YURTDIŞI YAYINLAR

1. Effects of verapamil, sodium nitroprusside and glutathione addition into perfusion/preservation solutions on preservation-related ICAM-1 molecule expression in rat liver.

Turk J Gastroenterol. 2009 Sep;20(3):180-5.

Dalgiç A, Taneri F, Cindoruk M, Poyraz A, Akyol G.

Departments of General Surgery, Gazi University, School of Medicine, Ankara, Turkey


Abstract

BACKGROUND/AIMS:

During cold preservation of liver grafts, expression of tissue adhesion molecules has been reported as a factor indicative of preservation injury. Some biochemical agents as well as increased levels of intracellular calcium also play important roles in preservation injury during cold storage. In the current study, we aimed to test if the addition of a calcium channel blocker, sodium nitroprusside, or glutathione into preservation solution would reduce upregulation of adhesion molecules, thus leading to decreased preservation injury in the rat liver.

METHODS:

Fifty Albino Wistar rats, weighing 200+/-50 g, were divided into 1 control (perfused with Wisconsin solution, without preservation) and 4 study groups of rat livers (10 livers each). Livers in study groups were harvested, perfused, and preserved for 16 hours in 4 different solutions (Wisconsin solution alone, Wisconsin solution+verapamil, Wisconsin solution+ sodium nitroprusside and Wisconsin solution+glutathione). At the end of the preservation time, levels of graft tissue adhesion molecule (ICAM-1) expression were analyzed.

RESULTS:

Preservation for 16 hours with Wisconsin solution alone and Wisconsin solution+verapamil perfusates caused significantly more ICAM-1 expression than did preservation for 16 hours with Wisconsin solution+sodium nitroprusside and Wisconsin solution+ glutathione perfusates (p=0.010). No significant difference was found in ICAM-1 expression between the Wisconsin solution+ sodium nitroprusside and Wisconsin solution+glutathione groups. In the control group, perfusion with Wisconsin solution alone, without preservation, represented minimal ICAM-1 expression, reflecting minimum preservation injury (p=0.0003).

CONCLUSIONS:

Addition of sodium nitroprusside and glutathione into the Wisconsin solution decreased levels of ICAM-1 molecule expression, which reflects lower levels of preservation injury. In this study, the addition of verapamil to the perfusate/preservation solution for reducing the intracellular calcium accumulation had no effect on tissue ICAM-1 molecule expression.


2. Preoperative detection of parathyroid adenomas with Tc-99m MIBI and Tc-99m pertechnetate scintigraphy: histopathological and biochemical correlation with Tc-99m MIBI uptake.

Bratisl Lek Listy. 2009;110(3):166-9.

Akin M, Atasever T, Kurukahvecioglu O, Dogan M, Gokaslan D, Poyraz A, Koksal H, Taneri F.

Gazi University Medical School, Department of General Surgery, Ankara, Turkey


Abstract

AIM:

The objective of this study was to compare the dual phase MIBI scinitgraphy with MIBI and Tc-99m pertechnetate (MIBI + Tc-99m) study in defining the parathyroid adenomas, and to evaluate the effect of histologic and biochemical characteristics on the imaging of parathyroid adenomas with Tc-99m methoxyisobutylisonitrile (MIBI) scintigraphy.

METHODS:

Thirty-six patients with parathyroid adenomas were studied prospectively. All patients were evaluated with both MIBI and (MIBI + Tc-99m) study. MIBI uptake of adenomas correlated with oxyphill, chief cell and tumour weight of the surgically excised glands. MIBI uptake was also compared with serum calcium (Ca), phosphorus (P) and intact parathormone (iPTH) levels.

RESULTS:

A total of 38 parathyroid adenomas were surgically excised from 36 patients. MIBI + Tc-99m identified 35 of the parathyroid lesions (92%). Whereas, MIBI study detected 30 of the 38 parathyroid adenomas (79% sensitivity) (p=0.0001). There were no false positives. Adenoma weight showed significiant correlation with MIBI uptake (p=0.001). Oxyphyill cell content also showed high correlation with MIBI uptake. Delayed images showed better correlation than the early views (Early MIBI p=0.033; Delayed MIBI; p=0.001).

CONCLUSION:

MIBI + Tc-99m pertechnetate interpretation is more sensitive than only dual MIBI imaging for the detection of parathyroid adenoma. Oxyphill cell content and weight of the lesions proved to be important determinants of 99mTc-MIBI accumulation in parathyroid adenoma. We found no significant correlation between MIBI accumulation, Ca, P and iPTH serum levels (Tab. 2, Fig. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.


3. The value of breast ductoscopy in radiologically negative spontaneous/persistent nipple discharge.

Breast J. 2009 Jul-Aug;15(4):329-32. Epub 2009 May 12.

Tekin E, Akin M, Kurukahvecioglu O, Tezcaner T, Gulen M, Anadol AZ, Taneri F.

Department of General Surgery, Gazi University School of Medicine, Ankara, Turkey.


Abstract

Breast ductoscope is a fiberoptic endoscope used for examining the distal breast ducts under direct vision in order to identify the source of pathologic nipple discharge. The purpose of this study was to investigate the reliability of intra-operative breast ductoscopy in patients with pathologic nipple discharge, which could not be identified by radiologic tests. Between April 2002 and March 2007, breast ductoscopy was performed in 34 patients who had pathologic nipple discharge with no radiologic evidence about the source. The procedures were carried out under general anesthesia and ductoscopic findings were as well as the histopathology of the specimens were recorded and documented. In 88%, (30 of 34) of the patients, endoscope was successfully introduced into the external orifice of the ducts at the nipple and proximal breast ducts were successfully visualized. Ductoscopy revealed intraductal lesions (i.e., ductal obstruction, intraductal papilloma, red patches, and erythematoid platter) in 20 patients (66%). Among the 20 patients with visible endoluminal pathology, nine had a papilloma and eight had signs of either acute inflammation (bleeding, erythema) or previous inflammation with healing (adhesions and blocked ducts). In two cases, invasive breast carcinoma was identified, one of which was ductal carcinoma in situ (DCIS) with minimal invasion. In both cases, there had been blocked ducts. In one case DCIS was identified. Breast ductoscopy is a reliable and easy-to-use method to demonstrate the source of pathologic nipple discharge in cases with bleeding and other intraductal lesions.


4. Is neopterin level a predictive and differential biomarker in patients with thyroid disorders?

J Endocrinol Invest. 2009 Feb;32(2):147-9.

Sahin TT, Yuksel O, Girgin G, Sipahi H, Dikmen K, Azili C, Taneri F, Baydar T.

