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  • Küçük Resim
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    Apendiksin Nadir Bir Anomalisi: Apendiks Vermiformis Agenezisi
    (2017) Aydın, Oktay; Aydın, Gülçin; Pircanoğlu, Eyüp; Civelek, Serdar; Pehlivanlı, Faruk; Karaca, Gökhan
    Apendiks vermiformis agenezisi oldukça nadirdir. Apandisit açısından kuşkulanılan vakalarda tesadüfi olarak bulunan, sıklığı yaklaşık 1/100.000 olan bir durumdur. Bu yazıda, akut karın tanısı ile operasyona alınan 24 yaşında kadın hastada, apendiks vermiformis agenezisi olgusu sunuldu
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    Ectopic liver tissue on the gallbladder: An incidental mass in laparoscopy
    (Academy of Medical Sciences of I.R. Iran, 2016) Karaca, Gökhan; Özden, Hüseyin; Pehlivanli, Faruk; Recep Pekcici, M.; Yıldırım, Yeşim
    Ectopic liver is a rare developmental abnormality. It is often asymptomatic and could be determined during the surgery. Although it could be detected in different areas of the body either below or above of the diaphragm, ectopic liver is usually found on the wall of the gallbladder. The importance of the ectopic liver came from the elevated risk of development of hepatocellulary carcinoma from ectopic tissue. Ectopic liver tissue could also mimic malign masses in radiographic studies. Ultrasound-guided percutaneous biopsie scould be helpful for preoperative diagnosis. Recently, widespread usage of laparoscopic techniques caused an increase on the description of ectopic liver tissues located on the gallbladder. Due to the potential risk of developing malignancy. the resection of the mass should be the preferred approach for an incidentally or intraoperatively diagnosed ectopic liver tissue. © 2015, Academy of Medical Sciences of the I.R. Iran. All rights reserved.
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    EFFECTS OF THYMOQUINONE, ZEOLITE AND PLATELET RICH PLASMA ON THE HEALING OF ISCHEMIC COLONIC ANASTOMOSIS
    (2019) Pehlivanlı, Faruk; Karaca, Gökhan; Aydın, Oktay; Altunkaya, Canan; Şahiner, İbrahim Tayfun; Özden, Hüseyin; Uzun, Hafize
    Objective: Anastomosis on ischemic intestines is a problematicissue in daily surgical routine. In this study, we investigated thepotential effects of thymoquinone, zeolite and platelet rich plasma.Material and Methods: Fifty rats were divided into five groups.In the sham group all rats underwent colonic anastomosis withoutany ischemic insult. Colonic anastomosis was performed aftermesenteric ischemia was induced by clamping the superiormesenteric artery in other study groups. In the control group, nomedication was given to the rats after ishemic anastomosis. InZeolite group and thymoquinone group, Zeolite and thymoquinonewere applied locally on the anastomosis. In the platelet richplasma group, platelet rich plasma was applied locally on theanastomosis. All the rats were sacrified on the 10th day. Blood andtissue samples were retrieved.Results: Hydroxyproline levels were not different between thegroups. Bursting pressure was higher in the thymoquinone groupthan the control group. Reepithelization was higher than thezeolite group in the sham and thymoquinone groups. TNF-? andIL 1? levels were significantly higher in the sham group than allthe other groups. TNF-? and IL 1? levels were also significantlyhigher in the thymoquinone, zeolite and platelet rich plasmagroups than the control group and higher in the thymoquinonegroup than the zeolite and platelet rich plasma groups.Inflammation and ischemic necrosis levels were not differentbetween the groups.Conclusion: Our data is suggesting that thymoquinone andplatelet rich plasma have positive effects on ischemic anastomosishealing, while thymoquinone has the best results.
