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Öğe Acute parathyroid storm secondary to parathyroid adenoma: a case report(Mrs Deepika Charan, 2014) Duran, Arif; Dikbaş, Oğuz; Ocak, Tarık; Tekçe, Hikmet; Şengül, NerimanHypercalcemic hyperparathyroid crisis is an infrequent but life threatening complication of main hyperparathyroidism. It is an infrequent manifestation for primary hyperparathyroidism by reason of parathyroid adenoma presenting with parathyroid storm. Acute hypercalcemic hyperparathyroid crisis is a rapidly developing syndrome characterized by severe hypercalcemia associated with life threatening disturbances in cardiac, renal, cerebral functions. This state should be doubted in acutely ill cases with gastrointestinal appearances, profound dehydration, changed mental state, urinary signs or cardiac arrhythmias. We offer this patients to give emphasis to the significance management of an acute hypercalcemic syndrome and early diagnosis as a result of primary hyperparathyroidism as a cause of an undefined adenoma of the parathyroid gland. We present this patients to give emphasis on early and rigorous treatment of hypercalcemic crisis as a result of parathyroid storm otherwise it could be fatal.Öğe Anal Fissure Patients: Before Treatment, First Consider Irritable Bowel Syndrome, Defecation Disorder and Psychopathology(2022) Şengül, Neriman; Arisoy, Özden; Yiğit, Direnç; Arslan, UfukAim: The exact etiology of anal fissure (AF) remains unclear but it appears that constipation and stress may instigate AF. Little is known about the role of functional bowel disorder and psychopathology in AF. The aim of this study was to investigate the comorbidity of irritable bowel syndrome (IBS) in AF and its effect on quality of life (QoL). Method: This was a cross-sectional observational study. Ninety-six AF patients (76 female; 79.2%) with a mean age of 36.54±14.98 years were recruited. The Rome 3 Criteria were applied to diagnose IBS, functional constipation (FC) and no functional gastrointestinal disorder (NoGIS). Depression, anxiety, stress level, stressful life events and QoL were evaluated. Results: Of the AF patients, 42.7% had IBS, 36.4% had FC, and 20.8% had noGIS. Furthermore, 59% had defecation disorder, characterized by obstructive defecation symptoms. Patients with IBS tended to have more anteriorly located AF (IBS: 40.5%, FC: 24.1%, NoGIS: 7.1%; p=0.053). IBS patients had a significantly higher anxiety score (p=0.021). More severe depression predicted IBS (p=0.009) and IBS predicted more severe depression score (p=0.027). Depression, pain symptom severity and IBS were the most important negative factors affecting QoL (p<0.05). Conclusion: IBS, FC and defecation disorder are frequent comorbidities in patients with AF. IBS especially and defecation disorder caused a more anxious emotional state, resulting in a decreased QoL. Depression and pain symptom severity appeared to have a greater negative effect on QoL than the other symptoms of AF itself.Öğe Anal incontinance(2009) Şengül, NerimanAnal incontinence is defined as involuntary defecation at least for two times in a month. Minor one is gas or liquid feces incontinance and major one is formed feces incontinance. Although it is a benign pathology, it causes low quality of life, psyhological and social problems. Because lots of pathologolies can cause anal incontinance, the differential diagnosis is important for the treatment. Aim of treatment includes to reconstruct the correctable pathologies and improve the quality of life.Öğe Asemptomatik kalsifiye apendiks taşı(2010) Şengül, Neriman; Çakmaz, Rıdvan; Şenocak, Efsun; Boran, ÇetinAsemptomatik kalsifiye apendiks taşı nadir görülen bir durumdur. Radyolojik olarak kalsifikasyon yapan diğer karın içi patolojiler ile karışabilir. Bu çalışmada insidental olarak tespit edilen, enterolitiazis ile karışan ve laparoskopik yaklaşım ile tedavi edilen apendikste taş olgusu sunulmuştur.