teoman coskun - Academia.edu (original) (raw)
Papers by teoman coskun
Annals of the Academy of Medicine, Singapore
Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thor... more Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors. Clinical Picture: A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rupture, mediastinal shift and herniation of gastric fundus into the pleural cavity. Treatment: Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fundus and a diaphragmatic gap were performed. Outcome: He made an uneventful recovery. Conclusions: Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.
PubMed, May 1, 1997
Background/aims: Bacterial translocation induced by intestinal obstruction is suggested to be due... more Background/aims: Bacterial translocation induced by intestinal obstruction is suggested to be due to increased intestinal luminal volume, leading to intestinal overgrowth with certain enteric microorganisms and intestinal mucosal damage. If this suggestion is true, maintenance of intestinal mucosal integrity by a cytoprotective agent, a-tocopherol, and inhibition of gastrointestinal secretions by octreotide should decrease the incidence of bacterial translocation and extent of mucosal injury due to intestinal obstruction. Methods: Complete intestinal obstruction was created in the distal ileum of male Wistar Albino rats by a single 3-0 silk suture. The animals received subcutaneous injections of 1 ml of physiologic saline (group 1) (PS 24) and 1 ml of saline containing octreotide acetate (100 micrograms/kg) (group 2) (OC 24), at 0, 12 and 24 hours of obstruction. In group 3 (PS 48) and group 4 (OC 48), the rats were treated with subcutaneous physiologic saline (1 ml) and octreotide acetate (100 micrograms/kg), respectively, beginning at the time of obstruction and every 12 hours for 48 hours. The rats in group 5 (Toc 24), were pretreated with intramuscular a-tocopherol 500 mg/kg on day 1 and 8, and underwent laparotomy on day 9. A third dose of a-tocopherol was injected at the time of obstruction on day 9 and no treatment was given thereafter. We tested the incidence of bacterial translocation in systemic organs and circulation and evaluated the histopathological changes in all groups. Results: Treatment with octreotide acetate was found to be ineffective in reducing the incidence of translocation, with no histopathological improvement. Mucosal damage scores, on the other hand, in the a-tocopherol group were statistically less than those in the octreotide and control groups (p < 0.05). Additionally, a-tocopherol treatment decreased the incidence of organ invasion with translocating bacteria, although this difference did not reach statistical significance. Conclusion: Octreotide acetate treatment in complete intestinal obstruction has no effect on the incidence of bacterial translocation. a-Tocopherol, on the other hand, has a cytoprotective effect on intestinal mucosa in intestinal obstruction which, in turn, is thought to decrease bacterial translocation when used in physiological doses and prophylactically.
PubMed, May 1, 1997
ABSTRACT
PubMed, May 6, 1999
Background/aims: Although malignant obstruction, itself, is a significant risk factor associated ... more Background/aims: Although malignant obstruction, itself, is a significant risk factor associated with post-operative mortality, factors affecting mortality in the surgery of malignant obstruction have not been thoroughly studied in the literature. Methodology: In order to identify independent risk factors which might be associated with an increase in post-operative mortality in patients with malignant biliary obstruction, 24 clinical and laboratory parameters in 52 patients undergoing biliary tract surgery were analyzed retrospectively. Results: Simple regression revealed 24 factors with prognostic significance, but multivariate analysis detected only 3 factors with independent significance in predicting mortality (cholangitis, weight loss of 10 kg or more and operative or post-operative blood transfusion). The presence of 2 of these risk factors identified a group of patients with an 37% mortality rate. Conclusions: The results of this study show that the presence of pre-operative cholangitis, marked weight loss, and operative and post-operative blood transfusion are associated with high post-operative mortality. The major challenge is the prevention of cholangitis in high-risk patients, improvement of the nutritional status of the patients, and avoidance of unnecessary blood transfusions.