Department of Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.


Abstract

Neopterin production provides information about the extent of cellular immune activation. Measurement of neopterin levels may also provide predictive and prognostic information in patients with malignant thyroid diseases. In the present study, neopterin levels were investigated in patients with thyroid disorders (no.=68). Twenty-four patients had papillary thyroid cancers and the rest of them benign thyroid disorders. Results were compared with a healthy control group (no.=30). It was observed that there was a significant difference in neopterin levels between the control group and the thyroid disorders group (p<0.05). The mean neopterin levels in malignant and benign patients were also significantly different (p<0.05). Monitoring of urinary neopterin profile may be used in early diagnosis of papillary thyroid cancer. Neopterin seems to be a differential biomarker for malignant and benign thyroid disorders.


5. Analysis of surgical complications of thyroid diseases: results of a single institution.

Bratisl Lek Listy. 2009;110(1):27-30.

Akin M, Kurukahvecioglu O, Anadol AZ, Yuksel O, Taneri F.

Department of General Surgery, Gazi University Medical School, Ankara, Turkey


Abstract

BACKGROUND:

The purpose of this study is to compare the complications of different types of thyroidectomy for benign and malignant thyroidal diseases.

METHODS:

Between January 2001 and March 2006, 982 patients underwent thyroidectomy in single institute. A retrospective analysis was performed on demographic characteristics and pathology reports of patients, complications of surgery as well as the follow-up of patients. Sixty patients could not be fully followed up and were excluded.

RESULTS:

The types of the surgical procedures were as follows; 451 (48.9%) total, 137 (14.9%) subtotal, 60 (6.5%) near-total thyroidectomy and 274 (29.8%) lobectomy with isthmectomy. In the benign group, temporary recurrent laryngeal nerve injury (RLNI) was the most common complication in patients with toxic diffuse goiter (TDG 2%) while this complication occurred in patients with differentiated thyroid cancer (DTC 1.5%) in the malign group. Permanent RLNI in benign thyroidal diseases was seen more commonly in patients with toxic multinodular goiter (1.3%). In benign thyroidal diseases, temporary hypoparathyroidism (THPT) was mostly found in patients with TDG (8%), whereas in malignant thyroidal diseases this was found more in patients with DTC (2%). Permanent HPT (PHPT) in benign thyroidal diseases was observed more commonly in patients with multinodular goiter (0.9%). In malignant thyroidal diseases, it was more frequently observed in patients with DTC (0.5%). Infective complications after thyroid surgery are rarely observed and have a low incidence (0.4%).

CONCLUSION:

RLNI and HPT are the most common complications of after thyroid surgery but they may be avoided with an accurate technique (Tab. 3, Ref. 15). Full Text (Free, PDF) www.bmj.sk.


6. The effect of calcitonin gene-related peptide on healing of intestinal anastomosis in rats with experimental obstructive jaundice.

J Hepatobiliary Pancreat Surg. 2009;16(4):546-51. Epub 2009 Apr 14.

Leventoglu S, Koksal H, Sancak B, Taneri F, Onuk E.

Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.


Abstract

PURPOSE:

Intestinal anastomotic healing is a complex procedure in which several mediators and cytokines play roles. Calcitonin gene-related peptide is an important neuropeptide in inflammation. In this study we aimed to investigate the effect of calcitonin gene-related peptide on healing of intestinal anastomosis in rats with obstructive jaundice.

MATERIALS AND METHODS:

Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after the operation, intestinal anastomosis was performed, and either calcitonin gene-related peptide or 0.9% NaCl was administered intraperitoneally to these jaundiced rats and controls. The concentrations of serum tumor necrosis factor-alpha (TNF-alpha) and triglyceride levels of all rats were measured, and healing of the anastomosis was evaluated by measuring the bursting pressure and hydroxyproline content on the 7th postoperative day.

RESULTS:

Calcitonin gene-related peptide was found to have positive effects on healing of the anastomosis by inhibiting the effects of TNF-alpha and increasing the bursting pressure and hydroxyproline content of the anastomosis.

CONCLUSION:

Calcitonin gene-related peptide increases anastomotic wound healing in experimental anastomosis in the presence of obstructive jaundice in rats.


7. The relation between pure papillary and follicular variant in papillary thyroid carcinoma.

Endocr Regul. 2008 Mar;42(1):29-33.

Yuksel O, Kurukahvecioglu O, Ege B, Ekinci O, Aydin A, Poyraz A, Tezel E, Taneri F.

Gazi University Faculty of Medicine, Department of Surgery, Ankara, Turkey.


Abstract

OBJECTIVE:

Pure papillary thyroid carcinoma and the follicular variant papillary thyroid carcinoma are the most common subtypes of papillary thyroid carcinoma. The aim of this study was to investigate the effects of prognostic factors of these two subgroups in our series.

PATIENTS AND METHODS:

Histopathological type of carcinoma was retrospectively revised in 199 patients who were then divided according to such type. Patients' age and gender as well as the size and multicentricity of tumor, association with Hashimoto's thyroiditis, serum thyroglobulin and anti-thyroglobulin antibodies levels, metastatic lymph node and distant metastases status for both groups were evaluated.

RESULTS:

Gender, size, multicentricity of tumor, serum thyroglobulin and anti-thyroglobulin levels were similar in both groups. It was found that, although the tumor size of pure papillary thyroid carcinoma was smaller than that of follicular variant papillary thyroid carcinoma, lymph node metastases occurred more frequently when both subgroups were examined.

CONCLUSION:

The pathological and clinical signs of pure papillary thyroid carcinoma and follicular variant papillary thyroid carcinoma were found similar. According to these results, this study does not support the literature which claims that follicular variant papillary thyroid carcinoma is more aggressive than pure papillary thyroid carcinoma. Moreover, it could be assumed that the number of patients who are diagnosed as pure papillary thyroid carcinoma may be higher when associated with Hashimoto's thyroiditis.


8. Comparison of the effects of sodium nitroprusside and L-carnitine in experimental ischemia-reperfusion injury in rats.

Transplant Proc. 2007 Dec;39(10):2997-3001.

Akin M, Kurukahvecioglu O, Gulbahar O, Isikgonul I, Taneri F, Tezel E, Onuk E.

Department of General Surgery, Gazi University, Ankara, Turkey.


Abstract

AIM:

The aim of this study was to evaluate the protective effect of sodium nitroprusside (SNP) as a nitric oxide (NO) donor and L-carnitine intraperitoneal administration to treat experimental ischemia-reperfusion (I/R) in rats.

