AKADEMİK

Uluslararası Yayınlar, Kongre Bildirileri, Kitaplar-Tezler

The Diagnostic Value of Cytokeratin 7 and 20 in Determination of Primary and Metastatic Liver Tumors

The Journal of Tepecik Education and Research Hospital, 2015

The serum levels of soluble interleukin-2 receptor levels in patients with obstructive jaundice

Hepato-gastroenterology
Increased susceptibility to infection in patients with obstructive jaundice is well recognized. Depression of reticuloendothlial system phagocytic function and suppression of cellular immunity suggested by in vivo studies have been postulated as the cause. It has been shown that increased serum soluble interleukin-2 receptor (sIL-2R) levels are the marker of immune system activation, especially T cell activation. The purpose of this study was to evaluate cellular immune system activation by measuring serum sIL-2R levels in 18 patients with obstructive jaundice (11 with choledocholithiasis, 7 with malignant obstructive jaundice), 10 patients with liver cirrhosis and 10 healthy subjects. Serum sIL-2R levels were measured by using ELISA (Boehringer Manheim). Lymphocyte subgroups were determined by flowcytometry. Serum immungolubulins (IgG, IgA, IgM) and autoantibodies such as antinuclear antibody, rheumatoid factor, anti-thyroglobulin and anti-microsomal antibody were measured. The lev...

Genetic polymorphisms of inflammatory response gene TNF-α and its influence on sporadic pancreatic neuroendocrine tumors predisposition risk

Medical Oncology, 2014
The diagnosed incidence of pancreatic neuroendocrine tumors (pNETs) is increasing; however, their etiology remains poorly understood. PNETs are a rare, heterogeneous group of tumors arising from the endocrine cells of the pancreas, and genetic risk factors for sporadic pNETs are inadequately understood. It is known that pNETs secrete biogenic amines, hormones and growth factors, tumor necrosis factor-a (TNF-α) being one of them. Furthermore, cytokines and other proinflammatory mediators have been implicated in inflammatory pancreatic diseases including pancreatitis and cancer. The aim of our study was to analyze TNF-α promoter gene polymorphisms as risk factors for pNETs using germline DNA collected in a population-based case-control study of pancreatic cancer [42 pNET cases, 78 pancreatic ductal adenocarcinoma (PDAC) cases, 17 intraductal papillary mucinous neoplasm (IPMN) and 98 healthy controls] conducted in the Athens, Greece and Izmir, Turkey areas. For subsequent analysis, we excluded cases and controls with known genetic syndromes. The CC genotype at the -1031 position was more frequent in pNET and IPMN patients (p=0.0002 and p=0.009, respectively), suggesting its possible role in pNET development. Furthermore, the AA genotype at the -308 position was overrepresented in IPMN cases (p=0.03), and AA genotype at the -238 position was more frequent in PDAC cases (p=0.03) compared to healthy individuals. With regard to tumor characteristics, no statistically significant association was detected. Our findings suggest the putative role of TNF-α -1031 polymorphism in the development of pNET and IPMN, whereas the -308 polymorphism seems to be overrepresented among IPMN cases and -238 polymorphism among PDAC cases.

Hepatic artery pseudoaneurysm as a cause of gastrointestinal system bleeding: a case report with a brief review of the literature

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2012

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Superior Mesenteric Artery Syndrome: A Rare Cause of Intestinal Obstruction. Diagnosis and Surgical Management

Indian Journal of Surgery, 2012
Superior mesenteric artery syndrome is a rare but well-known clinical entity characterized by compression of the third or transverse portion of the duodenum against the aorta by the superior mesenteric artery, resulting in chronic, intermittent, or acute, complete or partial, duodenal obstruction. The treatment for this arteriomesenteric compression includes conservative measures and surgical intervention. The aim of the study was to evaluate our surgical management and outcomes of the patients with superior mesenteric artery syndrome. The cases with superior mesenteric artery syndrome admitted between January 2000 and January 2010 were retrospectively investigated from the patients' records. All six patients had a history of chronic abdominal pain, nausea, postprandial early satiety, vomiting, and weight loss. Diagnostic methods included barium esophagogastroduodenography, upper gastrointestinal endoscopy, and computed tomography. Medical management was the first step of treatment in all cases before surgery. Of those, four underwent Roux-en-Y duodenojejunostomy and two underwent gastroenterostomy. Postoperative periods were uneventful and mean duration of hospitalization after the operations was 7 days. Conservative initial treatment is usually followed by surgical intervention for the main problem that is the narrowing of the aortomesenteric angle in patients with superior mesenteric artery syndrome. This syndrome should be considered in the differential diagnosis in patients with chronic upper abdominal pain. Duodenojejunostomy is the most frequently used procedure with a high success rate.

