A. Karamercan | Gazi University (original) (raw)

Papers by A. Karamercan

Research paper thumbnail of The effect of pneumoperitoneum on intravascular fibrinolytic activity in rats

TURKISH JOURNAL OF MEDICAL SCIENCES, 2016

Background/aim: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related ... more Background/aim: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related to fibrin synthesis and deposition. The etiologic factors underlying fibrinolysis or hypercoagulability are not clearly defined. This study aimed to determine the effects of pneumoperitoneum time and pressure on coagulation cascade and the fibrinolytic pathway. Materials and methods: After the pneumoperitoneum model was established in rats, PAI-1, tPA, TAFI, D-dimer, and fibrinogen activities were evaluated in different time periods under different pressures in groups including 6 rats. Group 1 did not undergo any procedure. Group 2 received 8 mmHg of pressure for 30 min, Group III 8 mmHg for 60 min, Group IV 12 mmHg for 30 min, and Group V 12 mmHg for 60 min. Results: D-dimer levels had a tendency to decrease with increasing intraabdominal pressures. In both low and high pressure groups, fibrinogen had a tendency to increase with exposure time. There was no statistically significant difference among the study groups in terms of fibrinogen, D-dimer, and PAI-1. The levels of TAFI were significantly decreased with increasing pressure regardless of the exposure time. Conclusion: Pneumoperitoneum of the coagulation system can be changed by duration of time and pressure.

Research paper thumbnail of Fournierʼs gangrene after hemorrhoidectomy: Association with drug-induced agranulocytosis

Diseases of the Colon & Rectum, 1999

An unusual case of Foumier's gangrene after hemorrhoidectomy and drug-induced agram~ocytosis, as ... more An unusual case of Foumier's gangrene after hemorrhoidectomy and drug-induced agram~ocytosis, as the predisposing condition, is described. The patient had severe granulocytopenia that was attributed to the recent use of dipyrone. Together with hemodynamic resuscitation, broad-spectrttm antibiotic and recombinant human granulocyte colony-stimulating factor were started. Wide surgical excision of all the gangrenous tissues, in addition to laparoscopic formation of a defunctioning sigmoid loop colostomy, was performed. The white blood cell count rose steadily and the patient experienced a rapid recovery. We emphasize that radical surgery must be accompanied by phatanacologic interventions for a successful outcome in such cases.

Research paper thumbnail of No association between serum levels of insulin‐like growth factor‐I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast …

Internal medicine …, 2004

Background: Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial grow... more Background: Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angiogenic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the ...

Research paper thumbnail of Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar

Ulus Travma Acil …, 2008

... Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar Ahmet Karamerca... more ... Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar Ahmet Karamercan 1 , Tonguç Utku Yılmaz 1 , Mehmet Akif Karamercan 2 , Bülent Aytaç 1 1 Gazi Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Ankara 2 Gazi Üniversitesi Tıp Fakültesi Acil ...

Research paper thumbnail of No association between serum levels of insulin-like growth factor-I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast carcinoma after surgery

Internal Medicine Journal, 2004

Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (V... more Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angio-genic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the progression of breast cancer at least partly by stimulating angiogenesis. The aim of the present study was to investigate the association between serum IGF-I, VEGF and prolactin levels and clinicopathological characteristics of breast carcinoma. Serum IGF-I, VEGF and prolactin levels were measured in breast cancer patients and controls and these levels were compared with well-known clinicopathological characteristics of breast carcinoma, including tumour size, axillary lymph node and oestrogen/progesterone receptor status, tumour grade and disease stage. Serum prolactin, VEGF and IGF-I levels were found to be similar in breast cancer patients and control subjects (P > 0.05). When the patients were divided into groups according to their tumour size, axillary lymph node status, tumour grade, oestrogen/progesterone receptor status and disease stage, no significant differences in serum prolactin, VEGF and IGF-I levels were found among the groups (P > 0.05). The present study failed to demonstrate an association between serum levels of VEGF, IGF-I and prolactin and well-known clinicopathological characteristics of breast carcinoma.

