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Nihal Kilinc

Publications and source records attributed to Nihal Kilinc.

13 recordsLinked to original sources
PubMed2005

Micronized purified flavonoid fraction may prevent formation of intraperitoneal adhesions in rats.

OBJECTIVE: To evaluate the efficacy of an anti-inflammatory and capillary regulator drug, micronized purified flavonoid fraction (MPFF), in the prevention of postoperative formation of adhesions. DESIGN: A double-blind, controlled study evaluated the efficacy of MPFF in reducing postoperative adhesion formation in a rat model. SETTING: Animal care facility of an academic research setting. ANIMAL(S): Thirty Sprague-Dawley female rats randomly divided into three groups. INTERVENTION(S): Starting on day of surgery, group 2 rats received oral MPFF (100 mg/kg per day for 7 days). Group 3 rats were intraperitoneally injected with 5 mL of saline (containing 200 mg/kg per day of MPFF for 3 days). Control rats received no medication. A standardized surgical trauma was applied in all animals. Three weeks after surgery, the rats were killed, and the adhesions were scored according to macroscopic and microscopic scales. MAIN OUTCOME MEASURE(S): Postoperative adhesions. RESULT(S): Both oral and intraperitoneal administration of MPFF reduced the scores of adhesions according to macroscopic and microscopic scales. There was no difference between the routes of administration. CONCLUSION(S): A statistically significant reduction in postoperative formation of adhesions was observed after oral and intraperitoneal administration of MPFF in our experimental animal model. However, further studies are required to reveal its mechanism of action.

Animals↗
PubMed2005

A proposal for a new and more practical grading scheme for pancreatic ductal adenocarcinoma.

There is no uniformly applied grading system for pancreatic ductal adenocarcinoma (DA). The scheme advocated by the WHO is essentially that of Kloppel et al, and is based on the "highest grade" focus. Although it is precise with good prognostic value, it is unfortunately not widely applied, largely because of the lack of recognition and partly because of its complex nature (interpretation of multiple parameters). Furthermore, it is fundamentally different from the one used in Japan, which evaluates the overall pattern. To establish a more widely applicable, practical, and clinically relevant grading system, a scheme similar to Gleason's scoring system was developed and tested on 112 cases of resected pancreatic DA and was compared with the WHO system. In the grading system devised, patterns (P) of infiltration were classified as follows: P1, well-defined glands with easily discernible contours; P2, fused or poorly formed glands with ill-defined contours; P3, nonglandular patterns. A score was then obtained by the summation of the predominant and the secondary patterns. Scores < or =3 (at least some well-formed glands and no nonglandular pattern) was graded as G1, 4 as G2, and > or =5 (at least some nonglandular patterns and no well-formed glandular pattern) as G3. Seventy-three percent of the cases displayed mixed patterns, with disparate patterns (P1 with P3) in 13%, confirming the high degree of heterogeneity of DA. There was a significant correlation between grade and survival, better than the correlation between survival and either the major or minor patterns evaluated separately. The median survival for G1, G2, and G3 were 22, 14, and 8 months; 1-year survival 68%, 44%, and 33%; 2-year was 67%, 11%, and 0%; and 3-year was 23%, 4%, and 0%, respectively (P = 0.0019). In a multivariate analysis, correlating survival with grade, tumor size, and lymph node status, the grade was the strongest independent predictor of survival. Odds ratio of dying of disease were 3.56 (P < 0.0001) in G3 versus G1, 1.79 (P = 0.058) in G2 versus G1, and 1.98 (P = 0.03) in G3 versus G2. Compared with this, the same odds ratio were 1.17 (P = 0.01) in tumors >2 cm versus < or =2 cm and 1.78 (P = 0.01) in cases with positive versus negative lymph nodes. The WHO grading scheme was not found to have as good a correlation with survival in this study, with WHO grade 2 showing a better survival than 1. The reproducibility of both the proposed grading system and that of WHO were found to be moderately good (with kappa values of 0.43 and 0.44, respectively), when 32 slides of DA were graded by four independent observers. The grading scheme for pancreatobiliary adenocarcinoma proposed here is highly applicable because it is practical and readily adoptable. It reflects biologic characteristics of ductal carcinoma (prominent tubule formation and tumor heterogeneity). Most importantly, it is clinically relevant with good prognostic value. Lastly, it is also applicable for use in research, by utilizing "patterns," even in small specimens like microarrays or biopsies.

Adult↗
PubMed2004

Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature.