Trakya Universitesi Tip Fakultesi Dergisi, 2008
Diagnostic and interventional radiology, 2012
Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI • 455 Volume 18 •... more Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI • 455 Volume 18 • Issue 5
Turkish Journal of Surgery, 2020
A. Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative ... more A. Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative pain, limitation of movement and quality of life.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2009
Karın ağrısı ya da akut primer (vasküler) mezenter iskemi (AMİ) ön tanısı ile gelen olgularda, ko... more Karın ağrısı ya da akut primer (vasküler) mezenter iskemi (AMİ) ön tanısı ile gelen olgularda, konvansiyonel ve dinamik bifazik (arteriyel ve venöz) Bilgisayarlı Tomografi (BT) tetkiklerinin AMİ tanısındaki rolünün ve BT bulgularının değerlendirilmesi amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Toplam 55 hastanın 22'sine konvansiyonel, 33'üne dinamik bifazik BT yapıldı. Konvansiyonel BT'de oral ve IV pozitif kontrast madde, Dinamik BT'de otomatik enjektör ile IV pozitif kontrast madde; oral ve rektal negatif kontrast madde (su) uygulanarak arteriyel ve venöz faz görüntüler elde olundu. Mezenterik vasküler yapılar ve AMİ'nin sekonder BT bulguları değerlendirildi. %95 ve üzeri seçicilik gösteren BT bulguları anlamlı kabul edildi ve hem konvansiyonel BT için hem dinamik BT için ayrı ayrı belirlendi. B Bu ul lg gu ul la ar r: : 55 olgunun 18'i primer (vasküler) AMİ tanısı aldı. 18 olgunun 15'inde tanı operasyonla 3'ünde klinik, biyokimyasal ve radyolojik tetkiklerle konuldu. 55 hastanın 29'u opere edildi. Opere 15 olguda primer, 6 olguda sekonder AMİ tanısı saptandı. Konvansiyonel BT için %95 üzeri seçicilik gösteren BT bulguları SMA oklüzyonu, SMV oklüzyonu, portomezenterik gaz, solid organ infarktı, dinamik BT için SMA oklüzyonu, SMV oklüzyonu, pnömatozis intestinalis, barsak duvarının hipokontrastlanması ve hipoatenüasyonu olarak belirlendi. SMA ve SMV oklüzyon bulguları iki yöntem için %100 seçicilikte bulundu. Konvansiyonel ve dinamik BT'nin duyarlılığı %89, seçicililiği %100 olarak hesaplandı. S So on nu uç ç: : Dinamik BT ve konvansiyonel BT tetkikleri AMİ tanısında oldukça yararlıdır. AMİ tanısı için en güvenilir (%100 seçicilik gösteren) BT bulguları olan SMA ve SMV trombozu dışındaki sekonder BT bulgularının diğer patolojilerle örtüştüğü bu nedenle duyarlılık ve seçicilik oranlarının daha az olduğu dikkati çekmektedir.
Turkiye Klinikleri Journal of Medical Sciences, 1992
Bratislava Medical Journal, 2013
Aims and background: In the present study, we investigated the associations between pre-and postt... more Aims and background: In the present study, we investigated the associations between pre-and posttreatment levels of adiponectin, ghrelin, resistin, visfatin and leptin levels in malign and benign groups Methods and study design: 20 malign colon carcinoma groups and 20 benign groups were included in this study. Serum levels of leptin, adiponectin, resistin, ghrelin, and visfatin were measured by Elisa kits (Milipore Corporation, Billerica, MA, USA). Results: In the malign group, serum ghrelin (71.90±23.7) levels signifi cantly decreased (p<0.05) when compared to those in the benign (88.00±16.9) group.
Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2019
Objective: The study was conducted to determine upper extremity problems and quality of life in p... more Objective: The study was conducted to determine upper extremity problems and quality of life in patients with breast cancer who underwent breast surgery and axillary dissection. Methods: This descriptive and cross-sectional research was included 64 patients who admitted for outpatient clinic between 01.01.2015-01.01.2016 in university hospital in western of Turkey and previously undergone surgery for breast cancer. The data was collected personal information form, Shoulder Pain and Disability Index (SPADI) the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Q-DASH), Breast Cancer Module Quality of Life Scale (EORTC QLQ-BR23) and Short Form-36 (SF-36). Statistical analyses were performed using descriptive statistics, Chi Ssquare test, Mann Whitney U test, Kruskal Walles test and the Spearman's correlation coefficient. Results: Mean age of the study group was 52.36±12.25 years. It was found that 54.7% of the patients were applied modified radical mastectomy and axillary dissection, and average time passed after surgery 11.27±10.00 months. Affected arm had shoulder pain (53.1%), restrictions on shoulder (51.6%) and lymphedema (21.9%).It was determined that patients were received low scores from SPADI and Q-DASH, and SF-36 physical and mental summary scores of below the average. The EORTC QLQ-BR23 functional status and symptom subscales scores of patients were low. Conclusion: It was seen that patients' quality of life was low, their functional status was poor, and cancer-related symptoms to be less. The working with multidisciplinary team on preoperative and postoperative will help prevent complications and increase the quality of life.
