Haseki Research and Education Hospital

İstanbul, Turkey

Haseki Research and Education Hospital

İstanbul, Turkey
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Kemik O.,Yuzuncu Yil University | Sumer A.,Yuzuncu Yil University | Kemik A.S.,Istanbul University | Hasirci I.,Yuzuncu Yil University | And 4 more authors.
World Journal of Surgical Oncology | Year: 2010

Backgraund: Acute-phase response proteins (APRP), cytokines and hormones have been claimed to be an independent prognostic factor of malignancies, however the basis for their association with prognosis remains unexplained. We suggest that in colon malignancies, as similar to pancreatic and lung cancers, changes in APRP are associated with angiogenesis.Methods: C-reactive protein (CRP), albumin, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, midkine, VEGF-A, VEGF-C, leptin, adiponectin, and ghrelin serum levels are studied in 126 colon cancer patients and 36 healthy subjects.Results: We found statistically significant difference and correlations between two groups. We found significantly higher serum CRP, IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α, VEGF-A, VEGF-C and leptin concentrations in patients relative to controls (p < 0.001). We found lower levels of the serum albumin, midkine, adiponectin and ghrelin in patients compared to control subjects (p < 0.001).Conclusions: Cachexia in patients with colon cancers is associated with changes in APRP, cytokines and hormone concentrations. These biomarkers and cachexia together have a direct relationship with accelerated angiogenesis. This may lead to a connection between the outcomes in malignancies and the biomarkers. © 2010 Kemik et al; licensee BioMed Central Ltd.


Ozaras R.,Istanbul University | Mete B.,Istanbul University | Ceylan B.,Bezmialem Foundation University | Ozgunes N.,Medeniyet University | And 8 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2014

BACKGROUND: Hepatitis B virus (HBV) infection is a health problem worldwide. Current treatment options for chronic hepatitis B (CHB) are nucleoside or nucleotide analogues and pegylated interferons. Tenofovir and entecavir are much more commonly used as they have better efficacy, tolerability, and high genetic barriers to resistance. AIM: The aim of this study was to assess the efficacies of tenofovir and entecavir in previously untreated CHB patients in a treatment cohort. PATIENTS AND METHODS: We included CHB patients in a cohort including previously untreated HBeAg-positive and HBeAg-negative patients from 10 centers in Istanbul, Turkey. The patients were compared in terms of baseline characteristics, decrease in alanine transaminase (ALT), decrease in HBV-DNA to undetectable levels, HBeAg loss and anti-HBe development (among baseline HBeAg-positive patients), interventions to therapy because of lack of efficacy, side effects, severe side effects, and side effects that required change in treatment. RESULTS: The study included 121 patients who were administered tenofovir and 130 patients who were administered entecavir. The majority of patients were men, with mild to moderate histology in both treatment groups. The mean duration of follow-up was 18 and 20 months for tenofovir and entecavir, respectively. Patients receiving both drugs showed comparable rates of HBeAg loss, rates of undetectable HBV-DNA levels, rates of ALT normalization, ALT decrease, and decrease in HBV-DNA. Both drugs were well tolerated. CONCLUSION: This study shows that although the baseline characteristics did not match, tenofovir and entecavir sustained comparable virological efficacies. More patients discontinued entecavir during follow-up. Both drugs provided effective viral control, with few side effects. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Sarac F.,Haseki Egitimve Arastirma Hastanesi | Kilincaslan H.,Bezmialem Foundation University | Kilic E.,Bezmialem Foundation University | Koldas M.,Haseki Research and Education Hospital | And 2 more authors.
Journal of Pediatric Surgery | Year: 2015

Background and purpose In our study, we investigated the effects of methylene blue (MB) on histopathological changes in renal ischemia/reperfusion (I/R) injury rat model. Material and methods Twenty-one Sprague-Dawley male rats were divided equally into three groups. Group 1 (control) was administered intraperitoneal saline solution. In Groups 2 (untreated group) and 3 (MB treatment), the renal arteries were clamped, and ischemia (for 1 hour) and then reperfusion (for 4 hours) were applied. Thirty minutes before ischemia, the untreated group received physiological saline, whereas the treatment group was administered 30 mg/kg MB through an intraperitoneal route. Blood samples were drawn, and renal specimens were harvested 5.5 hours after physiologic saline injection in the control and immediately after the reperfusion period in the other groups. The levels of tissue superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total oxidant status (TOS), total antioxidant status (TAS), plasma urea, creatinine and ischemia modified albumin (IMA) were measured. Moreover, the histopathological damage score of the renal tissue was determined. Results MB significantly alleviated the severity of histopathological damage by increasing the levels of tissue SOD and TAS and decreasing TOS concentrations in the renal I/R model (p < 0.05). Conclusion Administration of MB in renal I/R damage may play a protective role. © 2015 Elsevier Inc. All rights reserved.


