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Unusual histopathological findings in appendectomy specimens:A retrospective analysis and literature review

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World Journal of Gastroenterology 2011年第15期17卷 1961-1970页

作者： Sami Akbulut Mahmut Tas Nilgun Sogutcu Zulfu Arikanoglu Murat Basbug abdullah ulku Heybet Semur Yusuf Yagmur Department of Surgery Diyarbakir Education and Research Hospital 21400 Diyarbakir Turkey Department of Emergency Medicine DiyarbakirEducation and Research Hospital 21400 Diyarbakir Turkey Department of Pathology Diyarbakir Educa-tion and Research Hospital 21400 Diyarbakir Turkey Department of Surgery Ergani State HospitalDiyarbakir Turkey

AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens. RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed. CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination.

关键词： Appendicitis Carcinoid Unusual findings Goblet cell carcinoid Enterobius vermicularis Mucocele

Assessment of the implementation status of best available techniques for cleaner production in the textile industry

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Frontiers of Environmental Science & Engineering 2024年第8期18卷 133-148页

作者： Mehmet Eren Yaman Emrah Ozturk ulku Yetis Mehmet Kitis Department of Environmental Engineering Suleyman Demirel UniversityIsparta 32260Turkey Department of Environmental Protection Technologies Isparta University of Applied SciencesIsparta 32200Turkey Department of Environmental Engineering Middle East Technical UniversityAnkara 06800Turkey

The draft Integrated Pollution Prevention and Control(IPPC)regulation mandates compliance with best available techniques(BATs)for textile manufacturers.A study in Turkish textile facilities,covering 56 units across four sub-sectors,assessed the status of 488 BATs through on-site visits and *** aim was to gauge the sector’s adherence to *** findings revealed that 37% of surveyed BATs were fully implemented,rising to 88% when considering potential future *** suggests a strong industry inclination toward adopting BATs for cleaner production and *** study highlighted significant BAT-related investments in the textile sector,driven by environmental concerns,regulations,customer demands,resource efficiency,competition,and cost-benefit ***,the study results also indicated that there is still much work to do for the implementation of some *** was found that 60 BATs had lower implementation ratios(IR:0%-43%).Lower IR values for these BATs are mainly due to factors like specificity,high costs,long payback periods,operational difficulties,limited expertise,space constraints,customer requirements,quality concerns,operational issues,and sector-specific *** study recommends similar assessments in other European industrial sectors to evaluate compliance with mandatory BATs outlined in the Industrial Emissions *** insights from this study on the Turkish textile sector can serve as a valuable guide for future evaluations.

关键词： Best available techniques(BAT) Cleaner production Green Deal Integrated Pollution Prevention and Control(IPPC) Textile sector

Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography

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World Journal of Gastroenterology 2007年第30期13卷 4152-4153页

作者： ulku Saritas Bunyamin Aydin Yucel Ustundag Gastroneterology Department Süleyman Demirel University School of Medicine Turkey Gastroenterology Department Zonguldak Karaelmas University School of Medicine Turkey

Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow- up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure.

关键词： Endoscopic retrograde cholangiography Cholestasis Plasmapheresis

Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis

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World Journal of Gastroenterology 2009年第32期15卷 3999-4004页

作者： Altug Senol ulku Saritas Halil Demirkan Department of Gastroenterology Suleyman Demirel University School of Medicine32260 IspartaTurkey Department of Internal Medicine Suleyman Demirel University School of Medicine32260 IspartaTurkey

AIM： TO assess the efficacy of intramuscular diclofenac and fluid replacement for prevention of post-endoscopic retrograde cholangiopancreatography （ERCP） pancreatitis.METHODS： A prospective, placebo-controlled study was conducted in 80 patients who underwent ERCP. Patients were randomized to receive parenteral diclofenac at a loading dose of 75 mg followed by the infusion of 5-10 mL/kg per hour isotonic saline over 4 h after the procedure, or the infusion of 500 mL isotonic saline as placebo. Patients were evaluated clinically, and serum amylase levels were measured 4, 8 and 24 h after the procedure.RESULTS： The two groups were matched for age, sex, underlying disease, ERCP findings, and type of treatment. The overall incidence of pancreatitis was 7.5% in the diclofenac group and 17.5% in the placebo group （12.5% in total）. There were no significant differences in the incidence of pancreatitis and other variables between the two groups. In the subgroup analysis, the frequency of pancreatitis in the patients without sphincter of Oddi dysfunction （SOD） was significantly lower in the diclofenac group than in the control group （ρ = 0.047）.CONCLUSION： Intramuscular diclofenac and fluid replacement lowered the rate of pancreatitis in patients without SOD.

