Bülent Güngör

P53 Codon 72 and HER2 Codon 655 Polymorphisms in Turkish Breast Cancer Patients

The polymorphisms in codon 72 of the tumor suppressor protein p53 (P53) gene and codon 655 of the human epidermal growth factor receptor 2 (HER2) gene have been suggested to play roles in most cancers. The purpose of this study was to investigate the association between common variants of HER-2 and P53 genes with breast cancer risk. Blood samples collected from 204 women with primary breast carcinoma and 192 healthy female controls were analyzed through polymerase chain reaction-restriction fragment length polymorphism methods. The frequencies of Arg/Arg, Arg/Pro, and Pro/Pro genotypes for P53 codon 72 were 51.7%, 41.4%, and 6.9% in patients and 42.6%, 47.3%, and 10.1% in controls, respectively. The frequencies of Ile/Ile, Ile/Val, and Val/Val genotypes for HER2 codon 655 were 75.0%, 22.5%, and 2.5% in patients and 73.4%, 25.0%, and 1.6% in controls, respectively. The genotype and allele frequencies between patient and control groups for P53 gene polymorphism were not significantly different (p = 0.177 and p = 0.07, respectively). Similarly, the genotype and allele frequencies between patient and control groups for HER2 gene polymorphism were not significantly different (p = 0.716 and p = 0.891, respectively). With the exception of association between the P53 codon 72 polymorphism and tumor stages (p = 0.026), there was no significant association between the studied polymorphisms and clinicopathological characteristics. The P53 gene codon 72 Arg/Pro and Her2 gene Ile655Val polymorphisms were not associated with the risk of breast cancer in Turkish women. However, significant associations between the P53 codon 72 and the homozygote and heterozygote Pro genotypes with tumor stages were found.

Is oval flap reconstruction a good modification for treating pilonidal sinuses

BACKGROUND Flap techniques are acceptable for the surgical treatment of pilonidal sinuses. This study assessed a new modification of the rhomboid flap technique. METHODS The study included 133 patients with pilonidal disease who were treated between April 2004 and April 2009. The pilonidal sinus was removed with an oval excision, and an oval head rhomboid flap was prepared to reduce flap necrosis. RESULTS The mean age of the patients was 27.4 ± 4.6 years (range, 13-80). The rate of minor postoperative complications was 11.3%. The mean hospital stay was 2.3 ± .8 days (range, 1-6). The rate of recurrence was 1.5%. Regarding cosmetic results, 116 (87%) patients were very pleased, 15 (11.2%) were pleased, and 5 (3%) were displeased. The mean follow-up period was 22.5 ± 12.4 months (range, 5-57). CONCLUSIONS The oval flap reconstruction method is a recommended procedure that produces fewer ischemic flaps with a low rate of recurrence and acceptable cosmesis.

The Predictivity of Serum Biochemical Markers in Acute Biliary Pancreatitis

Background and Aim. There are no accurate methods of differentiating acute biliary pancreatitis. Obstructions of biliary ducts, idiopathic pancreatitis may be related with biliary origin which needs identification for acute treatment. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Patients and Methods. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Biliary and nonbiliary pancreatitis were differentiated by Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Intraoperative Cholangiopancreatography (IOC). Cut-off points of admission biochemical markers with sensitivity, specifity, positive predictive value and negative predictive value were determined after identification of significant variables. Receiver Operator Curves were plotted for each biochemical marker. Results. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Conclusion. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis.

Preventing intraperitoneal adhesions with linezolid and hyaluronic acid/carboxymethylcellulose: a comparative study in cecal abrasion model

BACKGROUND We aimed to compare the effectiveness of linezolid in preventing intraperitoneal adhesions with hyaluronic acid + carboxymethylcellulose (Seprafilm). METHODS Thirty rats were divided randomly into 3 groups: Group I (control), untreated; Group II (Seprafilm); and Group III (linezolid). All rats were sacrificed on the 14th day after surgery. Macroscopic adhesion, inflammation, and fibrosis were evaluated. RESULTS The multiple comparisons between groups showed a statistically significant difference for adhesion. There were statistically significant differences between Group I and II and I and III, but no statistically significant difference between Group II and III. The multiple comparisons between the groups showed a statistically significant difference for inflammation and fibrosis. For inflammation and fibrosis, there was a statistically significant difference between Group I and II and I and III, but no statistically significant difference between Group II and III. CONCLUSION The efficiency of linezolid in reducing the formation of intraperitoneal adhesions was statistically significant compared with the control group.