Research paper thumbnail of Nitric oxide synthase inhibitors appear to improve wound healing in endotoxemic rats: An investigator-blinded, controlled, experimental study

Current Therapeutic Research, 2006

Background: Although inflammation is a normal part of wound healing, if the inflammatory response... more Background: Although inflammation is a normal part of wound healing, if the inflammatory response is excessive the repair process might be prolonged. Nitric oxide (NO) has been implicated in healing inflammation and wounds.

Research paper thumbnail of A randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks

Pulmonary Pharmacology &amp Therapeutics

Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional ... more Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks. Twenty-six patients with asthma attack were enrolled in the study in a randomized single blind fashion. After obtaining initial peak expiratory flow measurements (PEFR) and clinical evaluation, all patients received 1mg/kg corticosteroids and oxygen therapy and then either isotonic MgSO4 (2.5 ml, 6.3%)+salbutamol (2.5 ml) or saline (2.5 ml)+salbutamol (2.5 ml) through a jet nebulizer (group 1 (n=14) vs group 2 (n=12), respectively). The nebulizati...

Research paper thumbnail of Gastrocolic fistula as a complication after gastrojejunostomy

Acta chirurgica Belgica

Gastrocolic fistula formation is an extremely rare complication of gastric ulcer disease. We repo... more Gastrocolic fistula formation is an extremely rare complication of gastric ulcer disease. We report a case of a 55-year-old man who presented with a two-month history of abdominal discomfort, postprandial diarrhea, nausea and faecal vomiting. Upper gastrointestinal endoscopy showed an ulcer in the greater curvature of the stomach. Barium enema examination revealed an obvious gastrocolic fistula between the greater curvature of the stomach and the transverse colon. The involved segment of the colon was excised and truncal vagotomy and antrectomy was performed. The patient was discharged on the 7th postoperative day. It is concluded that cases with postprandial diarrhea and nutritional disturbances after gastric surgery should remind us of the probability of gastrocolic fistula formation.

Research paper thumbnail of Blunt abdominal trauma: evaluation of diagnostic options and surgical outcomes

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2008

In the present study, it is intended to outline the diagnostic tests and their influences on deci... more In the present study, it is intended to outline the diagnostic tests and their influences on decisions of the surgeon about patients presented with blunt abdominal trauma. One hundred forty-four patients (98 males, 46 females; mean age 36; range 17 to 84 years) admitted to Gazi University School of Medicine due to blunt abdominal trauma (BAT) between May 2003-May 2005 were reviewed retrospectively. Age, gender, injury mechanism, Glasgow Coma Scale, revised trauma score, follow-up period, applied diagnostic procedures, and treatment methods were evaluated. The underlying cause was traffic accident in 126 (87.5%) patients, fall from height in 14 (9.7%) patients, and blows in 4 (2.8%) patients. Isolated abdominal trauma was seen in 21 patients and multisystem trauma in 123 patients. The most frequent associated trauma was head injury (66.6%). Abdominal ultrasonography (USG) was applied in 139 (97%) of the patients, and abdominal computed tomography (CT) was performed in 73 (51%). Diagn...

Research paper thumbnail of Effect of meloxicam on postoperative pain relief after inguinal hernia repair with local anaesthesia

The West Indian medical journal, 2007

To investigate the effect of the administration of a single dose of meloxicam pre-emptively on po... more To investigate the effect of the administration of a single dose of meloxicam pre-emptively on postoperative pain management in patients who underwent inguinal hernia repair under local anaesthesia. Fifty patients who underwent inguinal hernia repair under local anaesthesia during the period November 2005 to May 2006 were recruited into the study prospectively. The patients were randomized to two groups regarding administration and non-administration of pre-emptive meloxicam. The postoperative visual analogue pain scale (VAS) values at 4, 8, 12 and 24 hours and analgesic needs of the patients were recorded No difference was found between the groups in terms of age, gender, hernia localization and type. The VAS values of the patients regarding their pain severity were evaluated at 4, 8, 12 and 24 hours and were significantly lower in the group which received meloxicam pre-emptively (p = 0.001, 0.0001, 0.003 and 0.0001 respectively). The need for non-steroidal anti-inflammatory drug w...