Autoimmune Pancreatitis and Treatment Approaches with Case Reports

Balkan Medical Journal, 2012

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The Prognostic Significance of ERCC1, RRM1, MMP7 and VEGF Expression in Locally Advanced Pancreatic Cancer Patients Treated with Gemcitabine-based Radiochemotherapy

International Journal of Radiation Oncology*Biology*Physics, 2011

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The Prognostic Significance of ERCC1, RRM1, MMP7 and VEGF Expression in Locally Advanced Pancreatic Cancer Patients Treated with Gemcitabine-based Radiochemotherapy

Hong Kong Journal of Emergency Medicine · May 2011

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Gossypiboma mimicking a distal pancreatic mass: Report of a case

Central European Journal of Medicine, 2010

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Fat replacement of the malignant pancreatic tissue after neoadjuvant therapy

International Journal of Clinical Oncology, 2010

Pancreatic lipomatosis is characterized as massive lipid infiltration of the pancreatic tissue. Although its etiology is ill defined; obesity, diabetes mellitus, chronic pancreatitis, hereditary pancreatitis, and conditions that cause pancreatic ductal obstruction, for example tumors and stones, are related to its pathogenesis. Recently, with the increased use of computerized tomography and magnetic resonance imaging, it has become possible to observe the fat replacement of the pancreas. Herein, we report a 60-year-old man complaining of abdominal pain and weight loss. Preoperative work-up revealed a locally advanced (Stage III) pancreatic adenocarcinoma. Multimodal treatment was carried out and a 100% complete response was detected after neoadjuvant therapy. The patient underwent a standard pancreaticoduodenectomy, without complications. The tissue pathology revealed lipomatosis of the pancreas. He was disease-free and symptom-free at 1 year follow-up. To our knowledge, this is the first report in the literature of pancreatic head carcinoma with total fat replacement of the pancreas after neoadjuvant chemoradiotherapy.

OP047 EPA Enriched Nutritional Support And Fast Track Surgery For Elective Periampullary Carcinoma

Clinical Nutrition Supplements, 2010

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Laparoscopic cholecystectomy in a patient with situs inversus totalis

World Journal of Gastroenterology
Currently, laparoscopic cholecystectomy is an undoubtfully optimal treatment of cholelithiasis. What about performing this procedure on a patient with situs inversus totalis and what are the difficulties of this operation for a right-handed surgeon? We presented a 35-year-old man with unknown situs inversus totalis who was admitted with epigastric pain and digestive problems. Ultrasonography and computed tomography of the abdomen confirmed the diagnosis of a gallstone. Besides, the liver and gallbladder were on the left side and the spleen was on the right. All systems were left-right reversal as mirror image in all diagnostic studies. Laparoscopic cholecystectomy was safely performed, despite of difficulties of situs inversus. The patient was discharged on postoperative day 1. It should be considered that existence of other anomalies may easily cause uninvited injuries. In the patients with situs inversus, laparoscopic cholecystectomy can be safely managed by an experienced surgeon...

Does the tumor localization in advanced pancreatic cancer have an influence on the management of symptoms and pain?

