Browsing by Author "Kiziltan, R."
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Article Are Appendix Weight and Length Related To Inflammatory Parameters and Alvarado Score in Acute Appendicitis(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Kiziltan, R.; Çalli, I.; Karayil, A.R.; Aras, A.; Kotan, Ç.We aimed to investigate if appendix weight and length affects clinical presentation. This study prospectively enrolled 50 patients who were operated with the diagnosis of acute appendicitis. The appendix material was weighed in milligram. Then, the diameter of the appendix was measured in millimeter from its widest point using a surgical ruler. The length of the appendix was measured in millimeter using the same ruler. As appendix length may have influenced its weight, weight in milligram per millimeter was used for standardization. The obtained value was expressed as the unit weight (mg/mm). In order to make a comparison by the obtained unit weight, the patients were divided into two groups. Among 50 patients enrolled in the present study, 24 (48%) were men and 26 (52%) were women. The mean CRP level of the study population was 29.4 (3-160). The mean appendix diameter measured with ultrasonography at the preoperative period was 8.49 mm (range 6-13 mm), and the mean appendix diameter measured with a ruler at the postoperative period was 10.3 mm (range 8-20 mm). There was approximately a 2 mm difference between these measurements which were made from the widest points. In conclusion, it was found that the unit weight of the appendix increased proportionally to the CRP level. The appendix would be more edematous, have a greater diameter and weight, and be more likely to perforate in patients with a higher unit weight. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Article Comparison of Icodextrin With Thymoquinone: a New Hope for Postoperative Adhesions(Medknow Publications & Media Pvt Ltd, 2017) Yilmaz, O.; Kiziltan, R.; Celik, S.; Yildirm, S.; Alp, H. H.; Aras, A.; Kotan, C.Objective: The purpose of this study was to compare the effects of thymoquinone and icodextrin in rats within the framework of an experimental adhesion model. Materials and Methods: Rats were separated into three groups: (1) a control group consisting of rats that had 2 ml of isotonic solution administered intraperitoneally, (2) an ICO group administered with 2 ml of 4% icodextrin, and (3) a TQ group administered thymoquinone (10 mg/kg), all following cecal abrasion. The three groups underwent a reoperation on the 7th postoperative day. Hydroxyproline levels were analyzed in the resected adhesive tissues, and histopathological investigations were conducted. Blood samples were collected for biochemical analyses. Results: Fewer postoperative adhesions were observed in the ICO and TQ groups compared with the control group. A comparison of the TQ and ICO groups revealed lowers levels of postoperative adhesions in the TQ group. Compared with the control group, malondialdehyde, 8-OH-deoxyguanosine/deoxyguanosine (8-OHdG/10dG), Coenzyme Q10 (CoQ10), and CoenzymeQ10/reduced CoenzymeQ10 (CoQ10/CoQ10H) values were found to be lower in the TQ and ICO groups. When the TQ and ICO groups were compared with respect to their biochemical parameters, the results for all of the four parameters were found to be statistically significantly lower in the TQ group (P < 0.000). The levels of hydroxyproline in the control, ICO, and TQ groups were found to be (mean +/- standard deviation) 502.25 +/- 90.39 mu g/g, 342.13 +/- 66.61 mu g/g, and 287.88 +/- 49.59 mu g/g, respectively. Conclusions: A comparison of the antiadhesive effects of thymoquinone and icodextrin revealed thymoquinone to be more effective. These results indicate that thymoquinone is an efficient and strong antiadhesive molecule.Article Correlatıon of the Results of Fnac and Hıstopathologıcal Examınatıons İn Thyroıd Nodules(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Aras, A.; Karayıl, A.R.; Çallı, I.; Toktas, O.; Kiziltan, R.; Kotan, Ç.We aimed to evaluate the effectiveness of Fine Needle Aspiration Cytology(FNAC) in thyroid nodules by comparing the thyroid FNAC results and histopathological results of patients who underwent thyroidectomy surgery in our clinic. FNAC results of 1229 patients who underwent thyroidectomy for various indications in the General Surgery Clinic at Van Yuzuncu Yil University, Faculty of Medicine Hospital between January 2014 and December 2020 were categorized according to the Bethesda reporting system and compared with histopathological results. The cases were between ages of 18-78 with the mean age of 45.22 years and the female/male ratio was 1032(%84) /197(%16). According to the FNAC results, 8% of the patients were Bethesda-3, 12% were Bethesda-4, 33% were Bethesda-5, and 47% were Bethesda-6. According to histopathological results, malignancy was detected in 9.2% of patients in Bethesda-3, 22.8% of patients in Bethesda-4, 78.8% of patients in Bethesda-5, and 97.9% of patients in Bethesda-6. Malignancy detection rates were compatible with Bethesda 4, 5 and 6, but were incompatible with the Bathesda 3 category. We found a sensitivity of 95.4%, a specificity rate of 67%, a positive predictive value of 90% and a negative predictive value of 82%, and an accuracy rate of 89%. FNAC is an effective and reliable method in the evaluation of thyroid nodule. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Article Fine Needle Aspiration Biopsy and Comparison With Paraffin Section Results: a Prospective Cohort Study(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Kiziltan, R.; Kotan, Ç.In this study, we investigated the diagnostic value of intraoperative fine needle aspiration biopsy (FNAB) to determine thyroid cancer in patients with multinodular goiter or solitary nodules/dominant nodules and the results from intraoperative FNAB and paraffin sections were compared in order to determine whether intraoperative FNAB could be an alternative to frozen section analysis. 40 patients were included in the study. During thyroidectomy, intraoperative FNAB was performed and results were classified as malign, benign and suspicious/indeterminate. FNAB and paraffin section results were compared in all patients and evaluated in terms of FNAB sensitivity, specificity, positive/negative predictive values and overall accuracy. Among the 40 patients undergoing thyroidectomy, 7 were identified as thyroid cancer with paraffin section analysis. With intraoperative FNAB, two of the 40 patients were classified as malignant, three had suspicious lesions or ex tremely degenerated cells in which histopathologic evaluation was impossible. Diagnostic analysis of intraoperative FNAB for thyroid cancer revealed 33.33% sensitivity, 100% specificity and 94.59% overall accuracy. The positive and negative predictive values were 100% and 88.57% respectively. Thyroid nodules found to be malignant as a result of FNAB were also found to be malignant in histopathological evaluation. However this was not the case for thyroid nodules found to be benign in FNAB. That is w ith FNAB some malignant nodules may be erroneously classified as benign. Therefore although FNAB has an important role in the management of thyroid nodules it is not sufficient in the detection of malignant cases. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Article Intraoperatively Testing the Anastomotic Integrity of Esophagojejunostomy Using Methylene Blue(Sage Publications Ltd, 2017) Celik, S.; Almali, N.; Aras, A.; Yilmaz, O.; Kiziltan, R.Background: Intraoperative testing of gastrointestinal anastomosis effectively ensures anastomotic integrity. This study investigated whether the routine use of methylene blue intraoperatively identified leaks to reduce the postoperative proportion of clinical leaks. Methods: This study retrospectively analyzed consecutive total gastrectomies performed from January 2007 to December 2014 in a university hospital setting by a general surgical group that exclusively used the methylene blue test. All surgeries were performed for gastric or junctional cancers (n = 198). All reconstructions (Roux-en Y esophagojejunostomy) were performed using a stapler. The methylene blue test was used in 108 cases (group 1) via a nasojejunal tube. No test was performed for the other 90 cases (group 2). Intraoperative leakage rate, postoperative clinical leakage rate, length of hospitalization, and mortality rate were the outcome measures. Results: The intraoperative leakage rate was 7.4% in group 1. The postoperative clinical leakage rate was 8.6%. The postoperative clinical leakage rate was 3.7% in group 1 and 14.4% in group 2 (p = 0.007). There were no postoperative clinical leaks when an intraoperative leak led to concomitant intraoperative repair. The median length of hospital stay was 6 days in group 1 and 8 days in group 2 (p<0.001). One death occurred in each group. No test-related complications were observed. Conclusion: The methylene blue test for esophagojejunostomy is a safe and reliable method for the assessment of anastomosis integrity, especially in cases with difficult esophagojejunostomic construction.Article Nucleosome Assembly Protein 1-Like 1 (Nap1l1) in Colon Cancer Patients: a Potential Biomarker With Diagnostic and Prognostic Utility(verduci Publisher, 2020) Aydin, M. A.; Gul, G.; Kiziltan, R.; Algul, S.; Kemik, O.OBJECTIVE: To evaluate the diagnostic and prognostic utility of nucleosome assembly protein 1-like 1 (NAP1L1) in colon cancer patients. PATIENTS AND METHODS: A total of 95 patients with colon cancer [mean (SD) age: 61.0 (1.7) years, 58.9% were males] and 50 healthy individuals [mean (SD) age: 61.0 (2.3) years. 