Research paper thumbnail of A small bowel fistula extending into a metastatic tumour due to lung carcinoma

Acta chirurgica Belgica

We report the case of a 63-year-old man who presented with an abdominal mass that was subsequentl... more We report the case of a 63-year-old man who presented with an abdominal mass that was subsequently found to be a metastasis of small cell lung carcinoma into which the small bowel had fistulized. After a detailed diagnostic workup, the involved segment of the small bowel was resected along with the mass. The patient is alive and well six months after surgery. Lung carcinoma metastases to the bowel and mesentery are rare. Resection of the metastatic mass gives the best palliation and improves short-term survival.

Research paper thumbnail of Comparison of Shouldice and Lichtenstein repair for treatment of primary inguinal hernia

Acta chirurgica Belgica, 2004

The purpose of this study was to compare the outcome following Lichtenstein open mesh repair or S... more The purpose of this study was to compare the outcome following Lichtenstein open mesh repair or Shouldice repair for the surgical treatment of primary unilateral inguinal hernias. Patients with primary unilateral inguinal hernia who underwent a Shouldice repair (n: 120) and a Lichtenstein open mesh techniques (n: 121) between 1994 and 1998 were evaluated retrospectively. Operation time, hospital stay, postoperative analgesic consumption and complications, return to work and recurrence after surgery were assessed and compared. The two groups were comparable regarding age, types of hernia and the follow-up interval. There were no significant differences in hospital stay and postoperative complications. The number of recurrences differed significantly between the groups with five in the Shouldice group (4.1%) and one in the Lichtenstein group (0.8%) (p < 0.05). The need of analgesic medication after mesh repair was significantly lower than the Shouldice group (3.9+/-1.4 vs. 4.9+/-1....

Research paper thumbnail of A randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks

Pulmonary Pharmacology & Therapeutics, 2005

Although it is well known that intravenous administration of MgSO 4 as an adjunct to conventional... more Although it is well known that intravenous administration of MgSO 4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO 4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO 4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks.

Research paper thumbnail of No association between serum levels of insulin-like growth factor-I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast carcinoma after surgery

Internal Medicine Journal, 2004

Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (V... more Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angio-genic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the progression of breast cancer at least partly by stimulating angiogenesis. The aim of the present study was to investigate the association between serum IGF-I, VEGF and prolactin levels and clinicopathological characteristics of breast carcinoma. Serum IGF-I, VEGF and prolactin levels were measured in breast cancer patients and controls and these levels were compared with well-known clinicopathological characteristics of breast carcinoma, including tumour size, axillary lymph node and oestrogen/progesterone receptor status, tumour grade and disease stage. Serum prolactin, VEGF and IGF-I levels were found to be similar in breast cancer patients and control subjects (P &gt; 0.05). When the patients were divided into groups according to their tumour size, axillary lymph node status, tumour grade, oestrogen/progesterone receptor status and disease stage, no significant differences in serum prolactin, VEGF and IGF-I levels were found among the groups (P &gt; 0.05). The present study failed to demonstrate an association between serum levels of VEGF, IGF-I and prolactin and well-known clinicopathological characteristics of breast carcinoma.