Annali Italiani Di Chirurgia, Feb 24, 2023
Acta Chirurgica Belgica, 2009
Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external... more Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external genitalia and perineum with high morbidity and mortality. 15 patients with Fournier's gangrene were enrolled. Gender, age, aetiology, predisposing factors, symptomatology, associated diseases, hospital stay, FGSI, and body surface area were analysed. Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). E. coli and acinetobacter were the common organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. Common predisposing factors included diabetes mellitus (73.3%), poor personal hygiene (60%), obesity (33.3%), psychosis (20%) and decubitus ulcers (13.2%). Whereas five (33.3%) patients developed synergistic gangrene of the scrotum secondary to anorectal disease, five (33.3%) had a urological source of infection. Mean BSA and FSGI scores were 15.93 +/- 3.13 and 6.02 +/- 0.95, respectively. Serum glucose > 140 mg/dl, the existence of septic shock on admission, the spread of gangrene to the perineum and abdominal wall (Groups C and D), BSA > or = 24 cm2, a cutaneous source of infection and FGSI scores > or = 7 were factors affecting mortality rates with statistical significance (p < 0.05). There was a direct correlation between the culture of mixed type micro-organisms and the cutaneous source of infection (p < 0.05). The extent of gangrene correlated with higher FGSI scores (> or = 7) (p < 0.05). Mortality and morbidity rates were as 20% (n = 3) and 60% (n = 9). Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2004
Turkiye Klinikleri Journal of Gastroenterohepatology, 1992
Total abdominal kotektomi-mukozal prokteklonıi-J poş üeoanal anastomoz familial polipozis koli (F... more Total abdominal kotektomi-mukozal prokteklonıi-J poş üeoanal anastomoz familial polipozis koli (FPK) gibi prekanseröz ve sadece mukozayı tutan bir hastalığın en uygun ve en radikal cerrahi tedavisidir. FPK nedeni ile Hacettepe Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğine başvuran iki hasta bu teknik le öpere edildi. Bu çalışmada iki hastanın kısa dö nem takip ve sonuçlarını takdim ettik.
Turkiye Klinikleri Journal of Case Reports, 2016
Hepato-gastroenterology
Although periampullary carcinoma can often be diagnosed at an early stage because of its strategi... more Although periampullary carcinoma can often be diagnosed at an early stage because of its strategic location, in a substantial number of cases (23% to 25% of periampullary carcinoma cases), the papilla can be prominent, but without an identifiable mass or ulceration. As a result, duodenoscopy alone can miss the tumor. In this series, the usefulness of sphincterotomy in establishing a diagnosis of periampullary carcinoma is documented. A total of 664 patients, who had clinical, biochemical and/or sonographic evidence of pancreaticobiliary disorders underwent endoscopic retrograde cholangiopancreaticography (ERCP) at Hacettepe University Hospital between March 1985 and September 1994. All identified lesions were biopsied. In sixty-six of the 664 patients, a specific periampullary or pancreatic diagnosis could be made. These included 30 cases of pancreatic carcinoma (14 in the head, 15 in the corpus, and 1 in the tail), 10 cases of chronic pancreatitis, 15 cases of periampullary carcino...
