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Öğe Acute chest syndrome in severity of sickle cell diseases(E-Century Publishing Corp, 2014) Helvaci, Mehmet Rami; Acipayam, Can; Aydogan, Akin; Akkucuk, Seckin; Oruc, Cem; Gokce, CumaliBackground: Sickle cell diseases (SCDs) are chronic inflammatory processes on capillary level. We tried to understand whether or not there are some positive correlations between acute chest syndrome (ACS) and severity of SCDs. Methods: All patients with the SCDs were taken into the study. Results: The study included 337 cases (167 females). There were 15 patients (4.4%) with the ACS. The mean ages were similar in both groups (29.4 versus 29.7 years in the ACS group and other, respectively, P > 0.05). The female ratios were similar in both groups, too (60.0% versus 49.0%, respectively, P > 0.05). Additionally, prevalences of associated thalassemia minors were similar in them (66.6% versus 65.5%, respectively, P > 0.05). Smoking was higher in the ACS group (20.0% versus 13.9%), but the difference was nonsignificant (P > 0.05). Although the mean white blood cell count and hematocrit value of peripheric blood were higher in the ACS group, the mean platelet count was lower in them, but the differences were nonsignificant again (P > 0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, digital clubbing, pulmonary hypertension, rheumatic heart disease, cirrhosis, stroke, and mortality were higher in the ACS group, the difference was only significant for the stroke (P < 0.05), probably due to the small sample size of the ACS group. Conclusion: SCDs are chronic destructive processes on capillaries iniatiating at birth, and terminate with early organ failures in life. Probably ACS is one of the terminal consequences of the inflammatory processes that may indicate shortened survival in such patients.Öğe The Amelorative Role of Caffeic Acid Phenethyl Ester (Cape) in a Rat Model of Liver Ischemia/Reperfusion Model(Wiley-Blackwell, 2015) Dokuyucu, Recep; Oruc, Cem; Ozcan, Oguzhan; Gokce, Hasan; Bayraktaroglu, Suphi; Dogan, Hatice; Sefil, Fatih[Abstract Not Available]Öğe Colon Perforations Causing Morgagni Hernia Case(Derman Medical Publ, 2014) Ugur, Mustafa; Akkucuk, Seckin; Oruc, Cem; Kayali, Alperen; Aydogan, AkinHerniation of the intraabdominal organs through a diaphragmatic defect that occurs due to the joining anomaly of the sternal and costal segments of diaphragm is known as Morgagni Hernia. Although most of the patients with Morgagni Hernia are asymptomatic, intestinal obstruction, incarceration and strangulation can rarely occur. An 83 years old female patient admitted with acute abdomen to our clinic. Morgagni hernia was detected with preoperative thoracic and abdominal computed tomography. We aimed to present our management in Morgagni Hernia in this study.Öğe Colonoscope incarceration in an inguinal hernia: a complication of colonoscopy(Georg Thieme Verlag Kg, 2015) Tas, Adnan; Oruc, Cem; Olmez, Sehmus; Sahan, Mustafa; Ugur, Mustafa; Hakimoglu, Sedat; Demir, Mehmet[Abstract Not Available]Öğe Comparison of surgical procedures and percutaneous drainage in the treatment of liver hydatide cysts: a retrospective study in an endemic area(E-Century Publishing Corp, 2014) Akkucuk, Seckin; Aydogan, Akin; Ugur, Mustafa; Yetim, Ibrahim; Davran, Ramazan; Oruc, Cem; Kilic, ErolIntroduction: Surgical procedures are still the golden standard option in the treatment of liver cystic echinococcosis. However, minimal invasive technics like percutaneous drainage are rising trends. We aimed to compare the efficacy of surgical and percutaneous options in the treatment of liver hydatidosis in an endemic area. Methods: Patients who underwent surgical or percutaneous procedures for hydatid disease between January 2007 and December 2012 were retrospectively evaluated. Recurrence rates, hospital stay time, and related factors were analyzed. Results: There were 44 (35.5%) male and 80 (64.5%) female patients in this study. Eighty two patients (Group I) had undergone surgery (66.1%) and 42 patients (Group II) had undergone percutaneous drainage (33.9%). The mean cyst size was 7.28 +/- 2.51 cm in Group I and 8.76 +/- 3.30 cm in Group II. Nine recurrences (7.3%) were