Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Use of ERCP during Pregnancy: Is it Safe and Effective?(2014) Akcakaya, Adem; Koc, Bora; Adas, Gokhan; Kemik, Ozgur; 24901127Cholangitis and pancreatitis are the most gruesome complications that can be potentially fatal for the mother and fetus. The management of bile stone disease complicated with duct stones during pregnancy is challenging. Conservative treatment instead of surgery has always been advocated due to the increased risk for fetal compromise. Minimally invasive therapy with ERCP has been suggested as an effective therapeutic option for the management of pancreaticobiliary diseases during pregnancy. The main topics of discussion are the risks stemming from the endoscopic procedure itself, drugs used for sedation and the adverse effects of radiation exposure on the fetus. In this manuscript, we want to present the efficiency and feasibility of the ERCP for the management of hepatobiliary and pancreatic diseases in pregnancy.Item Effects of Mesenchymal Stem Cells and VEGF on Liver Regeneration Following Major Resection(2016) Adas, Gokhan; Koc, Bora; Adas, Mine; Duruksu, Gokhan; Subasi, Cansu; Kemik, Ozgur; Kemik, Ahu; Sakiz, Damlanur; Kalayci, Mustafa; Purisa, Sevim; Unal, Seda; Karaoz, Erdal; 27094936The study aims to determine the effects of mesenchymal stem cell (MSC) therapy and a combination therapy of MSCs transfected with vascular endothelial growth factor (VEGF) for liver regeneration after major resection. Thirty-eight rats were divided into four groups: group 1: control (sham operation); group 2: control (70 % hepatic resection); group 3: 70 % hepatic resection + systemically transplanted MSCs; and group 4: 70 % hepatic resection + systemically transplanted MSCs transfected with the VEGF gene. MSCs were injected via the portal vein route in study groups 3 and 4. Expression levels of VEGF, fibroblast growth factor (FGF), platelet-derived growth factor (PDGF), epidermal growth factor (EGF), transforming growth factor (TGF), hepatocyte growth factor (HGF), and augmenter of liver regeneration (ALR) were analyzed in the remnant liver tissue. We investigated the levels of angiogenic factors, VEGF-receptor, angiopoietin-1 (Angpt1) and Angpt2. Biochemical parameters of liver function in blood samples were measured and a histologic assessment of the livers was performed. The postoperative liver weight and volume of each rat were measured 14 days after surgery. The expression levels of all measured growth factors were significantly increased in groups 3 and 4 compared to the control groups. The levels of Angpt1 and Angpt2 correlated with levels of VEGF and thus were also significantly higher in the study groups. There were significant differences between the estimated liver weights and volumes of group 4 and the resected controls in group 2. With the exception of portal inflammation, levels of all histological parameters were observed to be higher in MSC-treated groups when compared with the resected controls in group 2. Transplanted stem cells and MSCs transfected with VEGF significantly accelerated many parameters of the healing process following major hepatic resection. After the injection of MSCs and VEGF-transfected MSCs into the portal vein following liver resection, they were engrafted in the liver. They increased bile duct and liver hepatocyte proliferation, and secreted many growth factors including HGF, TGF beta, VEGF, PDGF, EGF, and FGF via paracrine effects. These effects support liver function, regeneration, and liver volume/weight.