Research paper thumbnail of Metabolic syndrome and its association with ischemic cerebrovascular disease

Advances in Therapy, 2006

Metabolic syndrome (MS) is the term that encompasses metabolic risk factors that may lead to athe... more Metabolic syndrome (MS) is the term that encompasses metabolic risk factors that may lead to atherosclerotic cardiovascular disease. This study was undertaken to investigate the prevalence of MS in patients with ischemic cerebrovascular disease (CVD), according to National Cholesterol Education Program/Adult Treatment Panel III (ATP III) criteria. A total of 40 patients who were referred to the emergency department and given a diagnosis of CVD were included in this study. Detailed medical histories, physical examination findings, heights, weights, and waist circumferences of patients were recorded. Fasting blood glucose levels and lipid profiles of patients were evaluated. Those with hypertension, diabetes, or hyperlipidemia were regarded as meeting at least 1 of the ATP III criteria. Study results were compared, especially between females and males. In all, 55% of patients were female, and 70% were older than 65 y. Blood pressure over 130/85 mm Hg was assessed in 60% of patients. Among female patients, 81.8% had a waist circumference greater than 88 cm; 50% of male patients had a waist circumference over 102 cm. A fasting blood glucose level above 110 mg/dL was identified in 57.5% of patients. Serum triglyceride levels in 30% of patients were above 150 mg/L. It was noted that 33.3% of male patients had a high-density lipoprotein (HDL) level below 40 mg/L, and in 68.2% of female patients, an HDL level below 50 mg/dL was recorded. According to these findings, 14 of 22 female patients (64%) and 13 of 18 male patients (72%) were identified as having MS. High rates of stroke associated with MS reveal the importance of forthcoming preventive approaches.

Research paper thumbnail of Fournierʼs gangrene after hemorrhoidectomy: Association with drug-induced agranulocytosis

Diseases of the Colon & Rectum, 1999

Research paper thumbnail of The effect of pneumoperitoneum on intravascular fibrinolytic activity in rats

TURKISH JOURNAL OF MEDICAL SCIENCES, 2016

Background/aim: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related ... more Background/aim: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related to fibrin synthesis and deposition. The etiologic factors underlying fibrinolysis or hypercoagulability are not clearly defined. This study aimed to determine the effects of pneumoperitoneum time and pressure on coagulation cascade and the fibrinolytic pathway. Materials and methods: After the pneumoperitoneum model was established in rats, PAI-1, tPA, TAFI, D-dimer, and fibrinogen activities were evaluated in different time periods under different pressures in groups including 6 rats. Group 1 did not undergo any procedure. Group 2 received 8 mmHg of pressure for 30 min, Group III 8 mmHg for 60 min, Group IV 12 mmHg for 30 min, and Group V 12 mmHg for 60 min. Results: D-dimer levels had a tendency to decrease with increasing intraabdominal pressures. In both low and high pressure groups, fibrinogen had a tendency to increase with exposure time. There was no statistically significant difference among the study groups in terms of fibrinogen, D-dimer, and PAI-1. The levels of TAFI were significantly decreased with increasing pressure regardless of the exposure time. Conclusion: Pneumoperitoneum of the coagulation system can be changed by duration of time and pressure.

Research paper thumbnail of Fournierʼs gangrene after hemorrhoidectomy: Association with drug-induced agranulocytosis

Diseases of the Colon & Rectum, 1999

An unusual case of Foumier's gangrene after hemorrhoidectomy and drug-induced agram~ocytosis, as ... more An unusual case of Foumier's gangrene after hemorrhoidectomy and drug-induced agram~ocytosis, as the predisposing condition, is described. The patient had severe granulocytopenia that was attributed to the recent use of dipyrone. Together with hemodynamic resuscitation, broad-spectrttm antibiotic and recombinant human granulocyte colony-stimulating factor were started. Wide surgical excision of all the gangrenous tissues, in addition to laparoscopic formation of a defunctioning sigmoid loop colostomy, was performed. The white blood cell count rose steadily and the patient experienced a rapid recovery. We emphasize that radical surgery must be accompanied by phatanacologic interventions for a successful outcome in such cases.

Research paper thumbnail of No association between serum levels of insulin‐like growth factor‐I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast …

Internal medicine …, 2004

Background: Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial grow... more Background: Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angiogenic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the ...