detected during study. Five of the recurrences were in Group II (11.9%) and four (4.9%) of them were in Group I. The mean length of hospital stay of all patients was 5.42 +/- 3.16 days. Discussion: Percutaneous drainage techniques can be a good alternative to surgery in selected patients. In complicated cases like cystobiliary fistula, surgery is superior to percutaneous approaches. The hospital stay time, recurrence rate and postoperative complications were not enhanced when compared to percutaneous treatment in our study. Despite all controversy about the low morbidity after percutaneous treatment, surgical approach is still a preferable option in patients with liver hydatidosis when it is performed by experienced surgeons.Öğe Left Inguinal Bladder Hernia That Causes Dilatation in the Ureter(Acad Medical Sciences I R Iran, 2016) Ugur, Mustafa; Atci, Nesrin; Oruc, Cem; Akkucuk, Seckin; Aydogan, AkinThe scrotal bladder hernia is a rare condition that may present a scrotal swelling and urinary system obstruction or in Diagnosis of this condition before the operation decreases the severe complications like bladder, injury during operation. In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications.Öğe Left inguinal bladder hernia that causes dilatation in the ureter(Academy of Medical Sciences of I.R. Iran, 2016) Ugur, Mustafa; Atcı, Nesrin; Oruc, Cem; Akkucuk, Seckin; Aydogan, AkinThe scrotal bladder hernia is a rare condition that may present as scrotal swelling and urinary system obstruction or infection symptoms. Diagnosis of this condition before the operation decreases the severe complications like bladder injury during operation. In this article, a 75-year-old man presented to our clinic with right inguinal swelling and lower urinary system infection. Inguinal bladder hernia was diagnosed after performing a computed tomography. The hernia was repaired without any complications. © 2016, Academy of Medical Sciences of I.R. Iran. All rights reserved.Öğe Missed injuries in explosion-related deaths(Taylor & Francis Ltd, 2016) Demirkiran, D. Sumeyra; Celikel, Adnan; Oruc, Cem; Demirkiran, Gokhan; Zeren, Cem; Arslan, M. MustafaIn this study we aim to compare clinical diagnoses and post-mortem diagnoses of explosion-related deaths and identify the unrevealed diagnoses missed by physicians. Forensic autopsy reports of three years between January 2012 and December 2014 were collected retrospectively and 277 explosion-related deaths are included in the study. Out of 277 cases, 245 (88.4%) of them are male and 32 (11.6%) of them are female. The mean age is 27.8years. The mean injury severity score is 37.8 +/- 14.54.90 and 32.5% of the cases died in the first 24h after getting injured. The most frequent injury is head injury (39.0%) and the second most frequent is injuries to multiple body regions (27.8%). Of eight cases of lower extremity injuries, six were found to have injuries of large vessels in post-mortem examinations. Our conclusion is that injury severity scores in cases of explosion-related injuries are higher than those in cases of general trauma. The frequency of missed diagnoses is higher in cases of vessel injuries and multiple injuries. It can be thought that small but lethal lesions can be overlooked when a major trauma is dealt with. In addition, injuries of the internal organs due to blast effects without any macroscopic examination findings can be misleading for physicians.Öğe Mortal quintet of sickle cell diseases(E-Century Publishing Corp, 2015) Helvaci, Mehmet Rami; Gokce, Cumali; Davran, Ramazan; Akkucuk, Seckin; Ugur, Mustafa; Oruc, CemBackground: Sickle cell diseases (SCDs) are chronic inflammatory processes on capillary level. We tried to understand some possible correlations between stroke and severity of SCDs. Methods: All patients with SCDs were taken into the study. Results: The study included 343 patients (174 males and 169 females). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, P>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, P>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, P>0.05). Smoking was higher among the stroke cases, significantly (26.6% versus 13.0%, P<0.05). Mean white blood cell count, hematocrit value, and mean platelet count of the peripheric blood were similar in both groups (P>0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for acute chest syndrome (ACS), digital clubbing, and leg ulcers (P<0.05 for all), probably due to the small sample size of the stroke group. Conclusion: SCDs and smoking are chronic destructive processes on endothelium, and both terminate with early organ failures in life. Probably smoking, digital clubbing, leg ulcers, ACS, and stroke are mortal quintet of the SCDs that may indicate shortened survival in such patients.Öğe Protective Effect of Nigella Sativa in an Animal Model of Colon Anastomosis With Ischemia/Reperfusion Injury(Int College Of Surgeons, 2018) Bali, Ilhan; Polat, Fatin Rustu; Aziret, Mehmet; Sozen, Selim; Oruc, Cem; Coskunkan, Ufuk; Emir, SeyfiObjective: Anastomotic leaks are one of the chief complications after gastrointestinal surgery. The aim of this study was to evaluate whether Nigella sativa administration protects against ischemia/reperfusion injury on healing of colonic anastomosis in rats. Method: Thirty male Wistar albino rats, weighing between 200 and 240 g, were used in the study. They were randomly divided into three groups (n = 10 for each group): Anastomosis (group 1), anastomosis and ischemia/reperfusion injury (group 2), and treatment group of anastomosis, ischemia/reperfusion injury, and Nigella sativa (group 3). After 7 days, serum, plasma, and colonic tissue were obtained and then all rats were sacrificed. Tissue and serum level of total oxidant status, total antioxidant status, total thiol levels, hydroxyproline, interleukin-6, and TNF-alpha were determined and specimens were histopathologically evaluated. Results: In the Nigella sativa treated rats, serum hydroxyproline levels were significantly higher, while tissue levels were significantly lower than those seen in group 1 and group 2 (P = 0.007, P = 0.01, respectively). In the Nigella sativa group, the serum levels of TNF-alpha were significantly lower than those seen in group 1 and 2 (P = 0.001). Also, in group 3, the tissue IL-6 level was significantly higher than that seen in group 1 and group 2 (P = 0.009). The histopathologic analysis showed less edema and inflammatory cell infiltration in the Nigella sativa treated group, as well as a statistically significant difference according to the Chiu classification (P < 0.05). Conclusion: The results of this study indicate that Nigella sativa has a protective and therapeutic effect against ischemia/reperfusion injury on the healing of colonic anastomosis in rats.Öğe Protective Effects of Intralipid and Caffeic Acid Phenethyl Ester (CAPE) on Hepatotoxicity and Pancreatic Injury Caused by Dichlorvos in Rats(Springer/Plenum Publishers, 2016) Alp, Harun; Pinar, Neslihan; Dokuyucu, Recep; Sahan, Mustafa; Oruc, Cem; Kaplan, Ibrahim; Senol, SerkanThe present study was aimed to the investigate the protective effects of caffeic acid phenethyl ester (CAPE) and intralipid (IL) on hepatotoxicity and pancreatic injury caused by acute dichlorvos (D) intoxication in rats. Forty-eight Wistar rats were randomly divided into seven groups each containing seven rats except control groups. The groups included control, D, CAPE, IL, D + CAPE, D + IL, and D + CAPE + IL. Total antioxidant status and total oxidative stress levels were measured by automated colorimetric assay. Tissues were evaluated using hematoxylin and eosin (H&E) staining. Tissues were analyzed with hematoxylin and eosin by using standard protocols. Also, Bcl-2, Bax and caspase-3 were evaluated by immunohistochemical method in liver tissue. Total oxidant status in control, CAPE, and IL groups were significantly lower, and total antioxidant status in the D + CAPE, D + IL, and D + IL + CAPE groups were significantly higher compared to the D group. CAPE and IL treatment decreased the apoptotic and mitotic cell count in liver tissue. Parenchymal necrosis caused by dichlorvos is observed in pancreas tissues of rats. Mild congestion and edema formation occurred in pancreas tissues following D + CAPE and D + IL therapies. These results indicate that CAPE and IL have the potential to decrease oxidative stress and hepatic and pancreatic injuries caused by acute dichlorvos intoxication. These drugs can be considered as a new method for supportive and protective therapy against pesticide intoxication.