Journal of B.U.ON.: official journal of the Balkan Union of Oncology
PURPOSE:The symptoms and survival of patients with advanced pancreatic cancer show great variability according to tumor localization. The main purpose of this study was to see for any differences between the intensity of symptoms, mainly pain, and the need for analgesic treatment in advanced pancreatic cancer patients with different (head vs. body-tail) tumor localizations. METHODS: Ninety-six patients with histologically confirmed pancreatic cancer were enrolled in the study. The patients were divided into 2 subgroups according to tumor localization: group 1 (n=50) with head tumors and group 2 (n=46) with body and tail tumors. The demographic features of the patients as well as disease stages, onset of symptoms and necessity and consumption of analgesics were recorded. Patients were followed-up until death, and survival data was also analysed. RESULTS: At the time of diagnosis, patients with body and tail tumors had more advanced disease stages compared to head tumors (p=0.006). Wh...

Şiddetli pankreatit ve tedavi yaklaşımları: Mevcut sınıflamalar yeterli mi? Severe pancreatitis and treatment approaches: Are current classifications sufficient?

Journal of B.U.ON.: official journal of the Balkan Union of Oncology
G‹R‹fi Akut nekrotizan pankreatit (ANP), seyri s›ras›nda paran-kim nekrozu geliflti¤i için fliddetli akut pankreatit ile öz-deflleflmifl bir tan›md›r (1,2). Akut pankreatit; interstisiyel ödemden en fliddetli formu olan pankreatik nekroza ka-dar uzanabilen, pankreas›n non-bakteriyel inflamatuvar bir hastal›¤›d›r. Akut pankreatit ataklar›n›n yaklafl›k %20'sinde pankreasta nekroz geliflebilir, birçok hastada ise (%80) hastal›k kendini s›n›rlar ve birkaç gün içinde ge-riler (3). Son y›llarda gerek görüntüleme yöntemlerindeki geliflmeler gerekse de medikal alanlardaki geliflmeler sa-yesinde nekrotizan pankreatit tan› ve tedavisinde önemli geliflmeler olmakla birlikte, bilgisayarl› tomografi (BT) in-celemelerindeki parenkim nekrozunun seviyesiyle klinik tablo, sistemik ve infeksiyöz komplikasyonlar aras›nda her zaman birebir iliflki saptanamaz. Hastal›¤›n tan›s›n›n konmas› ile birlikte tedavide uygulanan yo¤un bak›m des-te¤i, genifl spektrumlu antibiyotikler ve cerrahi debrid-man say...

Solid pseudopapillary tumor of the pancreas as a cause of recurrent pancreatitis

Acta gastro-enterologica Belgica
Solid pseudopapillary tumor (SPT) of the pancreas is a rare pancreatic tumor mostly seen in young women. We here report a twelve-year-old girl presenting with recurrent attacks of pancreatitis. No history of a systemic disease, trauma, drug usage or infection was present. All other etiologic factors like familial, hypertriglyceridemia, hypercalcemia, cystic fibrosis, medications were excluded. On abdominal ultrasound a heterogeneous mass was noticed at the tail of pancreas. Computerized tomography and magnetic resonance imaging proved that the mass was cystic. The mass was surgically removed. The diagnosis was pancreatic solid cystic papillary epithelial neoplasm. Although acute pancreatitis due to SPT was exceptionally reported, this is the first description of SPT leading to recurrent pancreatitis especially in children.

Inflammatory myofibroblastic tumour

Canadian journal of surgery. Journal canadien de chirurgie, 2009

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Xanthogranulomatous pancreatitis treated by duodenum-preserving pancreatic head resection

Xanthogranulomatosis is an idiopathic, rare process in which lipid-laden histiocytes are deposited at various locations in the body. We present two cases who were treated by duodenum-preserving pancreatic head resection and eventually diagnosed as having xanthogranulomatous pancreatitis. A 30-year-old caucasian man was admitted to our clinic for vague abdominal pain and epigastric dullness. Magnetic resonance cholangiopancreatography and endoscopic retrograde pancreatography suggested the existence of chronic pancreatitis. Another 34-year-old caucasian woman was admitted to our clinic because of right upper quadrant pain. Magnetic resonance cholangiopancreatography demonstrated a dilatation and stone of the main pancreatic duct. Based on a diagnosis of chronic pancreatitis, pancreatic head resection was planned and a laparotomy was performed in both of cases. In both cases, duodenum-preserving pancreatic head resection was performed. Macroscopic and microscopic findings revealed xanthogranulomatous inflammation, which led to a diagnosis of xanthogranulomatous pancreatitis. Although this type of pancreatitis is extremely rare, it is important to keep it in mind for a differential diagnosis because it may simulate chronic pancreatitis or a malignant tumor on imaging.

