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Öğe Childhood, adolescents, and young adults (age 25 and younger) colorectal cancer: A multicenter study(Amer Soc Clinical Oncology, 2011) Kaplan, M. A.; Isikdogan, A.; Gumus, M.; Arslan, U. Yalcintas; Geredeli, C.; Ozdemir, N.; Koca, D.[Abstract Not Available]Öğe Clinical outcomes among ErbB2+MBC patients treated with lapatinib-capecitabine after trastuzumab progression: Role of early switch to lapatinib (TYCO study).(Amer Assoc Cancer Research, 2012) Abulkhair, O.; Uslu, R.; Sezgin, C.; Bueyuekberber, S.; Darwish, T.; Isikdogan, A.; Gumus, M.[Abstract Not Available]Öğe Clinically palpable breast abnormalities with normal imaging: Is clinically guided biopsy still required?(W B Saunders Co Ltd, 2012) Gumus, H.; Gumus, M.; Mills, P.; Fish, D.; Devalia, H.; Jones, S. E.; Jones, P. A.AIM: To determine the need for a fine-needle or core biopsy in patients with clinically palpable breast abnormalities who have negative mammographic and sonographic findings. METHOD AND MATERIALS: Over a 12-year period, 251 patients with a palpable abnormality at presentation and who had a negative ultrasound and mammogram underwent clinically guided biopsy (CGB) by breast surgeons. This was 2.7% (251/9313) of all breast biopsies performed from January 1999 to December 2010. Physical findings were qualitatively categorized into five groups as clinically normal, benign, probably benign, suspicious, and malignant at the time of initial assessment. The number of biopsies for each category and biopsy results were analysed retrospectively. RESULTS: Three (1.2%) of the 251 CGBs were reported as malignant; two (0.8%) of which were invasive. Forty-six (18.3%) of the 251 cases were regarded as clinically suspicious or malignant while the remaining 215 examinations were categorized as benign or probably benign. All three malignancies were in the clinically suspicious or malignant group. CONCLUSION: A negative ultrasound and mammogram in patients with a palpable abnormality does not exclude breast cancer; however, the likelihood is very low (1.2%). In this study, 81.7% of biopsies (205/251) could have been avoided if CGB was reserved for the clinically suspicious or malignant group only without missing any malignancies. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.Öğe Dosimetric comparison of TomoDirect and TomoHelical plans in post-mastectomy chest wall radiation therapy(Ijrr-Iranian Journal Radiation Res, 2017) Teke, F.; Dogan, M. H.; Kaya, M. A.; Gumus, M.Background: The purpose of this study was to evaluate the characteristics of TomoDirect (TD) plans compared to conventional TomoHelical (TH) plans in chest wall irradiation in patients with breast cancer. Materials and Methods: TD and TH plans for only chest wall were retrospectively created for 30 patients previously treated with TH technique in our clinic. The beam angles were arranged to cover PTV chest wall and to minimize doses to OARs, ipsilateral lung and contralateral breast in TD plan. The prescribed dose was 50 Gy in 25 fractions. Results: The mean treatment times were similar in TH and TD (310.8 and 309 s, respectively, p>0.05). There was no difference between the values of CI and HI of both plans (p>0.05). The values of Dmean, V5 and V20 of the ipsilateral lung in TD plan was significantly lower than that in TH plan for all 30 patients (p<0.001, p<0.001 and p=0.001, respectively). V25 and V30 values of the heart were significantly lower in TH than those in TD plan in left-sided chest wall irradiation (p=0.006 and p<0.001, respectively). However, V5 values in TH was significantly higher than those in TD (p<0.001). In the right-sided, there was no difference between two plans for V25 and V30 values of heart (p>0.05). Conclusion: Both of TH and TD plans produce acceptable target dose coverage in chest wall RT. Considering the risk of low-dose radiation to the critical organs; TD mode improve dose distribution.Öğe The effects of curcumin on the liver and remote organs after hepatic ischemia reperfusion injury formed with Pringle manoeuvre in rats(Verduci Publisher, 2013) Oguz, A.; Kapan, M.; Onder, A.; Kilic, E.; Gumus, M.; Basarali, M. K.; Firat, U.BACKGROUND: We aimed to investigate the effects of curcumin on ischemia/reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. MATERIALS AND METHODS: Totally 40 rats, divided into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and curcumin application, Group III hepatic IR; and Group IV as hepatic IR and curcumin application group. Ischemia was generated by hepatoduedonal ligament clamping for 30 minutes and then reperfusion is started. Curcumin capsules were opened and appropriate dose had been created within weighing scales. After calculations, the powder was diluted with saline. Fifteen minutes before the ischemia, curcumin was