Öğe A chemically induced experimental colitis model with a simple combination of acetic acid and trinitrobenzene sulphonic acid(Aves, 2023) Cinpolat, Havva Yasemin; Buğdaycı, Güler; Şengül, Neriman; Astarcı, Hesna MüzeyyenBackground: It was aimed to induce a new experimental colitis model by using acetic acid and trinitrobenzene sulphonic acid together and to investigate the severity of inflammation biochemically and histopathologically in comparison with other models. Methods: Fifty-six Wistar albino male rats were randomly divided into 4 groups as control, acetic acid, trinitrobenzene sulphonic acid, and combined groups, and the animals were sacrificed following the induction of colitis on the third day and on the seventh day. The serum amyloid A and myeloperoxidase were tested in plasma samples, and the tumor necrosis factor-alpha, interleukin 33, and ST2 were assayed in colon tissue samples with enzyme-linked immunosorbent assay in addition to histopathological examination. Results: There were statistically significant differences between the combined and the control groups both on the third day and on the seventh day in all parameters. There was no difference between the acetic acid group on the seventh day and the control groups in biochemical parameters. Conclusions: The acetic acid model forms acute colitis. The combined model is found to be more successful in forming inflammation when compared to other models.Öğe The effect of exopolysaccharide-producing probiotic strains on gut oxidative damage in experimental colitis(Springer, 2011) Şengül, Neriman; Işık, Sevil; Aslım, Belma; Uçar, Gülberk; Demirbağ, Ali EbaOxidative stress plays a role in disease initiation and progression in inflammatory bowel disease (IBD) and manipulation of this pathway may attenuate disease progress. In this study, the effect of exopolysaccharide (EPS)-producing probiotic bacteria on gut oxidative damage was evaluated in a rat model of experimental colitis. Colitis was induced by intracolonic administration of acetic acid. Rats were treated daily with two probiotic strains, L. delbrueckii subsp. bulgaricus B3 strain (EPS of 211 mg/l; high-EPS group) or L. delbrueckii subsp. bulgaricus A13 strain (EPS of 27 mg/l; low-EPS group), which were given directly into the stomach. Noncolitis-fed control and preventative groups were only treated with the high-EPS producing strain. Antioxidant enzyme activities (superoxide dismutase, catalase, total glutathione, reduced glutathione, glutathione disulfide) and lipid peroxidation were measured in colonic tissue samples after a treatment period of 7 days. Significant oxidative damage was associated with a higher level of malondialdehyde (MDA) activity and reduced antioxidant enzyme activities in the colitis model group. All antioxidant enzyme activities were higher in both probiotic-treated groups compared with those of the colitis model group (P < 0.001). Lipid peroxidation was significantly ameliorated in both probiotic groups. The improvement of oxidative stress parameters was significantly more in the high-EPS group than in the low-EPS group (P < 0.001). EPS-producing probiotic bacteria significantly attenuate oxidative stress in experimental colitis. Increased EPS production gives rise to a better probiotic function. These results suggest that EPS molecules could revaluate probiotic strains and exert their beneficial effects on the host and this may have a therapeutic potential.