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Öğe Anatomic Basis for Penis Transplantation: Cadaveric Microdissection of Penile Structures(Lippincott Williams & Wilkins, 2016) Tiftikcioglu, Yigit Ozer; Erenoglu, Cagil Meric; Lineaweaver, William C.; Bilge, Okan; Celik, Servet; Ozek, CuneytWe present a cadaveric dissection study to investigate the anatomic feasibility of penile transplantation. Seventeen male cadavers were dissected to reveal detailed anatomy of the dorsal neurovascular structures including dorsal arteries, superficial and deep dorsal veins, and dorsal nerves of the penis. Dorsal artery diameters showed a significant decrease from proximal to distal shaft. Dominance was observed in one side. Deep dorsal vein showed a straight course and less decrease in diameter compared to artery. Dorsal nerves showed proximal branching pattern. In a possible penile transplantation, level of harvest should be determined according to the patient and the defect, where a transgender patient will receive a total allograft and a male patient with a proximal penile defect will receive a partial shaft allograft. We designed an algorithm for different levels of penile defect and described the technique for harvest of partial and total penile transplants.Öğe Comparison of skin effects of immediate treatment modalities in experimentally induced hydrofluoric acid skin burns(Wiley-Blackwell, 2015) Songur, Meltem K.; Akdemir, Ovunc; Lineaweaver, William C.; Cavusoglu, Turker; Ozsarac, Murat; Aktug, Huseyin; Songur, Ecmel; Tiftikcioglu, Yigit O.Hydrofluoric acid (HF) burns cause immediate damage and painful long-term sequellae. Traditionally, chelating agents have been used as the initial treatment for such burns. We have introduced epidermal growth factor (EGF) into an HF model to compare EGF with Ca2+ and Mg2+ treatments; 40 Sprague Dawley rats were divided into five groups. Each rat suffered a 6 x 4 cm(2) burn induced by 40% HF. Group 1 had no treatment, group 2 had saline injected beneath the burn, group 3 received magnesium sulphate injections, group 4 received calcium gluconate and group 5 received EGF. Specimens were evaluated via planimetry and biopsy at intervals of 4, 8, 24 and 72 hours. Fluid losses were significantly less in the Mg2+ and EGF groups. The EGF group had the smallest burn area, least oedema, least polymorphonuclear granulocyte (PMN) infiltration, most angiogenesis and highest fibroblast proliferation of any group (P < 0.005). EGF limited HF damage morphologically and histologically more effectively than Ca2+ or Mg2+. This finding indicates that HF treatment via growth factors may be an improvement over chelation therapy.Öğe Impact of Aortic Cross-Clamping Time on Peripheral Nerves: Experimental Model(Medical Tribune Inc, 2015) Akdemir, Ovunc; Akdemir, Ilknur; Cavusoglu, Turker; Lineaweaver, William C.; Ates, Utku; Zhang, Feng; Erbas, OytunPurpose: The present study investigated the correlation between extend aortic cross-clamping time and peripheral nerve injury on rats. Methods: 24 male, Sprague Dawley rats were divided into 3 groups; (a) control group: abdomen was directly closed after reached aorta, and followed by 72 hours, (b) short-term ischaemia-reperfusion group: peripheral nerve ischemia was induced in rats by supraceliac aortic occlusion for 20 min followed by 72 h of reperfusion, (c) long-term ischaemia-reperfusion group: peripheral nerve ischemia was induced for 30 min followed by 72 h of reperfusion. Preoperative and postoperative, electromyography (EMG) recordings were done. End of 72 h, the sciatic nerves were harvested from each animal for histopathological and biochemical analysis. Results: The mean compound muscle action potential (CMAP) amplitude of long-term ischaemia-reperfusion group was statically significant reduced when compared to the control group (p < 0.01). However, the mean distal latency value of long-term ischaemia-reperfusion group was statically significant increased (p < 0.01). On the other hand, there were statically significant differences between the results of malondialdehyde, edema and ischemia fiber degeneration grades on control and long-term ischaemia-reperfusion group (p < 0.001). Conclusion: This study demonstrated that the extending cross clamping time directly harms the peripheral nerve of rats.