applied via oral gavage. Blood samples were taken from the animals for biochemical analysis at 60th minutes of the experiment in the first and second groups; 30 minutes after beginning reperfusion in the third and forth groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical and histopathological examinations. RESULTS: Plasma malondialdehyde levels were found to be higher (p < 0.001), but total antioxidant activity values were not different in IR group compared with IR + curcumin group (p > 0.05). Biochemical and histopathological evaluation of tissue samples revealed that there were no differences in total antioxidant activity, total oxidant activity and histopathologic scores in IR + curcumin group compared with values of IR group (p > 0.05). CONCLUSIONS: Curcumin did not reduce the effects of hepatic ischemia reperfusion injury on the liver and distant organs including kidneys and lungs significantly.Öğe The effects of ellagic acid on the liver and remote organs' oxidative stress and structure after hepatic ischemia reperfusion injury caused by pringle maneuver in rats(Comenius Univ, 2012) Kapan, M.; Gumus, M.; Onder, A.; Firat, U.; Basarali, Kemal M.; Boyuk, A.; Aliosmanoglu, F.Introduction: We aimed to investigate the possible protective effects of ellagic acid (EA) on the liver and remote organs against the hepatic ischemia-reperfusion injury. Methods: Forty Wistar-Albino rats were divided into four groups each containing 10 rats. Group I with laparotomy only, Group II with laparatomy and ellagic acid application, Group III with hepatic ischemia-reperfusion and Group IV with hepatic ischemia-reperfusion and ellagic acid application. Hepatic ischemia was induced by pringle's manoeuvre for 30 minutes followed by 30 minutes reperfusion period. After induction of ischemia, EA was applied via oral gavage at a dose of 85 mg/kg. Blood samples were taken from the animals for biochemical analysis at 60th minute of the experiment in all groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical analyses and histopathological examinations. Results: The administration of EA reduced serum malonyldialdehid levels (p<0.05) and liver's oxidative stress index compared with the non-use EA groups (p<0.05). Although, ameliorated liver histopathological changes were seen in EA groups, these changes were not statistically significant (p>0.05). The use of EA did not exert significant protective effects against the effects of liver ischemia-reperfusion injury on the kidney and lung. Conclusion: In our experiments ellagic acid reduced the liver oxidative stress induced by ischemia-reperfusion injury. However, no significant histological improvement was found with EA. There were no significant protective effects on the remote organ injuries induced by ischemia-reperfusion (Tab. 3, Fig. 7, Ref. 37). Full Text in PDF www.elis.sk.Öğe The effects of pomegranate on bacterial translocation in rats with obstructive jaundice(Verduci Publisher, 2013) Gumus, M.; Tekin, R.; Firat, U.; Onder, A.; Kapan, M.; Boyuk, A.; Aldemir, M.BACKGROUND: Obstructive jaundice may promote bacterial overgrowth and altered intestinal barrier function, with resultant increased bacterial translocation. AIMS: This study aimed to evaluate potential effects of pomegranate on bacterial translocation after bile duct ligation in rats. MATERIALS AND METHODS: Wistar albino rats were randomized into four groups. Group 1 underwent sham operation; Group 2 underwent sham operation and simultaneous treatment with pomegranate; Group 3 underwent common bile duct ligation, and Group 4 underwent common bile duct ligation and simultaneous treatment with pomegranate. After 8 days, the samples of systemic blood, liver, spleen and mesenteric lymph nodes (MLNs) were obtained under sterile conditions for microbiological culture. The segments of the ileum were removed for histopathological examination. RESULTS: Bacterial translocation significantly decreased in Group 4 compared to Group 3 (p = 0.007). The bacterial counts (Colony forming unit: CFU/g) of Group 3 were significantly higher than those of Groups 1, 2 and 4 (p < 0.05). The mean ileal villus heights in the Groups 1, 2, 3 and 4 were 480.5 +/- 20.5 mu m, 494.7 +/- 17.3 mu m, 356.3 +/- 25.7 mu m and 420.7 +/- 23.7 mu m, respectively. The mean villus height in Group 4 was higher than that of Group 3 (p = 0.010). CONCLUSIONS: Pomegranate has significant protective effects on intestinal mucosa barrier in obstructive jaundice and reduces bacterial translocation.Öğe Gemcitabine alone versus gemcitabine plus cisplatin for the treatment of patients with locally advanced and/or metastatic pancreatic adenocarcinoma: A retrospective analysis of multicenter study(Amer Soc Clinical Oncology, 2011) Inal, A.; Isikdogan, A.; Kos, T.; Algin, E.; Gumus, M.; Dikilitas, M.; Elkiran, E. T.