  • Küçük Resim
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    Gecikmiş tanı nedeniyle püerperiumda apandisit: olgu sunumu
    (2017) Sağsöz, Nevin; Taşdelen, Ceyhan; Bulanık, Murat; Karaca, Gökhan
    Lohusalık döneminde ortaya çıkan enfeksiyon ve ağrı gibi nedenlerin sıklıkla gebelik ve doğuma bağlı olduğu kabul edilir. Ancak, diğer önemli nedenlerde akılda tutulmalıdır. Akut apandisit gebelikte obstetrik nedenler dışında, en sık karşılaşılan akut cerrahi gerektiren durumdur. Bu yazıda; püerperal dönemde karın ağrısı, yüksek vücut ısısı ve yüksek C-reaktif protein ile kliniğimize başvuran akut apandisit tanısı alan bir hasta sunuldu ve konu literatür bilgisi eşliğinde tartışıldı
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    Healing Effects of Single-Dose Triptolide in Rats with Severe Acute Pancreatitis
    (2020) Özden, Hüseyin; Kilitci, Asuman; Şahin, Yaşar; Karaca, Gökhan; Umudum, Haldun; Yıldız, Ahmet; Dulkadiroğlu, Erkan
    Aim: Severe acute pancreatitis (SAP) carries high morbidity and mortality risk. If the proinflammatory response phase of SAP cannot be controlled, it may result in multiorgan failure (MOF). Nuclear factor-kappa B (NF-?B) activation plays an important role in the development of MOF. In this study, it was aimed to investigate the healing effects of triptolide, an anti-inflammatory and immunosuppressive agent in rats with SAP. Material and Methods: A total of 20 Wistar-Albino rats were divided into two groups as the SAP and triptolide treatment (TT) groups. SAP was induced by intraperitoneal injection of cerulean (50 mg/kg) in both groups. TT group was administered a single dose (0.2 mg/kg) triptolide 24 hour after the induction of SAP. Serum ALT, AST, GGT, Lipase, Glucose, ALP and amylase levels and pancreatic tissue samples were examined. Results: Serum glucose and amylase levels were found to be significantly lower in the TT group (p=0.011 and p=0.035, respectively). There was no significant difference between the groups in terms of other biochemical parameters. Pancreatic edema, acinar cell degeneration, fat necrosis, intrapancreatic&perivascular inflammation, inflammation in the peripancreatic fat tissue were common histopathological findings in both groups. There was no significant difference between the groups in terms of histopathologic changes. Conclusion: Cerulein-induced pancreatitis is a successful method for experimental SAP. The healing effects of single-dose triptolide treatment are not evident in the early phase of SAP. The therapeutic effects of triptolide on inflammatory and oxidative stress were not significantly approved by histopathological and biochemical parameters by the pancreatic tissue.
  • Küçük Resim
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    Karın Ağrısının Nadir Bir Nedeni: Apendiks Mukosel Olgu Sunumu
    (2018) Pehlivanlı, Faruk; Karaca, Gökhan; Daphan, Çağatay Erden; Eroğlu, Anıl Oğuz; Vural, Sevilay; Coşkun, Figen
    Apendiksin mukoseli, apendiks lümeninin anormal müsinöz sekresyonu sebebiyle dilatasyonu ile karakterize nadir görülen klinik bir durumdur. İnflamatuar bir duruma veya tümör kaynaklı olabilir. Mukosel, mukozal hiperplazi, müsinöz kistadenom veya müsinöz kistadenokarsinom sonucunda oluşabilir. Apendiks müsinöz kistadenomu en sık görülen şekli olup çok farklı klinik durumlarla kendini belli eder. Apendektomi spesimenlerinin %0.2?0.3’ünde saptanır. Preoperatif tanı konması zordur ve sıklıkla laparotomide saptanır. Rüptür riski, klinik olarak cerrahları zorlamaktadır. Cerrahi planlanmasında tam bir konsensus olmamakla birlikte genellikle apendektomi ya da sağ hemikolektomi ameliyatları uygulanır. Bu yazımızda plastron apendisit tanısıyla takip edilip sağ alt kadran ağrısı ve kitle saptanan apendiks mukosel olgusunu literatür eşliğinde tartıştık.
