Browsing by Author "Aydin, M"

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Biliary Tract Reconstruction With Autologous Rectus Sheath Graft -: an Experimental Study
(H G E Update Medical Publishing S A, 2005) Aydin, M; Bakir, B; Kösem, M; Kisli, E; Gençelep, M
Background/Aims: Common bile duct injuries which cause significant morbidity and mortality are one of the most serious complications of cholecystectomies. They can be repaired by various approaches. Methodology: We used an autologous graft obtained from the posterior sheath of the rectus muscle in biliary tract reconstruction for common bile duct defect. This experimental study was carried out on six dogs. A tissue fragment was excised from the posterior sheath of the rectus muscle together with the fascia transversalis and peritoneum. A channel from the fascial graft was formed around a T-tube. The autologous rectus sheath graft was sutured to the common bile duct as a segmental conduit graft. Afterwards, blood biochemistry values and liver histopathology were investigated. Dogs were studied by T-tube cholangiography 4 months postoperatively just prior to removing the T-tube and again 2 months later at relaparotomy. The hepatic parenchyma, intra- and extrahepatic bile ducts were detected by ultrasonography during the last 2 months, one time in fifteen days. Results: There was no anastomotic insufficiency. The fascial graft gained an appearance similar to bile duct in dogs. Postoperatively, no change in blood biochemical parameters was observed, and in the preoperative and postoperative periods no histopathological change in the liver was Conclusions: These findings indicate that the use of an autologous fascial graft to repair common bile duct injuries as a conduit graft for segmental bile duct loss may be a feasible and alternative method of treatment.
Blood and Tissue Findings in the Diagnosis of Mesenteric Ischaemia: an Experimental Study
(Walter de Gruyter Gmbh, 1998) Aydin, M; Guler, O; Ugras, S; Bakir, B; Sekeroglu, R
In this experimental study, after inducing mesenteric ischaemia in dogs, we investigated routine blood biochemistry, serum malondialdehyde (MDA) levels, histopathological changes and tissue MDA levels in the liver and intestines. The study group included 10 dogs. Six dogs which underwent sham operation served as controls. In the study group, the MDA level in liver tissue increased after superior mesenteric artery (SMA) ligation. Various degrees of necrosis were seen in the ileal biopsies 10 hours after the ligation. Hyperaemia and focal necrosis in the liver accompanied the intestinal necrosis if it was limited within the mucosa. However, massive or centrilobular necrosis was observed in the liver of those dogs which had intestinal necrosis that extended into muscular layers. MDA levels in intestinal tissue measured after SMA ligation were significantly higher than the preligation levels. On the other hand, the difference between serum and tissue MDA levels was not significant. The alterations in MDA were not significant in the sham group. Thus it is concluded that the serum MDA levels are valuable markers of diagnosis in intestinal ischaemia.
Comparison of the Analgesic Effect of Betamethasone and Diclofenac Potassium in the Management of Postoperative Haemorrhoidectomy Pain
(Taylor & Francis Ltd, 2005) Kisli, E; Baser, M; Güler, O; Aydin, M; Kati, I
Background: Outpatient postoperative haemorrhoidectomy pain remains a difficult problem. The purpose of this study is to compare the results of the use of betamethasone with diclofenac potassium in postoperative pain following haemorrhoidectomy. Material and methods : Closed haemorrhoidectomy was performed on 40 patients who were diagnosed grade III, grade IV haemorrhoid on physical examination. Patients were divided equally randomized into two groups, prospectively (betamethasone was used for 20 patients and diclofenac potassium was given for 20 patients). A verbal categorical scale was used to evaluate postoperative pain (for pain intensity, none = 0, mild = 1, moderate = 2 and severe = 3). Results : The amount of narcotics required on postoperative first, second and third day were significantly less in the betamethasone group than in the diclofenac potassium group (P < 0.001) (Pearson Chi-Square test). Conclusion : Results indicate that use of betamethasone provides more effective analgesia than diclofenac potassium for postoperative pain management in the haemorrhoidectomy patient.
