Browsing by Author "Uysal, Erdal"

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Alterations in thyroid hormones due to increased intraabdominal pressure in rats
(Taylor, 2015-11-02) Uysal, Erdal; Kırdak, Türkay; Korun, Nusret; Uysal, Erdal; Kırdak, Türkay; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Anabilim Dalı; 0000-0002-8616-9784; Z-6311-2019; CZX-7145-2022; FJN-9955-2022
Purpose: Although the effects of increased intraabdominal pressure on the abdominal organs are well known, there is a limited data regarding its effects on the thyroid hormones. The aim of this study is to investigate the changes in thyroid hormone profiles during stress endocrine response induced by increased intraabdominal pressure, which was obtained by pneumoperitoneum in rats. Materials and Methods: A hundred-fifty female wistar albino rats were divided into three main groups, according to intraabdominal pressure applied; Control (Group 1), (n:30), low pressure, 15 mmHg, (Groups 2 and 3), (n:60), and high intraabdominal pressure, 25 mmHg, (Groups 4 and 5), (n:60) groups. Groups 2, 3, 4, 5 were divided into three subgroups separately, according to duration of intraabdominal pressure. Rats in Groups 3 and 5 were decompressed at the end of times indicated (15th, 30th, and 45th min) and blood samples were obtained. Whereas blood samples from Groups 2 and 4 were drawn without decompression at the end of times indicated. Measurements included thyroid stimulating hormone, cortisole, vasopressin, adrenocorticotropic hormone, triiodotronin and thyroxin. Result: Our study revealed that blood TSH levels reduce and free T3 and T4 levels increase in case of prolonged intraabdominal pressure increase that cause abdominal compartment syndrome. The change in blood thyroid hormone levels are encountered prominently on 30th and 45th min. Conclusion: Secretion of vasopressin, adrenocorticotropic Hormone and cortisol increases with increasing intraabdominal pressure. At high pressures, thyroid stimulating hormone secretion decreases while the secretion of triiodotronin increases. The effect of this case on the clinical findings has not been fully clarified yet and it needs further studies to clarify underlying mechanism. In this perspective, the findings of this study may be used in further clinical and experimental studies.
Analysis of the effect of locally applied bovine collagen sponge and adipose-derived mesenchymal stem cells on seroma development in rats undergone mastectomy and axillary dissection
(Surgery, 2016-09-12) Bakır, Hasan; Uysal, Erdal; Kurt, Akif Hakan; Kırdak, Türkay; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 8704181100
Purpose: Seroma is the most frequently seen complication after the mastectomy and axillary dissection. The aim of this study was to analyze the effects of locally applied bovine collagen sponge and adipose-derived mesenchymal stem cells on seroma development in rats that undergone mastectomy and axillary dissection. Materials and Methods: Wistar albino rats, were randomly divided into 3 groups (n = 10 per group). For the rats in Group 1, 1 ml 0.09% NaCl was implemented. 2 x 106/kg adipose-derived mesenchymal stem cell was implemented within 1 ml 0.09% NaCl for the rats in Group 2, and 3 cm2 bovine collagen sponge were locally applied for the rats in Group 3. Adhesion scores, histopathological examination, E-cadherin expression and tissue seroma volume were evaluated. Results: The seroma volume of Group 3 were significantly lower than those of Groups 2 and 1 (p < 0.001). General adhesion scores of Group 3 were significantly higher than those of Groups 1 and 2 (p < 0.05). Statistically significant increase was observed in Group 3 compared to Group 1 in terms of fibroblast, neovascularization and collagen density (p < 0.05). Conclusion: Local application of bovine collagen sponge and ADSCs in rats, which have undergone experimental mastectomy and axillary dissection, can be told to decrease the seroma formation and to increase the neovascularization and collagen deposition. This effect is more significant in bovine collagen sponge group.