Öğe Perioperative management of penile transplantation(Wiley, 2016) Tiftikcioglu, Yigit O.; Erenoglu, Cagil M.; Lineaweaver, William C.; Zhang, FengÖğe Preventive Effect of Edaravone Against Ischemia-Reperfusion Injury in Rat Epigastric Island Flaps: An Experimental Study(2023) Tatar, Burak Ergün; Uyanıkgil, Yiğit; Lineaweaver, William C.; Akdemir, Ovunc; Erbaş, Oytun; Zhang, FengObjective Ischemia-reperfusion (I/R) injury is tissue damage occurring when blood returns to a tissue after an ischemic phase. Reperfusion initiates a cascade of acute inflammatory processes that end in cell death, tissue malfunction, and necrosis. Edaravone (3-methy-1-pheny1-2-pyrazolin-5-one) is a powerful and unique synthetic radical scavenger. In this research, the effects of edaravone on I/R damage were investigated. Material and Methods: 16 adult male Sprague–Dawley rats were utilized. Eight rats were allocated at random into two groups. Group 1 (the control group) experienced ischemia and reperfusion of an abdominal skin flap for 10 hours without therapy. Group 2 (treatment group) received an intraperitoneal injection of 3 mg/kg edaravone 10 hours prior to ischemia and reperfusion in an abdominal skin flap. Using planimetry, flaps were examined at intervals of 1, 3, 7, and 10 days. Then, flaps were removed for biochemical (measurement of tissue glutathione [GSH], tissue protein, lipid peroxidation [MDA], and nitric oxide [NO] levels) and histopathological (measurement of tissue glutathione [GSH], tissue protein, lipid peroxidation [MDA], and nitric oxide [NO] levels) Results: We found no significant changes (p > 0.05) between groups 1 and 2 in terms of NO, MDA, GSH, or planimetric analyses. Group 2 had a lower neutrophil count than group 1, however the difference was not statistically significant (p > 0.05). Conclusion Edaravone is a very effective antioxidant. Nevertheless, our research indicates that it may not influence I/R damage in a skin flap model.Öğe Submandibular artery: Bilobed platysma myocutaneous flap for total lower lip reconstruction(Churchill Livingstone, 2014) Akdemir, Ovunc; Lineaweaver, William C.; Celik, Servet; Cinar, Celal; Zhang, FengBackground: Lower lip reconstruction following cancer resection includes a variety of clinical and microsurgical options. Objective: We have developed a myocutaneous flap for full thickness reconstruction with a functioning muscle. Technique: In all patients, the submandibular artery was outlined using computerized tomographic angiography and Doppler. The flap was designed after resection. The first lobe was designed to fill the defect and was outlined 90 degrees from the defect margin, with the submandibular artery in the center of the flap. A second lobe was then outlined 90 degrees from the first lobe. The flap was raised along with the platysma muscle and artery, with the first lobe rotated to the lip and the second lobe inset into the first lobe site, permitting neck closure without skin redundancy. Results: From January to May 2012, 17 patients were treated with this flap, and all flaps survived. All of the patients had oral continence at sixteen months, and electromyography documented platysma function. Conclusion: The flap provides single-stage lower lip reconstruction with functional muscle. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.Öğe A Systematic Review of Penile Replantations: May It Guide us in Penile Allotransplantation?(Wolters Kluwer Medknow Publications, 2018) Tiftikcioglu, Yigit Ozer; Erenoglu, Cagil Meric; Lineaweaver, William C.Introduction: Penis replantation cases may serve as a model for identifying important elements in developing clinical penile allotransplantation. Material and Methods: We reviewed 82 published cases of penis replantation. Results: Besides the basic repair of urethra and corpora, we found that dorsal artery and dorsal nerve repair was associated with significantly better sensory return. Deep dorsal vein repair was associated with decreased sensation and increased complication rates. Conclusion: Penile allotransplantation may need to incorporate these findings.
