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    Profile of gallbladder diseases diagnosed at Afyon Kocatepe University: A retrospective study
    (Federation of Turkish Pathology Societies, 2011) Mazlum M.; Dilek F.H.; Yener A.N.; Tokyol Ç.; Aktepe F.; Dilek O.N.
    Objective: Gallbladder is one of the most commonly encountered specimen in a pathology laboratory. A diverse spectrum of diseases affect the biliary system, often presenting with similar clinical signs and symptoms. We aimed to define the profile of gallbladder diseases in our region, and to determine potential correlations between histopathologic features we observed. Material and Method: We reviewed all cholecystectomies processed in Department of Pathology of Afyon Kocatepe University Hospital between January 2000 and March 2008. Gross and histopathologic features of the specimens were reevaluated. Results: Among 1500 patients; 69.9% were women and 30.1% were men. We found out fourteen primary gallbladder carcinomas (0.93%) with adenocarcinomas being the most frequent type (78.57%). The rate of cholelithiasis was found as 89.9%. The most common type of gallstones was mixed cholesterol type gallstones with 67.5% followed by black pigment and brown pigment types as 23.83% and 5.89%, respectively. The association of metaplasia with dysplasia and also gallstones were statistically significant (p<0.001, p<0.005). The rate of the gallbladder polyps was 2.6% with the cholesterol polyps being the most common type (56.4%). Conclusion: Gallbladder diseases often present with similar clinical signs and symptoms and a surgical pathologist should be alert especially of precancerous lesions. With our results, we also conclude that elderly women with longstanding gallstone disease should undergo elective surgery even when no symptoms are present.
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    Stepwise rising CO2 insufflation as an ischemic preconditioning method
    (2007) Sahin D.A.; Haliloglu B.; Ahin F.K.; Akbulut G.; Fidan H.; Koken G.; Buyukbas S.; Aktepe F.; Arikan Y.; Dilek O.N.
    Background: The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative stress. Various ischemic-preconditioning (IP) methods were used to reduce ischemic injury in intra-abdominal organs. In this experimental, randomized, controlled trial with a blind assessment of the outcome, we evaluated the effects of a new IP method, stepwise rising CO 2 insufflation, on oxidative stress and inflammatory cytokine response. Methods: Twenty-one rats were divided into three groups. Rats in the control group were subjected to general anesthesia for only 60 minutes. The stepwise group was subjected to 5 mm Hg for 10 minutes, 10 mm Hg for 10 minutes, and 15 mm Hg of CO2 insufflation for 60 minutes without deflation. In the Pp15 group, the pressure of CO2 insufflation was fixed at 15 mm Hg for 60 minutes without deflation. Liver and blood samples were examined to determine malondialdehyde (MDA), the antioxidant, superoxide dismutase (SOD), and inflammatory cytokine (tumor necrosis factor-alpha [TNF-?], interleukin-6 [IL-6]) levels. Histopathologic scores of liver tissue were examined in all groups. Results: The highest plasma and liver MDA, TNF-?, and IL-6 values were in the Pp15 group, followed by the stepwise and control groups. However, plasma and liver SOD levels determined in the control group were significantly higher, compared to stepwise and Pp15 groups. The lowest plasma and liver levels of SOD were in the Pp15 group, followed by the stepwise and control groups. Significantly higher histopathologic scores were found in the Pp15 group, followed by the stepwise and control groups, as well as MDA and inflammatory cytokine (TNF-?, IL-6) levels. Conclusions: We concluded that the stepwise rising CO2 insufflation method may be an alternative IP method that may lead to a reduction in I/R injury. © 2007 Mary Ann Liebert, Inc.