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    KOLESİSTEKTOMİ PLANLANAN HASTALARDA KOLELİTİYAZİSİN VE KOLESİSTEKTOMİNİN TİYOL/DİSÜLFİD DENGESİ'NE ETKİSİ
    (2019) Aydın, Oktay; Pehlivanlı, Faruk; Karaca, Gökhan; Daphan, Çağatay; Aydınuraz, Kuzey; Boyunağa, Akan; Neselioglu, Salim
    Amaç: Bu prospektif kontrollu klinik çalışmanın amacıyetişkinlerde komplike olmamış kolelitiyazisin ve buna yönelikuygulanan laparoskopik kolesistektomi ameliyatının hastalardatiyol/disülfid dengesine etkilerini araştırmaktır.Gereç ve Yöntem: Çalışmaya 18-80 yaş arası sağlıklı gönüllükatılımcılar (Kontrol grubu, n=30) ve 18-80 yaş arasındasemptomatik safra taşı tanısı konulup laparoskopikkolesistektomi planlanan hastalar (KLS grubu, n=30) alındı.Çalışmada sağlıklı gönüllülerden bir defaya mahsus ve tümhastalardan ameliyattan 1 saat önce ve ameliyattan 24 saat sonraiki kez olmak üzere 2 mL venöz kan örnekleri alındı veserumlarda tiyol/disülfid düzeyleri incelendi.Bulgular: Çalışmanın sonunda Kontrol grubunun Nativ Tiyol,Total Tiyol ve Disülfid değerleri KLS grubunun ameliyat öncesiölçülen değerlerine göre daha yüksek bulundu (p<0.001). KLSgrubuna ait ameliyat sonrası bakılan Nativ Tiyol, Total Tiyol veDisülfid değerlerinin Kontrol grubuna göre düşük olduğu tespitedildi (p<0.001). Ayrıca Kontrol grubunda Disülfid/Nativ Tiyolve Disülfid/Total Tiyol oranları KLS grubu ameliyat sonrasıdeğerlerine kıyasla daha yüksek ve Nativ Tiyol/Total Tiyol oranıdaha düşük olarak ölçüldü. Diğer yandan KLS grubununameliyat öncesi ve ameliyat sonrası laboratuvar değerleriarasında da farlılık olmadığı görüldü.Sonuç: Bu sonuçlarla kolelitiyazis hasta grubunda hem ameliyatöncesi hem de ameliyat sonrası doğal tiyol, toplam tiyol, disülfidseviyelerinin düşük olması kolelitiyazis kaynaklı oksidatif stresnedeniyle bu bileşiklerin bu hastalarda tüketildiğini düşündürdü.Diğer yandan bu hastalarda oksidatif metabolizmada olan budeğişikliklerin safra kesesinde taş oluşumunu provakeedebileceği de düşünüldü.
  • Küçük Resim
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    Kırıkkale Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalında 2013-2017 Yılları Arasında Rastlantısal Safra Kesesi Kanseri Sıklığı
    (2017) Karaca, Gökhan
    AMAÇ: Safra kesesi tümörleri sıklıkla yaşlılarda görülen agresif seyirli tümörlerdir. Genellikle ilerlemiş halde tanı konabilen safra kesesi tümörlerine erken dönemde kolesistektomi yapılmaksızın tanı konulması oldukça zordur. Tüm gastrointestinal sistem maligniteleri içinde 5. Sıklıkta görülen safra kesesi tümörlerinin tüm evrelerdeki safra kesesi tümörleri göz önüne alındığında tanı sonrası 5 yıllık yaşam oranı %5 olarak görülmektedir. GEREÇ VE YÖNTEMLER: Bu çalışmada Kırıkkale Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı'nda 2013 -2017 tarihleri arasında taşlı veya taşsız akut ve kronik kolesistit tanısıyla ameliyat edilen 867 hastanın histopatolojik sonuçları incelenmiştir. BULGULAR: Bu dönemde 867 hasta içinde 7 malignite olgusu saptanmış olup 6 tanesi adenokarsinom, 1 tanesi nöroendokrin tümör tanısı almıştır. Serimizde malignite oranı % 0,8 olarak bulunmuştur.SONUÇ: Maligniteden ve bilier komplikasyonlardan kaçınmak için safra kesesi taşlarına erken ameliyat önerilebileceğini düşünmekteyiz.
  • Küçük Resim
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    May dexpanthenol, platelet-rich plasma, and thymoquinone provide new hope to maintain liver regeneration after partial hepatectomy?