MATERIALS AND METHODS:

Rats were divided into four groups, each one consisting of 10 animals. Group 1 was subjected to a sham operation. In group 2, an I/R process was applied to the rats. In group 3, SNP (5 mg/kg) and in group 4, L-carnitine (500 mg/kg) was administered in addition to the I/R process. Ileal tissue samples were obtained for analysis of tissue malonyl dialdehyde (MDA) and for histopathologic examination.

RESULTS:

By histopathologic examination, the I/R group showed a significant difference from the SNP and L-carnitine groups (P<.05). There was no difference between the sham, the SNP, and the L-carnitine groups (P>.05). SNP used as an NO donor produced a significant decrease in MDA levels. There was a significant difference between the MDA levels of the SNP and the I/R groups (P<.05). Also, the difference between this group and the I/R group was significant (P<.05).

CONCLUSION:

SNP helped to both prevent and reduce mucosal damage in terms of histological and tissue MDA levels. Since the results of the L-carnitine group and the SNP group were similar, L-carnitine was as effective as exogenous NO.


9. Infliximab "TNF-alpha antagonist" decreases intraabdominal adhesions.

Saudi Med J. 2007 Dec;28(12):1830-5.

Kurukahvecioglu O, Koksal H, Gulbahar O, Erdem O, Engin D, Yazicioglu O, Kerem M, Taneri F.

Faculty of Medicine, Gazi Universitesi Tip Fakultesi, Genel Cerrahi Anabilim Dali Besevler, Ankara, Turkey.


Abstract

OBJECTIVE:

To evaluate the effect of infliximab on adhesion formation and it's associated morbidity and complications.

METHODS:

This study was performed in the Faculty of Medicine, Gazi University, Turkey between July 2005 and October 2005. Thirty-five rats were randomly divided into 4 groups. Laparotomy was performed in the Sham group (n=5), whereas cecal abrasion was carried out in all other groups. After cecal abrasion 0.9% sodium chloride was administered in the saline group (n=10), infliximab was administered to the study group (n=10) and nothing was administered to the last group (n=10). Adhesion formation was evaluated with macroscopic and microscopic adhesion scoring systems. Peritoneal fluid samples and mesenteric lymph node biopsies were taken to rule out bacterial peritonitis. Blood and peritoneal irrigation fluid samples were taken to measure the Tumor necrosis factor-alpha (TNF-alpha) levels.

RESULTS:

Macroscopic adhesion scores showed fewer adhesions in the infliximab group. The infliximab group had significantly fewer adhesions than the abrasion control and saline groups. According to the histological findings, there were no statistically significant differences between the groups.

CONCLUSION:

Early blocking of the activity of TNF-alpha after cecal abrasion resulted in lower rates of adhesion formation, macroscopically. The TNF-alpha, a proinflammatory cytokine appears to be an important mediator for postoperative adhesion formation.


10. Total thyroidectomy for the treatment of Hashimoto's thyroiditis coexisting with papillary thyroid carcinoma.

Adv Ther. 2007 May-Jun;24(3):510-6.

Kurukahvecioglu O, Taneri F, Yüksel O, Aydin A, Tezel E, Onuk E.

Gazi University Medical School, Department of General Surgery, Ankara, Turkey.


Abstract

The coexistence of Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC) is controversial. This study was conducted to evaluate the correlation between HT and PTC and to identify predictive factors for the coexistence of PTC and HT. A total of 922 patients underwent surgery for thyroid disorders between January 2001 and August 2005. In all, 199 patients had been diagnosed with PTC, 37 of whom had coexistent HT; in 689 patients, benign thyroid disease had been diagnosed. Patients' age and sex, as well as histopathology, tumor size, nodal involvement status, multicentricity, presence of metastasis, and serum thyroglobulin levels, were retrospectively reviewed. A significant correlation was observed between HT and PTC, although no statistical significance was noted between PTC and HT type (nodular or diffuse). Most patients with PTC+HT were female and younger (<40 y old) than those with PTC only. The rate of occult tumor in patients with PTC+HT was higher than that in patients with PTC alone. Data indicate the coexistence of PTC and HT and suggest that PTC may develop even in cases of diffuse HT. Total thyroidectomy is the surgical procedure of choice, especially in young, female patients with HT.


11. Anaplastic thyroid carcinoma with long term survival after combined treatment: case report.

Endocr Regul. 2007 Mar;41(1):41-4.

Kurukahvecioglu O, Ege B, Poyraz A, Tezel E, Taneri F.

Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Turkey


Abstract

Anaplastic thyroid carcinoma (ATC) is associated with an almost uniformly rapid and lethal clinical course. ATC grows rapidly and invades surrounding tissues at an early stage. Despite surgery, chemotherapy and radiotherapy, few patients with ATC live more than 1 year follow-up diagnosis. The mean survival is reported to be only 7.2 months. Treatment of ATC is still controversial because of its rarity and advanced stage at the time of diagnosis. We report herein an unusual case of ATC, 35 year old woman. She is alive without evidence of recurrence more than 36 months after combined therapy.


12. Potential benefit of oral calcium/vitamin D administration for prevention of symptomatic hypocalcemia after total thyroidectomy.

Endocr Regul. 2007 Mar;41(1):35-9.

Kurukahvecioglu O, Karamercan A, Akin M, Tezel E, Ege B, Taneri F, Onuk E.

Gazi University Faculty of Medicine, Department of General Surgery, Ankara, Turkey


Abstract

OBJECTIVE:

To evaluate routine oral calcium and vitamin D administration for preventing symptoms of hypocalcemia after total thyroidectomy.

SUBJECTS AND METHODS:

A total of 487 consecutive patients were prospectively randomized into two groups in terms of routine oral calcium and vitamin D supplementation: In the control group (244 patients) the treatment was not routinely started after surgery, whereas the treated group (243 patients) received routine supplementation that started on postoperative day 1.

RESULTS:

Patients of treated group had only minor hypocalcemia symptoms, whereas 7 patients of control group experienced carpopedal spasm as a major symptom (p<0.001). None of the patients in the treated group required intravenous calcium administration. Average hospital stay of the treated group patients was significantly shorter than that of control group (p<0.001).

CONCLUSIONS:

Routine postoperative calcium and vitamin D supplementation therapy may be useful for the prevention of symptomatic hypocalcemia after total thyroidectomy and may allow for a safe and early discharge from the hospital.


13. Primary hyperparathyroidism due to parathyroid adenoma.

Saudi Med J. 2007 Feb;28(2):305; author reply 305-6.

Hamidi S, Koksal H, Kurukahvecioglu O, Taneri F.