The vast majority of pancreatic carcinomas are primary, and, among these, more than 90% are of ductal origin. However, a variety of extrapancreatic tumors may involve the pancreas secondarily and may manifest different clinicopathological characteristics and outcomes. In this study, pathology material from 973 surgical specimens and 4955 adult autopsy cases was reviewed to identify the tumors metastatic to or secondarily involving the pancreas. Biliary and periampullary neoplasms and tumors confined to peripancreatic soft tissue were excluded. In the autopsy series, the pancreas was involved by tumor in 190 cases, and 81 of these were secondary tumors. These were predominantly of epithelial origin, most commonly from lung (34), followed by GI tract (20), kidney (4), breast (3), liver (2), ovary (1), and urinary bladder (1). In addition, there were six tumors of hematopoietic origin, two melanomas, two sarcomas, and two mesotheliomas. Among the 973 surgical specimens, 38 cases contained metastatic tumors to the pancreas. Of these, 11 were lymphomas, and the others were carcinomas of stomach (7), kidney (6), lung (2), liver, prostate, ovary, uterus (1 case of each), and a Merkel cell carcinoma. In addition, there were three malignant gastrointestinal stromal tumors and one retroperitoneal leiomyosarcoma. In conclusion, lung cancer is the most common source of metastasis to pancreas, followed by gastrointestinal carcinomas and lymphomas. These tumors are usually seen in patients with disseminated disease and are detected mainly in autopsies. Secondary tumors constitute about 4% of pancreatic specimens in the authors' surgical database. Approximately one-third of them are clinically mistaken as primary tumors of the pancreas. These are predominantly hematopoietic malignancies or carcinomas of renal or gastric origin. Secondary tumors should be entertained in both the clinical and pathological differential diagnosis of pancreatic neoplasia.

Autopsy↗
PubMed2004

Examination of the distribution of mast cells in the nasal mucosa of patients with seasonal allergic rhinitis.

OBJECTIVE: It is known that mast cells play an important role in pathogenesis of allergic rhinitis. In this study, we investigated the distribution of mast cells in the nasal mucosa of patients with seasonal allergic rhinitis during the pollen-season. METHODS: This study was carried out at the Faculty of Medicine, Dicle University, Turkey, during the grass-pollen season between, March and July in 2002. Twenty patients with seasonal allergic rhinitis (12 females and 8 males) and 20 healthy (10 females and 10 males) non-allergic controls were examined for the distribution and abundance of mast cells in nasal biopsies. Biopsies were performed in all patients and controls, once during natural provocation in the spring and were taken from the lower edge of the inferior turbinate using a forceps. The samples of nasal mucosa were fixed in 10% neutral buffered formaline, stained with 0.5% aqueous toluidine blue and hematoxylin and eosin were examined under a light microscope. RESULTS: Mast cells were observed in the nasal mucosa obtained from 12 patients (60%) and 5 patients (25%) controls cases (p=0.025). It was found out that intrapitelial mast cells are present in nasal mucosa samples of patients with SAR (seasonal allergic rhinitis) but not in the epithelium of non-allergic controls. CONCLUSION: The number of submucosal mast cells has considerably increased in the nasal mucosa samples of patients with SAR. Besides this, these cells are determined in great amounts in non-allergic individuals.

Adult↗
PubMed2004

Strong association of HMB-45 expression with renal angiomyolipoma.

OBJECTIVE: Angiomyolipoma (AML) is a benign neoplasm consisting of varying mixtures of smooth muscle, blood vessels and fat. Although, most of these tumors are easy to recognize, some may pose a diagnostic dilemma due to unusual histologic features. Recently, it was suggested that melanosome-associated protein (HMB-45) immunoreactivity may be used for diagnostic confirmation of several neoplasm. The aim of this study is to analyze the diagnostic efficacy of HMB-45 in patients with AML. METHODS: This study was carried out at the Faculty of Medicine, Department of Pathology, Dicle University, Diyarbakir, Turkey, during the period January 2000 to September 2003. HMB-45 immunoreactivity was analyzed in 6 patients with AML and in 34 patients with other renal and retroperitoneal pathologies, including 10 nephrectomized patients for non-neoplastic reasons by means of immunohistochemistry. RESULTS: Patients with AML were positive for HMB-45. Whereas, HMB-45 immunoreactivity was negative in all of the histologic specimens from the patients with renal cell carcinoma, retroperitoneal sarcomas, Wilms' tumor, lipoma, leiomyoma, and nephrectomized kidneys of non-neoplastic reason. The association of AML with HMB-45 immunoreactivity was highly significant (p<0.001). CONCLUSION: Our findings suggest that HMB-45 may not be a melanocyte-restricted marker, and can be useful in differential diagnosis between AML and other tumors seen in kidney and retroperitoneal region.