Comparison of early and interval laparoscopic cholecystectomy for treatment of acute cholecystitis. Which is better? A multicentered study (Retracted Article)
(Lippincott Williams & Wilkins, 2016-10-02) Uysal, Erdal; Türel, Kadir Serkan; Sipahi, Mesut; Yılmaz, Nimet; Yılmaz, Fatih A.; Işık, Özgen; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 0000-0002-9541-5035; AAW-9602-2020; 36600543700
Introduction: The aim of this study was to compare early laparoscopic cholecystectomy (LC) and LCs performed at different time intervals for treatment of acute cholecystitis, contribute to the literature with data obtained from different centers, and provide assistance to clinicians about the timing of LC in acute cholecystitis. Materials and Methods: The study was designed as a retrospective, observational, and multicentered study. The data of 470 patients who had undergone LC for treatment of acute cholecystitis between January 2010 and March 2016 were included. Four different centers contributed to the study. The patients were divided into 4 groups. The groups were identified according to the timing of LC following the onset of findings and symptoms of acute cholecystitis as group 1 (first week), group 2 (1 to 4 wk), group 3 (4 to 8 wk), and group 4 (> 8 wk). The clinical and demographical characteristics, comorbidities, complications, hospital stay, duration of operation, conversion rates, and rehospitalizations in the following 30 days of patients in the groups were compared. Results: A significant increase was found in group 4 compared with groups 1 and 2 in relation to comorbidities (P < 0.01) (P= 0.042). No statistically significant difference was observed among the groups for the comparison of operation durations, conversion rates, and total number of complications (P > 0.05). The groups were compared with regard to the mean hospital stay, and the hospital stay was found to be significantly higher in group 4 than in group 1 (P= 0.001). In our study, the 30-day readmission rate was determined to be significantly higher in the > 8-week group (group 4) compared with the first-week (group 1) and 1- to 4-week group (group 2) (P < 0.05). Conclusions: Interval LC does not decrease the complication rate, conversion rate, or the operation time. Early LC could be preferred for treatment of acute cholecystitis as no significant differences related to the conversion rate, operation time, and overall complication rate are observed between the early and delayed LCs; however, a shorter hospital stay and lower 30-day readmission rate are observed in early LC for the treatment of acute cholecystitis.
Giant multicystic malignant pheochromocytoma
(Aves, 2017-12-01) Uysal, Erdal; Gürer, Ahmet Orhan; İkidağ, Mehmet Ali; Kırdak, Türkay; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; CZX-7145-2022
Pheochromocytoma is a rare tumor originating from the embryonic neural crest and secreting high levels of catecholamines. The average tumor size is approximately 7 cm, and the average weight is approximately 200 g in the previous publications. Sometimes these tumors may be bigger. In this report, a case of multicystic malignant pheochromocytoma with a huge size is presented, which is seldom reported in the past. A 37-year-old male patient was referred to our hospital for etiological investigation of his recently diagnosed hypertension. Contrast-enhanced computed tomography (CT) examination was performed for further evaluation of the lesion and surrounding tissues. The lesion was 18x8x13 cm in size. It had lobulated margins, large cystic components, and peripheral and septal contrast enhancement. The levels of metanephrine, normetanephrine, adrenaline, noradrenaline, vanilmandelic acid, and dopamine were significantly elevated. The patient was prepared for surgery. In the pathological evaluation, the mass weighed 1018 g and was 18x8x13 cm in size. He was diagnosed with malignant pheochromocytoma. After eight months, a CT examination showed a recurrent mass, liver metastasis, and distant metastasis. The patient received chemotherapy and radiotherapy. Multicystic malignant pheochromocytoma may reach huge sizes without causing any symptoms.
Idiopathic spontaneous bladder perforation: A rare case
(Urol & Nephrol Res Ctr-unrc, 2015-03-01) Uysal, Erdal; Dokur, Mehmet; İkidağ, Mehmet Ali; Kırdak, Türkay; Kırdak, Türkay; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Bölümü; CZX-7145-2022
Inflammatory response markers in rats undergoing abdominal surgical procedures
(Hellenic Soc Gastroenterology, 2020) Uysal, Erdal; Sezgin, Efe; Kirdak, Türkay; Çeçen, Gülce Sevdar; Çavun, Sinan; Uludağ Üniversites/Tıp Fakültes/Genel Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Farmakoloji Anabilim Dalı.; CZX-7145-2022; JCN-7924-2023; EPN-2927-2022; 8704181100; 57218595192; 6507468595
Background The aim of this study was to determine the effectiveness of cortisol, interleukin (IL)-6, C-reactive protein (CRP), and white blood cell (WBC) count as inflammatory markers to evaluate the postoperative inflammatory response associated with various abdominal surgical procedures in rats. Methods Wistar albino rats (N=152) were randomly assigned to 7 groups: control, hepatectomy, splenectomy, nephrectomy, colectomy, gastrectomy, and sham. Apart from the control group, each group was then divided into 3 subgroups: 6th, 24th and 48th h. Thus, a total of 19 groups were defined, each including 8 rats. At the 6th, 24th and 48th h following the surgical procedures blood samples from each rat were collected. The plasma concentrations of IL- 6, cortisol, CRP, and WBC were measured. Results Both the surgery category and the elapsed time after the surgery had a significant effect on IL-6 levels (P<0.0001). Blood CRP levels were primarily determined by the surgery category (P<0.0001). Neither surgery nor the elapsed time had a significant effect on the cortisol levels. The elapsed time after surgery was the major factor that influenced the differences in WBC count among the surgery groups (P<0.0001). Conclusions Our results cumulatively indicate that the levels of IL-6, CRP, and cortisol and WBC count change at different time points after several abdominal surgical procedures. Cortisol level is not related to the type of surgical procedure or the elapsed time, while WBC count decreases with the elapsed time. None of the changes in the markers investigated in this study is specifically related to the category of abdominal surgical procedure.