Biliary intraductal papillary mucinous neoplasia: three case reports

Virchows Archiv, 2009

Intrahepatic cholangiocarcinoma is subdivided as mass-forming, periductal-infiltrating, and intraductal-growing types. Intraductal-growing type is an entity described in recent years as mucin-producing intrahepatic cholangiocarcinoma or intrahepatic (biliary) intraductal papillary mucinous neoplasia (b-IPMN). b-IPMN is classified as adenoma, borderline tumor, carcinoma in situ, and carcinoma, from benign to malignant. Using a different classification, b-IPMNs are subdivided into intestinal, pancreatobiliary, gastric, or oncocytic based on morphology of the cells forming the lesion and expression of MUC1, MUC2, and MUC5 gene proteins in the mucin family. The clinical and histopathological features of b-IPMN diagnosed in three cases are presented herein. Case 1 was classified as borderline. Case 2 was diagnosed as carcinoma in situ. Case 3 had large invasive areas, and was diagnosed as carcinoma. In all three cases, immunohistochemical investigation revealed MUC1 and MUC5AC to be positive, and MUC2 to be negative. We present herein three cases diagnosed with the clinical and pathological findings of a new entity in the literature, b-IPMN, and we discuss the macroscopic, histological, and immunohistochemical features.

A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

World Journal of Emergency Surgery, 2009

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Minimally invasive treatment of patients with bronchobiliary fistula: a case series

Journal of Medical Case Reports, 2009

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Can hyperbaric oxygenation decrease doxorubicin hepatotoxicity and improve regeneration in the injured liver

Journal of Hepato-biliary-pancreatic Surgery, 2009

Background/Purpose Portal vein embolization is used in the treatment of hepatocellular cancer, with the purpose of enhancing resectability. However, regeneration is restricted due to hepatocellular injury following chemotherapeutics (e.g. doxorubicin). The aim of this study was to investigate whether hyperbaric oxygenation (HBO) can alleviate the hepatotoxicity of chemotherapy and improve regeneration in the injured liver. Methods Rats were allocated to four experimental groups. Group I rats were subjected to right portal vein ligation (RPVL); rats in groups II and III were administered doxorubicin prior to RPVL, with group III rats being additionally exposed to HBO sessions postoperatively; group IV rats was sham-operated. All rats were sacrificed on postoperative day 7, and liver injury was assessed by measuring alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Protein synthetic ability was determined based albumin levels and liver regeneration by the mitotic index (MI). Results The AST and ALT values of group II rats were significantly higher than those of group I, but not those of group III. Rats treated with doxorubicin and HBO (groups II and III) showed slightly but not significant differences in albumin levels than those subjected to only RPVL or sham-operated. The MI was significantly increased in groups I, II, and III, with the MI of group III rats significantly higher than those of group I rats. Conclusions Based on our results, we conclude that HBO treatment has the potential to diminish doxorubicin-related hepatotoxicity and improve regeneration in the injured liver.

The Effects of the Pringle Maneuver on the Pancreas: Can Octreotide Be Protective

Journal of the Pancreas, 2009

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Spontaneous cutaneous fistula of infected liver hydatid cyst

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2009

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P117 OMEGA3 FATTY ACIDS INHIBIT OXIDATIVE STRES IN A RAT MODEL OF LIVER REGENERATION

Clinical Nutrition Supplements, 2008

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A New Technique of Biliary Reconstruction After “High Hilar Resection” of Hilar Cholangiocarcinoma with Tumor Extension to Secondary and Tertiary Biliary Radicals

Annals of Surgical Oncology, 2008

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Is it more dangerous to perform inadequate packing

World Journal of Emergency Surgery, 2008

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DOES MATRIX METALLOPROTEINASE ACTIVITY PREDICT SEVERITY OF ACUTE PANCREATITIS

