Browsing by Author "Kotan, C."

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Carcinoid Tumor of the Stomach a Rare Form of Gastrointestinal Carcinoid Tumor: a Report on Three Cases
(2001) Kotan, C.; Kösem, M.; Özgören, E.; Ilhan, M.; Sönmez, R.; Akpolat, N.
Between 1994 and 1999 three patients with gastric carcinoid tumors were diagnosed at Yüzüncü Yil University Medical Faculty, Department of Surgery. Their ages were 65, 80, and 50 years, and all were male. The major complaints were epigastric pain, dysphagia, loss of appetite and weight, postprandial vomiting and in one patient, hematemesis and melena. None of the patients had carcinoid syndrome. The tumor was located in the upper portion of the stomach in one case and distal portion of the stomach in two cases. All three patients were initially diagnosed as adenocarcinoma of the stomach due to the endoscopic appearance of the tumor and histologic evaluation of the endoscopic biopsy. Because of the diagnosis of gastric carcinoma, two of them underwent subtotal gastrectomy and the other had a total gastrectomy. Histological examination of the resected materials showed well differantiated carcinoid tumors. Two cases had lymph node metastasis. Tumor cells in the stomach were immunoreactive for chromogranin A and neuron specific enolase and Grimelius positive for argyrophil cell detection. This paper presents a literature review and describes these three cases.
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.
The Effect of Obesity on Response To Neoadjuvant Therapy in Locally Advanced Gastric Cancer
(Asian Pacific Organization for Cancer Prevention, 2020) Sakin, A.; Sahin, S.; Sakin, A.; Aldemir, M.N.; Bayram, I.; Kotan, C.
Introduction: The effect of obesity on response to neoadjuvant chemotherapy (NACT) remains unknown. We aimed to investigate the effect of obesity on response to NACT and survival in locally-advanced gastric cancer (GC). Methods: From 2010 to 2019, 142 GC patients with clinical stage III disease who underwent curative surgery after NACT were enrolled. Patients were divided into 3 groups according to body mass index (BMI) as follows; BMI < 25 kg/m2, BMI = 25-30 kg/m2, and BMI > 30 kg/m2. The Mandard tumor regression grading system was used for tumor regression grade (TRG). Results: Of the 142 GC patients, 45(31.7%) were female. The median age was 58 years. BMI was < 25 kg/m2 in 60 (42.3%) patients, 25-30 kg/m2 in 44 (31%) patients, and > 30kg/m2 in 38 (26.8%) patients. The numbers of patients with TRGI-II, TRGIII, and TRGIV-V were 35 (24.6%), 44 (31%), and 63 (44.4%), respectively. There was no statistically significant difference among BMI groups in terms of disease-free survival (DFS) and overall survival (OS) (p = 0.919 and p = 0.398, respectively). According to TRG groups; mDFS was 46 months in TRG I-II, 28 months in TRG III, and 18 months in TRG IV-V (p<0.001). In multivariate analysis, presence of perineural invasion and lymphovascular invasion were the factors affecting TRG. Conclusion: In our study, we found that pre-treatment obesity did not affect the TRG in clinical stage III GC patients. However, a better TRG status was associated with improved survival. © 2020 Asian Pacific Organization for Cancer Prevention.
Influence of the Refinement of Surgical Technique and Surgeon's Experience on the Rate of Complications After Total Thyroidectomy for Benign Thyroid Disease
(ARSMB-KVBMG, 2003) Kotan, C.; Kösem, M.; Algün, E.; Ayakta, H.; Sönmez, R.; Söylemez, O.