Öğe THE PROTECTIVE EFFECTS OF PEPTIDE YY AND GHRELIN IN ACUTE BILIARY PANCREATITIS(Carbone Editore, 2014) Aydogan, Akin; Akkucuk, Seckin; Ozkan, Orhan Veli; Aydin, Mehmet; Motor, Sedat; Ugur, Mustafa; Oruc, CemAim: Glzrelin and peptide YY are gut hormones that have an anti-inflammatory effect by inhibiting proinflammatory cytokines. We aimed to determine the anti-inflammatory and protective effects of ghrelin and Peptide YY. Methods: The study group included 28 patients with acute biliary pancreatitis and 38 controls. Ghrelin, peptide YY, IL-6, TNF-alpha, amylase, lipase, glucose, alanine aminotransferase, aspartate aminotransferase, leucocyte count, and hematocrit were measured three times in each patient and once in the control group. Results: Ghrelin levels tended to increase as treatment continued, but still were below the levels in the control group. On the other hand, peptide YY levels in all of the patient samples were higher than in the control group (p>0.001). Conclusion: Ghrelin is proposed as a protective hormone for acute pancreatitis. Exogenous ghrelin exhibits protective activity in caerulein-induced pancreatitis. All previous in vivo and in vitro studies have reported that exogenous PYY administration inhibited izzflammation and had protective effects. This study indicates for the first time that endogenous PYY has protective effects on pancreatitis via the inhibition of inflammation, and that these effects are stronger than the effects of ghrelin.Öğe The protective effects of peptide YY and ghrelin in acute biliary pancreatitis(Acta Medica Mediterranea, 2014) Aydogan, Akin; Akkucuk, Seckin; Ozkan, Orhan Veli; Aydin, Mehmet; Motor, Sedat; Ugur, Mustafa; Oruc, CemAim: Ghrelin and peptide YY are gut hormones that have an anti-inflammatory effect by inhibiting proinflammatory cytokines. We aimed to determine the anti-inflammatory and protective effects of ghrelin and Peptide YY. Methods: The study group included 28 patients with acute biliary pancreatitis and 38 controls. Ghrelin, peptide YY, IL-6, TNF-?, amylase, lipase, glucose, alanine aminotransferase, aspartate aminotransferase, leucocyte count, and hematocrit were measured three times in each patient and once in the control group. Results: Ghrelin levels tended to increase as treatment continued, but still were below the levels in the control group. On the other hand, peptide YY levels in all of the patient samples were higher than in the control group (p>0.001). Conclusion: Ghrelin is proposed as a protective hormone for acute pancreatitis. Exogenous ghrelin exhibits protective activity in caerulein-induced pancreatitis. All previous in vivo and in vitro studies have reported that exogenous PYY administration inhibited inflammation and had protective effects. This study indicates for the first time that endogenous PYY has protective effects on pancreatitis via the inhibition of inflammation, and that these effects are stronger than the effects of ghrelin.Öğe A Rare Cause of Small Bowel Perforation; Tree Branches Ingested: A Case Report(Derman Medical Publ, 2015) Oruc, Cem; Ugur, Mustafa; Akkucuk, Seckin; Aydogan, AkinIngestion of foreign bodies, especially, is more common among children, prisoners, alcoholics, psychiatric patients and the elderly. The majority of ingested foreign bodies pass through the intestinal tract causing perforation less than 1%. Sharp and pointed foreign bodies cause small bowel perforation more frequently than round-tipped objects. In this article, we present a small bowel perforation case of 16 year-old mentally retarded male patient that underwent surgery for the third time for swallowing a number of tree branches who had been undergone two operations previously due to foreign bodies ingestion.