[Abstract Not Available]Öğe Gemcitabine and Cisplatin Combination Chemotherapy in Triple Negative Metastatic Breast Cancer Previously Treated with a Taxane/Anthracycline Chemotherapy; Multicenter Experience(Aepress Sro, 2012) Ozkan, M.; Berk, V.; Kaplan, M. A.; Benekli, M.; Coskun, U.; Bilici, A.; Gumus, M.This study was aimed to establish clinical efficacy and tolerability of gemcitabine and cisplatin combination in patients with metastatic triple negative breast cancer progressing after anthracycline and taxane based chemotherapies. Thirty-three patients who were given cisplatin and gemcitabine for triple negative and metastatic breast cancer were evaluated retrospectively. A total of 141 cycles were administered with a median 4 cycles per patient. Median follow-up time was 14 months (range, 2-36 months). Objective response rate was 27.3%. Total clinical benefit of the combination was 48.4%. The estimated median progression free survival and median overall survival were 5 months and 14 months, respectively. The most common Grade 3 and 4 toxicity were neutropenia and thrombocytopenia observed in 10 (27.7%) and 9 (24.9%) patients, respectively. The combination of the gemcitabine and cisplatin after taxane/anthracycline is well tolerated and seems to be effective with acceptable toxicity profile.Öğe The Protective Effect of Ellagic Acid on Lung Damage Caused by Experimental Obstructive Jaundice Model(Acta Medical Belgica, 2013) Gul, M.; Aliosmanoglu, I.; Uslukaya, O.; Firat, U.; Yuksel, H.; Gumus, M.; Ulger, B. V.Aim : This study aimed to investigate protective effects of ellagic acid on lungs in an experimental obstructive jaundice model. Methods : Four groups were established, each consisting of ten randomly selected rats : Group 1: sham, Group 2: ellagic acid, Group 3 : obstructive jaundice, and Group 4 : obstructive jaundice + ellagic acid. Ellagic acid was administered orally at a dose of 60 mg/kg/day to group 2 and 4. The animals were sacrificed eight days later. The total oxidative status and the total antioxidant capacity in their lung tissue were determined, and malondialdehyde levels in their blood were measured. Histopathological changes in the lungs were examined. Results : In the obstructive jaundice group treated with ellagic acid, there was a decrease in malondialdehyde levels and a reduction in the total oxidative status and the oxidative stress index, whereas the total antioxidant capacity increased (p < 0.001). The histopathological examination showed that neutrophil leukocyte infiltration and edema formation decreased and destruction of lung parenchyma disappeared following the treatment with the ellagic acid (p < 0.05). Conclusion : This study shows that ellagic acid has a protective effect against oxidative damage in lung tissue in obstructive jaundice.Öğe The protective effects of pomegranate on liver and remote organs caused by experimental obstructive jaundice model(Verduci Publisher, 2016) Yilmaz, E. E.; Arikanoglu, Z.; Turkoglu, A.; Kilic, E.; Yuksel, H.; Gumus, M.OBJECTIVE: We aimed to investigate the protective potential of pomegranate extract on the liver and remote organs in rats with obstructive jaundice. MATERIALS AND METHODS: The rats were split into 4 groups. In Group 1 (G1) (sham group) rats, the common bile duct was mobilized without any ligation. Group 2 (G2) received a combination of the sham operation and synchronous treatment with pomegranate. Group 3 (G3) received common bile duct ligation (CBDL). Group 4 (G4) were subjected to CBDL and treatment with pomegranate. After 8 days, we measured total oxidative status (TOS) and antioxidant capacity in the rats' liver tissue and remote organs, and evaluated blood levels of malondialdehyde and total antioxidant capacity (TAC). RESULTS: G3 rats showed significantly raised malondialdehyde level as compared to G1 rats (p < 0.001). Following the pomegranate therapy, a decrease in malondialdehyde was observed (p = 0.015). TAC levels were significantly raised in the G3 rats compared to the G1 rats (p = 0.004). TAC levels dropped after pomegranate therapy (p = 0.011). CBDL caused elevated TOS levels in the liver and remote organs, with a statistically significant increase in the lung tissue (p = 0.002). TOS levels in the CBDL groups decreased after pomegranate treatment (p < 0.001). CONCLUSIONS: This study reveals the marked protective effect of pomegranate on the liver and remote organs in obstructive jaundice.Öğe Sigmoid colon torsion: mortality and relevant risk factors(Verduci Publisher, 2013) Onder, A.; Kapan, M.; Arikanoglu, Z.; Palanci, Y.; Gumus, M.; Aliosmanoglu, I.; Aldemir, M.INTRODUCTION: Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department. MATERIALS AND METHODS: The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality. RESULTS: The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of omega ans in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p = 0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002). CONCLUSIONS: Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.