52.0% were males] were included in this prospective multicenter study. Data on patient demographics (age, gender) and serum NAP1L1 levels were recorded in both control and colon cancer groups. In colon cancer patients. serum NAP1L1 levels were further analyzed with respect to TNM stages and tumor size. RESULTS: Serum NAP1L1 levels were significantly higher in colon cancer patients as compared with control subjects [median (min-max) 14(12-16) vs. 2(1-2) ng/mL, p<0.001]. In colon cancer patients, serum NAP1L1 levels were significantly higher for tumor size of >4 cm vs. <4 cm [15(12-16) vs. 12(12-14) ng/mL), p<0.001] and for M1 vs. MO stage [15(12-16) vs. 12(12-14) ng/mL), p<0.001]. Serum NAP1L1 levels were significantly higher in T4 stage tumors vs. T1, T2 and T3 stage tumors (p<0.001 for each), in T3 stage tumors vs. T1 and T2 stage tumors (p<0.001 for each) and in N2 stage tumors vs. N0 and N1 stage tumors (p<0.001 for each). CONCLUSIONS: Our findings revealed for the first time the substantial rise in serum NAP1L1 levels among colon cancer patients as compared to controls and as correlated with the disease progression. Accordingly. NAP1L1 seems to be a potential biomarker for colon cancer, offering clinically important information on early diagnosis and risk stratification.Article Outcomes of Splenectomy for Hematologic Diseases-A Single Center Experience(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Çalli, I.; Aslan, F.; İliklerden, Ü.H.; Kiziltan, R.; Kotan, M.Ç.Splenectomy is a standard, effective and approved approach to the treatment of patients with failed medical treatment who develop recurrent, refractory or chronic diseases. The leading indications for elective splenectomy are benign and malignant hematologic diseases. We present here the findings of a retrospective analysis of the splenectomies performed in a single center for the treatment of hematologic diseases, and the associated outcomes . A retrospective examination was made of 64 patients who underwent splenectomy for the treatment of hematologic diseases at our clinic between 2010 and 2018. The patients were assessed for gender, age, hematologic disease, spleen size, presence of hepatomegaly, presence of accessory spleen, type of surgery (laparoscopic or open), wound site infection, preoperative and postoperative platelet counts, intraoperative and/or postoperative blood replacement, and length of hospital stay. The study sample comprised 23 (36%) male and 41 (64%) female patients, with a mean age of 40.4 years. Of the patients, 51 underwent laparoscopic splenectomy and 13 underwent splenectomy with laparotomy. Of the total, 57 (89%) patients responded fully to the splenectomy, six (9%) patients recorded a partial response and one (2%) patient had no response. Following the splenectomy procedure, one patient developed wound site infection and two patients died due to sepsis. Splenectomy should be considered a good treatment option in hematologic splenic diseases that are resistant to medical treatment, being also associated with low mortality and morbidity. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Article Portal Venous Thrombosis Developing After Torsion of a Wandering Spleen(Medknow Publications & Media Pvt Ltd, 2017) Yilmaz, O.; Kiziltan, R.; Almali, N.; Aras, A.Torsion of a wandering spleen is a rare disease. The symptoms and signs of this condition are only present when the splenic pedicle torts. The etiological factors are the congenital absence of the ligaments that hold the spleen in its normal anatomic position, or the relaxation of these ligaments resulting from conditions like trauma and abdominal surgery. We aimed to present a rare case with torsion of wandering spleen that consequently developed thrombosis of portal vein and its branches, taking into consideration the relevant literature.Article The Prevalence of Gynecomastia and Its Relationship With Age in 1589 Turkish Patients Who Underwent Ct Scans Due To Various Reasons(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Kaya, N.; Aydın, M.A.; Kiziltan, R.In this study, we aimed to contribute to the literature on the prevalence of gynecomastia and its relationship with age in Turkey by examining patients who underwent chest CT scans ordered for various reasons in male patients in our hospital. A total of 1589 male patients were included in our study. If a patient underwent multiple chest CT scans, only the first examination was used for the analysis. Patients’ age, presence of gynecomastia (GM) and laterality were recorded. Furthermore, the patients were divided into age decades. The correlations between GM, laterality and age decades were investigated. In CT examinations, GM was detected incidentally in 439 (27.6%) of the patients. Of all GMs, 234 (53.3%) were bilateral, 117 (26.6%) were left unilateral and 88 (20.0%) were right unilateral. GM peaked in the age range of 60-70 years and 70-80 years. A significant positive correlation was found between bilateral GM and age, (r=0.115, p<0.001). In our study, the prevalence of GM was found as 27.6%. Bilateral GMs were more common by 53.3%, while left unilateral GMs were more frequent. The prevalence of GM peaked to times in the age ranges o f 60-70 years and 4 70-80 years. There was a statistically significant correlation between bilateral GM and age. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.