Anz Journal of Surgery, 2006

Background:  Matrix metalloproteinases (MMP) modulate end-organ complications of acute pancreatitis, but the correlation between increased MMP production and histological severity of disease remains unclear. We examined the role of MMP and pancreas histology on experimental acute pancreatitis.Methods:  Forty male Wistar albino rats were subjected to cerulein-induced pancreatitis (8, 16, 24 and 32 h groups) or sham treatment. The animals were killed at different time points and pancreatic tissues were harvested to assess MMP (1, 2 and 9) activity and inflammatory changes.Results:  Compared with other groups, 8 h group had decreased tissue MMP-1 concentrations. MMP-9 concentrations were lower in 24-h and 32-h groups, as were histological severity scores. MMP-2 activity did not differ among groups. Pancreatitis was prominent in 8-h, 16-h and 24-h groups by means of histology.Conclusion:  Induction of pancreatitis by cerulein altered pancreatic MMP levels in the early phase of inflammation. Inhibition of MMP-2 and MMP-9 paralleled histological scores. Therefore, MMP may have a predictive value to assess histological severity.

Surgical management of superior mesenteric artery syndrome: Report of four cases

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2007

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Management of small bowel volvulus in a patient with simultaneous pancreas-kidney transplantation (SPKT): a case report

Journal of Medical Case Reports, 2007

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A rare clinical entity misdiagnosed as a tumor: peliosis hepatis

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2007
Peliosis hepatis (PH) is a rare condition characterized by the presence of cystic, blood filled cavities within the hepatic parenchyma. Regardless of the reason, surgery should be performed under meticulous control of hemorrhage, if it is thought to be unavoidable. In this case report, ominous results of clinically misdiagnosed PH have been presented. PH should be kept on mind in all patients with hepatic mass, especially presented by sudden onset distention of the abdomen. Every effort should be done for the differential diagnosis with other cystic conditions like hydatid cyst in endemic areas.

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Gallstone ileus as an unexpected complication of cholelithiasis: diagnostic difficulties and treatment

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES

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Bimanual 'bi-finger' liver hanging maneuver: an alternative and safe technique for liver hanging

HPB, 2007

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A new approach to the surgical treatment of parasitic cysts of the liver: Hepatectomy using the liver hanging maneuver

World J Gastroenterol 2007

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The role of SPIO-enhanced MRI in the detection of malignant liver lesions

Clinical Imaging, 2006

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Effect of contrast agents in the experimental model of acute pancreatitis

AKADEMİK GASTROENTEROLOJİ DERGİSİ, 2005

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Akut pankreatit olgularinin kanita dayali tip kilavuzlari rehberliğinde incelenmesi

AKADEMİK GASTROENTEROLOJİ DERGİSİ, 2005

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Combined segmental and focal adenomyomatosis involving the body of the gallbladder

Journal of Clinical Ultrasound, 2005

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The effects of vascular bed expansion in steatotic rat liver graft viability

Transplant International, 2004

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Gemcitabine Combined with Infusional 5Fluorouracil and High-Dose Leucovorin for the Treatment of Advanced Carcinoma of the Pancreas

Chemotherapy, 2004
5-Fluorouracil (5-FU) and gemcitabine are the major active drugs in the treatment of pancreatic cancer. Twenty-two patients with advanced pancreas cancer were treated with a new chemotherapy regimen consisting of infusional 5-FU and high-dose leucovorin with gemcitabine (GEMFUFOL). A total of 200 cycles of chemotherapy were administered. The response rate was 27.3%, all responses being partial. The median survival time and 1-year survival rate were, respectively, 13 months and 60.4%. The toxicity was very low and severe hematological toxicity was exceptional. The GEMFUFOL regimen can be an active regimen for the treatment of advanced pancreatic cancer and has a low toxicity.