14. Postoperative analgesic effects of lornoxicam after thyroidectomy: a placebo controlled randomized study.

Agri. 2006 Apr;18(2):27-33.

Arslan M, Tuncer B, Babacan A, Taneri F, Karadenizli Y, Onuk E, Ege B.

Gazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Turkey


Abstract

The purpose of the present study was to determine the postoperative analgesic effects of lornoxicam and the reduction in tramadol consumption. Fourty patients of ASA class I-II, 18-70 years of age, undergoing thyroidectomy were assigned in a randomized manner into two groups: GroupL received 8 mg of lornoxicam i.v. at the end of the operation followed by 8 mg of lornoxicam b.i.d., i.v. for 24 hours postoperatively. GroupP received 4 ml of saline solution i.v. at the end of the operation and the same amount b.i.d., i.v. for 24 hours postoperatively. The requirements for supplemental analgesics were recorded at 0-6, 6-12 and 12-24 hour intervals. Postoperative pain scores were evaluated at 15th min. and 1, 2, 4, 6, 8, 12, 18 and 24th hours using Visual Analogue Scale (VAS). The time to first analgesic requirement was significantly longer in GroupL compared to GroupP (101.7 vs 37.9 min, p<0.001). Pain scores were significantly lower in GroupL compared to GroupP at 15th min, 1, 8 ,12 and 18th hours. Twenty four hour analgesic consumption was significantly lower in GroupL compared to GroupP (p<0.05). The amount of tramadol consumed in GroupL was 60% lower compared to GroupP (100 mg and 250 mg (mean), respectively). 100% of the patients in GroupL and 60 % of the patients in GroupP needed supplemental analgesics. The degree of satisfaction with postoperative pain management was excellent in 95 % of patients in GroupL and 25 % of patients in GroupP. Eighteen patients in GroupP and 9 patients in GroupL had nausea (p=0.002), and fifteen patients in GroupP and 8 patients in GroupL had vomiting (p=0.025). Lornoxicam decreased the opioid need, the incidence of nausea and vomiting and postoperative pain scores. Moreover, it was observed that the time needed for the first analgesic requirement was prolonged following thyroidectomies.


15. Microanatomy of milk ducts in the nipple.

Eur Surg Res. 2006;38(6):545-9. Epub 2006 Nov 3.

Taneri F, Kurukahvecioglu O, Akyurek N, Tekin EH, Ilhan MN, Cifter C, Bozkurt S, Dursun A, Bayram O, Onuk E.

Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.


Abstract

The aim of this study was to determine number and diameter of milk ducts in the nipple and to investigate the possible influences of age, breast weight, and diameter of the nipple on the number of ducts. Two hundred and twenty-six carcinoma mastectomy specimens were weighed and the nipple diameters measured. The number of ducts was counted in histological cross sections. Mean diameter of the nipple and mean breast weight were 13.9 mm and 844.6 g, respectively. There was a small but statistically significant positive correlation between nipple diameter and number of milk ducts (rho = 0.158; p = 0.01), but no correlation with breast weight. The mean number of ducts in the nipple duct bundle was 17.5. This is significantly higher than the number of ducts reported to open on the nipple surface. This discrepancy could reflect duct branching within the nipple or the presence of some ducts which do not reach the nipple surface. Smaller breast ducts (diameter < 0.5 mm) represent nearly 50% of the nipple ducts and could be a challenge to the ductoscopy technology.


16. Primary hyperparathyroidism due to parathyroid adenoma.

Saudi Med J. 2006 Jul;27(7):1034-7.

Koksal H, Kurukahvecioglu O, Yazicioglu MO, Taneri F.

Chief Assistant in General Surgery, 7. Cadde 23.Sokak Kural Apartmani, No: 5/12 Bahcelievler, 06500 Ankara, Turkey


Abstract

OBJECTIVE:

To evaluate the clinical characteristics and outcome of patients with parathyroid adenoma.

METHODS:

We diagnosed and operated 54 patients with primary hyperparathyroidism in the Faculty of Medicine, Gazi University, Turkey from January 2000 to December 2004. In this study, 52 (96.2%) of these patients who had parathyroid adenoma were retrospectively evaluated.

RESULTS:

There were 46 female, and 6 male patients with a median age of 54.5 years (range, 18-87 years) at diagnosis. Preoperative mean serum level of calcium was 11.09 +/- 0.9 mg/dL, while phosphorus was 2.3 +/- 0.5 mg/mL, and parathyroid hormone (PTH) was 338.99 +/- 416.43 pg/ml. Ultrasound imaging revealed parathyroid adenoma in 38 of the 52 patients (73%), while 27% of the patients were normal. In 29 (69%) of the 42 patients who had sestamibi scanning, results revealed parathyroid adenoma and in the others (31%), sestamibi scanning was normal. On the postoperative period, the mean serum calcium level was 9.2+/- 0.74 mg/dL (p=0.0001 compared to preoperative level), phosphorus was 2.7 +/- 0.39 mg/mL (p=0.07 compared to preoperative level), and PTH level was 41.01 +/- 43.03 pg/ml (p=0.0001 compared to preoperative level). All patients were cured after operation, as determined by normalization in serum calcium levels in the postoperative period.

CONCLUSION:

Parathyroid adenoma is the most common cause of primary hyperparathyroidism. Preoperative serum calcium and PTH levels are the most useful parameters for diagnosis. Preoperative screening methods and operative findings are not always correlated so the patients with high serum calcium and PTH should be planned for surgery, independent of radiological results. All patients were cured after operation, as determined by normalization in serum calcium levels in the postoperative period.


17. The effects of carbon dioxide pneumoperitoneum on tyrosine hydroxylase activity.

Surg Laparosc Endosc Percutan Tech. 2006 Feb;16(1):25-8.

Sare M, Yürekli M, Kurukahvecioğlu O, Tekin EH, Taneri F, Yusif-Zade K, Onuk E.

Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey


Abstract

PURPOSE:

The aim of this study is to investigate the effects of carbon dioxide (CO2) pneumoperitoneum on tyrosine hydroxylase (TH) activity and total protein (TP) levels.

METHODS:

Forty male Sprague-Dawley rats were randomized into 10 groups, each consisting of 10 rats. Groups 1 and 2 consisted of anesthesia and sham-operated control rats, respectively. In the study groups, 10 mm Hg (group 3) and 15 mm Hg (group 4) pneumoperitoneum with CO2 were accomplished. At the end of the procedures, the brains and adrenals were removed quickly, and the hypothalamus and adrenal medulla separated, weighed, and homogenized. TH activity and TP levels were determined.

