Browsing by Author "Bircan, Huseyin Yuce"

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Complications Following Endoscopic Retrograde Cholangiopancreatography: Minimal Invasive Surgical Recommendations
(Public Library Science, 2014) Koc, Bora; Bircan, Huseyin Yuce; Adas, Gokhan; Kemik, Ozgur; Akcakaya, Adem; Yavuz, Alpaslan; Karahan, Servet
Background: ERCP has a complication rate ranging between 4% and 16% such as post-ERCP pancreatitis, hemorrhage, cholangitis and perforation. Perforation rate was reported as 0.08% to 1% and mortality rate up to 1.5%. Besides, injury related death rate is 16% to 18%. In this study we aimed to present a retrospective review of our experience with post ERCP-related perforations, reveal the type of injuries and management recommendations with the minimally invasive approaches. Methods: Medical records of 28 patients treated for ERCP-related perforations in Okmeydani Training and Research Hospital between March 2007 and March 2013 were reviewed retrospectively. Patient age, gender, comorbidities, ERCP indication, ERCP findings and details were analyzed. All previous and current clinical history, laboratory and radiological findings were used to assess the evaluation of perforations. Results: Between March 2007 and March 2013, 2972 ERCPs were performed, 28 (0.94%) of which resulted in ERCP-related perforations. 10 of them were men (35.8%) and 18 women (64.2%). Mean age was 53.36 +/- 14.12 years with a range of 28 to 78 years. 14 (50%) patients were managed conservatively, while 14 (50%) were managed surgically. In 6 patients, laparoscopic exploration was performed due to the failure of non-surgical management. In 6 of the patients that ERC-Prelated perforation was suspected during or within 2 hours after ERCP, underwent to surgery primarily. There were two mortalities. The mean length of hospitalization stay was 10.46 +/- 2.83 days. The overall mortality rate was 7.1%. Conclusion: Successful management of ERCP-related perforation requires immediate diagnosis and early decision to decide whether to manage conservatively or surgically. Although traditionally conventional surgical approaches have been suggested for the treatment of perforations, laparoscopic techniques may be used in well-chosen cases especially in type II, III and IV perforations.
The Effects of Aging on Lymphocyte Subgroups in Males and Females
(int Scientific Literature, inc, 2014) Inal, Ali; Koc, Bora; Bircan, Huseyin Yuce; Ogan, Ebru; Yavuz, Alpaslan; Kemik, Ozgur
Background: Age-associated immune senescence is a catch-all phrase that has been used to describe a plethora of changes to the immune system across the lifespan. Aging is associated with a decline in immune function. Our aim in this study was to investigate how lymphocyte subgroups in peripheral blood are affected by aging among males and females. Material/Methods: Study participants were 70 healthy individuals from 3 different age groups, observed from January 2010 to January 2012. The average levels of CD3+, CD4+, CD8+, CD19+, CD16+/CD56+, CD3+/CD69+, and CD19+/CD69+ were determined for each group and compared in terms of age and sex. Results: We found significant reduction in the level of CD3+T cells related with age, but no significant changes in CD19+ B cell levels (p<0.005). Aging significantly reduces activated B cell (CD19+/CD69+) levels in males (p<0.005). Conclusions: Our results show that there may be differences between males and females in terms of immune senescence.
Massive Alimentary Tract Bleeding Due To Cytomegalovirus Infection in an Elderly Patient
(Pagepress Publ, 2014) Koc, Bora; Bircan, Huseyin Yuce; Altaner, Semsi; Cinar, Ozlem; Ozcelik, Umit; Yavuz, Alpaslan; Kemik, Ozgur
In recent years, cytomegalovirus (CMV) has been recognized as an important common pathogen in immunocompromized patients. This is due to the increasing number of immunosuppressive medications, intensive cancer chemotherapy use, recurrent transplantations, progressively aging population, and the higher number of human immunodeficiency virus infections. Cytomegalovirus infection especially interests the gastrointestinal tract, anywhere. from the mouth to the anus. Namely, the most commonly affected area is the colon, followed by duodenum, stomach, esophagus and small intestine. The most frequent manifestations of CMV colitis are: diarrhea. fever, gastrointestinal bleeding and abdominal pain. We report here the case of an 82-year-old woman, who was treated for non Hodgkin lymphoma: she was admitted to the emergency, department for abdominal pain and diffuse arthralgia following massive upper and lower-gastrointestinal bleeding, due to duodenal and colonic ulcers related to CMV infection.