabendazole administration is often an effective treatment, with improvements occurring over the course of a few months.Öğe Fournier's Gangrene: A Summary of 10 Years of Clinical Experience(Int College Of Surgeons, 2015) Oguz, Abdullah; Gumus, Metehan; Turkoglu, Ahmet; Bozdag, Zubeyir; Ulger, Burak Veli; Agacayak, Elif; Boyuk, AbdullahWe aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 +/- 1.86 and 10.00 +/- 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary.Öğe The Management and Outcomes of Male Breast Cancer(Aves, 2016) Uslukaya, Omer; Gumus, Metehan; Gumus, Hatice; Bozdag, Zubeyir; Turkoglu, AhmetObjective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. Materials and Methods: The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. Results: The mean age of the patients was 63.03 +/- 12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twenty-nine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. Conclusion: Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.Öğe Mean Platelet Volume/Platelet Count Ratio: A New Diagnostic Parameter for Necrosis in Adhesive Small Bowel Obstruction-A Retrospective Cohort Study(Int College Of Surgeons, 2015) Ulger, Burak Veli; Erbis, Halil; Turkoglu, Ahmet; Gumus, Metehan; Gul, Mesut; Arikanoglu, Zulfu; Bozdag, ZubeyirAbdominal adhesions are still one of the most common causes of intestinal obstruction. A major challenge in adhesive small bowel obstruction (SBO) management is to detect ischemia as early as possible to avoid necrosis and resection. Elevated mean platelet volume and decreased platelet count have been associated with worse disease course for various ischemic diseases in many clinical studies. The objective of the current study was to evaluate the predictive value of the mean platelet volume/platelet count ratio for patients with small bowel obstruction. Data for patients with adhesive small bowel obstruction, admitted to the general surgery department of Dicle University Hospital between November 2010 and March 2014, were reviewed retrospectively. Mean platelet volume (MPV)/platelet count (PC) ratio values, demographic data, vital signs, and laboratory blood test results of the patients were analyzed. Mean platelet volume/platelet count ratio was higher in bowel necrosis group, while there were no differences between the groups in terms of mean platelet volume values. Mean platelet volume and mean platelet volume/platelet count ratio was higher in patients who underwent surgical treatment. The cutoff value with the highest sensitivity and specificity for MPV/PC ratio was 0.02855 (sensitivity 68%, specificity 65%) for predicting bowel necrosis in patients with adhesive SBO. Mean platelet volume/platelet count ratio is associated with the failure of the conservative management and the presence of bowel necrosis in patients with adhesive small bowel obstruction.Öğe Mean Platelet Volume: Is It a Predictive Parameter in Diagnosis of Acute Mesenteric Ischemia?(Int College Of Surgeons, 2015) Turkoglu, Ahmet; Gul, Mesut; Oguz, Abdullah; Bozdag, Zubeyir; Ulger, Burak Veli; Yilmaz, Ahmet; Aldemir, MustafaOur objective for this study was to discuss the usability of mean platelet volume, which is associated with numerous vascular pathologies, in the early diagnosis of acute mesenteric ischemia. Acute mesenteric ischemia is an uncommon, life-threatening clinical condition mostly seen in the elderly. Early diagnosis of acute mesenteric ischemia and correction of blood circulation before necrosis occurs are important factors affecting prognosis. A total of 95 patients who underwent emergency surgery for acute mesenteric ischemia and 90 healthy volunteers as control group were included in this study. Age, gender, hemoglobin values, white blood cell counts, mean platelet volume, and platelet counts are recorded for evaluation. The mean platelet volume values were significantly higher in patients with acute mesenteric ischemia than in the controls (9.4 +/- 1.1 fL and 7.4 +/- 1.4 fL, respectively; P < 0.001). Receiver-operating characteristic analysis demonstrated a cutoff value of mean platelet volume as 8.1 fL (area under the curve, 0.862), a sensitivity of 83.2%, and a specificity of 80%. As a result, in the patients who are admitted to the hospital with acute nonspecific abdominal pain and suspected of having acute mesenteric ischemia, high mean platelet volume values in routine hemograms support the diagnosis of acute mesenteric ischemia.