Öğe Effects of exopolysaccharide-producing probiotic strains on experimental colitis in rats(Lippincott Williams & Wilkins, 2006) Şengül, Neriman; Aslım, Belma; Uçar, Gülberk; Yücel, Nihal; Işık, Sevil; Bozkurt, Hatice; Sakaoğulları, ZişanPURPOSE: Inflammatory bowel disease is suggested to result from a dysregulated immune response toward intestinal microflora, which may be restored by probiotic therapy based on the concept of healthy microflora. Ideal probiotic bacteria may be beneficial in inflammatory bowel disease; however, the mechanism of action and the clinical efficacy of probiotic usage are still unclear. In the present study, the effect of exopolysaccharide producing probiotics was evaluated on an experimental colitis model in rats. METHODS: Colitis was induced by intracolonic administration of acetic acid. Then, rats were treated daily with two probiotic strains, Lactobacillus delbrueckii subsp. bulgaricus B3 strain ( exopolysaccharide of 211 mg/l: high- EPS group) or Lactobacillus delbrueckii subsp. bulgaricus A13 strain ( EPS of 27 mg/ l: low- EPS group), which were given into the stomach. The non-colitis-fed control group was only treated with high- exopolysaccharide strain. The model-control and control groups were treated only with tap water. Rats were killed after a seven-day treatment period. Disease activity was quantified by use of histologic scores and colonic myeloperoxidase activity, which is a marker of neutrophil infiltration during inflammation. RESULTS: The enhanced inflammatory response was accompanied by a higher level of myeloperoxidase activity in the colitis group. Histologic scores of colonic damage and myeloperoxidase activity were lower in both probiotic- treated groups compared with those of the colitis control group (P < 0.001), although the mentioned scores improved significantly more in the high- EPS group than in the low- EPS group (P < 0.001). CONCLUSIONS: Exopolysaccharide- producing probiotics significantly attenuate experimental colitis, which may be mediated by exopolysaccharide in a dose-dependent manner. Therefore, exopolysaccharide- producing probiotics may be a promising therapeutic role in inflammatory bowel disease.Öğe Effects of probiotic bacteria on central neuronal activation in experimental colitis(AVES, 2022) Şengül, Neriman; Töre, Fatma; Işık, Sevil; Aslım, Belma; Uçar, Gülberk; Fırat, TülinBackground: Brain-gut axis dysregulation is observed in inflammatory bowel disease. However, the effect of altered gut flora on neuro-immunomodulation and its role in the pathogenesis of inflammatory bowel disease are unknown. The aims of this study are to determine (i) whether colitis modifies the expression of c-fos, a marker of general neuronal activation in the brain and (ii) whether this activation could be modulated by probiotic bacteria. Methods: In this study, 28 Sprague-Dawley rats were divided into 4 groups: colitis-probiotic group, non-colitis-fed-control group receiving probiotic Lactobacillus delbrueckii subsp. Bulgaricus B3 strain for 7 days, colitis group, and sham group receiving only sodium chloride. Colitis was induced by intracolonic administration of trinitrobenzene sulfonic acid-ethanol. The expression of c-fos was detected by immunohistochemistry in the brain tissue. Cytokines and inflammatory mediators were analyzed in the plasma. Histological scores and oxidative status were analyzed in the colon samples. Results: The inflammatory response was accompanied by increased levels of cytokines, lipid peroxidation activities, c-fos expression in the medial nucleus of the amygdala, and decreased levels of antioxidant enzymes in the colitis (P < .001). Probiotic treatment reversed those effects. Also, histopathologic scores were significantly lower in the probiotic-treated groups compared to the colitis group (P = .035). In contrast, the expression of c-fos was significantly increased in the paraventricular nucleus of hypothalamus in the probiotic-treated rats (P <.001). Conclusion: Colitis and intestinal inflammation are associated with the activation of neurons in the limbic system creating stress-like effects in the brain. Probiotics diversely modulate limbic response and hypothalamic axis activity in addition to protective effects in inflammation.