The Effect of Lymphatic Blockage on the Amount of Endotoxin in Portal Circulation, Nitric Oxide Synthesis, and the Liver in Dogs With Peritonitis
(Springer verlag, 1999) Güler, O; Ugras, S; Aydin, M; Dilek, FH; Dilek, ON; Karaayvaz, M
This study was performed to investigate the effect of lymphatic blockage on the amount of endotoxin in portal venous blood, nitric oxide synthesis, the release of aspartate aminotransferase (AST) from the liver, hepatic damage, and survival in an experimental model of dogs with peritonitis, The dogs were divided into a control group (group 1), an unligated thoracic duct peritonitis group (group 2), and a ligated thoracic duct peritonitis group (group 3), Peritoneal fluid and blood from the portal vein and femoral artery were taken for peritoneal culture, endotoxin, and AST assay, respectively, and liver biopsies were performed to assess for hepatic damage and for nitric oxide assay, There was a higher bacteria count in the peritoneal fluid from group 3 than in that from group 2 (P < 0.0001), Bacteria grew in all of the blood cultures from the group 2 animals, but growth was seen only in blood cultures from four of the group 3 animals. The levels of endotoxin, nitrite, and AST levels in group 3 were significantly increased in comparison with those in group 2 (P < 0.0001), Extensive hepatocellular necrosis,vith hemorrhage was observed in the livers of the group 3 animals, and all of them died,within 48 h, The results of this study suggest that the blockage of lymph flow has a negative effect on liver and survival in dogs with peritonitis, and that hepatic damage is directly related to the amount of endotoxin to which the liver is exposed,
The Effect on Survival of Thoracic Duct Ligation in Experimental Peritonitis
(H G E Update Medical Publ Ltd., 1999) Aydin, M; Guler, O; Yigit, MF; Ugras, S; Bozkurt, H
BACKGROUND/AIMS: It has been shown that systemic bacteremia and endotoxemia in peritonitis is mainly related to lymphatic transport via the thoracic duct. This study was performed to investigate the effect on mortality of thoracic duct ligation in experimental peritonitis. METHODOLOGY: Thirty dogs were divided into three groups. Groups I, II, and LII were control, unligated, and ligated thoracic duct peritonitis groups, respectively. Liver biopsy, blood and peritoneal fluid cultures were taken and survival time was established. RESULTS: Bacteria were determined in peritoneal fluid in all animals in groups II and III. Growing bacteria numbers in group III were two times higher than in group II. While bacterium was grown on blood cultures in all group II animals, growing was determined on blood cultures in only 2 animals in group III. Diffuse necrosis was determined in the liver of 2 animals who died within 72 hours in group II. Another 8 animals had minimal focal necrosis in their livers. Diffuse and progressive necrosis was determined in the liver of all animals in group III. The difference between liver necrosis in group II and group III was found to be statistically significant (p=0.002). CONCLUSIONS: This experimental study demonstrates that thoracic duct ligation decreases bacteremia rates clearly but that mortality increases significantly.
Eighteen-Month Follow-Up of Cystovaginoplasty: a New Augmentation Operation for Repair of Vesicovaginal Fistulae
(Scandinavian University Press, 1997) Yilmaz, Y; Atan, A; Odabas, O; Aydin, S; Gurel, SA; Aydin, M
We present an 18-month follow-up of a cystovaginoplasty case. Surgery was performed because of a large vesicovaginal fistula. A new technique using the vagina as a pouch was utilized.
The Influence of Sphincterotomy and Hepatic Plexus Vagotomy on Ascending Infections of the Biliary Tract: an Experimental Study in Dogs
(H G E Update Medical Publ Ltd., 1998) Guler, O; Aydin, M; Ugras, S; Demirtas, I; Berktas, M; Gonenci, R
BACKGROUND/AIMS: Hypertonic dyskinesia of the sphincter of Oddi is an important factor in the pathogenesis of postcholecystectomy syndrome, and this condition is usually treated by endoscopic sphincterotomy. However, it has been demonstrated that the biliary tract may also be cont;aminated after sphincterotomy. In various experimental studies, it has been established that the choledochal pressure decreases by a mean of 32% to 28% after hepatic plexus vagotomy. This experimental study was performed to investigate whether hepatic plexus vagotomy and/or sphincterotomy result in contamination of the biliary tract. METHODOLOGY: Thirty street dogs were divided into three equal groups. The three groups underwent simple laparotomy, transduodenal papillotomy, hepatic plexus vagotomy, respectively, and gallbladder bile samples were taken from all of them. Relaparotomy was performed after four weeks, and again, bile samples were taken from the gallbladder. All bile samples were examined microbiologically. RESULTS: Bacteria were not found in the first bile samples taken from the three groups. Bacteria were not found in the bile samples taken during the second surgery in the simple laparotomy and hepatic plexus vagotomy groups. However, both aerobic and anaerobic bacteria were found in the papillotomy group in seven of the ten dogs. CONCLUSION: These results demonstrate that hepatic plexus vagotomy decreased choledochal pressure and did not cause contamination of the biliary tract. It may be a treatment of choice to prevent postcholecystectomy syndrome resulting from sphincter of Oddi dysfunction.