RESULTS:

The adrenal medulla TP and TH activity levels were decreased consistently and this decrease was significant in the sham and pneumoperitoneum groups compared with the control group (P<0.05). The adrenal medulla TP and TH activity levels were reduced significantly in group 4, as compared with the other groups (P<0.05). Elevation of hypothalamic TH activity in group 4 was significantly higher than in the other groups (P<0.05).

CONCLUSIONS:

These results indicate that CO2 pneumoperitoneum applied with 10 and 15 mm Hg pressure gradually decreases the adrenal medulla TH activity; TH is an indispensable enzyme for the biosynthesis of catecholamines. CO2 pneumoperitoneum with 15 mm Hg pressure significantly elevated hypothalamus TH activity.


18. Clinical presentation and treatment of hyperthyroidism associated with thyroid cancer.

Endocr Regul. 2005 Sep;39(3):91-6.

Taneri F, Kurukahvecioglu O, Ege B, Yilmaz U, Tekin EH, Cifter C, Onuk E.

Gazi University Faculty of Medicine, Department of Surgery, Ankara, Turkey.


Abstract

OBJECTIVE:

Hyperthyroidism apparently does not protect the patients from thyroid cancer as believed before. In contrast, hyperthyroidism with concurrent thyroid cancer can be diagnosed after pathological examination of unsuspect nodules. The aim of this study was to evaluate the coexistence of hyperthyroidism and thyroid carcinoma and to discuss the advantages of total thyroidectomy in such cases.

METHODS:

Between January 2002 and October 2004, 120 hyperthyroid patients underwent surgical treatment in our clinic. All patients with hyperthyroidism in this study underwent fine-needle aspiration biopsy and cytologic examination. Frozen section evaluation was performed in all of these patients during the operation.

RESULTS:

Among these patients 10 had concurrent thyroid cancer. Only one of these patients was examined by fine needle aspiration biopsy prior to operation, while the rest of malignancies was diagnosed from unsuspect nodules.

CONCLUSIONS:

The selection of appropriate operation procedure appears very important to find out and treat concurrent thyroid cancers. We diagnosed 90 % of thyroid cancers incidentally. If there are no technical difficulties, we prefer total thyroidectomy for the patients with toxic multinodular goiter and Graves' disease with nodules.


19. Prospective analysis of 518 cases with thyroidectomy in Turkey.

Endocr Regul. 2005 Sep;39(3):85-90.

Taneri F, Kurukahvecioglu O, Ege B, Yilmaz U, Tekin E, Cifter C, Onuk E.

Gazi University Faculty of Medicine, Department of Surgery, Ankara, Turkey.


Abstract

OBJECTIVE:

Thyroid malignancies can present in different manners, among them as asymptomatic solid nodule being the most puzzling. Nodules have been found in the 60-70 % of autopsy specimens and it is very important to rule out the malignancies in such cases. Incidence of carcinomatous changes is reported in 5-15 % of solitary nodules. We present the results of prospective study on 418 thyroidectomies with the aim to review the experience of our unit, to establish the correlation between clinical presentation and histopathology, to discuss the malignancy rates and surgical complications.

PATIENTS AND METHODS:

Five hundred eighteen consecutive cases of thyroidectomy 419 female (80.8 %), and 99 male (19.2 %) patients performed between January 2002 and October 2004 were included in this prospective study.

RESULTS:

In 71 (13.7 %) cases the malignancy was found by paraffin specimens, the highest prevalence of malignancy being found in patients with nodular goiter (NG-18 %) followed by 14.6 % in multinodular goiter (MNG). The sensitivity of preoperative fine needle cytology (FNAC) was 83.3 % with false positive rate of 1.3 %. Complications were seen in 5.2 % of cases of which 4 (0.7 %) had hypoparathyroidism and 7 (1.3 %) had recurrent laryngeal nerve injury. All patients observed came from endemic area. Family history nearly doubles the risk of malignancy.

CONCLUSIONS:

In an endemic area the nodular goiter is the most common. Preoperative cytology, although sensitive, gives a considerable number of false positive results. Results of thyroid surgery at a high volume centre are satisfactory with very low rates of recurrent laryngeal nerve and parathyroid injury. Probability of malignant transformation in a long standing thyroid swelling should always be kept in mind. There appears to be an increase in prevalence of thyroid malignancies in Turkey after Chernobyl disaster.


20. A patient with occult breast cancer presenting with an axillary lymph node metastasis and a synchronous contralateral breast cancer.

Breast. 2005 Apr;14(2):157-62.

Yirmibeşoğlu E, Tekin E, Memiş L, Yamaç D, Taneri F, Erkal HS.

Department of Radiation Oncology, Gazi University Faculty of Medicine, Beşevler, Ankara TR-06510, Turkey.


Abstract

Detection of a breast mass accompanied by a contralateral axillary lymphadenopathy presents a dilemma because of the possible presence of an occult breast cancer on the same side as the axillary lymphadenopathy. A patient presented with an axillary lymphadenopathy from an occult breast cancer and a synchronous contralateral breast cancer, for which the differential diagnosis was established through a significant difference in estrogen and progesterone receptor levels. The patient was treated with neoadjuvant chemotherapy followed by bilateral modified radical mastectomy, adjuvant chemotherapy, and adjuvant radiation therapy. She is alive and free of disease 1.5 years after the diagnosis.


21. The effects of hypothyroidism in rats on serum leptin concentrations and leptin mRNA levels in adipose tissue and relationship with body fat composition.

Endocr Res. 2004 May;30(2):247-55.

Karakoc A, Ayvaz G, Taneri F, Toruner F, Yilmaz M, Cakir N, Arslan M.

Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.