Karıniçi yapışıklıkların önlenmesinde metilprednizolonun farklı dozlarının etkinliğinin incelenmesi
(Türk Travma ve Acil Cerrahi Derneği, 2008-07) Kırdak, Türkay; Uysal, Erdal; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 8704181100; 25643371300; 6602316874
To assess the effectiveness of different doses of methylprednisolone on preventing intraabdominal adhesions established experimentally in rats. METHODS Forty female Wistar rats were divided into four groups: high-dose steroid (16 mg/kg), low-dose steroid (10 mg/kg), serum physiologic, and control. Following median laparotomy and procedure for adhesion formation in all rats, 16 mg/kg methylprednisolone (high-dose steroid group), 10 mg/kg methylprednisolone (low-dose steroid group), or serum physiologic (serum physiologic group) was administered into the intraperitoneal space, topically. No additional procedure was applied to rats in Group 4 (Control). All rats were sacrificed on day 15 postoperatively, and intraperitoneal adhesions were assessed according to Linsky's scale. RESULTS No significant differences were determined between the groups with respect to severity (p=0.867), degree (p=0.919), extent (p=0.876), and general scores (p=0.574) of adhesion formation. Wound infection rates were also similar in the four groups (p>0.05). CONCLUSION There was no difference in the effectiveness of different methylprednisolone doses, administered topically, in preventing intraabdominal adhesion formation, and furthermore, steroids do not prevent intraabdominal adhesion development.
Outcomes of parathyroid autotransplantation during total thyroidectomy: A comparison with age- and sex-matched controls
(Taylor & Francis, 2016-09-01) Uysal, Erdal; Kırdak, Türkay; Dündar, Halit Ziya; Ocakoğlu, Gökhan; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; AAH-5180-2021; 8704181100; 55453773300; 15832295800; 6602316874
Purpose: To determine the effect of parathyroid autotransplantation (PA) on postoperative hypocalcemia in cases of total thyroidectomy. Materials and Methods: Cases undergoing total thyroidectomy and PA were compared with age and sex-matched controls who had not undergone PA. The postoperative percentage changes (PC) of parathyroid hormone (PTH) and calcium (Ca+2) in the first 12-24 hours (12-24 -> hrpreop), between the 1st-3rd weeks (1-3 -> wkpreop) and at the 6th month (6mo -> preop), the rates of hypocalcemia (Ca+2< 8mg/dL) and low PTH level (PTH< 15 pg/mL), permanent hypocalcemia, inadvertent parathyroidectomy in both groups were compared. Results: The number of patients with PTH12-24hr<15 pg/mL was significantly higher (n:34,(55.7%)) than the number of patients in the control group (n:16(26.2%)), (p=0.001). The rate of decrease in the blood Ca+2 median PC (6mo -> preop) was significantly higher in the PA group (4.2%) than the control group (1.1%), (p=0.008). There was no significant difference between the 2 groups in terms of the postoperative frequency of hypocalcemia (p>0.05). In the PA & 50 group, the rate of inadvertent parathyroidectomy was higher than that of cases over age 50 (p=0.029). Conclusion: In spite of the presence of an increased postoperative hypocalcemia trend in cases requiring PA during total thyroidectomy, the rates of transient and permanent hypocalcemia were not different to the control cases. But the frequency of cases with low PTH level in cases undergoing PA was higher than that of the control cases. In cases of 50 years of age and under, who had undergone PA, the possibility of inadvertent parathyroidectomy increased.
Sıçanlarda artmış karın içi basıncına bağlı gelişen stres endokrin yanıt sırasındaki tiroid hormon değişiklikleri
(Uludağ Üniversitesi, 2008) Uysal, Erdal; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.