The effects of vascular bed expansion in steatotic rat liver graft viability

Transplant International, 2004

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The importance of cyclin D1 and Ki67 expression on the biological behavior of pancreatic adenocarcinomas

Pathology Research and Practice, 2004
The aim of this study was to evaluate the role of cyclin D1 and Ki67 proteins involved in cell-cycle control as a prognostic factor in pancreatic carcinomas.We examined formalin-fixed, paraffin-embedded material from 59 pancreatic adenocarcinomas, for which appropriate clinical and prognostic data were available. The standard streptavidin–biotin immunoperoxidase method was used for immunostaining with cyclin D1 and Ki67. The extent of positive nuclear and cytoplasmic cyclin D1 staining was graded semiquantitatively. Ki67 reactivity was quantified and expressed as the percentage of stained nuclei. Staining with cyclin D1 and Ki67 was compared with histopathological prognostic features, and their relation with survival was also tested statistically.Patients whose tumors were cyclin D1-positive showed perineural invasion significantly more frequently than did patients with cyclin D1-negative tumors at the immunohistochemical level. In addition, tumors with lymphatic vessel invasion and without showed a significant difference in terms of cytoplasmic cyclin D1 staining. Ki67 indices were statistically different in stage groups. There was a significant and direct correlation between Ki67 index and nuclear cyclin D1 staining scores. No relation with survival was found.Our results suggest that cell-cycle proteins do not directly affect the prognosis of patients with pancreatic adenocarcinoma. Conversely, cyclin D1-positive tumors tend to have perineural invasion more frequently. In addition, lymph vessel invasion is another factor related to cyclin D1 reactivity of the cells. Ki67 indices differ statistically in stage groups.

Legal liability and medico-legal problems of surgeons in Turkey

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2004
Medicine, as a profession, is quite a hard commitment, with the main aim of giving care to patients. Physicians assume professional accountability not only to their patients and relatives but also to legal authorities. In case of insufficiency in exercising this multi-dimensional accountability, they may confront legal and ethical issues. A high index of awareness of responsibility and accountability may help them avoid getting involved in unwilling situations. This article revisits physicians' and, in particular, surgeons' legal liability to medical legislation and jurisprudence in Turkey, with emphasis on medico-legal consequences.

Prognostic significance of mean nuclear volume in pancreatic adenocarcinoma

Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology, 2003
To evaluate the correlation of stereologically estimated mean nuclear volume of tumor cells with other clinicopathologic prognostic features and survival in pancreatic ductal adenocarcinoma. The study included 27 patients with primary pancreatic ductal adenocarcinoma. A stereologic method proposed by Gundersen et al was used for the estimation of mean nuclear volume in hematoxylin and eosin-stained histologic sections of each case. Mean nuclear volume values were compared statistically with histopathologic prognostic feature groups and survival. The mean nuclear volume values of tumor cells ranged from 296.83 to 982.79 microns 3 (mean, 633.906 +/- 212.310). Higher values of mean nuclear volume were significantly related to advanced tumor stage and the presence of distant metastasis (Kruskal-Wallis, P = .036; Mann-Whitney U, P = .020). In contrast, nodal stage, tumor grade, perineural invasion, lymphatic and blood vessel invasion, and size of tumor showed no statistical relation to m...

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Effects of hepatectomy and arginine enriched diet on colonic mucosa originated inflammatory cytokines

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2003
To assess the effects of arginine-enriched diet and partial hepatectomy in rats on gut-originated inflammatory cytokines. Of 24 rats, Group 1 and 2 animals were fasted 24 hours before surgery, Group 3 and 4 animals received regular plus arginine-enriched diet(AED). Group 2 and 4 animals had undergone 30% hepatic resection. Leukotriene B4 (LT B4) levels were detected in colonic mucosa and mucosal perfusates immediately after resection. Mean leukocyte counts (MLC) were detected also in the mucosa. In the basis of fasting situation regardless hepatectomy, all MLC were lower in Group 3 and 4 but LTB4 levels both in mucosa and perfusate were higher. On hepatectomy based comparison there was not any statistically significant difference between groups but mucosal perfusate LTB4 levels. But when hepatectomy added on fasted animals MLC levels were lower than fed by AED + sham operation. LTB4 levels were insignificant in both perfusate and mucosa. When hepatectomy added on AED animals (Group ...