关键词： Endoscopic retrograde cholangiopancreatography Pancreatitis Diclofenac Nonsteroidal antiinflammatory drugs Fluid replacement

Manometric findings in patients with isolated distal gastroesophageal reflux

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World Journal of Gastroenterology 2009年第43期15卷 5461-5464页

作者： Yasemin Ozin ulku Dagli Sedef Kuran Burhan Sahin Gastroenterology Department Turkey Yuksek Ihtisas Training and Research HospitalKizilay Sokak06040 SihhiyeAnkara Turkey

AIM： To analyze manometric abnormalities in patients with isolated distal reflux and compare these findings in patients with erosive and non-erosive disease, METHODS： Five hundred and fifty patients who presented to the outpatient clinic of Turkiye Yuksek Ihtisas Hospital with gastroesophageal reflux disease-like symptoms were enrolled, Each individual was evaluated with esophageal manometry, 24-h ambulatory pH monitoring, and upper gastrointestinal endoscopy, Manometric findings for the patients with isolated distal reflux were compared to findings in controls who were free of reflux disorders or hypersensitive esophagus, Findings for isolated distal reflux patients with and without erosive reflux disease were also compared, RESULTS： Of the 550 subjects enrolled, 97 （17.6%, mean age 48 years） had isolated distal reflux and i00 had no abnormalities on ambulatory pH monitoring （control group, mean age 45 years）. There were no significant differences between the isolated distal reflux group and control group with respect to age, body mass index, and esophageal body contraction amplitude （EBCA）. Mean lower esophageal sphincter pressure was significantly higher in the control group （12.7 ± 10.3 mmHg vs 9.6 ± 7.4 mmHg, P = 0.01）. Fifty-five （56.7%） of the 97 patients with isolated distal reflux had erosive reflux disease. There were no statistical differences between the erosive reflux disease and non-erosive reflux disease subgroups with respect to mean EBCA, lower esophageal sphincter pressure, or DeMeester ***, 13% of patients with gastroesophageal reflux disease had distal wave amplitudes ≤ 30 mmHg, whereas none of the patients with non-erosive reflux disease had distal wave amplitudes in this low category. CONCLUSION： Patients with erosive and non-erosive disease present with similar manometric abnormalities. The only striking difference is the observation of very low EBCA exclusively in patients with erosive disease.

关键词： Esophageal motility disorders Isolated distal reflux Gastroesophageal reflux disease Manometry Esophagitis

Precut sphincterotomy:A reliable salvage for difficult biliary cannulation

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World Journal of Gastroenterology 2013年第1期19卷 1-7页

作者： ulku Saritas Yucel Ustundag Ferda Harmandar Department of Internal Medicine Gastroenteorology ClinicsZonguldak Karaelmeas University Hospital67600 ZonguldakTurkey

Even experienced endoscopists have 90% success in achieving deep biliary cannulation with standard methods. Biliary cannulation may become difficult in 10%-15% of patients with biliary obstruction and pre- cut (access) sphincterotomy is frequently chosen as a rescue treatment in these cases. Generally, precut sphincterotomy ensures a rate of 90%-100% success- ful deep biliary cannulation. The precut technique has been performed as either a fistulotomy with a needle knife sphincterotome or as a transpapillary septotomy with a standard sphincterotome. Both methods have similar efficacy and complication rates when adminis- tered to the proper patient. Although precut sphincter- otomy ensures over 90% success of biliary cannula- tion, it has been characterized as an independent risk factor for pancreatitis. The complications of the precut technique are not limited to pancreatitis. Two more important ones, bleeding and perforation, are also re- ported in some publications as being observed more commonly than during standard sphincterotomy. It is also reported that precut sphincterotomy increases morbidity when performed in patients without dilata- tion of their biliary tract. Nevertheless, precut sphinc- terotomy is a good alternative as a rescue method in the setting of a failed standard cannulation method. This paper discusses the technical details, timing, ef- ficacy and potential complications of precut sphincter- otomy.