The American Journal of Surgery, 1998
The direct effect of free oxygen radicals, if any, on the morphology of the pancreas has never be... more The direct effect of free oxygen radicals, if any, on the morphology of the pancreas has never been studied in vivo. This study was designed to evaluate the effects of hydrogen peroxide (H2O2) on permeability of the main pancreatic duct (MPD) and morphology of pancreas in cats when administered intraductally or intraarterially. Thirty-six mongrel cats were randomly allocated into three groups, and all groups were divided into two subgroups. In group I and III, MPD was perfused with either standard perfusate (group IA and IIIA) or H2O2 at a concentration of 150 microM (group IB and IIIB) for 3 hours. In group II, the splenic artery was infused either with 0.9% sodium chloride (group IIA) or H2O2 (group IIB) for 3 hours. After 3 hours, in group I and II, MPD was perfused with 99mTc labelled dextran, and the percentage of the dextran permeated from the MPD into the portal vein was calculated for the evaluation of the pancreatic duct permeability. Then, tissue samples were obtained for the examination of early histopathological changes in pancreas. In group III, following ductal perfusion studies, the cats were allowed to recover. After 24 hours animals were killed, and samples were taken for the examination of late histological changes in pancreas. In all groups, an inflammatory score was created for each animal based on the pathological changes in pancreas: edema, leukocyte infiltration, parenchymal necrosis, and hemorrhage. Group I: All cats developed acute edematous pancreatitis with significantly higher inflammatory scores than controls (P < 0.01). Desquamation of the single layer of columnar epithelium that normally lined the duct and leukocyte infiltration around the MPD duct were found. Pancreatic duct permeability was found to be increased significantly (P < 0.01). Group II: There were no statistical differences in inflammatory scores and pancreatic duct permeability between experimental and control groups (P > 0.05). Group III: All animals developed gross acute edematous pancreatitis after 3 hours of intraductal H2O2 perfusion. Histopathological changes at 24 hours were much more pronounced in group IIIB than in group IIIA including focal necrosis and hydropic degeneration of acinar cells. This study has shown that intraductal H2O2 perfusion induced acute edematous pancreatitis with marked histopathological changes and increased pancreatic duct permeability in cats. Intraarterial H2O2 infusion, however, has no effect on the permeability of the MPD and morphology of pancreas in our model.
Annals of the Academy of Medicine, Singapore
Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thor... more Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors. Clinical Picture: A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rupture, mediastinal shift and herniation of gastric fundus into the pleural cavity. Treatment: Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fundus and a diaphragmatic gap were performed. Outcome: He made an uneventful recovery. Conclusions: Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.
PubMed, May 1, 1997
Background/aims: Bacterial translocation induced by intestinal obstruction is suggested to be due... more Background/aims: Bacterial translocation induced by intestinal obstruction is suggested to be due to increased intestinal luminal volume, leading to intestinal overgrowth with certain enteric microorganisms and intestinal mucosal damage. If this suggestion is true, maintenance of intestinal mucosal integrity by a cytoprotective agent, a-tocopherol, and inhibition of gastrointestinal secretions by octreotide should decrease the incidence of bacterial translocation and extent of mucosal injury due to intestinal obstruction. Methods: Complete intestinal obstruction was created in the distal ileum of male Wistar Albino rats by a single 3-0 silk suture. The animals received subcutaneous injections of 1 ml of physiologic saline (group 1) (PS 24) and 1 ml of saline containing octreotide acetate (100 micrograms/kg) (group 2) (OC 24), at 0, 12 and 24 hours of obstruction. In group 3 (PS 48) and group 4 (OC 48), the rats were treated with subcutaneous physiologic saline (1 ml) and octreotide acetate (100 micrograms/kg), respectively, beginning at the time of obstruction and every 12 hours for 48 hours. The rats in group 5 (Toc 24), were pretreated with intramuscular a-tocopherol 500 mg/kg on day 1 and 8, and underwent laparotomy on day 9. A third dose of a-tocopherol was injected at the time of obstruction on day 9 and no treatment was given thereafter. We tested the incidence of bacterial translocation in systemic organs and circulation and evaluated the histopathological changes in all groups. Results: Treatment with octreotide acetate was found to be ineffective in reducing the incidence of translocation, with no histopathological improvement. Mucosal damage scores, on the other hand, in the a-tocopherol group were statistically less than those in the octreotide and control groups (p < 0.05). Additionally, a-tocopherol treatment decreased the incidence of organ invasion with translocating bacteria, although this difference did not reach statistical significance. Conclusion: Octreotide acetate treatment in complete intestinal obstruction has no effect on the incidence of bacterial translocation. a-Tocopherol, on the other hand, has a cytoprotective effect on intestinal mucosa in intestinal obstruction which, in turn, is thought to decrease bacterial translocation when used in physiological doses and prophylactically.