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Evaluation of prosthetic mesh closure in semiopen-abdomen patients

Hernia, 2002

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Immunohistochemical Detection of PS2 Protein and Heat Shock Protein70 in Pancreatic Adenocarcinomas. Relationship with Disease Extent and Patient Survival

Pathology Research and Practice, 2002

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Protective effects of carnitine in an experimental ischemia–reperfusion injury

Pathology Research and Practice, 2002
Clinical Nutrition, 2002

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Pancreatic adenocarcinoma: detection and staging with dynamic MR imaging

European Journal of Radiology, 2001
Clinical Nutrition, 2002

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Mirizzi's syndrome: diagnostic and surgical considerations in 25 patients

Journal of Hepato-biliary-pancreatic Surgery, 2000

Mirizzi's syndrome is a rare complication of long-standing cholelithiasis. Many surgical approaches of varying complexity have been advocated for treatment. However, the distorted extrahepatic biliary anatomy continues to be threatening, with a high risk of biliary complications. Presented here is a series of 25 patients with Mirizzi's syndrome who were treated at the Dokuz Eylul University Hospital since 1985. Type I lesion (without cholecystocholedochal fistula) was encountered in 11 patients, while the remaining 14 had type II lesions (with cholecystocholedochal fistula). Preoperative diagnoses were made in 14 of the 25 patients (56%). Follow-up in 17 patients ranged from 1 to 96 months (mean, 40 months). Unfortunately, the remaining 8 patients were lost to follow-up after discharge. The morbidity rate in our series was 32%, while no mortality was encountered. During long-term follow-up, no biliary stricture was diagnosed. Following an uneventful postoperative course, all of our patients are symptom-free and doing well, with normal liver function. We conclude that partial cholecystectomy alone is a safe and sound surgical approach for the treatment of type I lesions. For type II lesions, depending on the size of the fistula, either primary closure over a T-tube, or bilio-digestive anastomosis, preferably Roux-en-Y, can be an appropriate treatment modality, with a low morbidity rate.

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Tumor angiogenesis as a prognostic predictor in pancreatic cancer

Journal of Hepato-biliary-pancreatic Surgery, 2000
The purpose of this study was to evaluate the role of angiogenesis, proliferative activity (assessed by Ki-67 expression), p53 and ras-oncogene (H-ras) expression, and conventional clinicopathologic factors in predicting overall survival rates in patients with pancreatic ductal adenocarcinoma. We followed-up 22 patients with ductal adenocarcinoma of the pancreas for a median of 19 months (range, 2 to 44 months). Angiogenesis was quantitated as vascular surface density (VSD) and the number of vessels per mm2 stroma (NVES) after microvessels were immunostained, using factor VIII-related antigen. p53, H-ras, and Ki-67 proteins were also determined immunohistochemically. VSD and NVES showed significant correlations with increased proliferative activity, poor tumor differentiation, and tumor size of 3 cm or more (P = 0.001, P = 0.013, and P = 0.047, respectively). The overall 2-year survival rate of 33.3% in patients with high VSD and NVES values was significantly worse than that of 66.6% estimated in patients with low microvessel count (log rank, 3.97; P = 0.046). In multivariate analysis using the Cox model, VSD was found to be an independent prognostic factor of survival (P = 0.039). H-ras and p53 expressions were not correlated with angiogenesis parameters. We conclude that, in pancreatic ductal adenocarcinoma, angiogenesis is closely related to tumor growth and patient survival.

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Beneficial Effects of Pentoxifylline Pretreatment in Non-Heart-Beating Donors in Rats

Transplantation, 2000
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Loss of hIRH mRNA Expression from Premalignant Adenomas and Malignant Cell Lines

Biochemical and Biophysical Research Communications, 1996

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Tiroid kanseri ve cerrahi tedavisi

Çağdaş Cerrahi Dergisi - 1995

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The acute effects of pancreaticopyelostomy on the pancreas and kidney. A preliminary study

International Journal of Pancreatology, vol. 14, no. 3,227-235, December 1993

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Esophagocoloplasty in the management of postcorrosive strictures of the esophagus

Hepato-gastroenterology - 1990

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 Prof. Dr. Ahmet Çoker - Tüm hakları Saklıdır. ©