Yazar "Unalp O.V." seçeneğine göre listele

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    The effects of the pringle maneuver on the pancreas: Can octreotide be protective?
    (2009) Unalp O.V.; Aydin U.; Yazici P.; Nart D.; Yenisey C.; Kavak T.; Zeytunlu M.; Coker A.
    Objective: The aim of this study was to evaluate the negative effects of the Pringle maneuver on pancreatic tissue with respect to the time of performing the maneuver. Moreover, the efficacy of octreotide therapy on pancreatic changes at the time of the Pringle maneuver was assessed. Animals: Fifty male Wistar Albino rats were randomized into 5 groups. Design: The groups were formed as follows: Group A: sham operation, Group B: Pringle maneuver for 30 min plus octreotide (PM30-OCT), Group C: Pringle maneuver for 60 min plus octreotide (PM60-OCT) and Group D: Pringle maneuver for 30 min plus 0.9 % saline solution (PM30-SS), Pringle maneuver for 60 min plus 0.9 % saline solution (PM60-SS, Group E). Main outcome measures: Blood samples for the evaluation of both amylase and lipase levels were taken via the portal vein. Levels of glutathione, glutathione reductase, catalase, myeloperoxidase, nitric oxide, xanthine oxidase, malondialdehyde, tumour necrosis factor alpha (TNF-alpha), and interleukin-1 beta (IL-1 beta) were assessed in the excised pancreatic tissue. Results: In the octreotide-treated groups, the catalase level was significantly higher in Group B (PM30-OCT) as compared to Group C (PM60-OCT). Amylase, lipase, NO and IL-1 beta levels were higher in Group C (PM60-OCT). In the saline solution-treated groups, the catalase level was significantly higher in Group E (PM60-SS) than in Group D (PM30-SS) while nitric oxide and glutathione levels were found to be significantly lower in Group E (PM60-SS) than in Group D (PM30-SS). Comparison of those groups using the Pringle maneuver for 30 minutes, the octreotide-treated group (Group B, PM30-OCT) was found to have a higher degree of edematous change than the saline-treated group (Group D, PM30-SS). Among the treatment groups, TNF-alpha expression decreased with increasing occlusion time. Conclusion: In this study, pancreatic damage and the duration of the Pringle maneuver are directly proportional to each other. Moreover, the administration of octreotide prior to the Pringle maneuver contributed to the pancreatic damage.
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    Factors CD10, cytokeratin 19 and staging-grading systems in predicting the prognosis of pancreatic neuroendocrine tumors (PNET)
    (2012) Uguz A.; Unalp O.V.; Yeniay L.; Farajov R.; Yoldas T.; Sezer T.O.; Ipek N.Y.; Nart D.; Yilmaz F.; Sozbilen M.; Coker A.
    Objective. This study was undertaken to examine prognostic factors in patients with pancreatic neuroendocrine tumors (PNET) undergoing surgical treatment to evaluate the prognostic value of recently introduced immunohistochemical staining methods of CD10 and cytokeratin 19. Materials and Methods. Tumors were classified on the basis of 2004 WHO Classification Guidelines and European Neuroendocrine Tumor Society (ENETS) grading system. Immunohistochemical staining with Ki- 67, CD10 and cytokeratin 19 was performed. Results. A total of 36 patients with a mean age of 53.7 ± 12.0 years were included. Overall, 33 patients had a long-term follow-up with 10 patients (30.3%) experiencing recurrence. Seven patients (21.1%) died. Clinical parameters that were associated with recurrence included liver metastasis at the time of surgery and extra-pancreatic invasion (p < 0.005). Positive surgical margins, extra-pancreatic invasion, and multi-focal disease were associated with reduced survival (p < 0.05). In addition, there was an association between survival and WHO 2004 classification (p < 0.05). Conclusions. Although vascular and peripancreatic invasion showed increased risk of recurrence, they were unrelated to survival. Of the histopathological examinations, Ki-67 and mitotic activity showed a correlation with both recurrence and survival, while immunohistochemical staining with cytokeratin 19 and CD 10 did not provide adequate prognostic information.
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    Success of microvascular surgery; repair mesenteric injury and prevent short bowel syndrome: A case report
    (2007) Aydin U.; Unalp O.V.; Yazici P.; Guler A.
    Background: Superior mesenteric injury is a rare entity but when it occurs, short bowel syndrome is one of the uninvited results of the emergency surgical procedures. Case presentation: We present a 19-year-old boy with blunt abdominal trauma which caused serious mesenteric injury. Because ultrasound revealed free intraabdominal fluid, he underwent emergency laparotomy. Adequate vascularization of approximately 20 cm of proximal jejunal segment and approximately 20 cm of terminal ileum was observed. Nevertheless, the mesentery of the rest of the small intestine segments was ruptured completely. We performed an end-to-end anastomosis between a distal branch of the superior mesenteric artery in the mesentery of the ileal segment and a branch of the superior mesenteric artery using separate sutures of 7.0 monofilament polypropylene. The patient's gastrointestinal passage returned to normal on the postoperative day 2. He recovered without any complication and was discharged from hospital on the postoperative day seven. Discussion: In this case report, we emphasize the importance of preservation of injured mesenteric artery due to abdominal trauma which could have resulted in short bowel syndrome. © 2007 Aydin et al; licensee BioMed Central Ltd.