Öğe Effects of sleeve gastrectomy surgery on electrocardiographic ventricular arrhythmia markers(Bayrakol Medical Publisher, 2022) İnanir, Mehmet; Memioğlu, Tolga; Yılmaz, Fatih; Eren, Hayati; Toprak, Kenan; Şengül, NerimanAim: Severely obese patients are known to be at risk of malignant arrhythmias. The frequency of ventricular arrhythmia and sudden death is increasing in morbidly obese patients. Ventricular depolarization and repolarization parameters on the electrocardiogram can predict mortality and morbidity. Electrocardiographic (ECG) markers of ventricular depolarization and repolarization parameters like QT, QTc, QTd, QTdc, JT, JTc and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios were evaluated before and after sleeve gastrectomy surgery. Material and Methods: ECG recordings of 35 (24 females and 11 males) morbid obese patients without evident cardiovascular disease were analyzed before and 20.3 +/- 9.6 (6-36) months after sleeve gastric surgery. QT, QRS, JT, and Tp-e intervals were measured. QTc, QTd, QTdc, and JTc intervals and Tp-e/QT, Tp-e/ QTc, Tp-e/JT and Tp-e/JTc ratios were calculated. Results: Body mass index (48.29 +/- 7.65 to 31.38 +/- 4.94 kg/m2, p<0.001), QTc interval (405.6 +/- 17.3 to 389.2 +/- 16.6 milisecond (ms), p<0.001), QTd (27.5 +/- 12.4 to 18.3 +/- 9.0 ms, p<0.001), QTdc (30.7 +/- 14.4 to 19.1 +/- 9.1 ms, p<0.001), JTc interval (315.0 +/- 19.0 to 301.2 +/- 20.4 ms, p=0.001), Tp-e interval (81.6 +/- 7.8 to 69.5 +/- 9.3 ms, p<0.001), Tp-e/QT ratio (0.22 +/- 0.03 to 0.19 +/- 0.02, p<0.001), Tp-e/QTc ratio (0.20 +/- 0.02 to 0.18 +/- 0.02, p<0.001), Tp-e/JT ratio (0.29 +/- 0.04 to 0.24 +/- 0.03, p<0.001) and Tp-e/JTc ratio (0.26 +/- 0.03 to 0.23 +/- 0.03, p<0.001) were significantly decreased after sleeve gastrectomy surgery. Discussion: QTc, QTd, QTdc, JTc, and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios, which are potential ECG ventricular arrhythmia predictors were significantly decreased. Therefore weight reduction with sleeve gastrectomy surgery may be associated with decreased malign arrhythmia tendency and sudden cardiac death.Öğe The Effects of Splenectomy and Splenic Autotransplantation on Plasma Lipid Levels(Taylor & Francis Inc, 2008) Akan, Arzu Atalay; Şengül, Neriman; Şimşek, Şerife; Demirer, SeherPurpose: Atherosclerosis observations after splenectomy for trauma and hypersplenism suggests a possible role for the spleen in lipid metabolism. The authors examined the effects of splenectomy on serum lipids in rats and also cholesterol-fed rats with experimental atherosclerosis. Methods: This study was designed on rats. The rats were divided into five groups: splenectomy, normal diet (SP-N, n: 8), splenectomy, cholesterol-fed groups (SP-C, n: 8), splenic autotransplantation after splenectomy, normal diet (SA-N, n: 8), splenic autotransplantation after splenectomy, cholesterol-fed groups (SA-C, n: 8) and sham groups (n: 8). Total triglyceride, total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipoprotein), and VLDL (very low-density lipoprotein) levels were determined in 40 rats. The rats were classified into five groups based on the surgical procedures. The spleens were removed and then the rats were fed a normal diet in Group SP-N (n = 8). The spleens were removed and then the rats were fed a diet containing 1% cholesterol in Group SP-C (n = 8). Splenectomy and splenic autotransplantations were performed and then the rats were fed a normal diet in Group SA-N (n = 8). Splenectomy and splenic autotransplantations were performed and then the rats were fed a diet containing 1% cholesterol in Group SA-C (n = 8). The rats were sham-operated in the control group (Group S, n = 8). An active splenic function was shown in rats that underwent splenic autotransplantation in both groups by using Technicium 99 in sulphurcolloide sintiscan on day 30. Blood lipid levels were repeated 6 months later. Results: There was no difference between pre- and postoperative lipid levels in the sham group and SA-N group (P > .05). All lipid levels including HDL were increased significantly in SP-C group (P < .05). Also VLDL and total tryglyceride levels were increased significantly in SP-N and SAC groups (p < .05). Conclusions: This study showed that the spleen might have an important effect on lipid metabolism and splenic autotransplantation may be protective in conditions with increased lipid levels.