Öğe New hormones to predict the severity of gallstone-induced acute pancreatitis(Aves, 2014) Ulger, Burak Veli; Gul, Mesut; Uslukaya, Omer; Oguz, Abdullah; Bozdag, Zubeyir; Yuksel, Hatice; Boyuk, AbdullahBackground/Aims: Levels of the hormones ghrelin and leptin in rat models of acute pancreatitis (AP) have been investigated in several experimental studies. However, there are very few clinical studies addressing the connection between hormone levels and AP. A few recent studies investigating the changes in ghrelin and leptin levels in patients with AP have been reported; however, our study is the first clinical study to investigate the change of nesfatin-1 levels in patients with gallstone-induced AP. Materials and Methods: Forty patients were enrolled in this study, eight of which presented with severe AP. Two blood samples were obtained from each study patient. The first blood samples were obtained at patient admission to the hospital and the second was obtained at patient discharge. All samples were collected after at least 6 h of fasting. Plasma nesfatin-1, leptin, and ghrelin levels were measured. Results: In all 40 patients, nesfatin-1 and leptin levels were higher at admission and had decreased at discharge. In contrast, the ghrelin levels at discharge were significantly higher than those at admission. Only the changes in these hormones in the mild AP group were significant. Conclusion: Levels of these hormones were altered during the course of gallstone-induced AP. These changes might be associated with the clinical outcomes of the disease. To clarify whether the magnitude of the change in hormone levels at AP onset can be used as a biomarkers to predict the severity of the disease requires further investigation.Öğe A rare reason for acute abdomen: Intraperitoneal liver hydatid cyst rupture(Elsevier Science Inc, 2016) Bozdag, Zubeyir; Turkoglu, Ahmet; Yilmaz, Edip Erdal; Gul, Mesut[Abstract Not Available]Öğe Risk factors influencing morbidity and mortality in perforated peptic ulcer disease(Aves, 2015) Tas, Ilhan; Ulger, Burak Veli; Onder, Akin; Kapan, Murat; Bozdag, ZubeyirObjective: Peptic ulcer perforation continues to be a major surgical problem. In this study, risk factors that influence morbidity and mortality in perforated peptic ulcer disease were examined. Material and Methods: Files of 148 patients who were included in the study due to peptic ulcer perforation between January 2006 and December 2010 were retrospectively analyzed. Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, length of hospital stay, morbidity and mortality were recorded. Results: The study group included 129 (87.2%) male and 19 (12.8%) female patients. The mean age was 51.7 +/- 20 (15-88) years. Forty five patients (30.4%) had at least one co-morbid disease. In the postoperative period, 30 patients (20.3%) had complications. The most common complication was wound infection. Mortality was observed in 27 patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality. Conclusion: Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation.Öğe Superior mesenteric artery (Wilkie's) syndrome: a rare cause of upper gastrointestinal system obstruction(Taylor & Francis Ltd, 2016) Oguz, Abdullah; Uslukaya, Omer; Ulger, Burak Veli; Turkoglu, Ahmet; Bahadir, Mehmet Veysi; Bozdag, Zubeyir; Boyuk, AbdullahBackground Superior mesenteric artery syndrome (SMAS) results from the compression of the third part of the duodenum between the aorta and the proximal part of the superior mesenteric artery (SMA). Clinical presentation of SMAS is characterized by the dilatation of the proximal part of the third part of the duodenum. SMAS is a rare cause of the upper gastrointestinal system (UGS) obstruction. In this study, we aimed to present our clinical experience in the treatment of five patients with SMAS, which is a rare clinical condition requiring surgery. Patients and methods The retrospective study included five patients who were treated due to SMAS at our clinic between January 2010 and January 2014. Results All