PubMed, May 1, 1997
ABSTRACT
PubMed, May 6, 1999
Background/aims: Although malignant obstruction, itself, is a significant risk factor associated ... more Background/aims: Although malignant obstruction, itself, is a significant risk factor associated with post-operative mortality, factors affecting mortality in the surgery of malignant obstruction have not been thoroughly studied in the literature. Methodology: In order to identify independent risk factors which might be associated with an increase in post-operative mortality in patients with malignant biliary obstruction, 24 clinical and laboratory parameters in 52 patients undergoing biliary tract surgery were analyzed retrospectively. Results: Simple regression revealed 24 factors with prognostic significance, but multivariate analysis detected only 3 factors with independent significance in predicting mortality (cholangitis, weight loss of 10 kg or more and operative or post-operative blood transfusion). The presence of 2 of these risk factors identified a group of patients with an 37% mortality rate. Conclusions: The results of this study show that the presence of pre-operative cholangitis, marked weight loss, and operative and post-operative blood transfusion are associated with high post-operative mortality. The major challenge is the prevention of cholangitis in high-risk patients, improvement of the nutritional status of the patients, and avoidance of unnecessary blood transfusions.
Trakya Universitesi Tip Fakultesi Dergisi, 2008
Diagnostic and interventional radiology, 2012
Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI • 455 Volume 18 •... more Three-dimensional vascular mapping of the breast by using contrast-enhanced MRI • 455 Volume 18 • Issue 5
Turkish Journal of Surgery, 2020
A. Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative ... more A. Comparison of prolene and progrip meshes in inguinal hernia repair in terms of post-operative pain, limitation of movement and quality of life.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2009
Karın ağrısı ya da akut primer (vasküler) mezenter iskemi (AMİ) ön tanısı ile gelen olgularda, ko... more Karın ağrısı ya da akut primer (vasküler) mezenter iskemi (AMİ) ön tanısı ile gelen olgularda, konvansiyonel ve dinamik bifazik (arteriyel ve venöz) Bilgisayarlı Tomografi (BT) tetkiklerinin AMİ tanısındaki rolünün ve BT bulgularının değerlendirilmesi amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Toplam 55 hastanın 22'sine konvansiyonel, 33'üne dinamik bifazik BT yapıldı. Konvansiyonel BT'de oral ve IV pozitif kontrast madde, Dinamik BT'de otomatik enjektör ile IV pozitif kontrast madde; oral ve rektal negatif kontrast madde (su) uygulanarak arteriyel ve venöz faz görüntüler elde olundu. Mezenterik vasküler yapılar ve AMİ'nin sekonder BT bulguları değerlendirildi. %95 ve üzeri seçicilik gösteren BT bulguları anlamlı kabul edildi ve hem konvansiyonel BT için hem dinamik BT için ayrı ayrı belirlendi. B Bu ul lg gu ul la ar r: : 55 olgunun 18'i primer (vasküler) AMİ tanısı aldı. 18 olgunun 15'inde tanı operasyonla 3'ünde klinik, biyokimyasal ve radyolojik tetkiklerle konuldu. 55 hastanın 29'u opere edildi. Opere 15 olguda primer, 6 olguda sekonder AMİ tanısı saptandı. Konvansiyonel BT için %95 üzeri seçicilik gösteren BT bulguları SMA oklüzyonu, SMV oklüzyonu, portomezenterik gaz, solid organ infarktı, dinamik BT için SMA oklüzyonu, SMV oklüzyonu, pnömatozis intestinalis, barsak duvarının hipokontrastlanması ve hipoatenüasyonu olarak belirlendi. SMA ve SMV oklüzyon bulguları iki yöntem için %100 seçicilikte bulundu. Konvansiyonel ve dinamik BT'nin duyarlılığı %89, seçicililiği %100 olarak hesaplandı. S So on nu uç ç: : Dinamik BT ve konvansiyonel BT tetkikleri AMİ tanısında oldukça yararlıdır. AMİ tanısı için en güvenilir (%100 seçicilik gösteren) BT bulguları olan SMA ve SMV trombozu dışındaki sekonder BT bulgularının diğer patolojilerle örtüştüğü bu nedenle duyarlılık ve seçicilik oranlarının daha az olduğu dikkati çekmektedir.