Preventing intraperitoneal adhesions with ethyl pyruvate and hyaluronic acid/carboxymethylcellulose: a comparative study in an experimental model

OBJECTIVE To compare the effectiveness of ethyl pyruvate (EP) with that of hyaluronic acid+carboxymethyl cellulose (Seprafilm) for the prevention of intraperitoneal adhesions. Seprafilm has been shown to be effective in many experimental and clinical studies. STUDY DESIGN Thirty rats were divided into three groups at random, and uterine horn abrasion was performed by laparotomy. One group received no treatment (control group), one group received a single intraperitoneal dose of EP 50mg/kg (EP group), and a 2×1-cm patch of Seprafilm was applied in the third group (Seprafilm group). All rats were killed 14 days after surgery. Macroscopic and histopathological evaluation were performed by a surgeon and a pathologist who were blinded to group allocation. Histopathologically, inflammation, fibroblastic activity, foreign body reaction, collagen proliferation, vascular proliferation, Masson-Trichrome score, matrix metalloproteinase-2 score and vascular endothelial growth factor score were studied. RESULTS Median macroscopic intraperitoneal adhesion scores for the control, EP and Seprafilm groups were 2.8, 1.2 and 1.1, respectively. Multiple comparisons between groups showed a significant difference (p<0.05). In binary comparisons, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.05). No significant difference was found between the adhesion scores for the EP group and the Seprafilm group (p>0.05). After histopathological evaluation, significant differences in all parameters were found between the groups (p<0.05). In the paired comparison, significant differences were found between the control group and the EP group, and between the control group and the Seprafilm group (p<0.0167), but no significant difference was found between the EP group and the Seprafilm group (p>0.0167). CONCLUSIONS In comparison with the untreated control group, EP and Seprafilm were found to reduce the formation of intraperitoneal adhesions. No significant difference was found between EP and Seprafilm.

Comparison of the adherence of E.Coli and S. Aureus to ten different prosthetic mesh grafts: In vitro experimental study

BackgroundThe prosthetic mesh grafts used to repair the abdominal wall may become infected, primarily by S. aureus and E. coli. This study sought to provide a rational basis for the choice of mesh used to repair a hernia when there is a likelihood of infection or contamination.MethodsS. aureus and E. coli were incubated with ten types of prosthetic mesh graft (Table 1) in liquid growth medium. After sequential dilution of samples from the prosthetic mesh grafts, the colony forming units of adherent S. aureus and E. coli were counted.ResultsThere was no significant difference in the numbers of E. coli and S. aureus adherent to simple polypropylene mesh grafts. Significantly more of both species were adherent to the polyester, expanded polytetrafluoroethylene (ePTFE), and composite prosthetic mesh grafts, except for E. coli on graft 5. Significantly fewer E. coli were adherent to composite mesh grafts 5, 8, and 10 than S. aureus.ConclusionS. aureus and E. coli adhere to polypropylene similarly. In vitro, fewer S. aureus and E. coli adhere to simple polypropylene mesh grafts than to polyester, ePTFE, or composite prosthetic mesh grafts.

Protective effect of ethyl pyruvate on ischemia-reperfusion injury in rat ovary: biochemical and histopathological evaluation.

BACKGROUND To investigate the protective effect of ethyl pyruvate (EP), an anti-oxidant agent, against ischemia-reperfusion injury in a rat model of ovarian torsion, considering biochemical and histopathological aspects. METHODS Forty Wistar Albino rats were divided into five groups: Group I, sham operation; Group II, ischemia alone, Group III, ischemia-reperfusion; Group IV, ischemia-reperfusion+50 mg/kg EP; and Group V, ischemia-reperfusion+100 mg/kg EP. Through laparotomy, 360° torsion was performed and maintained for 3 h, and detorsion was maintained for a further 3 h. Intraperitoneal EP was given 30 min before the surgical procedure. Ovarian tissues and blood samples were obtained after surgery. Malondialdehyde (MDA) and asymmetric dimethyl arginine (ADMA) levels were measured in both plasma and tissue samples. Tissue sections were evaluated histopatologically. Analysis of variance was used for statistical analyses. RESULTS In both serum and tissue samples, ADMA and MDA levels were found to be significantly lower in the EP groups compared with the ischemia alone and ischemia-reperfusion groups (p=0.0001). However, no significant difference was found between groups treated with 50 mg/kg or 100 mg/kg EP. On histopathological evaluation, the total tissue injury score was found to be lower in rats treated with EP. No significant difference was detected between groups treated with 50 mg/kg or 100 mg/kg EP. CONCLUSION Ethyl pyruvate may exert positive effects in ischemia-reperfusion injury in cases of ovarian torsion. However, no difference was detected between 50 mg/kg and 100 mg/kg EP.

