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    Portal Hyperfusion or Hepatic Venous Congestion: Which One Affects Kupffer Cell Function More?
    (Baskent Univ, 2009) Firat, Ozgur; Mutlukoca, Nadide; Makay, Ozer; Yilmaz, Funda; Omur, Ozgur; Kitapcioglu, Gul; Yuzer, Yildiray
    Objectives: Because of their effects on the liver parenchyma after surgery, portal hyperperfusion and hepatic venous congestion are challenging problems for hepatobiliary surgeons. However, the effects of those conditions on Kupffer cells have not been established. The aim of this study was to investigate the effects of vascular streams modified by portal hyperperfusion and hepatic venous congestion on Kupffer cell function. Materials and Methods: Thirty rats were allocated into 3 groups of 10 rats each and were subjected to right portal vein ligation to induce hyperperfusion in the left lobe of the liver (group 1), occlusion of the right hepatic vein to produce venous congestion (group 2), or sham operation (controls; group 3). After 72 hours, the right and left liver lobes of the subjects were submitted separately for scintigraphic and histopathologic evaluation, and the radiocolloid uptake per gram of liver tissue and the number of Kupffer cells per square millimeter were calculated. Results: The mean technetium-99m labeled sulfur colloid uptake values of the liver tissue per gram were 0.126 +/- 0.038 for group 1, 0.106 +/- 0.032 for group 2, and 0.110 +/- 0.031 for group 3. Portal hyperperfusion significantly increased the technetium-99m labeled sulfur colloid uptake of the liver tissue per gram (P = .043). The mean number of Kupffer cells per square millimeter was calculated for each group as follows: 321 +/- 094 x 10-6 for group 1, 369 083 x 10-6 for group 2, and 355 +/- 096 x 10-6 for group 3. Both vascular streams produced no significant effects on the number of Kupffer cells (P > .05). Conclusions: In this experimental model, portal hyperperfusion affected Kupffer cell function more than did hepatic venous congestion.
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    Postoperative gemcitabine alone and concurrent with radiation therapy in locally advanced pancreatic carcinoma
    (Sage Publications Ltd, 2010) Ozkok, Serdar; Demirci, Senem; Yalman, Deniz; Zeytunlu, Murat; Nart, Deniz; Yuzer, Yildiray; Coker, Ahmet; Goker, Erdem
    Aims and background. To evaluate the treatment results of gemcitabine alone and concurrent with radiotherapy after R0/R1 resection of locally advanced pancreatic cancer. Methods and study design. From 1999 to 2005, 55 patients with stage II resected pancreatic cancer treated with gemcitabine-based radiochemotherapy were retrospectively evaluated. Initially, one cycle of induction gemcitabine was administered and followed by weekly gemcitabine concurrent with radiotherapy. After the completion of radiochemotherapy, patients received 3 additional courses of gemcitabine. Results. Thirteen patients were stage IIA and 42 were stage JIB. Forty-six patients (83.6%) had RO and 9 patients (16.4%) had R1 resection. All of the patients received induction chemotherapy and radiotherapy, all but 3 received concurrent radiochemotherapy, and 46 (84%) patients received maintenance chemotherapy. During induction, concurrent and maintenance phases of the protocol, 11%, 13.5% and 19.5% of the patients had at least one grade 3 toxicity, respectively. Within a median 47 months (range, 34-105) of follow-up, 4 (7.3%) patients had isolated local recurrence, 5 (9%) patients had local recurrence and distant metastases, and 27 (49%) had only distant metastases. Median disease-free survival and overall survival were 13 (range, 4-105) and 19 months (range, 6-105), respectively. In multivariate analysis, nodal stage, AJCC stage and number of lymph nodes dissected were the significant factors affecting disease-free survival whereas Karnofsky performance status was the only significant factor for overall survival. Conclusions. The prognosis for pancreatic cancer remains poor despite adjuvant radiochemotherapy. More aggressive treatments should be considered in patients with unfavorable prognostic factors. Free full text available at www.tumorionline.it
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    Using marginal right lobe living liver donors: Safety of expanding the margins
    (Blackwell Publishing, 2007) Dayangac, Murat; Taner, Burcin C.; Akin, Baris E.; Balci, Deniz; Uraz, Suleyman; Duran, Cihan; Killi, Refik; Ayanoglu, Omer H.; Yuzer, Yildiray; Tokat, Yaman