Pulmonary Endarteritis and Subsequent Embolization To the Lung as a Complication of a Patent Ductus Arteriosus -: a Case Report
(Westminster Publ inc, 2004) Bilge, M; Üner, A; Özeren, A; Aydin, M; Demirel, F; Ermis, B; Özkökeli, M
The authors describe a case of pulmonary endarteritis and subsequent embolization to the lungs as a complication of a patent ductus arteriosus (PDA). Although 2-dimensional echocardiography has been shown to be of great value in the diagnosis of patients with infective endocarditis, echocardiographic detection of vegetation within the pulmonary artery and subsequent embolization to the lung is extremely rare and, to our knowledge, has been previously reported only in a few cases. In brief, our case not only shows the importance of echocardiography in making this rare diagnosis but also emphasizes the role of echocardiography as an effective means of following up such a case.
Rothmund Thomson Syndrome Associated With Esophageal Stenosis: Report of a Case
(Springer verlag, 1998) Guler, O; Aydin, M; Ugras, S; Kisli, E; Metin, A
Rothmund Thomson syndrome (RTS) is a rare autosomal recessive disorder which is primarily diagnosed by clinical manifestations that include poikiloderma, short stature, sparse hair distribution, juvenile cataracts, small hands and feet, bone defects, photosensitivity, hypogonadism, defective dentition, onychodystrophy, and hyperkeratosis. Although a few reports have been published on patients with RTS associated with gastrointestinal abnormalities, to our knowledge the case described herein is the first documentation of a patient with RTS having upper esophageal stenosis.
Use of an Autologous Vein Graft and Stent in the Repair of Common Bile Defects: an Experimental Study
(Springer verlag, 1998) Karaayvaz, M; Ugras, S; Guler, O; Aydin, M; Alkan, I; Yigit, MF
We investigated the effectiveness of using an autologous vein graft and stent in the repair of large defects of the common bile duct (CBD) in a canine model. A 3-cm segment of the vena cephalica antibrachii and a 2-cm segment of the CBD were removed from eight healthy mongrel dogs with normal blood biochemistry levels. A stent was passed through the vein segment, and one end was introduced into the proximal end of the CBD while the other end was introduced into the distal end. The venous graft was then sutured to the CBD. A liver biopsy was taken for histopathological examination during laparotomy and relaparotomy. Blood samples were obtained on postoperative days 7, 14, and 20 for biochemical examination. The defect was effectively repaired by the autologous vein graft and stent in 7 dogs, after the exclusion of 1 dog that died of hemorrhage 3 days after the operation. No change in blood biochemistry was observed postoperatively, and no histopathological change in the liver was found in the preoperative or postoperative periods. These findings indicate that the use of an autologous vein graft and stent to repair CBD injuries may be a feasible and alternative method of treatment.
Utilising an Ileal Segment in the Posterior Urethral Replacement Procedures Using Anal Sphincter To Provide Continence in Dogs
(Tohoku Univ Medical Press, 1998) Yilmaz, Y; Aydin, M; Bakir, B; Atilla, MK; Odabas, Ö; Aydin, S
We aimed to replace an ileal segment in the place of posterior urethra using the anal sphincter as a continence mechanism. The experiment was carried on three male street dogs. In the first stage, only urethral replacement with an ileal segment was done and pulled through the anal sphincter in a male dog to see if anal sphincter would do any help for continence. A protruding stoma was created on the perineum. Perineal end of the ileal segment was sutured to the bulbous urethra in the other two male dogs to provide urethral patency in the second step of the operation. The dog in which the first operation was made gained continence on the 12th postoperative day. The other two male dogs, in which ileourethral anastomosis were made, became continent on the postoperative 12th and 15th days. No residual urine was found by catheterisation performed after urination. In controls, neither the stoma nor the anastomosis sites developed stenosis. This procedure may be applied in patients with complete incontinence who can not be corrected by any other surgical procedures, and a very good cosmetic result may be obtained.