Background: In recent years, many surgeons dealing with endocrine surgery have increasingly performed total thyroidectomy for benign thyroid disease. However, total excision of the thyroid in the treatment of benign lesions has been surrounded by even more controversy than its role in cancer treatment. The complication rate appears to be higher when the operation is done by inexperienced surgeons who have no special skills in endocrine surgery using proper techniques. The aim of this study is to determine whether surgeons experience and the refinement of surgical techniques are associated with postoperative recurrent laryngeal nerve (RLN) palsy or hypocalcemia after total thyroidectomy for benign thyroid disease. Methods: A total of 68 consecutive patients who underwent total thyroidectomy for benign thyroid disease were reviewed. Twenty-six of these were from between January 1998 and June 1999 (first period) and 42 from between June 1999 and September 2000 (second period). Patients were divided into two subgroups according to different periods and different surgical techniques to identify the RLNs and the parathyroid glands. RLNs function was evaluated pre- and post-operatively by an otolaryngologist, and serum calcium levels were measured at the postoperative follow-up. Results: During the first period of the study, transient hypocalcaemia was determined in 8 (31%) patients. Hypocalcaemia was clinically symptomatic in 5 (19%) patients. Transient RLN palsy developed in 4 (15%) patients. Unilateral permanent RLN palsy due to operative injury was observed in 1 (4%) patient. During the second period, we noted transient hypocalcemia in 11 (26%) patients and symptomatic hypocalcemia in 6 (4%) patients. Serum calcium levels returned to normal within 4 weeks after operation in all patients. Neither transient nor permanent RLN palsy was observed during this period. Conclusions: Complications of total thyroidectomy can be minimized with increasing experience and the refinement of surgical technique.
Isolated Splenic Metastases Occuring as an Unknown Primary Lesion
(D.K. Publishing House, 2003) Alici, S.; Kosem, M.; Kotan, C.
Rectal Cancer and Pregnancy: Report of Two Cases
(I R O G Canada, inc, 2009) Kolusari, A.; Ugurluer, G.; Kotan, C.; Sahin, H. G.; Kamaci, M.
Colorectal cancers are rare during pregnancy and the management is controversial and challenging. Prognosis is usually unfavorable due to late diagnosis since the presenting symptoms of colorectal cancer are attributable to the usual manifestations of pregnancy. Management depends on the patient's age and desire for future pregnancy, gestational age, cancer stage and religious principles. Thus, the treatment should be individualized. We present two cases of rectal cancer during pregnancy.
The Relationship Among Acute-Phase Responce Proteins, Cytokines, and Hormones in Various Gastrointestinal Cancer Types Patients With Cachectic
(Sage Publications Ltd, 2012) Kemik, O.; Kemik, A. S.; Begenik, H.; Erdur, F. M.; Emre, H.; Sumer, A.; Kotan, C.
Background: Acute-phase response proteins (APRPs), cytokines, and hormones have been claimed to be an independent, important factor of cancers. We suggest that in gastrointestinal system cancers, changes in APRP, cytokines, and hormones are associated. Methods: C-reactive protein (CRP), albumin, interleukin I alpha (IL-I alpha), IL-I beta, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-alpha), midkine, vascular endothelial growth factor-A(VEGF-A), VEGF-C, VEGF receptor I (VEGFR I), leptin, adiponectin, and ghrelin serum levels are studied in 148 gastrointestinal system cancer types and 40 healthy controls. Results: We found statistically significant differences and correlations between groups. We found significantly higher serum CRP, IL-I alpha, IL-1 beta, IL-6, IL-8, IL- 10, TNF-alpha, VEGF-A, VEGF-C, VEGFRI, and leptin concentrations in patients with esophageal, gastric, pancreas, colon, and rectum cancers than controls (p < 0.001, p < 0.0001). But, we found lower levels of the serum albumin, midkine, adiponectin, and ghrelin in patients with esophageal, gastric, pancreas, colon, and rectum cancers compared to control subjects (p < 0.05, p < 0.001). Conclusions: Cachexia in gastrointestinal system cancer types is associated with changes in APRP, cytokines, and hormone concentrations. This may be reflected between the outcomes in malignancies and the biomarkers.