Turkiye Klinikleri Journal of Medical Sciences, 1992
Bratislava Medical Journal, 2013
Aims and background: In the present study, we investigated the associations between pre-and postt... more Aims and background: In the present study, we investigated the associations between pre-and posttreatment levels of adiponectin, ghrelin, resistin, visfatin and leptin levels in malign and benign groups Methods and study design: 20 malign colon carcinoma groups and 20 benign groups were included in this study. Serum levels of leptin, adiponectin, resistin, ghrelin, and visfatin were measured by Elisa kits (Milipore Corporation, Billerica, MA, USA). Results: In the malign group, serum ghrelin (71.90±23.7) levels signifi cantly decreased (p<0.05) when compared to those in the benign (88.00±16.9) group.
Bakirkoy Tip Dergisi / Medical Journal of Bakirkoy, 2019
Objective: The study was conducted to determine upper extremity problems and quality of life in p... more Objective: The study was conducted to determine upper extremity problems and quality of life in patients with breast cancer who underwent breast surgery and axillary dissection. Methods: This descriptive and cross-sectional research was included 64 patients who admitted for outpatient clinic between 01.01.2015-01.01.2016 in university hospital in western of Turkey and previously undergone surgery for breast cancer. The data was collected personal information form, Shoulder Pain and Disability Index (SPADI) the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Q-DASH), Breast Cancer Module Quality of Life Scale (EORTC QLQ-BR23) and Short Form-36 (SF-36). Statistical analyses were performed using descriptive statistics, Chi Ssquare test, Mann Whitney U test, Kruskal Walles test and the Spearman's correlation coefficient. Results: Mean age of the study group was 52.36±12.25 years. It was found that 54.7% of the patients were applied modified radical mastectomy and axillary dissection, and average time passed after surgery 11.27±10.00 months. Affected arm had shoulder pain (53.1%), restrictions on shoulder (51.6%) and lymphedema (21.9%).It was determined that patients were received low scores from SPADI and Q-DASH, and SF-36 physical and mental summary scores of below the average. The EORTC QLQ-BR23 functional status and symptom subscales scores of patients were low. Conclusion: It was seen that patients' quality of life was low, their functional status was poor, and cancer-related symptoms to be less. The working with multidisciplinary team on preoperative and postoperative will help prevent complications and increase the quality of life.
Annali Italiani Di Chirurgia, Feb 24, 2023
Acta Chirurgica Belgica, 2009
Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external... more Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external genitalia and perineum with high morbidity and mortality. 15 patients with Fournier's gangrene were enrolled. Gender, age, aetiology, predisposing factors, symptomatology, associated diseases, hospital stay, FGSI, and body surface area were analysed. Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). E. coli and acinetobacter were the common organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. Common predisposing factors included diabetes mellitus (73.3%), poor personal hygiene (60%), obesity (33.3%), psychosis (20%) and decubitus ulcers (13.2%). Whereas five (33.3%) patients developed synergistic gangrene of the scrotum secondary to anorectal disease, five (33.3%) had a urological source of infection. Mean BSA and FSGI scores were 15.93 +/- 3.13 and 6.02 +/- 0.95, respectively. Serum glucose > 140 mg/dl, the existence of septic shock on admission, the spread of gangrene to the perineum and abdominal wall (Groups C and D), BSA > or = 24 cm2, a cutaneous source of infection and FGSI scores > or = 7 were factors affecting mortality rates with statistical significance (p < 0.05). There was a direct correlation between the culture of mixed type micro-organisms and the cutaneous source of infection (p < 0.05). The extent of gangrene correlated with higher FGSI scores (> or = 7) (p < 0.05). Mortality and morbidity rates were as 20% (n = 3) and 60% (n = 9). Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.