Serebruany V.L.,Johns Hopkins University | Serebruany V.L.,HeartDrug Research Laboratories | Fortmann S.D.,HeartDrug Research Laboratories | Rao S.V.,Duke University | And 6 more authors.
Thrombosis and Haemostasis | Year: 2016

Vorapaxar, a novel antiplatelet thrombin PAR-1 inhibitor, has been evaluated in the successful TRA2P trial and the failed TRACER trial. The drug is currently approved for post myocardial infarction and peripheral artery disease indications with concomitant use of clopidogrel and/or aspirin. The FDA ruled that the vorapaxar safety profile is acceptable. However, both trials revealed excess diplopia (double vision) usually reversible after vorapaxar. The diplopia risk appears to be small (about 1 extra case per 1,000 treated subjects), but real. Overall, there were 10 placebo and 34 vorapaxar diplopia cases (p=0.018) consistent for TRACER (2 vs 13 cases; p=0.010) and for TRA2P (8 vs 21 cases; p=0.018). Hence, we review the FDA-confirmed evidence and discuss potential causes and implications of such a surprising adverse association, which may be related to off-target PAR receptor mismodulation in the eye. © Schattauer 2016.


PubMed | Istanbul University, Bezmialem Foundation University, Zeynep Kamil Research and Education Hospital and Haseki Research and Education Hospital
Type: Journal Article | Journal: European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie | Year: 2014

The aim of this study was to investigate the effects of dimethyl sulfoxide (DMSO) on stricture formation in corrosive esophageal burns.A total of 21 male rats were divided equally into three groups. In Group 1 (burn) and Group 2 (burn+DMSO) burns were induced in the distal esophagi with a 30% NaOH solution. In Group 3 (control), a saline solution was applied to the esophageal lumen. In Group 2, DMSO was administered intraperitoneally (3 mg/kg) 15 minutes after the burn was induced and then every 24 hours for 7 days. All rats were humanely killed at the end of Day 22. Distal esophagi were harvested for analysis. The stenosis index (SI) and histopathologic damage score were evaluated in addition to malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), tumor necrosis factor alpha (TNF-), and interleukin-6 (IL-6) levels.DMSO significantly decreased the levels of MDA, NO, TNF-, and IL-6 in the rats with burned esophagi. Furthermore, the SI and histopathologic scores decreased significantly in the burn+DMSO group relative to the burn group (p<0.05).Our results suggest that DMSO can decrease the occurrence of stricture formation and could represent a beneficial alternative therapy for the treatment of corrosive esophagitis.


PubMed | Bezmialem Foundation University, Abant Izzet Baysal University and Haseki Research and Education Hospital
Type: Journal Article | Journal: Journal of pediatric surgery | Year: 2015

In our study, we investigated the effects of methylene blue (MB) on histopathological changes in renal ischemia/reperfusion (I/R) injury rat model.Twenty-one Sprague-Dawley male rats were divided equally into three groups. Group 1 (control) was administered intraperitoneal saline solution. In Groups 2 (untreated group) and 3 (MB treatment), the renal arteries were clamped, and ischemia (for 1 hour) and then reperfusion (for 4 hours) were applied. Thirty minutes before ischemia, the untreated group received physiological saline, whereas the treatment group was administered 30 mg/kg MB through an intraperitoneal route. Blood samples were drawn, and renal specimens were harvested 5.5 hours after physiologic saline injection in the control and immediately after the reperfusion period in the other groups. The levels of tissue superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), total oxidant status (TOS), total antioxidant status (TAS), plasma urea, creatinine and ischemia modified albumin (IMA) were measured. Moreover, the histopathological damage score of the renal tissue was determined.MB significantly alleviated the severity of histopathological damage by increasing the levels of tissue SOD and TAS and decreasing TOS concentrations in the renal I/R model (p<0.05).Administration of MB in renal I/R damage may play a protective role.


Hasiloglu Z.I.,Istanbul University | Albayram S.,Istanbul University | Gorucu Y.,Haseki Research and Education Hospital | Selcuk H.,Bakirkoy Dr Sadi Konuk Research And Education Hospital | And 3 more authors.
Headache | Year: 2012

Aim.- Spontaneous intracranial hypotension (SIH) is caused by spontaneous cerebrospinal fluid (CSF) leaks and is known to cause orthostatic headaches. Phase-contrast magnetic resonance imaging (PC-MRI) is a non-invasive technique that can be used to quantify variation in CSF flow. The aim of this study was to assess CSF flow dynamics using PC-MRI in SIH. Materials and Methods.- Twenty-five patients with a definitive diagnosis of SIH and 25 healthy subjects were evaluated with PC-MRI. Magnetic resonance (MR) images were acquired using a 1.5-T unit with an 8-channel head coil. Differences between SIH patients and control subjects were assessed statistically using Wilcoxon's rank sum test, Spearman's rho test, or Pearson's chi-square test, as appropriate. Results.- CSF flow volumes toward the third ventricle, CSF flow volumes toward the fourth ventricle, the absolute stroke volume, the peak systolic velocity, and the peak diastolic velocity in SIH patients were significantly smaller than those in control subjects (P <.0001). On the other hand, the net CSF flow volume (P =.9227) and the net CSF flow direction (P =.2472) for SIH patients and control subjects were not significantly different. Conclusions.- The results obtained by CSF flow analysis were directly related to values of CSF opening pressure, determined by lumbar puncture, and clinical findings, such as headache scores. Thus, CSF flow analysis with PC-MRI, which has a short performance time and is non-invasive, may contribute to assessment of SIH patients. © 2012 American Headache Society.