Abstract

Both thyroid hormones and leptin affect sympathetic nervous system activity, basal metabolic rate, body fat mass, food intake, and thermogenesis, and each one also affects the actions of the other. We examined the alterations in serum leptin concentrations and leptin mRNA expression in hypothyroid rats and investigated the relation between serum leptin and leptin mRNA levels with the total adipose tissue mass and total body weight. Twenty male Wistar rats were divided into 2 groups, euthyroid and hypothyroid. Their body compositions were examined by Dual Energy X-ray Absorptiometry at the beginning and end of the study. Serum leptin concentrations and levels of leptin mRNA in the retroperitoneal white adipose tissue were measured at the end of the study. Serum leptin concentrations did not show any difference between the two groups (1.9 +/- 0.2 ng/ml in the hypo and euthyroid group, P > 0.05), but the fat mass of the hypothyroid rats were lower than the euthyroid rats (21.1 +/- 2.5 g in the euthyroid group and 14.2 +/- 1.9 g in the hypothyroid group, P > 0.05 between groups at the end of the study) although the difference between the groups was statistically not significant. Leptin mRNA level was significantly higher in the hypothyroid group than in the euthyroid group (21.6 +/- 1.6 vs. 15.1 +/- 1.2 ng respectively, P = 0.002) although the dissected retroperitoneal fat weight was significantly lower in the hypothyroid group versus the euthyroid group (1.0 +/- 0.2 vs. 1.8 +/- 0.2 g respectively, P = 0.013). In conclusion, the change of leptin mRNA expression in white adipocytes was thought to be the direct result of hypothyroidism or a compensatory response to metabolic changes caused by hypothyroidism


22. Laparoscopic "second-look" in the management of mesenteric ischemia.

Surg Laparosc Endosc Percutan Tech. 2004 Aug;14(4):191-3.

Anadol AZ, Ersoy E, Taneri F, Tekin EH.Department of Surgery, School of Medicine, Gazi University, Ankara, Turkey.


Abstract

Mesenteric ischemia is a major cause of mortality in surgery. Despite the advances in medicine, considerable number of patients undergoes reoperations for a better assessment of intestinal viability. Although great majority of these second-look operations are "negative explorations," progressive nature of this devastating disease pushes surgeons to re-explore the abdomen. This study compares open and laparoscopic "second-look" procedures in patients with mesenteric ischemia. In the first group (n = 41), abdomen was closed and second-look laparotomy was performed to 23 patients. In the second group (n = 36), a 10-mm trocar was inserted before closing the abdomen and second-look intervention was performed by a telescope to 23 patients. Sixteen of relaparotomies in the first group (70%) revealed nothing and were unnecessary. Two patients (8%) in the laparoscopy group needed re-resection while 20 patients (87%) were rescued from unnecessary laparotomies. Conclusively, patients with mesenteric ischemia are "ill enough" to deserve the "minimal invasion" spirit of laparoscopic surgery.


23. Outcome and cost comparison of laparoscopic transabdominal preperitoneal hernia repair versus Open Lichtenstein technique.

J Laparoendosc Adv Surg Tech A. 2004 Jun;14(3):159-63.

Anadol ZA, Ersoy E, Taneri F, Tekin E.

Gazi University, School of Medicine, Department of Surgery, Ankara, Turkey.


Abstract

Laparoscopic hernia repair has all the advantages of a tension free repair. This study compares the laparoscopic transabdominal preperitoneal (TAPP) approach with tension-free open hernia repair in terms of operative time, postoperative pain, hospital stay, complications, and cost. Open and TAPP repairs using polypropylene mesh were performed in two groups of 25 male patients. The difference in operative times between the groups was not significant. Mean pain scores (0-100) for the open group were 54.12 +/- 13.06 at 12 hours and 37.24 +/- 11.38 at 24 hours, significantly higher than the corresponding scores of 38.36 +/- 8.21 at 12 hours and 20.92 +/- 8.73 at 24 hours for the TAPP group (P < 0.05). The mean postoperative analgesic dose was 6.72 +/- 2.72 in the TAPP group, which was insignificantly lower than 7.52 +/- 2.00 in the open group. Mean hospital stay was 2.24 +/- 0.97 days in the open group and 1.52 +/- 0.51 in the TAPP group, which was significant (P < 0.05). Twenty patients (80%) in the TAPP group rated themselves highly satisfied with the surgery as compared to 11 patients (44%) in the open group (P < 0.05). There was no recurrence in either group during a mean followup period of 13.5 months (range, 8-28 months). Laparoscopic hernia repair was significantly more expensive than open (1100 US dollars versus 629 US dollars). TAPP repair is superior to open repair in terms of shorter hospital stay, lower postoperative pain, and better patient satisfaction. It is also safe, with no recurrence in a short-term period. This technique will be the operation of choice for the treatment of groin hernia after long-term results have been established in our center.


24. Effects of PPARgamma and PPARalpha agonists on serum leptin levels in diet-induced obese rats.

Horm Metab Res. 2004 Apr;36(4):226-30.

Törüner F, Akbay E, Cakir N, Sancak B, Elbeg S, Taneri F, Aktürk M, Karakoç A, Ayvaz G, Arslan M.

Gazi University Faculty of Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey


Abstract

Leptin and peroxisome proliferator-activated receptors are two important adipose tissue factors involved in energy metabolism regulation. It has been shown that PPARgamma agonists decrease leptin levels. However, the effects of PPARalpha agonists on leptin have not been investigated much. The aim of this study was to compare the effects of a PPARgamma agonist rosiglitazone (RSG) and PPARalpha agonist gemfibrozil (G) on body weight and serum insulin and leptin levels in diet-induced obese rats. Male Wistar rats were divided into six groups according to diet and drug therapy. After four weeks, serum glucose, triglyceride, insulin and leptin levels were significantly decreased in the high-fat-fed and RSG-treated groups compared to the group fed a high-fat diet only (162 +/- 19 vs. 207 +/- 34 mg/dl, 58 +/- 20 vs. 112 +/- 23 mg/dl, 3.1 +/- 1.0 vs. 15.2 +/- 4.0 ng/ml, 1.6 +/- 0.5 vs. 3.6 +/- 1.6 ng/ml, respectively). However, these parameters were not statistically different in RSG animals treated with a standard diet compared to the standard diet group. The high fat+RSG group gained much more weight compared to high-fat and high-fat+G groups (p > 0.05). Additionally, serum glucose, insulin and leptin levels were significantly decreased in the high-fat-fed and G-treated group compared to high-fat group (149 +/- 19 vs. 207 +/- 34 mg/dl, 57 +/- 16 vs. 112 +/- 23 mg/dl, 4.3 +/- 2.1 vs. 15.2 +/- 4.0 ng/ml, 1.6 +/- 0.4 vs. 3.6 +/- 1.6 ng/ml, respectively). These results suggest that PPARalpha agonists may decrease serum glucose, insulin and leptin levels as PPARgamma agonists do in diet-induced obese rats.


25. A comparison of radionuclide thyroid angiography, (99m)Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules.

Eur J Nucl Med Mol Imaging. 2003 May;30(5):642-50. Epub 2003 Mar 1.

Demirel K, Kapucu O, Yücel C, Ozdemir H, Ayvaz G, Taneri F.