Relationship Between Clinicopathologic Variables and Serum and Tissue Levels of Dickkopf-1 in Patients With Rectal Cancer
(BMJ Publishing Group, 2011) Kemik, O.; Kemik, A.S.; Sumer, A.; Begenik, H.; Purisa, S.; Tuzun, S.; Kotan, C.
The major biomarker for rectal cancer is the pathologic development of the tumor. In our study, we identified Dikkopf-1 (DKK1) as a novel biomarker and a therapeutic target for rectal cancer. To emphasize the biological and clinicopathologic significance, we performed tumor tissue and serum analysis of 150 rectal cancer samples with enzymelinked immunosorbent assay. Serum DKK-1 levels are found significantly higher in controls, in poor differentiation, and depth of invasion (in pT3 and pT4), present lymph node metastasis, and TNM stage (in pT3 and pT4) according to good differentiation, depth of invasion (in pT1 and pT2), absent lymph node metastasis, and TNM stage (in pT1 and pT2; P < 0.001 and P < 0.0001, respectively). Tissue DKK-1 levels are found in patients with rectal cancer than in control tissues (P < 0.0001). Dikkopf-1 correlated significantly with depth of invasion (P = 0.009), lymph node metastasis (P = 0.028), venous involvement (P = 0.019), and advanced pTNM stage (P = 0.001). There was no correlation between DKK-1 and age or sex (P > 0.05). This marker is also a potential candidate for development of rectal cancer cells and cancer progression. Copyright © 2011 by The American Federation for Medical Research.
The Role of Diffusion-Weighted Mr Imaging and Adc Values in The Diagnosis of Gastric Tumors
(Assoc Royal Soc Scientifiques Medicales Belges, 2012) Avcu, S.; Arslan, H.; Unal, O.; Kotan, C.; Izmirli, M.
Background: The aim of this study was to investigate the role of diffusion-weighted MR imaging (DWI) in the diagnosis of gastric tumors by means of measuring the apparent diffusion coefficient (ADC) values of these lesions, and making a comparison with the endoscopic biopsy results. Subjects and Methods: Seventy patients having gastric tumor constituted the case group. For the control group 30 healthy individuals were included. Abdominal MRI examinations were performed with a 1,5Tesla unit. DWI examinations were obtained by single shot spin echoplanar imaging. The ADC was measured based on the tissue of the gastric tumoral entities and normal gastric mucosa in the control group. Results: Mean ADC values were 0,84 +/- 0,17 x 10(-3) mm(2)/s and 1,79 +/- 0,08 x 10(-3) mm(2)/s in gastric tumor group and in control group, respectively, being statistically significant (p < 0.05).There was no significance among ADC values of adenocarcinoma subgroups. The comparison of the ADC values in the adenocarcinoma and lymphoma cases were also found to be statistically significant. Conclusions: DWI is beneficial in the diagnosis of malignant gastric lesions by the aid of ADC measurements. Although ADC quantification seems to be invaluable in the evaluation of histopathologic subgroups of adenocarcinoma, it can help in the diagnosis of gastric lymphoma.
Sigmoid Volvulus in Pregnancy and Puerperium: a Case Series
(2009) Kolusari, A.; Kurdoglu, M.; Adali, E.; Yildizhan, R.; Sahin, H.G.; Kotan, C.
Intestinal obstruction due to sigmoid volvulus during pregnancy is rare. The presenting signs/symptoms seen in these patients are the same as with non-pregnant patients. Fetal and maternal mortality rates are higher during pregnancy due to delays in diagnosis. We aimed to present four patients diagnosed with sigmoid volvulus during pregnancy and puerperium in our clinic. Diagnosis requires a high index of suspicion in a patient who presents with complaints of abdominal pain and evidence of bowel obstruction. Prompt intervention is necessary to minimize maternal and fetal morbidity and mortality. © 2009 Kolusari et al.; licensee Cases Network Ltd.