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Öğe An electron microscopy study of liver and kidney damage in an experimental model of obstructive jaundice(Edizioni Luigi Pozzi, 2020) Özozan, Ömer Vefik; Dinç, Tolga; Vural, Veli; Özoğul, Candan; Özmen, Mehmet Mahir; Coşkun, FarukWith this experimental study we investigated the consequences of ligation of the common bile duct (CBD) on hepatic cells and on the renal ultrastructure by electron microscopy and also determine the effects after liberation of the ductus joint in order to clarib the mechanisms of renal failure commonly observed in cholestatic liver disease. The study was conducted on 53 Wistar albino rats divided into 4 subgroups. In the comparison group (sham) we proceeded to the simple laparotomy. After preparation of the common bile duct of all the rats of the four groups, and ligation of the duct at the level of the distal third, eight rats in each group were sacrificed on the 3rd, 7th, 10th and 14th day after surgery, taking blood samples to measure the serum levels of ALP and bilirubin, and liver and renal tissue samples for histological evaluation. In four rats of each group the common bile duct was unligated at the same deadlines to obtain free drainage of the bile for a week. At the end of this week, the rats were sacrificed by collecting blood and liver and kidney tissue samples. RESULTS: after CBD ligation in both groups, the ALP value, total and direct bilurubin levels were proportionally increased. After duct release, bilurubin levels decreased significantly. In group II, while large lipid granules were observed to indicate oxidative damage, mitochondrial swelling and crystals were observed after duct liberation. Areas of glycogen and normal mitochondria were observed in group IV. After duct release in this group, increases in Ito granules, lipid granules and normal mitochondria were observed, which may reflect the evolution of hepatic regeneration. When renal tissue was examined in group II, fusion processes in the feet, thickening of the basement membrane and mesengium were observed, and mitochondrial crystals were observed in renal tissue as well as in the liver after duct release. Damage in group III and group IV was increased parallel to prolongation of jaundice and after loosening persistent damage with mitochondrial crystals. CONCLUSION: Ultrastructural changes in rat liver tissue in conditions of obstructive jaundice may be reversible after restoration of drainage. On the other hand, ultrastructural changes in renal tissue in cases of prolonged jaundice are irreversible even if the internal drainage is restored.Öğe An electron microscopy study of liver and kidney damage in an experimental model of obstructive jaundice(Edizioni Luigi Pozzi, 2019) Özozan, Ömer Vefik; Dinç, Tolga; Vural, Veli; Özoğul, Candan; Özmen, Mehmet Mahir; Coşkun, FarukAbstract With this experimental study we investigated the consequences of ligation of the common bile duct (CBD) on hepatic cells and on the renal ultrastructure by electron microscopy and also determine the effects after liberation of the ductus joint in order to clarify the mechanisms of renal failure commonly observed in cholestatic liver disease. The study was conducted on 53 Wistar albino rats divided into 4 subgroups. In the comparison group (sham) we proceeded to the simple laparotomy. After preparation of the common bile duct of all the rats of the four groups, and ligation of the duct at the level of the distal third, eight rats in each group were sacrificed on the 3rd, 7th, 10th and 14th day after surgery, taking blood samples to measure the serum levels of ALP and bilirubin, and liver and renal tissue samples for histological evaluation. In four rats of each group the common bile duct was unligated at the same deadlines to obtain free drainage of the bile for a week. At the end of this week, the rats were sacrificed by collecting blood and liver and kidney tissue samples. RESULTS: after CBD ligation in both groups, the ALP value, total and direct bilurubin levels were proportionally increased. After duct release, bilurubin levels decreased significantly. In group II, while large lipid granules were observed to indicate oxidative damage, mitochondrial swelling and crystals were observed after duct liberation. Areas of glycogen and normal mitochondria were observed in group IV. After duct release in this group, increases in Ito granules, lipid granules and normal mitochondria were observed, which may reflect the evolution of hepatic regeneration. When renal tissue was examined in group II, fusion processes in the feet, thickening of the basement membrane and mesengium were observed, and mitochondrial crystals were observed in renal tissue as well as in the liver after duct release. Damage in group III and group IV was increased parallel to prolongation of jaundice and after loosening persistent damage with mitochondrial crystals. CONCLUSION: Ultrastructural changes in rat liver tissue in conditions of obstructive jaundice may be reversible after restoration of drainage. On the other hand, ultrastructural changes in renal tissue in cases of prolonged jaundice are irreversible even if the internal drainage is restored.Öğe High C-reactive protein level as a predictor for appendiceal perforation(Turkish Assoc Trauma Emergency Surgery, 2020) Özozan, Ömer Vefik; Vural, VeliBACKGROUND: Between 18% and 34% of acute appendicitis (AA) patients may have complicated appendicitis. Perforation is the most important complication of AA. Perforation increases morbidity and mortality. In this study, we aimed to investigate the role of basic inflammatory markers in the diagnosis of perforated AA. METHODS: A retrospective chart review was conducted of patients who underwent appendectomy with a diagnosis of AA between January 2014 and October 2019 at Akdeniz University Faculty of Medicine; and between December 2017 and October 2019 at lstinye University Faculty of Medicine Hospital. Markers recorded were as follows: white blood cell count, neutrophils, lymphocytes, platelets, c-reactive protein, mean platelet volume, red cell distribution width and eosinophils. Hematological indices were combined to generate the following three ratios: white cell neutrophil ratio, platelet lymphocyte ratio and neutrophil-lymphocyte ratio. RESULT: A total of 536 patients with a diagnosis of AA underwent an operation. There were 344 (64.1%) male patients and 192 (35.9%) female patients. The mean age of the patients was 36.7 +/- 16.2 (15-88) years. There were 94 (17.5%) patients with perforated AA and 442 (82.5%) patients with non-perforated AA. C-reactive protein (AUC: 0.81, p<0.00 I) was the most accurate markers in distinguishing the perforated and non-perforated group. CONCLUSION: Elevated CRP level is a nonspecific inflammatory marker in most of the inflammatory diseases. A high CRP level can, therefore, be used as a supplement in the diagnosis of perforated AA.Öğe The usefulness of inflammation-based prognostic scores for the prediction of postoperative mortality in patients who underwent intestinal resection for acute intestinal ischemia(Cureus Inc, 2019) Vural, Veli; Özozan, Ömer VefikObjective The current study was conducted to clarify whether the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are clinically useful in predicting postoperative mortality among patients undergoing surgery for acute intestinal ischemia (AII). Materials and methods The study was conducted as a retrospective investigation of 37 consecutive patients operated for AII between January 2014 and September 2019. Data regarding potential prognostic factors, including age, sex, preoperative white blood cell count (WBC), C-reactive protein (CRP), neutrophil, lymphocyte, and platelet counts were obtained from medical records. Results Univariate analysis revealed that age, WBC, and neutrophil count were predictors of postoperative mortality. In multivariate analysis, age (OR=1.14; 95% CI, 1.005-1.303; P=0.02) was found to be the only independent variable predicting postoperative mortality. Conclusions Preoperative NLR and PLR cannot be used as independent variables to predict postoperative 30-day mortality in patients with AII who underwent surgery.