Comparative Evaluation of Adhesions to Intraperitoneally Placed Fixation Materials: A Laparoscopic Study in Rats: Adhesions to Fixation Materials

After laparoscopic ventral hernia repair, the nature of the adhesions to fixation materials or to mesh had not been clarified. We examined adhesion formation specific to the fixation material in rats. We designed an experimental laparoscopy setup, and placed four intraperitoneal fixation materials on the peritoneum of rats without a mesh graft. Another group of researchers documented the incidence and intensity of postoperative adhesion formation. The adhesion scores for the nickel-titanium anchor were significantly greater than those for polylactic acid (p = 0.004), a titanium tacker (p < 0.0001), and fibrin glue (p < 0.0001). No adhesions occurred in the fibrin glue group. Fibrin glue is the preferred fixation material because it produced no postoperative adhesions. The nickel-titanium anchor produced heavy adhesions but may be applicable for recurrent hernia cases and in patients with thin abdominal walls.

The Whitehead operation procedure: Is it a useful technique?

OBJECTIVE Hemorrhoidal disease is a very common entity in the general population; however, the therapeutic approaches to hemorrhoids remain controversial. The choice of treatment method depends on the grade of the hemorrhoid as well as the experience of the surgeon. The Whitehead hemorrhoidectomy procedure is often applied for grade IV hemorrhoids. MATERIAL AND METHODS We studied 49 patients who underwent surgery between December 1982 and January 2013. The indications for the Whitehead procedure in all patients were grade IV hemorrhoidal disease. The data on these patients were evaluated retrospectively with respect to age, gender, preoperative diagnosis, and postoperative complications. RESULTS Of the patients included in this study, 34 were male and 15 were female. The mean age of the patients was 41.93±12.42, and the age range was 24-70 years. Complications of the Whitehead procedure included bleeding (6.12%, three cases), stricture (2.04%, one case), urinary retention (16.33%, eight cases), and temporary anal incontinence (2.04%, one case). No patients developed Whitehead deformities, entropion, or infectious complications. All patients were discharged from hospital between the fifth and eighth days post-surgery (6.45±1.00 days). The follow-up period was 1-234 months (70.02±54.89). CONCLUSION The Whitehead procedure is successful in patients with prevalent peripheral prolapse and/or thrombosed hemorrhoids. With the right indications, and if the surgeon has adequate experience, the morbidity rate of the Whitehead procedure is similar to that of other treatment methods.

Pilonidal sinüs hastalığında ameliyat yöntemlerinin komplikasyon ve hastaların yaşam kalitesine etkisi

GIRIŞ Pilonidal sinus agirlikli olarak calisma cagindaki erkekleri etkileyen sakrokoksigeal bolgenin sik gorulen bir hastaligidir. Hastalik genellikle apse veya kronik akintili olan bir sinus trakti ile kendini gosterir. Sikligi bolgesel ve irksal olarak degismektedir. Etyoloji ve patogenezi yillardir tartisilmaktadir. Pilonidal sinus hastaliginin tedavisi icin bircok medikal ve cerrahi yontem tarif edilmesine karsin tartismalar devam etmektedir. Pilonidal sinuste uygulanacak ideal tedavi az agrili, hastanede kalis suresi kisa, dusuk komplikasyon riski, hastanin normal aktivitesine hizli donmesini saglayan ve dusuk nuks orani olan bir yontem olmalidir (1-3). Eksizyon sonrasi primer onarimda ameliyatin kisa surmesi, hastanede kalis suresinin kisa olmasi gibi avantajlari olmasina karsin flep yontemlerinde orta hattin lateralize olmasi nedeniyle nuks oranlarinin daha dusuk olmasi beklenmektedir.