Turkiye Klinikleri Journal of Gastroenterohepatology, 2004
Turkiye Klinikleri Journal of Gastroenterohepatology, 1992
Total abdominal kotektomi-mukozal prokteklonıi-J poş üeoanal anastomoz familial polipozis koli (F... more Total abdominal kotektomi-mukozal prokteklonıi-J poş üeoanal anastomoz familial polipozis koli (FPK) gibi prekanseröz ve sadece mukozayı tutan bir hastalığın en uygun ve en radikal cerrahi tedavisidir. FPK nedeni ile Hacettepe Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğine başvuran iki hasta bu teknik le öpere edildi. Bu çalışmada iki hastanın kısa dö nem takip ve sonuçlarını takdim ettik.
Turkiye Klinikleri Journal of Case Reports, 2016
Hepato-gastroenterology
Although periampullary carcinoma can often be diagnosed at an early stage because of its strategi... more Although periampullary carcinoma can often be diagnosed at an early stage because of its strategic location, in a substantial number of cases (23% to 25% of periampullary carcinoma cases), the papilla can be prominent, but without an identifiable mass or ulceration. As a result, duodenoscopy alone can miss the tumor. In this series, the usefulness of sphincterotomy in establishing a diagnosis of periampullary carcinoma is documented. A total of 664 patients, who had clinical, biochemical and/or sonographic evidence of pancreaticobiliary disorders underwent endoscopic retrograde cholangiopancreaticography (ERCP) at Hacettepe University Hospital between March 1985 and September 1994. All identified lesions were biopsied. In sixty-six of the 664 patients, a specific periampullary or pancreatic diagnosis could be made. These included 30 cases of pancreatic carcinoma (14 in the head, 15 in the corpus, and 1 in the tail), 10 cases of chronic pancreatitis, 15 cases of periampullary carcino...
The American Journal of Surgery, 1998
The direct effect of free oxygen radicals, if any, on the morphology of the pancreas has never be... more The direct effect of free oxygen radicals, if any, on the morphology of the pancreas has never been studied in vivo. This study was designed to evaluate the effects of hydrogen peroxide (H2O2) on permeability of the main pancreatic duct (MPD) and morphology of pancreas in cats when administered intraductally or intraarterially. Thirty-six mongrel cats were randomly allocated into three groups, and all groups were divided into two subgroups. In group I and III, MPD was perfused with either standard perfusate (group IA and IIIA) or H2O2 at a concentration of 150 microM (group IB and IIIB) for 3 hours. In group II, the splenic artery was infused either with 0.9% sodium chloride (group IIA) or H2O2 (group IIB) for 3 hours. After 3 hours, in group I and II, MPD was perfused with 99mTc labelled dextran, and the percentage of the dextran permeated from the MPD into the portal vein was calculated for the evaluation of the pancreatic duct permeability. Then, tissue samples were obtained for the examination of early histopathological changes in pancreas. In group III, following ductal perfusion studies, the cats were allowed to recover. After 24 hours animals were killed, and samples were taken for the examination of late histological changes in pancreas. In all groups, an inflammatory score was created for each animal based on the pathological changes in pancreas: edema, leukocyte infiltration, parenchymal necrosis, and hemorrhage. Group I: All cats developed acute edematous pancreatitis with significantly higher inflammatory scores than controls (P < 0.01). Desquamation of the single layer of columnar epithelium that normally lined the duct and leukocyte infiltration around the MPD duct were found. Pancreatic duct permeability was found to be increased significantly (P < 0.01). Group II: There were no statistical differences in inflammatory scores and pancreatic duct permeability between experimental and control groups (P > 0.05). Group III: All animals developed gross acute edematous pancreatitis after 3 hours of intraductal H2O2 perfusion. Histopathological changes at 24 hours were much more pronounced in group IIIB than in group IIIA including focal necrosis and hydropic degeneration of acinar cells. This study has shown that intraductal H2O2 perfusion induced acute edematous pancreatitis with marked histopathological changes and increased pancreatic duct permeability in cats. Intraarterial H2O2 infusion, however, has no effect on the permeability of the MPD and morphology of pancreas in our model.