the patients were underweight, with a mean BMI of 15.73 (14-16). The clinical symptoms included epigastric pain after food intake, large volume bilious emesis, early satiety, failure to gain weight, indigestion, esophageal reflux, sense of fullness, and persistent weight loss. SMAS was diagnosed using barium meal studies, upper gastrointestinal endoscopy, abdominal ultrasonography, and CT angiography. Four patients underwent duodenoje-junostomy and one patient was managed with gastrojejunostomy. No complication was observed during the postoperative period, and all the patients achieved significant improvement in symptoms. Conclusion SMAS is a rare cause of UGS obstruction, and the diagnosis of SMAS is often delayed. SMAS should be suspected in the differential diagnosis of the patients with unsubstantiated symptoms of persistent nausea, emesis, and significant weight loss.Öğe Therapeutic effects of ellagic acid on L-arginin induced acute pancreatitis(Acta Cirurgica Brasileira, 2016) Yilmaz, Edip Erdal; Bozdag, Zubeyir; Ibiloglu, Ibrahim; Arikanoglu, Zulfu; Yazgan, Umit Can; Kaplan, Ibrahim; Gumus, MetehanPURPOSE: To investigate the therapeutic effects of ellagic acid on L-arginin induced acute pancreatitis in rats. METHODS: Thirty-two were split into four groups. Group 1 (control) rats were performed only laparotomy, no drugs were administered. Group 2 (control+EA) rats were administered 85mg/kg EA orally. Rats were sacrificed by cardiac puncture 24 hours after the administration. Group3 (AP) 24 hours after intraperitoneal L-arginine administration, rats were sacrificed by cardiac puncture. Group 4 (EA)-(AP): 85mg/kg EA was administered orally after the L-arginine administration. 24 hours later, rats were sacrificed by cardiac puncture. Serum TNF-alpha, IL-1 beta, IL-6, total oxidative status (TOS), total antioxidant capacity (TAC), amylase levels were determined in all groups. RESULTS: Group 3 (AP) rats showed significantly raised TOS level as compared to Group1 (control) rats (p<0.001). Following the EA therapy, a decrease in TOS was observed in Group 4 (AP+EA). TAC levels were significantly raised in the Group 4 (AP+EA) compared to the Group 3 (AP) (p=0.003). Group 3 (AP) showed significantly increased TNF-alpha, IL-1 beta and IL-6 serum levels as compared to Group 4 (AP+EA). Histopathological changes were supported our result. CONCLUSION: The healing effects of ellagic acid on inflammatory and oxidative stress were confirmed by histopathological and biochemical evaluations of the pancreatic tissue.Öğe Topical N-Acetylcysteine Improves Wound Healing Comparable to Dexpanthenol: An Experimental Study(Int College Of Surgeons, 2015) Oguz, Abdullah; Uslukaya, Omer; Alabalik, Ulas; Turkoglu, Ahmet; Kapan, Murat; Bozdag, ZubeyirIn this study, we aimed to compare the effects of dexpanthenol and N-acetylcysteine on wound healing. The wound healing process is a multifaceted sequence of activities associated with tissue restoration process. A number of investigations and clinical studies have been performed to determine new approaches for the improvement of wound healing. A total of 30 rats were divided into 3 equal groups. A linear 2-cm incision was made in the rats' skin. No treatment was administered in the first (control) group. Dexpanthenol cream was administered to the rats in the second group and 3% N-acetylcysteine cream was administered to the rats in the third group. The wound areas of all of the rats were measured on certain days. On the 21st day, all wounds were excised and histologically evaluated. The epithelialization and granulation rates between the groups were revealed to be similar in microscopic evaluations. Although the fibrosis was remarkable in the control group as compared with the other groups, it was similar in N-acetylcysteine and dexpanthenol groups. Angiogenesis rate was remarkable in the N-acetylcysteine group compared with the others. In multiple-comparison analysis, Dexpanthenol and N-acetylcysteine groups had similar results in terms of wound healing rates (P < 0.05), which were both higher than in the control group (P > 0.05). The efficacy of N-acetylcysteine in wound healing is comparable to dexpanthenol, and both substances can be used to improve wound healing.