Research paper thumbnail of Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar

Ulus Travma Acil …, 2008

... Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar Ahmet Karamerca... more ... Künt karın travması: Tanı yöntemlerinin değerlendirilmesi ve cerrahi sonuçlar Ahmet Karamercan 1 , Tonguç Utku Yılmaz 1 , Mehmet Akif Karamercan 2 , Bülent Aytaç 1 1 Gazi Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı, Ankara 2 Gazi Üniversitesi Tıp Fakültesi Acil ...

Research paper thumbnail of No association between serum levels of insulin-like growth factor-I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast carcinoma after surgery

Internal Medicine Journal, 2004

Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (V... more Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angio-genic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the progression of breast cancer at least partly by stimulating angiogenesis. The aim of the present study was to investigate the association between serum IGF-I, VEGF and prolactin levels and clinicopathological characteristics of breast carcinoma. Serum IGF-I, VEGF and prolactin levels were measured in breast cancer patients and controls and these levels were compared with well-known clinicopathological characteristics of breast carcinoma, including tumour size, axillary lymph node and oestrogen/progesterone receptor status, tumour grade and disease stage. Serum prolactin, VEGF and IGF-I levels were found to be similar in breast cancer patients and control subjects (P &gt; 0.05). When the patients were divided into groups according to their tumour size, axillary lymph node status, tumour grade, oestrogen/progesterone receptor status and disease stage, no significant differences in serum prolactin, VEGF and IGF-I levels were found among the groups (P &gt; 0.05). The present study failed to demonstrate an association between serum levels of VEGF, IGF-I and prolactin and well-known clinicopathological characteristics of breast carcinoma.

Research paper thumbnail of Nitric oxide synthase inhibitors appear to improve wound healing in endotoxemic rats: An investigator-blinded, controlled, experimental study

Current Therapeutic Research, 2006

Background: Although inflammation is a normal part of wound healing, if the inflammatory response... more Background: Although inflammation is a normal part of wound healing, if the inflammatory response is excessive the repair process might be prolonged. Nitric oxide (NO) has been implicated in healing inflammation and wounds.

Research paper thumbnail of A randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks

Pulmonary Pharmacology &amp Therapeutics

Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional ... more Although it is well known that intravenous administration of MgSO4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks. Twenty-six patients with asthma attack were enrolled in the study in a randomized single blind fashion. After obtaining initial peak expiratory flow measurements (PEFR) and clinical evaluation, all patients received 1mg/kg corticosteroids and oxygen therapy and then either isotonic MgSO4 (2.5 ml, 6.3%)+salbutamol (2.5 ml) or saline (2.5 ml)+salbutamol (2.5 ml) through a jet nebulizer (group 1 (n=14) vs group 2 (n=12), respectively). The nebulizati...

Research paper thumbnail of Gastrocolic fistula as a complication after gastrojejunostomy

Acta chirurgica Belgica

Gastrocolic fistula formation is an extremely rare complication of gastric ulcer disease. We repo... more Gastrocolic fistula formation is an extremely rare complication of gastric ulcer disease. We report a case of a 55-year-old man who presented with a two-month history of abdominal discomfort, postprandial diarrhea, nausea and faecal vomiting. Upper gastrointestinal endoscopy showed an ulcer in the greater curvature of the stomach. Barium enema examination revealed an obvious gastrocolic fistula between the greater curvature of the stomach and the transverse colon. The involved segment of the colon was excised and truncal vagotomy and antrectomy was performed. The patient was discharged on the 7th postoperative day. It is concluded that cases with postprandial diarrhea and nutritional disturbances after gastric surgery should remind us of the probability of gastrocolic fistula formation.