Öğe The role of co-administration of damage control surgery and vacuum-assisted closure in the treatment of perineal wounds(Turkish Surgical Assoc, 2018) Ugur, Mustafa; Oruc, Cem; Yildiz, Ihsan; Koca, Yavuz Savas; Daban, UgrasPerineal wounds caused by high-kinetic-energy shotgun blasts have a high mortality risk because they are often accompanied by injuries of the anus, rectum, genitourinary system, and extremities. Mortality often results from hemorrhage in the early stage and from multiple organ failure caused by sepsis in the late stage. The primary step in the treatment of patients presenting with perineal wound and hemodynamic instability caused by severe hemorrhage is to control hemorrhage and contamination using damage control surgery. After achieving hemodynamic stability, vacuum-assisted closure can be used to reduce the risks of infection and sepsis. In this report, we present a case who had a perineal wound caused by a mine blast and was successfully treated by damage control surgery and vacuum-assisted closure.Öğe Sickle cell diseases and ileus(E-Century Publishing Corp, 2014) Helvaci, Mehmet Rami; Aydogan, Akin; Akkucuk, Seckin; Oruc, Cem; Ugur, MustafaBackground: We tried to understand whether or not there is an increased incidence of ileus in patients with sickle cell diseases (SCDs). Methods: All cases with SCDs were taken into the study. Results: The study included 325 patients (160 females). The mean ages were similar in both sexes (29.3 versus 29.8 years in females and males, respectively, p > 0.05). Incidence of ileus was higher in males, significantly (3.6% versus 1.2%, p < 0.01). All of the ileus cases were able to be treated with simple and repeated red blood cell (RBC) transfusions without any surgical procedure. Smoking was higher in males, too (21.8% versus 6.2%, p < 0.001). The mean hematocrit value was also higher in males, significantly (24.4% versus 23.0%, p = 0.016). RBC units transfused, digital clubbing, leg ulcers, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, and chronic renal disease were all higher in males, too (p < 0.05 for all). On the other hand, although the general mortality, white blood cell and platelet counts of peripheric blood, painful crises per year, rheumatic heart disease, avascular necrosis of bone, cirrhosis, and stroke were all higher in males, the differences were nonsignificant probably due to the small sample sizes of the groups (p > 0.05 for all). Conclusion: Although the relatively young mean ages of the patients with SCDs, the very high incidences of ileus are probably due to the strong atherosclerotic and obstructive natures of the two pathologies, and ileus should be treated with simple and repeated RBC transfusions to restore bowel perfusion in such patients.Öğe Where should the damage control surgery be performed, at the nearest health center or at a fully equipped hospital?(Turkish Assoc Trauma Emergency Surgery, 2016) Ugur, Mustafa; Akkucuk, Seckin; Koca, Yavuz Savas; Oruc, Cem; Aydogan, Akin; Kilic, Erol; Yetim, IbrahimBACKGROUND: Transport of casualties from a combat area to a fully equipped hospital where all techniques of damage control surgery (DCS) can be performed requires a great deal of time. Therefore, prior to transport, prompt control of hemorrhage and contamination should be achieved, and resuscitative procedures should be performed at the nearest health center. The aim of the present study was to investigate the effect of the location at which DCS was performed on rates of mortality. METHODS: The present retrospective study included 51 combat casualties who underwent DCS at the present clinic or at hospitals nearest the combat area due to high kinetic energy gunshot injuries to the abdomen between 2010 and 2015. Patients were evaluated in terms of acidosis, hypothermia, coagulopathy, and mortality. RESULTS: Patients were divided into 2 groups depending on the location where the first step of DCS was performed: (1) at the present hospital or (2) at other hospitals. Group 1 comprised 26 patients (51%), and Group 2 comprised 25 (49%). Total mortality occurred in 23 (45.1%) patients, including 15 (57.7%) patients in Group 1 and 8 (32%) in Group 2. In Group 1, mean time from injury to hospital admission was longer, and deep acidosis, hypothermia, and coagulopathy were more marked. CONCLUSION: Initial surgical control of hemorrhage and contamination in patients injured by high kinetic gunshots should be promptly achieved at the nearest health center. In this way, acidosis, hypothermia, and coagulopathy can be prevented, and the risk of mortality can be reduced.
