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- 저자 : Serhat Meric (검색결과 3 건)
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Nadir Adnan Hacım,Ahmet Akbaş,Yigit Ulgen,Talar Vartanoglu Aktokmakyan,Serhat Meric,Merve Tokocin,Onder Karabay,Gulcin Ercan,Yuksel Altinel 대한노인병학회 2021 Annals of geriatric medicine and research Vol.25 No.4
Background: Older patients undergoing emergency laparotomy have high morbidity and mortality rates. Preoperative risk assessment with good predictors is an appropriate measure in this population. Frailty status is significantly associated with postoperative outcomes in older adults. This study aimed to investigate the effect of preoperative risk factors and frailty on short-term outcomes following emergency surgery for acute abdomen in older patients. Methods: This study included older patients (≥65 years of age) who underwent emergency abdominal surgery. We retrospectively analyzed their demographic and clinical variables and used the modified Frailty Index-11 to evaluate their frailty status. The primary outcome was the 30-day mortality rate. We also analyzed risk factors of mortality in these patients. Results: The study included 150 patients with a median age of 74 years. The mortality rate was 17.3% (n=26). We observed significantly higher mortality rates in patients who were obese and who had higher American Society of Anesthesiology (ASA grades) (p<0.05). Frailty status was worse in deceased group (p<0.001), when compared to individuals who survived. Septic shock was associated with the development of mortality (p<0.001). Multivariate regression analysis revealed that ASA grade was the only independent risk factor for mortality (odds ratio=19.642; 95% confidence interval, 3.886–99.274; p<0.001). Conclusion: Older patients with obesity and frailty presenting with higher ASA grades and septic shock had the worst survival following emergency abdominal surgery. The ASA grade was an independent risk factor for mortality.
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Nadir Adnan Hacım,Ahmet Akbaş,Yigit Ulgen,Talar Vartanoglu Aktokmakyan,Serhat Meric,Merve Tokocin,Onder Karabay,Yuksel Altinel 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.1
Purpose: The minimum harvested 12 lymph nodes (LNs) is regarded as the limit for accurate staging of nodal status in colorectal cancer patients. Besides the association of the lengths of resected intestinal segments and vascular pedicles, the mesocolic mesenteric area’s impact on LN count has not been studied. We aimed to evaluate the associations between metric variables, including the mesocolic mesentery area on the nodal harvest. Methods: All consecutive patients who underwent elective colectomy with a curative intention for colon adenocarcinoma were prospectively included. The metric variables included the lengths of resected intestinal segments, vascular pedicle, and colonic mesenteric area. The variables influencing the LN count and the correlation between the total LN count and the specimens’ relevant metric measurements were analyzed. Results: There were 46 patients with a median age of 64 years. The median count for total LNs was 22, and the LN positivity was 59.2%. There was an inadequate LN yield (<12) in 3 patients (6.1%). No significant associations were found between the adequacy of nodal harvest and the demographic, clinical, and tumoral features (P>0.05). There were significant positive correlations between total LN number and length of vascular pedicle and mesenteric area (r=0.576, P<0.001 and r=0.566, P<0.001). Conclusion: The length of the vascular pedicle and mesenteric area were significantly correlated with total LN counts. Although there was no significant impact on the length of resected segments, the colonic mesenteric area can be used alone as a measure for the assessment of the nodal yield in colon cancer.
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Gulcin Ercan,Rumeysa İlbar Tartar,Ali Solmaz,Osman Bilgin Gulcicek,Onur Olgac Karagulle,Serhat Meric,Huseyin Cayoren,Ramazan Kusaslan,Ahu Kemik,Damla Gokceoglu Kayali,Sule Cetinel,Atilla Celik 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.6
Purpose: To determine the potential protective and therapeutic effects and action mechanism of ruscogenin on ceruleininduced acute pancreatitis (AP) model in rats. Methods: Overall, 32 rats were attenuated to the sham (2-mL/kg/day isotonic solution for 4 weeks), control (20-μg/kg cerulein-induced AP for 12 hours), prophylaxis groups (cerulein-induced AP following 3-mL/kg/day ruscogenin for 4 weeks) and treatment (3-mL/kg/day ruscogenin following cerulein-induced AP for 12 hours). Blood samples were collected for biochemical analysis of nitric oxide synthase 1 (NOS1/neuronal NOS), malondialdehyde (MDA) and intercellular adhesion molecule 1 (ICAM-1). After sacrification, pancreas tissues were collected and prepared for light microscopic (hematoxylin and eosin), immunohistochemical (nuclear factor kappa B) and biochemical analysis (tumor necrosis factor-alpha [TNF-α], interleukin-6 and 1β [IL-6 and IL-1β], CRP, high-sensitivity CRP [hs-CRP] amylase, lipase, and ICAM-1). Ultrastructural analysis was performed by transmission electron microscopy. Results: The protective and therapeutic actions of ruscogenin were accomplished by improvements in histopathology, by decreasing blood cytokine levels of CRP, hs-CRP levels, TNF-α, IL-6, IL-1β, ICAM-1, by reducing the pancreatic enzymes amylase and lipase in blood, and by suppressing the expression of nuclear factor kappa B, ICAM-1, and NOS-1, but not MDA in pancreatic tissues. Ruscogenin also improved cerulein-induced ultrastructural degenerations in endocrine and exocrine cells, especially in treatment group. Conclusion: The present findings have demonstrated the beneficial protective and therapeutical effects of ruscogenin, nominating it as a highly promising supplementary agent to be considered in the treatment of AP, and even as a protective agent against the damages induced by disease
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