Research paper thumbnail of Blunt abdominal trauma: evaluation of diagnostic options and surgical outcomes

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2008

In the present study, it is intended to outline the diagnostic tests and their influences on deci... more In the present study, it is intended to outline the diagnostic tests and their influences on decisions of the surgeon about patients presented with blunt abdominal trauma. One hundred forty-four patients (98 males, 46 females; mean age 36; range 17 to 84 years) admitted to Gazi University School of Medicine due to blunt abdominal trauma (BAT) between May 2003-May 2005 were reviewed retrospectively. Age, gender, injury mechanism, Glasgow Coma Scale, revised trauma score, follow-up period, applied diagnostic procedures, and treatment methods were evaluated. The underlying cause was traffic accident in 126 (87.5%) patients, fall from height in 14 (9.7%) patients, and blows in 4 (2.8%) patients. Isolated abdominal trauma was seen in 21 patients and multisystem trauma in 123 patients. The most frequent associated trauma was head injury (66.6%). Abdominal ultrasonography (USG) was applied in 139 (97%) of the patients, and abdominal computed tomography (CT) was performed in 73 (51%). Diagn...

Research paper thumbnail of Effect of meloxicam on postoperative pain relief after inguinal hernia repair with local anaesthesia

The West Indian medical journal, 2007

To investigate the effect of the administration of a single dose of meloxicam pre-emptively on po... more To investigate the effect of the administration of a single dose of meloxicam pre-emptively on postoperative pain management in patients who underwent inguinal hernia repair under local anaesthesia. Fifty patients who underwent inguinal hernia repair under local anaesthesia during the period November 2005 to May 2006 were recruited into the study prospectively. The patients were randomized to two groups regarding administration and non-administration of pre-emptive meloxicam. The postoperative visual analogue pain scale (VAS) values at 4, 8, 12 and 24 hours and analgesic needs of the patients were recorded No difference was found between the groups in terms of age, gender, hernia localization and type. The VAS values of the patients regarding their pain severity were evaluated at 4, 8, 12 and 24 hours and were significantly lower in the group which received meloxicam pre-emptively (p = 0.001, 0.0001, 0.003 and 0.0001 respectively). The need for non-steroidal anti-inflammatory drug w...

Research paper thumbnail of A small bowel fistula extending into a metastatic tumour due to lung carcinoma

Acta chirurgica Belgica

We report the case of a 63-year-old man who presented with an abdominal mass that was subsequentl... more We report the case of a 63-year-old man who presented with an abdominal mass that was subsequently found to be a metastasis of small cell lung carcinoma into which the small bowel had fistulized. After a detailed diagnostic workup, the involved segment of the small bowel was resected along with the mass. The patient is alive and well six months after surgery. Lung carcinoma metastases to the bowel and mesentery are rare. Resection of the metastatic mass gives the best palliation and improves short-term survival.

Research paper thumbnail of Comparison of Shouldice and Lichtenstein repair for treatment of primary inguinal hernia

Acta chirurgica Belgica, 2004

The purpose of this study was to compare the outcome following Lichtenstein open mesh repair or S... more The purpose of this study was to compare the outcome following Lichtenstein open mesh repair or Shouldice repair for the surgical treatment of primary unilateral inguinal hernias. Patients with primary unilateral inguinal hernia who underwent a Shouldice repair (n: 120) and a Lichtenstein open mesh techniques (n: 121) between 1994 and 1998 were evaluated retrospectively. Operation time, hospital stay, postoperative analgesic consumption and complications, return to work and recurrence after surgery were assessed and compared. The two groups were comparable regarding age, types of hernia and the follow-up interval. There were no significant differences in hospital stay and postoperative complications. The number of recurrences differed significantly between the groups with five in the Shouldice group (4.1%) and one in the Lichtenstein group (0.8%) (p < 0.05). The need of analgesic medication after mesh repair was significantly lower than the Shouldice group (3.9+/-1.4 vs. 4.9+/-1....