    (2019) Aydın, Oktay; Pehlivanlı, Faruk; Karaca, Gökhan; Aydın, Gülçin; Altunkaya, Canan; Bulut, Huri; Aydınuraz, Kuzey
    Background/Aims: Complete liver regeneration may not always be possible after liver injuries and/or partial liver resection. The present study investigated the effects of dexpanthenol, platelet-rich plasma (PRP), and thymoquinone on liver regeneration in rats after partial hepatectomy (PH). Materials and Methods: A total of 34 Wistar albino rats, each weighing 250-280 g, were randomly separated into four groups. PH was performed, and except for the control group, intraperitoneal dexpanthenol, PRP, or thymoquinone was administered to the relevant groups for 7 days. All rats were then sacrificed, and the liver tissues were examined histopathologically and biochemically. Results: PRP reduced all oxidant-antioxidant parameters in rats that experienced liver regeneration, but did not create histopathological improvement in the liver tissue. Dexpanthenol had a histopathological improving effect on the liver tissue, but had no effect on biochemical parameters. Thymoquinone showed no histopathological or biochemical effects on liver regeneration. Conclusion: Although dexpanthenol did not affect biochemical oxidative parameters, it was considered to have improving effects on liver regeneration histopathologically. In addition, it was thought that PRP may be used for treatment of ischemia-reperfusion injury and cholestatic damage of the liver. Nevertheless, further studies are required on these subjects.
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    The healing effects of prp and thymoquinone on dssinduced inflammatory bowel disease in rats
    (2021) Özden, Hüseyin; Karaca, Gökhan
    Aim: Crohn's disease and ulcerative colitis are included in inflammatory bowel disease (IBD). The study aimed to compare the healing effects of two promising therapeutic agents: Platelet Rich-Plasma and Thymoquinone (TQ) on DSS induced IBD.Materials and Methods: The animals were divided into three groups as IBD (n=10), PRP treatment (n=10) and TQ treatment (n=10). Experimental IBD was initiated through the oral intake of 5% Dextran Sodium Sulfate (DSS) in drinking water. PRP (0.5 cc) and thymoquinone dissolved in distilled water (100mg/kg) were daily administered rectally to PRP treated group animals for seven days. All animals were sacrificed and rectal tissue calprotectin, lactoferrin and hydroxyproline levels were assessed on the seventh day. Total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels were statistically compared.Results: Rectal tissue calprotectin, lactoferrin and hydroxyproline levels were higher in the IBD group (p<0.001, p<0.001 and p<0.001, respectively). TQ treated group animals had lower rectal tissue lactoferrin levels (p<0.011) and TOS and OSI levels (p=0.001 and p=0.001, respectively) than PRP group animals and also the highest antioxidant capacity. Conclusion: Calprotectin, lactoferrin, and hydroxyproline levels are valuable markers in the presence of IBD and response to treatment. Oxidative stress is an important problem that cannot be avoided in unattended cases. Our experimental IBD model found TQ treatment to be more effective in healing than PRP treatment.
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    The healing effects of the topical mesenchymal stem cells application on colonic anastomosis subjected to ischemia reperfusion injury
    (Veteriner Fakultesi Dergisi, 2021) Özden, Hüseyin; Karaca, Gökhan; Bulut, Huri; Niyaz, Mehmet; Gömeç, Muhammed; Daphan, Çağatay E.
    Intestinal ischemia reperfusion injury (IRI) is a challenging problem and it adversely affects the healing of colonic anastomosis. Our experimental study aimed to investigate the role of mesenchymal stem cells (MSC) administration in the healing of colonic anastomosis. A total of 33 rats were grouped as Control, IRI and MSC treatment groups. Three rats were reserved for obtaining MSCs. Colonic resection and anastomosis procedure was performed in all groups. Anastomotic line was wrapped with MSCs impregnated spongostan after colonic anastomosis in the rats of the MSC treatment group. All rats were sacrificed and anastomotic line were sampled for examination on the post operative seventh day. Tissue hydroxyproline (HP) levels and anastomotic bursting pressures were statistically compared. Anastomotic bursting pressures were found to be significantly high in MSC treatment group rats. The lowest anastomotic bursting pressure was detected in IRI group rats. Hydroxyproline content of the anastomotic sites were also found to be significantly higher in the rats of the MSC treatment group when compared with the IRI group rats. Our study showed that the detrimental effects of IRI on the healing process of colonic anastomosis in an experimental model may be alleviated with the treatment of MSCs. © 2021, Veteriner Fakultesi Dergisi. All rights reserved.