Bu çalışmada pnömoperitonyum ile oluşturulmuş artmış karın içi basıncına bağlı oluşan stres endokrin yanıt sırasında tiroid hormon profilindeki değişikliklerin incelenmesi amaçlanmıştır.Çalışmada 150 adet "wistar albino" dişi sıçan kullanıldı. Sıçanlar 5 ana gruba ayrıldı. Grup 1: (Kontrol), Grup 2 ve Grup 3, 15 mmHg basınca maruz bırakılan gruplar, Grup 4 ve Grup 5: 25 mmHg basınca maruz bırakılan gruplar olarak belirlendi. Grup 2 ve Grup 4'e dekompresyon yapılmadan, Grup 3 ve Grup 5'e dekompresyon yapıldıktan sonra kan örnekleri alındı. Tüm gruplar 3 ayrı alt gruba ayrıldılar. Tüm alt gruplar 10 adet sıçandan oluşturuldu. Kan örneklerinden TSH, T3, T4, ACTH, vazopressin ve kortizol düzeyleri çalışıldı.Yüksek basınca maruz kalan Grup 4 ve Grup 5'deki deneklerde TSH değerleri anlamlı olarak düşük (p<0,001) bulunurken, Grup 4'de serbest T3 ve total T3 değerlerinde anlamlı artış bulundu (p<0.05). Total T4 değerleri açısından karşılaştırmalarda hiçbir grupta anlamlılık saptanmazken serbest T4 değerlerinde sadece Grup 3'de anlamlı artış görüldü. Karın içi basınç arttıkça vazopressin, ACTH ve kortizol değerlerinde artış bulundu. Dekompresyonla birlikte ACTH ve vasopressin değerlerinde düşme saptandı.Karın içi basınç arttıkça vazopressin, ACTH ve kortizol salgılanması artmaktadır. Bu bulgular karbondioksit insuflasyonu ile elde edilen karın içi basıncı artışında, basınç arttıkça organizmada daha belirgin stres yanıt oluştuğunu göstermektedir. Yüksek basınçlarda TSH salınımı azalırken T3 salınımı artar. Bu durumun klinik bulgulara etkisi henüz tam netleşmemiştir. Karın içi basınç artışında TSH'daki farklı davranışı ortaya koymak ve klinik sonuçlarının daha iyi anlaşılabilmesi için yeni çalışmalara ihtiyaç vardır.
Sıçanlarda farklı uzunluk ve farklı yerleşimdeki karın orta hat kesilerinin yara ayrışmasına etkisi
(Türk Travma ve Acil Cerrahi Derneği, 2009-05) Kırdak, Türkay; Uysal, Erdal; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; 8704181100; 25643371300; 6602316874
BACKGROUND To assess the effect of different lengths and placements of median laparotomy incision on wound dehiscence in the rat. METHODS Eighty female Wistar rats were divided into 8 groups of 10 rats each. Groups underwent median laparotomy with different incision lengths (2, 3, 4, 6 cm) at two sites (upper and lower abdomen). Pneumoperitoneum was established in all rats using an insufflator on postoperative day 3. When gas leakage through the wound with an instantaneous decrease in intraabdominal pressure was noticed, these values were recorded as dehiscence pressure. In addition, the time until wound breakage was recorded. The different incision groups were compared. RESULTS After excluding 4 rats for various causes, statistical analysis was performed on the remaining 76 rats. When the different incisional lengths were compared, there were no significant differences in dehiscence pressures and time (p>0.05). Similarly, there were no significant differences between the incision groups according to upper or lower abdominal wall site of incision (p>0.05). CONCLUSION Midline abdominal wall incisions of different lengths and placements (upper or lower abdomen) have similar dehiscence pressures against the pneumoperitoneum in the early postoperative period (p>0.05).
The reasons of renal transplant recipients' admission to the emergency department; a case series study
(Shahid Beheshti Univ Medical Sciences, Fac Med, 2016-09-01) Uysal, Erdal; Dokur, Mehmet; Bakır, Hasan; İkidağ, Mehmet Ali; Kırdak, Türkay; Kazımoğlu, Hatem; Kırdak, Türkay; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Bölümü; CZX-7145-2022
Introduction: Renal transplantation are admitted to emergency department (ED) more than normal population. The present brief report aimed to determine the reasons of renal transplant patient's ED visits. Methods: This retrospective case series study analyzed the reasons of renal transplant recipients admission to one ED between 2011 and 2014. The patient data were collected via a checklist and presented using descriptive statistics tools. Results: 41 patients with the mean age of 40.63 +/- 10.95 years were studied (60.9% male). The most common ED presenting complaints were fever (36.6%) and abdominal pain (26.8%). Infections were the most common final diagnosis (68.3%). Among non-infectious causes, the most common was acute renal failure (9.7%). 73.2% of the patients were hospitalized and no cases of graft loss and mortality were seen. Conclusion: The most common reason for ED admission was fever, and infections were the most common diagnosis. Acute gastroenteritis being the most frequent infection and among non-infectious problems, acute renal failure was the most frequent one.