Department of Nuclear Medicine, Gazi University School of Medicine, Ankara, Turkey


Abstract

We prospectively studied 43 patients with solitary cold thyroid nodules greater than 1.5 cm in diameter to determine the comparative diagnostic value of radionuclide thyroid angiography (RTA), technetium-99m methoxyisobutylisonitrile ((99m)Tc-MIBI) scintigraphy and power Doppler ultrasonography (PDUS) in the differentiation of benign and malignant thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0, avascular; 1, hypovascular; 2, isovascular; 3, hypervascular. (99m)Tc-MIBI uptake in the nodules compared with that in surrounding thyroid tissue was scored for both early and delayed images as follows: 0, cold; 1, decreased; 2, equal; 3, increased. PDUS patterns were classified as nodule vascularisation patterns. The malignancy criteria were set as follows: hypervascular nodule with rapid washout in RTA; complex ring sign with anarchic structure or delta sign in PDUS, and positive retention and increased uptake in the nodule in the early and delayed (99m)Tc-MIBI images. These data were compared with the histopathological results. Histology revealed thyroid carcinoma in nine patients (five cases of papillary carcinoma, three of follicular carcinoma and one of medullary carcinoma) and benign conditions in 34 patients (30 cases of nodular goitre, three of lymphocytic thyroiditis and one of follicular adenoma). Sensitivity, specificity and accuracy were, respectively, 0.89, 1.00 and 0.97 for RTA, 1.00, 0.76 and 0.81 for PDUS, and 0.67, 0.91 and 0.86 for (99m)Tc-MIBI scintigraphy (when nodules with increased uptake in both the early and the delayed images and a positive retention index were considered as malignant). RTA, (99m)Tc-MIBI scintigraphy and PDUS could be helpful in the preoperative assessment of solitary cold thyroid nodules. In this study, RTA was found to be the most accurate and specific method for differentiation of malignant from benign thyroid nodules.


26. Using imprint and frozen sections in determining the surgical strategies for thyroid pathologies.

Endocr Regul. 2001 Jun;35(2):71-4.

Taneri F, Poyraz A, Salman B, Tekin E, Akyuerek N, Bayram O, Onuk E.

Department of General Surgery, Gazi University Medical School, Ankara, Turkey


Abstract

OBJECTIVE:

To compare the diagnosis of thyroid pathological findings by using frozen section and preoperative imprint.

METHODS:

From January 1998 to December 1999, one hundred and three consecutive patients admitted to Department of Surgery, Gazi University Medical Faculty for thyroid operation, were prospectively included into the study. In all patients, imprint and frozen section were carried out from their suspected nodules and the results were compared with the permanent biopsy. Those findings used to find out sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of frozen section and imprint. Because of the definitive differentiation of malignant or benign lesions could not be done, three patient were excluded from the study.

RESULTS:

In our study; sensitivity, specificity, PPV, NPV and accuracy for imprints was found as 83.3%, 97.7%, 83.3%, 97.7% and 96% (respectively), while respective corresponding data for frozen section were 81.8%, 96.6%, 75%, 97.7% and 95%. In one patient, the pathological finding of follicular carcinoma as found by permanent section was accurately diagnosed by imprint, but missed by frozen section. Both the imprint and frozen section failed to diagnose two papillary carcinoma. Overall cancer rate among 103 patients was 12 % (nine papillary carcinoma, one Hürthle cell carcinoma and two follicular carcinoma).

CONCLUSION:

Both the frozen sections and imprints showed high sensitivity rate and similar accuracy rates. So, if there is no opportunity for frozen section, the imprints could be used. Furthermore, the use of imprints is less time consuming and less expensive than that of frozen sections.


27. The clinicopathologic characteristics of colorectal cancer in patients under 50 years of age: experience of an oncology center.

Tumori. 2001 Mar-Apr;87(2):74-7.

Günel N, Yamac D, Akcali Z, Taneri F, Oguz M.

Department of Medical Oncology, Gazi University Medical School, Beşevler, Ankara, Turkey.


Abstract

BACKGROUND/AIM:

Colorectal cancer is seen mostly among patients older than 50 years of age. An aggressive behavior is a frequently cited as characteristic of colorectal cancer in young patients. The purpose of the present study was to reveal the clinicopathologic characteristics of colorectal cancer among patients under 50 years of age.

METHODS:

Two hundred and seventy-one patients with colorectal cancer admitted to our oncology center were evaluated, and clinicopathologic findings of the young and old patients were compared. Patient gender, site distribution, tumor stage classification, lymph node involvement, metastatic site, histologic classification, histologic differentiation, family history of malignant tumors, presenting symptoms and survival rates were compared.

RESULTS:

One hundred patients were 50 years of age or under. Clinical, histopathologic characteristics and overall survival of the two groups did not differ. A higher rate of familial cancer syndromes was detected among young patients.

CONCLUSIONS:

The presentation and outcome of the disease in young patients do not differ from those of older patients. A significant family history of colorectal cancer in the young patients showed the need for screening whereas the outcome of metastatic disease was poor. In order to anticipate long survival, early detection and aggressive treatment is necessary.


28. The effect of pentoxifylline on the healing of intestinal anastomosis in rats with experimental obstructive jaundice.

Surg Today. 2000;30(10):896-902.

Cömert M, Taneri F, Tekin E, Ersoy E, Oktemer S, Onuk E, Düzgün E, Ayoğlu F.

Department of General Surgery, Gazi University, Faculty of Medicine, Ankara, Turkey.


Abstract

The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor alpha (TNF-alpha) and serum triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting pressure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-alpha release from macrophages and monocytes, and the stabilizing effect on the neutrophils.


29. Huerthle cell neoplasms of the thyroid: predicting malignant potential.

Endocr Regul. 2000 Mar;34(1):19-21.

Taneri F, Tekin E, Salman B, Anadol AZ, Ersoy E, Poyraz A, Onuk E.

Gazi University, Faculty of Medicine, Beoevler, Ankara, Turkey.


Abstract

OBJECTIVE:

Assessment of malignancy criteria in Huerthle cell neoplasm.

METHODS:

This study intends to review retrospectively the patients who were operated for Huerthle cell neoplasia at Gazi University, Department of General Surgery between January 1986 and October 1999. Pathological specimens from 63 patients (20 males and 43 females) were investigated in this study, 48 of which revealed Huerthle cell adenoma and 15 revealed Huerthle cell carcinoma. The mean age of the patients with Huerthle cell adenoma was 40.7+/-1.59 yr while it was 51.3+/-1.83 yr in patients with Huerthle cell carcinoma. Mann-Whitney U and Chi-square tests were used for statistical analysis.