关键词： Biliary cannulation Salvage Precut sphincterotomy Needle knife Transpancreatic septotomy

The effect on wound healing of pazopanib and bevacizumab compared with corticosteroid in experimental glaucoma filtration surgery

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International Journal of Ophthalmology(English edition) 2018年第12期11卷 1909-1915页

作者： Sabiha Gungor Kobat Fatma ulku Celiker Adile Ferda Dagli Kader Kasar Department of Ophthalmology Elazig Health Sciences University Department of Ophthalmology School of Medicine Firat University Department of Pathology School of Medicine Firat University Department of Ophthalmology Ordu State Hospital

AIM: To compare the effects of bevacizumab and pazopanib with corticosteroids on wound healing after trabeculectomy. METHODS: In the study, 35 New Zealand white rabbits were randomly divided into five groups. Apart from the first group, limbus-based trabeculectomy was performed for the eyes of rabbits. No postoperative treatment was administered for group Ⅰ. Topically administered saline, prednisolone acetate(1%), bevacizumab 5 mg/mL, pazopanib 5 mg/mL for group Ⅱ, Ⅲ, Ⅳ and Ⅴ respectively were applied for groups 6 h daily for 28 d. On day 28 of the experiment, eyes were enucleated and histologically and immunohistochemically ***: The fibroblast counts of groups Ⅳ and Ⅴ were determined to be lower than those of groups Ⅱ and Ⅲ(P0.05). The immunohistochemical staining intensity of fibroblast growth factor β(FGF-β) and vascular endothelial growth factor(VEGF) was determined to be lower in groups Ⅳ and Ⅴ than in groups Ⅱ and Ⅲ(P0.05). The platelet derived growth factor β(PDGF-β) intensity was lower in group Ⅴ than in groups Ⅱ, Ⅲ and Ⅳ(P0.05). CONCLUSION: Bevacizumab and pazopanib might be good alternatives of corticosteroid treatment on delaying wound healing in glaucoma surgery.

关键词： trabeculectomy wound healing corticosteroid bevacizumab pazopanib

Transcutaneous cervical esophagus ultrasound in adults: Relation with ambulatory 24-h pH-monitoring and esophageal manometry

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World Journal of Gastroenterology 2007年第39期13卷 5245-5252页

作者： Sabite Kacar Selma Uysal Sedef Kuran ulku Dagli Yasemin Ozin Erdem Karabulut Nurgul Sasmaz Gastroenterology Department Turkiye Yuksek Ihtisas Hospital Turkey Radiology Department Ankara Training and Research Hospital Turkey Biostatistics Department Hacettepe University Turkey

AIM: To determine the gastroesophageal refl uxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) f indings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS f indings as a predictor of gastroesophageal refl ux (GER). METHODS: In 45/500 patients, refl uxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry. RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal refl ux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no refl ux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F refl ux-negatives with HSE (n = 18), and Groups A + F refl ux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry fi ndings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid refl ux and/or pathologic manometry fi nding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PRbetween Groups B + D and E (AUC = 0.775, P = 0.015). CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT.

关键词： Ambulatory 24-h pH monitoring Cervical esophageal ultrasound Gastroesophageal reflux Esophageal manometry Esophageal refluxate

Modeling of Trophospheric Ozone Concentrations Using Genetically Trained Multi-Level Cellular Neural Networks

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Advances in Atmospheric Sciences 2007年第5期24卷 907-914页

作者： H.Kurtulus OZCAN Erdem BILGILI ulku SAHIN O.Nuri UCAN Cuma BAYAT Istanbul University Engineering Faculty Environmental Eng.Dept.34320AvcilarIstanbulTurkey Tuzla Marine Education Center Tuzla IstanbulTurkey Istanbul University Engineering Faculty Electrical-Electronics Eng.Dept.34320AvcilarIstanbulTurkey Beykent University 34500 Buyukcekmece Istanbul

Tropospheric ozone concentrations, which are an important air pollutant, are modeled by the use of an artificial intelligence structure. Data obtained from air pollution measurement stations in the city of Istanbul are utilized in constituting the model. A supervised algorithm for the evaluation of ozone concentration using a genetically trained multi-level cellular neural network （ML-CNN） is introduced, developed, and applied to real data. A genetic algorithm is used in the optimization of CNN templates. The model results and the actual measurement results are compared and statistically evaluated. It is observed that seasonal changes in ozone concentrations are reflected effectively by the concentrations estimated by the multilevel-CNN model structure, with a correlation value of 0.57 ascertained between actual and model results. It is shown that the multilevel-CNN modeling technique is as satisfactory as other modeling techniques in associating the data in a complex medium in air pollution applications.

关键词： genetic algorithm cellular neural networks (CNN) ozone meteorological data