Öğe Enterovesical fistula secondary to Crohn's disease mimicking bladder tumor(2006) Kandirali, Engin; Şengül, Neriman; Akkoç, Ali; Türkeli, Vildan; Semerciöz, Atilla; Metin, AhmetIntroduction: Although most fistulas in Crohn's disease are perianal or enterocutaneous, a small portion involves the bladder and urinary system. We describe enterovesical fistulas in a patient with Crohn's disease that presented exclusively as urinary symptoms mimicking bladder tumor. A 55 years-old man presented with lower urinary tract symptoms to our clinic. Ulrasonographic examination showed a normal upper urinary tract and 4 cm papillary bladder tumor. TUR-T was performed and an enterovesical fistula was noticed during operation. Patient underwent abdominal exploration and partial resection of the ileum, ileostomy, and primary bladder repair was performed. Urologic manifestations must be recognized of fistulizing Crohn's disease and urologist should be aware that Crohn's disease may involve the bladder as inflammatory tumor.Öğe Erythema nodosum associated with granulomatous mastitis: report of two cases(Springer Heidelberg, 2010) Beş, Cemal; Soy, Mehmet; Vardı, Şeref; Şengül, Neriman; Yılmaz, FahriGranulomatous mastitis is a rare breast disease characterized by chronic inflammation. Clinical presentation of granulomatous mastitis usually mimics malignancy or infection. Coincidence of granulomatous mastitis and erythema nodosum is a quite rare feature. In this paper, we aimed to present two young women with granulomatous mastitis accompanied by erythema nodosum and successfully treated with corticosteroids. Granulomatous mastitis should be kept in the mind for differential diagnosis of erythema nodosum.Öğe The impact of the D727e polymorphism has no significant role in multi nodular goiter(Macedonian Acad Sciences Arts, 2012) Tuğ, Esra; Şengül, Neriman; Aydın, Hatip; Yılmaz, Edip ErdalInteractions between individual genetic and environ-mental factors determine the onset of the multi nodular goiter (MNG). The thyroid-stimulating hormone receptor (TSHR) gene is a convincing candidate gene in the pathogenesis of certain thyroid diseases including MNG. We investigated the codon 727 polymorphism (p.Asp727Glu, p.D727E) of the human TSHR gene using the polymerase chain reaction-restriction fragment length polymorphim (PCR-RFLP) methods in 31 Turkish patients with MNG and in 30 control subjects, aiming to evaluate the relationship between this polymorphism and MNG. After genomic DNA isolation, PCR amplification was performed using a pair of primers in exon 10 of the TSHR gene that contains the p.D727E polymorphism and digested by theNlaIII (Hin1II) restriction enzyme. We found the CC and CG genotype incidence for the patient group to be 0.71 and 0.29, respectively, and for the control group to be 0.8 and 0.2, respectively. No statistically significant difference was found between the genotype and allele distribution of both groups (p = 0.417 and p = 0.449, respectively). However, the polymorphism is significantly correlated with the low serum level of the TSH (p = 0.047). These results suggest that the p.D727E polymorphism of the TSHR gene may not contribute to the pathogenesis of nontoxic MNG diseases.Öğe Inflammatory polyp of the gallbladder containing intestinal metaplasia(Springer, 2013) Yılmaz, Fahri; Kilitçi, Asuman; Şengül, NerimanÖğe İntraabdominal lenfanjiomyiyomatoz(2006) Türkeli, Vildan; Şengül, Neriman; Şenocak, Efsun; Erkol, HayriLenfanjiomyomatozis lenf nodülü, lenfatik ve kan damarlarında hamartamatöz karakterde düz kas hücre proliferasyonu ile giden akciğer, mediasten ve abdomende görülebilen nadir bir hastalıktır (1). Üreme çağındaki genç kadınların hastalığı olarak bilinir. Ekstrapulmoner yayılım oldukça nadir olup en sık renal anjiomyiyomlar görülür. Bu çalışmada genç erkek hastada intraabdominal yerleşimli lenfanjiomyiyomatoz olgusu sunulmuştur.