RESULTS:

Fifty-two of the 63 patients had fine needle aspiration (FNA) biopsy prior to operation, 49 of those were reported to have suspected Huerthle cell neoplasia (HCN) and three had suspected Huerthle cell carcinoma (HCC). The sensitivity of FNA for HCN was 20 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 76 %. For all patients, peroperative frozen section (FS) biopsy was examined. Fifty-nine of the FS specimens revealed HCN and four revealed HCC. The sensitivity, specificity, positive predictive value and negative predictive value of FS biopsy were 27 %, 79 %, 28.5 % and 77.5 %, respectively. In this retrospective study, there was a statistically significant correlation between malignancy and the size of the tumor (P<0.05) according to Chi-square test, and also a statistically significant correlation between malignancy and the age of the patient (P<0.05) according to Mann-Whitney U test.

CONCLUSIONS:

In cases where FS and FNA biopsies cannot adequately define the benign or malignant behaviour of the tumor, the age of the patient and the diameter of the tumor must be taken into consideration for accurate surgical strategy. Particularly for 50 year-old and elderly, incidence of malignancy is statistically significant without considering sex of the patient.


30. Preoperative fine-needle aspiration cytology versus frozen section in thyroid surgery.

Endocr Regul. 1999 Sep;33(3):141-4.

Ersoy E, Taneri F, Tekin E, Poyraz A, Cihan A, Dursun A, Onuk E.

Department of General Surgery, Gazi University Medical Faculty, Besevler, Ankara, Turkey


Abstract

OBJECTIVE:

In a double blind prospective clinical study to evaluate the diagnostic potential of peroperative fine needle aspiration cytology as compared to peroperative frozen section in thyroid surgery.

METHODS:

The diagnostic value of one hundred consecutive preoperative (FNA) and peroperative fine needle aspiration (p-FNA), frozen section (FS) and permanent section (PS) examination for thyroid nodules were studied prospectively in order to assess and compare the accuracy, sensitivity and specificity.

RESULTS:

Out of 100 patients PS showed 11 % of malignancies, while p-FNA showed 5 % and FS showed 6% of malignant cases with no false positive, but with 6 and 5 false negative results, respectively. Thus, as compared with FS, one false negative finding was obtained by p-FNA in a case of malignant tumor which could be definitely ascertained by frozen section technique. However, concerning the benign nodules no differences were found between p-FNA and FS.

CONCLUSIONS:

Peroperative fine needle aspiration seems to be a useful method which can be properly performed because the nodule can be easily seen during the surgical procedure. However, further clinical observations of large numbers of patients are needed.


31. Ileal and colonic contractions by endothelin-1 in experimentally induced paralytic ileus in rats.

Gen Pharmacol. 1999 Jun;32(6):631-5.

Tekin E, Taneri F, Ersoy E, Bozkurt S, Yavuzer R, Ercan S, Oguz M.

Department of General Surgery, Gazi University Medical Faculty, Ankara, Turkey.


Abstract

The aim of the present study was to investigate the effect of endothelin-1 on the isolated distal ileum and proximal colon in an experimentally induced ileus in rats. Ileal and colonic contractions by endothelin-1, acetylcholine alone and with endothelin-1 were recorded both in normal and experimentally induced paralytic ileus in rats. In the control group, all the responses to acetylcholine were found to be potentiated significantly when used together with endothelin-1 but in paralytic ileus group, no detectable change was observed in the responses of the amine after administration of acetylcholine together with endothelin-1. This study indicates that endothelin-1 might have an effect on gastrointestinal motility and postoperative paralytic ileus.


32. Accuracy and Significance of Fine-Needle Aspiration Cytology and Frozen Section in Thyroid Surgery.

Endocr Regul. 1998 Dec;32(4):187-191.

Taneri F, Poyraz A, Tekin E, Ersoy E, Dursun A.

Depatment of General Surgery, Medical Faculty, Gazi University, Besevler, Ankara, Turkey.


Abstract

OBJECTIVE: In the retrospective study to review the records of patients who had undergone thyroid surgery between 1986-1995 and to determine the need of frozen section (FS) following FNA biopsy. METHODS: The records of 2083 patients who had thyroid surgery in Gazi University Medical Faculty Department of General Surgery between 1986-1995 were retrospectively reviewed to determine and compare the accuracy and significance of fine-needle aspiration (FNA) cytology and intraoperative frozen section (FS). Results. In 61 patients, both FNA and FS diagnosis were available for the comparison with the final pathologic diagnosis. In 196 patients, FNA diagnosis was available for the comparison with the final pathological diagnosis by permanent section and in 377 patients FS diagnosis was available for the comparison with the final pathological diagnosis. The sensitivity value for detection of malignancy by means of FNA was 57.1 % compared to 82.2 % by means of FS, and FS diagnosis was more specific (99 %) than FNA diagnosis (90.9 %). FNA diagnosis of benign conditions was correct in 141 of 150 (94 %) patients. FS diagnosis of benign conditions was correct in 313 of 321 (97.5 %) patients. Nine patients had the FNA findings that were positive for malignancy and FS confirmed this diagnosis in 8 patients. Conclusions. FNA is an important diagnostic tool for eliminating benign nodules, but it is not perfect. FS is very important for determining the surgical procedure, and because of direct observation of suspicious nodule, it is even more accurate. Using these tools together is more reliable, since the number of false positive and false negative values is lower than if only the individuals methods are used.


33. Intestinal endotoxins as co-factors of liver injury in obstructive jaundice.

HPB Surg. 1996;9(2):61-9.

Mentes BB, Tatlicioglu E, Akyol G, Uluoglu O, Sultan N, Yilmaz E, Celebi M, Taneri F, Ferahkose Z.

Department of Surgery, Gazi University Medical School, Ankara, Turkey.


Abstract

The concept of endotoxin-mediated rather than direct liver injury in biliary obstruction was investigated using the experimental rat model of bile duct ligation (BDL) and small bowel bacterial overgrowth (SBBO). Small identical doses of intravenous endotoxin (bacterial LPS) caused a significantly more severe liver injury in rats with BDL, compared with sham-operated rats, suggesting the possible contribution of LPS in this type of liver damage. BDL was then combined with surgically created jejunal self-filling blind loops, which resulted in SBBO. Plasma LPS level increased significantly, and once again a more severe liver injury, determined by liver histology and serum gamma-glutamyl transpeptidase levels, was observed compared with the control group of rats with BDL+self-emptying blind loops. The data presented suggest that small amounts of exogenous LPS and/or the ordinarily innocous amounts of LPS constantly absorbed from the intestinal tract may be critical in the hepatic damage caused by obstruction of the biliary tract.