Öğe Splenic injuries: factors affecting the outcome of non-operative management(Springer Heidelberg, 2012) Boyuk, A.; Gumus, M.; Onder, A.; Kapan, M.; Aliosmanoglu, I.; Taskesen, F.; Arikanoglu, Z.The aim of this study was to evaluate the outcome of non-operative management (NOM) in patients with splenic injuries and to determine the predictive factors of NOM failure. Two hundred and six patients with splenic injury were admitted between January 2005 and April 2011. Of the 206 patients with splenic injury, 47 patients met the inclusion criteria of NOM. The mechanism of injury, grade of splenic injury, other intra- and extra-abdominal injuries, systolic blood pressure on admission, hemoglobin levels, number of transfusions, Injury Severity Score (ISS), Glasgow Coma Scale score, and hospitalization period were recorded. The patients were divided into two groups: those with NOM and those in whom the failure of NOM led to laparotomy. The patients were monitored for vital signs, abdominal findings, and laboratory data. NOM was abandoned in cases of hemodynamic instability, ongoing bleeding, or development of peritonitis. Independent predictive factors of NOM failure were identified. The patients managed non-operatively were compared with the patients for whom NOM failed. NOM was successful in 40 of 47 patients. There were differences between the two groups for ISS, hemoglobin levels, need for blood transfusion, and the number of associated extra-abdominal injuries. The grade of splenic injury was determined to be an important and significant independent predictive factor for the success of NOM of splenic injuries. The grade of splenic injury is an important and significant independent predictor factor for the success of NOM. NOM is not recommended in patients with high-grade splenic injury.Öğe Surgical management of pyogenic liver abscess(Verduci Publisher, 2011) Onder, A.; Kapan, M.; Boyuk, A.; Gumus, M.; Tekbas, G.; Girgin, S.; Tacyildiz, I. H.Background and Aim: Although Pyogenic Liver Abscess (PLA) has lower mortality rate in recent years due to the broad spectrum antibiotic usage, developed imaging techniques and improved intensive care services, it is still a potentially fatal disease. The objective of this study is to examine the treatment methods and our case load with the current literature. Materials and Methods: Of 55 patients with PLA, between January 2000 and December 2009, records of 28 who received surgical drainage treatment have retrospectively been analysed. Results: Nineteen (67.9%) of the patients were male, while 9 (32.1%) were female. Average age was 41.07 (15-76). Seven (25%) had associated disease. The most common symptoms were fever and abdominal pain. Twenty three (82.1%) patients had single and 5 (17.9%) had multiple cavitary lesion. Nineteen (67.9%) patients had abscess on the right and 7 (25%) had on the left one, while 2 (7.1%) had on both lobes. All were treated surgically, because of 11 (39.3%) inappropriate localization for percutaneous treatment, 6 (21.5%) insufficient percutaneous drainage, 6 (21.5%) intraabdominal free rupture and 5 (17.7%) multiple cavitary lesion. We observed 5 pulmonary complications, 5 wound infections and 2 perihepatic collections. The average hospital stay was 11.2 days. We observed only two deaths (7.1%). Conclusions: Surgical treatment is the sole option for the patients with PLA who; (a) can't be treated by percutaneous drainage or had an unsuccessful one, (b) have multiple abscess cavity, (c) are thought to have perforated abscess, (d) have additional abdominal pathology requiring laparatomy.Öğe Unusual extraperitoneal rectal injuries: a retrospective study(Springer Heidelberg, 2012) Gumus, M.; Boyuk, A.; Kapan, M.; Onder, A.; Taskesen, F.; Aliosmanoglu, I.; Tufek, A.Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. Eleven patients who had been treated for unusual rectal injuries in the General Surgery Clinic of Dicle University between 2004 and 2011 were retrospectively reviewed. The reasons for rectal injuries included foreign bodies in four cases, sexual intercourse in three cases, iatrogenic injuries in two cases, electric shock in one case, and animal horns in one case. All cases had extraperitoneal rectal injuries and all injuries were grade 2 injuries, except for the electrical burn. Primary repair was adequate for the treatment of six patients. Four patients underwent primary repair and ostomy, whereas one of the patients underwent debridement and an ostomy. The patients recovered without complications, except for one patient with sphincter insufficiency. The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.