Research paper thumbnail of A randomized clinical trial of magnesium sulphate as a vehicle for nebulized salbutamol in the treatment of moderate to severe asthma attacks

Pulmonary Pharmacology & Therapeutics, 2005

Although it is well known that intravenous administration of MgSO 4 as an adjunct to conventional... more Although it is well known that intravenous administration of MgSO 4 as an adjunct to conventional therapy is effective in treating asthma attacks, the effect of nebulized MgSO 4 as a vehicle for salbutamol has been less evaluated. The aim of this study was to compare the effects of nebulized salbutamol administrated through either MgSO 4 or isotonic saline solution on the 'peak expiratory flow rate' (PEFR), other respiratory and clinical parameters, and hospitalization rate of patients suffering from moderate to severe asthma attacks.

Research paper thumbnail of No association between serum levels of insulin-like growth factor-I, vascular endothelial growth factor, prolactin and clinicopathological characteristics of breast carcinoma after surgery

Internal Medicine Journal, 2004

Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (V... more Angiogenesis is essential for tumour growth and metastasis. Vascular endothelial growth factor (VEGF) has been suggested as the major angio-genic factor in breast carcinoma. Both insulin-like growth factor-I (IGF-I) and prolactin are involved in the progression of breast cancer at least partly by stimulating angiogenesis. The aim of the present study was to investigate the association between serum IGF-I, VEGF and prolactin levels and clinicopathological characteristics of breast carcinoma. Serum IGF-I, VEGF and prolactin levels were measured in breast cancer patients and controls and these levels were compared with well-known clinicopathological characteristics of breast carcinoma, including tumour size, axillary lymph node and oestrogen/progesterone receptor status, tumour grade and disease stage. Serum prolactin, VEGF and IGF-I levels were found to be similar in breast cancer patients and control subjects (P &gt; 0.05). When the patients were divided into groups according to their tumour size, axillary lymph node status, tumour grade, oestrogen/progesterone receptor status and disease stage, no significant differences in serum prolactin, VEGF and IGF-I levels were found among the groups (P &gt; 0.05). The present study failed to demonstrate an association between serum levels of VEGF, IGF-I and prolactin and well-known clinicopathological characteristics of breast carcinoma.

Research paper thumbnail of Metabolic syndrome and its association with ischemic cerebrovascular disease

Advances in Therapy, 2006

Metabolic syndrome (MS) is the term that encompasses metabolic risk factors that may lead to athe... more Metabolic syndrome (MS) is the term that encompasses metabolic risk factors that may lead to atherosclerotic cardiovascular disease. This study was undertaken to investigate the prevalence of MS in patients with ischemic cerebrovascular disease (CVD), according to National Cholesterol Education Program/Adult Treatment Panel III (ATP III) criteria. A total of 40 patients who were referred to the emergency department and given a diagnosis of CVD were included in this study. Detailed medical histories, physical examination findings, heights, weights, and waist circumferences of patients were recorded. Fasting blood glucose levels and lipid profiles of patients were evaluated. Those with hypertension, diabetes, or hyperlipidemia were regarded as meeting at least 1 of the ATP III criteria. Study results were compared, especially between females and males. In all, 55% of patients were female, and 70% were older than 65 y. Blood pressure over 130/85 mm Hg was assessed in 60% of patients. Among female patients, 81.8% had a waist circumference greater than 88 cm; 50% of male patients had a waist circumference over 102 cm. A fasting blood glucose level above 110 mg/dL was identified in 57.5% of patients. Serum triglyceride levels in 30% of patients were above 150 mg/L. It was noted that 33.3% of male patients had a high-density lipoprotein (HDL) level below 40 mg/L, and in 68.2% of female patients, an HDL level below 50 mg/dL was recorded. According to these findings, 14 of 22 female patients (64%) and 13 of 18 male patients (72%) were identified as having MS. High rates of stroke associated with MS reveal the importance of forthcoming preventive approaches.

Research paper thumbnail of Fournierʼs gangrene after hemorrhoidectomy: Association with drug-induced agranulocytosis

Diseases of the Colon & Rectum, 1999