Öğe Karsinomayı taklit eden ve kolo-kolik invajinasyona neden olan lipom(2006) Şengül, Neriman; Dinler, Kahraman; Boran, Çetin; Kalfaoğlu, Melike E.; Erkol, HayriKolonik lipomlar, oldukça ender görülmelerine rağmen kolonda non-epiteliyal tümörler arasında en sık rastlanılan selim yağ dokusu tümörleridir. Genellikle asemptomatiktirler ve görüntüleme çalışmalarında, kolonoskopi sırasında veya başka bir nedenle ameliyat edilen hastalarda insidental olarak saptanır. Nadir olarak konstipasyon, diayare, karın ağrısı, hematokezya, obstruksiyon gibi belirtiler görülebilir. Bu sunumda kolokolonik invajinasyona neden olmuş, klinik ve endoskopik olarak kolon karsinomuna benzer bulgular sergileyen, ancak bilgisayarlı tomografi bulgularıyla tanısı konulan ve histopatolojik olarak da kolonik submukozal lipom tanısı doğrulanan olgu sunulmaktadır.Öğe Mesane tümörünü taklit eden fistülizan Crohn hastalığı(2006) Kandıralı, Engin; Şengül, Neriman; Akkoç, Ali; Türkeli, Vildan; Semerciöz, Atilla; Metin, AhmetCrohn hastalığında genellikle perianal veya enterokütanöz fistüller gelişmesine rağmen, bazen mesaneye veya diğer üriner sisteme fistüller görülebilir. Burada kliniğimize alt üriner sistem belirtileri ile başvurup mesane tümörü ön tanısı ile ameliyat edilen ve sonucunda mesaneye fistülüze Crohn hastalığı tespit edilen bir olgu sunulmuştur. 55 yaşında erkek hasta kliniğimize alt üriner sistem belirtileri ile başvurdu. Yapılan US’de mesane posteriyöründe 4x4 cm. boyutlarında lümene protrüze papiller oluşum tespit edildi. Hastaya mesane tümörü ön tanısı ile TUR-T operasyonu yapıldı. Rezeksiyon sırasında mesane ile intestinal sistem arasında fistül tespit edildi. Çekilen sistografide kontrast maddenin ileuma geçtiği görüldü. Hastaya daha sonra yapılan batın eksplorasyonunda, mesaneye fistülize terminal ileumu tutan Crohn hastalığı tespit edildi ve ileum rezeksiyonu ve mesane tamiri yapıldı. Crohn hastalarında görülen alt üriner sistem bulgularında, hastalığın mesaneye fistülüze olabileği ve sistoskopi sırasında saptanan fistüllerde de Crohn hastalığı mutlaka akılda tutulmalıdır.Öğe Multinodular leiomyoma of the esophagus with internodular hydropic degeneration and bulbous serosal protrusions similar to cotyledonoid uterine leiomyoma(Oxford Univ Press Inc, 2007) Boran, Çetin; Şengül, Neriman; Balaban, Hatice Yasemin; Gürel, SafiyeLeiomyoma is the most common benign tumor of the esophagus, and usually occurs as a solitary mass. We report a case of esophageal leiomyoma which shows multinodular growth pattern with bulbous serosal protrusions. The patient was a 26-year-old woman who had an esophageal ulcerated mass near the gastroesophageal junction. Clinical findings were consistent with carcinoma of the gastric cardia. Based on the clinical diagnosis, total gastrectomy with distal esophagectomy was performed. Histologic appearance of the resected specimen was consistent with leiomyoma which had a multinodular growth pattern.Öğe Nevoid hyperkeratosis of the nipple and areola: a diagnosis of exclusion(Blackwell Publishing, 2006) Şengül, Neriman; Parlak, Ali Haydar; Oruk, Şemsettin; Boran, ÇetinA 17-year-old woman presented with a 4 year history of hyperkeratotic and hyperpigmented lesions over both her nipples. She denied associated pain, pruritus, and discharge. The patient was not taking any medications and had never been pregnant. There was no personal or family history of any dermatologic diseases.Öğe Perineal leiomyoma mimicking complex Bartholin mass(Springer London Ltd, 2010) Koç, Önder; Şengül, Neriman; Gürel, SafiyeLeiomyomas of the external genitalia are uncommon soft tissue tumors. We report the case of a 47-year-old woman with perineal leiomyomas mimicking Bartholin's gland mass according to the preoperative magnetic resonance imaging (MRI) findings. Leiomyomas in the vulvar region should be differentiated from complicated Bartholin's gland cysts and preoperative MRI findings may be misleading. The complete surgical excision should be the choice of treatment.