Adolescent↗
PubMed2003

A severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with alpha-interferon and ribavirin.

We report a reactivation of hepatitis B virus infection and a severe hepatitis flare in a patient with chronic hepatitis due to dual infection with hepatitis B and C viruses during combination therapy with alpha-interferon and ribavirin. Pretreatment, HCV was the dominant virus, with detectable serum HCV-RNA but undetectable HBV-DNA. The patient responded to therapy, with the disappearance of HCV-RNA and normalization of serum alanine aminotransferase (ALT) at months 1 and 6. In the seventh month of therapy, an ALT flare was observed, and serum HBV-DNA became detectable. The patient had a severe hepatitis flare leading to impending hepatic failure. Treatment was discontinued and the patient had marked clinical and biochemical improvement and recovered with normalization of liver function test results within 1 month. Two months later, serum HBV-DNA was again undetectable, both by hybridization and polymerase chain reaction (PCR) assays. The patient had a rapid progression to cirrhosis in a year. At month 24, 17 months after the end of therapy, serum HCV-RNA reappeared, with a level of 2.4 x 10(5) copies/ml. In conclusion, severe HBV reactivation may occur during interferon plus ribavirin therapy in patients with chronic hepatitis C who are also hepatitis B surface antigen (HBsAg)-positive, and thus more careful monitoring than usual should be considered. Longterm follow-up is recommended, because very late HCV relapses may occur in coinfected patients. These data exemplify the complexity of viral dominance in patients infected with multiple hepatitis viruses, and this has significant importance for treatment decisions. Lamivudine may be administered early in HCV-RNA/HBsAg-positive patients who are at high risk of liver failure once reactivation of HBV occurs during interferon therapy.

Antiviral Agents↗
PubMed2003

Neuroprotective effect of N-acetylcysteine and hypothermia on the spinal cord ischemia-reperfusion injury.

The purpose of this study was to investigate the effect of N-acetylcysteine (NAC) on spinal cord ischemia-reperfusion (I-R) in rabbits. Thirty rabbits were divided into five equal groups, group I (sham-operated, no I-R), group II (control, only I-R), group III (I-R+NAC), group IV (I-R+hypothermia), group V (I-R+NAC+hypothermia). Spinal cord ischemia was induced by clamping the aorta both below the left renal artery and above the aortic bifurcation. Forty-eight hours postoperatively, the motor function of the lower limbs was evaluated in each animal according to Tarlov Score. Spinal cord samples were taken to evaluate the histopathological changes. The sham-operated rabbits (group I) showed no neurologic deficit (Score=4). Paraplegia (Score=0) developed in all rabbits in the control group (group II). Administration of 50 mg/kg of NAC (group III) resulted in significant reduction of motor dysfunction (Score=3.1+/-1.3, p=0.002). Application of hypothermia alone (group IV) showed significant recovery of motor functions (Score=3.0+/-1.1, p=0.002), and combination of hypothermia and 50 mg/kg of NAC (group V) showed complete recovery of lower limb motor function (Score=4, p=0.001). Histologic examination of the spinal cord in rabbits with paraplegia revealed several injured neurons. The cords of animals with no motor function deficits showed only minimal cellular infiltrates in the gray matter, and there was good preservation of nerve cells. NAC showed protective effects of the spinal cord. Moderate hypothermia alone also showed protective effects. Combined use of NAC and hypothermia resulted in highly significant recovery of spinal cord function.

Acetylcysteine↗
PubMed2003

Use of radial forearm free flap with palmaris longus tendon in reconstruction of total maxillectomy with sparing of orbital contents.