Kilincaslan H.,Bezmialem Foundation University | Cipe G.,Bezmialem Foundation University | Aydogdu I.,Bezmialem Foundation University | Sarac F.,Haseki Research and Education Hospital | And 2 more authors.
American Journal of Case Reports | Year: 2014

Objective: Rare disease Background: The use of the laparoscopic approach versus open approach for the management of giant ovarian cysts is controversial. Exclusion of malignant conditions has critical importance in the laparoscopic management of these cases. However, in some cases, the possibility of malignancy and the ovarian origin of a cyst cannot be excluded during the preoperative period. Case Report: Herein we present the case of a 16-year-old girl with a giant ovarian cyst. The abdominal cavity was laparoscopically explored, and no signs suggestive of malignancy were encountered; the ovarian origin of the cyst was confirmed. A Veress needle was inserted percutaneously, and the cyst was drained and laparoscopically excised. No complications were encountered at follow-up visits 3 and 6 months after surgery. Conclusions: In addition to the well-known advantages of laparoscopic surgery (e.g., decreased postoperative pain, length of hospital stay, and wound infection), perfect cosmetic results are particularly important for young women. The pure laparoscopic management of giant ovarian cysts is safe and feasible. © Am J Case Rep.


Toptas M.,Haseki Research and Education Hospital | Akkoc I.,Haseki Research and Education Hospital | Savas Y.,Haseki Research and Education Hospital | Uzman S.,Haseki Research and Education Hospital | And 2 more authors.
Blood Coagulation and Fibrinolysis | Year: 2016

Acute mesenteric ischaemia (AMI) is an emergency condition that requires urgent diagnosis. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been studied as inflammatory biomarkers in atherosclerosis, but data regarding AMI are lacking. The study population included patients with AMI (n=46) versus age and sex-matched healthy controls (n=46). Computed multidetector tomographic angiography was performed to diagnose AMI. NLR and PLR were calculated using complete blood count. C-reactive protein (CRP) levels were also analyzed. Neutrophil levels and lymphocytes were significantly higher in patients with AMI than in the control individuals (P<0.001 and P=0.43, respectively). NLR levels were significantly higher in patients with AMI compared with that in the control individuals (P<0.001). Platelet levels did not reach statistical significance between the groups (P=0.709). However, patients with AMI had significantly higher PLR levels than the control group (P=0.039). CRP levels on admission were higher in patients with AMI in comparison with control individuals. There was also a positive correlation between NLR and CRP (r=0.548, P<0.001), and between PLR and CRP (r=0.528, P<0.001). NLR level greater than 4.5, measured on admission, yielded an area under the curve value of 0.790 (95% confidence interval 0.681-0.799, sensitivity 77%, specificity 72%), and PLR level of greater than 157 yielded an area under the curve value of 0.604 (95% confidence interval 0.486-0.722, sensitivity 59%, specificity 65%). Patients with AMI had increased NLR, PLR, and CRP levels compared with controls. Increased NLR and PLR was an independent predictor of AMI. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.


PubMed | Haseki Research and Education Hospital
Type: Journal Article | Journal: Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica | Year: 2014

To investigate success of endoscopic lithotripsy for bladder stone following stress urinary incontinance surgery and contraception surgery.Charts of patients admitted in two centers between January 2006 and March 2013 were retrospectively reviewed and seven women were enrolled in our study. Patients demographic parameters including age, main complaint(s), previous surgery type, time to diagnosis were analyzed. Also operative time, hospitalisation lenght, perioperative and postoperative complication( s) were evaluated.Five patients had undergone tension free vaginal tape procedure and one patient had undergone transobturator tape procedure. Median age was 62 (50-71) years. In one patient bladder stone formed around an intrauterine device. Dysuria (85%), hematuria (57%) and recurrent urinary tract infection (57%) were the main complaints. The median diagnosis time was 44.1 months. Abdominal ultrasonography and non contrast enhanced computer tomography were performed for five and two patients respectively and diagnosis was confirmed cystoscopically. Endoscopic lithotripsy using Holmium laser lithotripter or pneumatic lithotripter was used for all cases. The mean operation time was 41.2 minutes (20-70) and success was 100%. There was no intraoperative complication. Only one patient had fever higher than 38C postoperatively and was treated by appropriate antibiotic. The median hospitalisation time was 1.57 day.In conclusion endoscopic lithotripsy is a safe and effective approach to manage bladder stone associated with mid-urethral synthetic slings and intrauterine devices.

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