Nasal paragangliomas are extremely rare. The most adequate treatment is total excision. After surgical excision requiring total maxillectomy, there has been no ideal technique for reconstruction. A 47-year-old man was admitted to our clinic because of recurrent epistaxis, which lasted for 2 months. He was also suffering from nasal airway obstruction. The physical examination revealed a mass originating from the medial aspect of the middle turbinate of the right nasal cavity. It invaded the anterior maxillary wall and hard and soft palate. Endoscopic examination showed that the mass pushed the nasal septum to the left side and protruded into the nasopharynx. The mass was fleshy and had a rich capillary network. Conventional paranasal sinus radiographs were normal. Computerized tomography of the skull showed the mass protruding into the nasopharynx. A total maxillectomy was performed. Histopathological evaluation showed neoplastic tissue consisting of round, oval, or slightly elongated cells, altogether of a rather monomorphous appearance, tending to arrange themselves in clusters adjacent to or around capillary blood vessels. The blood vessels were numerous and branched. Reticulum staining showed a typical Zellballen arrangement of the neoplastic cells to provide a firmer basis for the diagnosis of paraganglioma. To reconstruct the total maxillectomy defect, a radial forearm free flap with the palmaris longus tendon was elevated to inlay the nasal cavity and the oral cavity and to suspend the ocular globe. The flap was placed into the defect, and the palmaris longus tendon was medially and laterally anchored to the periosteum of the frontal bone to suspend the ocular globe in the orbital cavity. One part of the skin island was used to close the defect of the nasal mucosal cavity, and the other part was used to repair the oral mucosal defect of the palate. Consequently, speech was considered near normal; the patient was able to eat an unrestricted diet and to retain both solid and liquid food inside the oral cavity without drooling, and there was no diplopia or enophthalmos. Six months later, porous polyethylene was inserted and fixed to the zygomatic bone with a miniplate and miniscrews to restore malar contour. No further procedure was believed to be necessary later on. Two years later, a satisfactory and functional esthetic result was obtained, providing an acceptable suspension of the ocular globe and filling of the total maxillectomy defect. We believe that a total maxillectomy is indicated if it is needed in nasal paragangliomas and that microsurgical repair with the composite radial forearm-palmaris longus free flap has several advantages: 1) it can offer en bloc reconstruction of the entire defect after a total maxillectomy in terms of good function and cosmesis; 2) it can repair mucosal defects; and 3) it can anchor and suspend the ocular globe in its original anatomical location, protecting against gravity through the sling effect of the palmaris longus tendon. The composite radial forearm-palmaris longus free flap has not been described previously for suspension of the ocular globe.

Biocompatible Materials↗
PubMed2003

Cyclopia.

True cyclopia is a rare anomaly in which the organogenetic development of the 2 separate eyes is suppressed. We report a fetus with an association of cyclopia with other anomalies. The possible mechanism of the histogenesis is discussed, together with a review of the relevant literature.

Abnormalities, Multiple↗
PubMed2002

[A rare cause of acute abdomen in childhood: primary omental torsion].

We examined the fact that 12 years old obese girl who applied to our clinic with acute abdomen symptoms and we determined primer omental torsion (POT) at laparotomy in this case. This disease is rare in childhood and imitates the signs of acute appendicitis. Obesity and anatomic variations ofthe omentum are predisposingfactorsfor POI ln this study we wanted to share our experiences in diagnosis and treatment ofPOI

Abdomen, Acute↗
PubMedDate not supplied

Influence of L-NAME and L-Arg on ischaemia-reperfusion induced gastric mucosa damage.

OBJECTIVE: The aim of this study was to investigate effects of L-NAME and L-Arginine on gastric mucosal injury induced by ischaemia-reperfusion. METHODS: In the experiment, 20 New Zealand rabbits were used (2700-3000 g). Celiac artery was clamped for 30 min for ischaemia and then 60 min of reperfusion followed this after all rabbits were anaesthetized. In the Sham-control group (G 1, n = 5), laparotomy was performed, and the celiac artery was prepared without clipping. Group 2 (Untreated, n = 5) rabbits were only subjected to ischaemia-reperfusion. Group 3 (n = 5) rabbits had L-Arginine Methyl Ester (L-Arg) 3 mg/kg/min as i.v. infusion during the first 15 min of the reperfusion. Group 4 (n = 5) rabbits had a nitric oxide inhibitor NG-nitro-L-arginine methyl ester (L-NAME) 100 micrograms/kg/min i.v. during the first 15 min of the reperfusion. After 60 min of reperfusion, the rabbits were killed, and their stomachs were removed for histopathologic evaluation and determination of malondialdehyde (MDA) level. RESULTS: After ischaemia-reperfusion, Untreated group had macroscopic necrosis involving 50 +/- 6% of total gastric mucosa area and deep mucosal necrosis involving 10 +/- 5% of mucosal strips. In the group treated with L-NAME, macroscopic mucosal necrosis involved 52 +/- 6% of total gastric mucosa area and deep mucosal necrosis involved 11 +/- 3% of mucosal strips (both p > 0.05 versus Untreated group). L-Arg treatment significantly reduced macroscopic mucosal necrosis area to 20 +/- 6% and deep mucosal necrosis to 3 +/- 1% (both p < 0.05 versus Untreated group and L-NAME group). MDA level in the L-Arg group was significantly lower when compared to control and L-NAME group MDA level (p < 0.05). CONCLUSION: These results suggest that NO increase induced by L-Arginine injection is involved in the protection of gastric mucosa after ischaemia-reperfusion.

Animals↗