Sürdürülebilir Kalkınma Amaçları
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- ArticleAçık Erişim2015Incarceration of the hepatic lobe in incisional hernia: A case report
Eken, Huseyin; Isik, Arda; Buyukakincak, Sercan; Yilmaz, Ismayil; Firat, Deniz; Cimen, Orhan
Introduction: Incisional hernias are abnormal peritoneal outward pouch-like protrusions that develop due to defects that arise as a result of the disruption of the fascia's continuity after abdominal surgery. Presentation of case: A 77-year-old female patient presented to the emergency department of our hospital with complaints of abdominal swelling, abdominal pain, nausea and vomiting. The patient was recommended for surgery. It was decided that the primary fascia closure and onlay patch was the most appropriate approach. Discussion: When the defect in the abdominal wall grows, the functionality of the related abdominal wall is disrupted thereby eliminating the dynamic structure of the abdominal wall. Incisional hernias lead to a significant number of job losses and morbidity and negatively affect quality of life. Moreover, the formations in the hernia pouch might lead to higher risk of strangulation and dysfunction. Conclusion: Subcutaneous herniation of the left lobe of the liver passing through the abdominal wall is a very rare condition.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2014Hiatal Hernili hastalarda intragastrik manometrik ölçümler: Prospektif kontrollü bir çalışma
Isik, Arda; Yılmaz, İsmayil; İnal, Abdullah; Emiroglu, Mustafa; Peker, Kemal; Demiryılmaz, İsmail
Objective: Hiatal hernia is a disorder in which abdominal contents, especially gastroesophageal junction and proximal stomach are displaced through an incompetent esophageal hiatus into mediastinum. Aim of this study is to investigate the relationship betweeen intragastric pressure and incompetent cardioesophageal sphincter and hiatal hernia. Methods: The sample is composed of 81 individuals; 51.9% of which are male (n: 42) and 48.1% of which are female (n: 39) with median age of 42.00. Two groups have been constituted: A control group of healthy volunteers (G1) and a patient group with hiatal hernia (G2). After gastroscopy, all patients and controls underwent gastric and esophageal manometry using a water perfused catheter Results: Mean intragastric pressure was 1,308 mmHg for G1 and, -0,105 mmHg for G2. Mean lower esophageal pressure were 13,143 mmHg and 11,65 mmHg, and upper esophageal pressure were 35,273 mmHg and 27,211 mmHg for G1 and G2, respectively. 24 hour pH metry test revealed 26.8% physiologic gastroesophageal reflux and 73.2% pathologic gastroesophageal reflux in G2. There were statistically significant difference between two groups for mean intragastric pressure (p <0.001) and mean lower esophageal pressure (p <0.05). Conclusion: This study shows that hiatal hernia results in significantly lower intragastric pressures.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2014Mastitis in Early Infancy
Peker, Kemal; Dehmen, Dilek; Peker, Necla Aydin; Isik, Arda
Mastitis, which is infection of breast tissue, is a rare infection apart from breast feeding period; it is a relatively frequent case at neonatal period. Breast tissue reserves inclination to infections due to early infancy immaturity. Conventionally, as breast tissue, which is hypertrophic and affected by maternal hormones at pregnancy, is squeezed, massaged, or a coin is fastened on it in our country, its being infected due to skin breakdown plays a significant role at neonatal mastitis. In our study, we would like to present a 14-day-old case where mastitis abscess developed after massage on right breast.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Multifocal tumoral calcinosis in a 4-year-old girl
Sayar, Ilyas; Peker, Kemal; Kapisiz, Alparslan; Bostanci, Isil Esen; Gürbüzel, Mehmet; Isik, Arda; Peker, Necla Aydin
Background: Tumoral calcinosis is an uncommon condition associated with the deposition of painless calcific masses. It is more common in childhood or early adolescence of African-American females. Case Report: We present a case of a 4-year-old girl with tumoral calcinosis treated surgically. The case is rather rare in terms of the age of the patient and the localization of the masses (gluteal site). In our patient, the biochemical findings were normal, except for hyperphosphatemia and elevated alkaline phosphatase. Conclusions: Total excision appears to lead to a good clinical outcome and a low incidence of local relapse.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2014How Lichtenstein hernia repair affects abdominal and anal resting pressures: A controlled clinical study
Peker, Kemal; Isik, Arda; Inal, Abdullah; Demiryilmaz, Ismail; Yilmaz, Ismayil; Emiroglu, Mustafa
Purpose: Inguinal hernia repair is the most common surgical procedure performed by general surgeons worldwide. The Lichtenstein tension-free hernioplasty was first introduced in 1984 and evolved through 1988. Today it is the gold standard in hernia repair. The objective of this study was to determine if intra-abdominal and anal pressures changed in patients with inguinal hernias after Lichtenstein hernioplasties were performed. Materials and methods: A sample of 103 individuals, 92.2% of whom were male (n = 95) and 7.8% of whom were female (n = 8), aged 38.38 ± 14.03 years was used. The sample was divided into two groups: those with inguinal hernia (n = 53) and those without hernia (n = 50), who served as controls. Anal and abdominal manometric measurements were taken from each control patient at baseline and from each study patient before and after surgical repair. Results: Data analysis revealed differentiation of abdominal and anal pressures between the controls, the study patients before operation, and the study patients after operation. The average [SD] abdominal pressure was -2.58 mmHg [5.35] before hernia repair and 2.33 mmHG [3.62] after repair. The average [SD] abdominal pressure in the control group was 1.16 mmHg [1.96]. Conclusions: The Lichtenstein tension-free hernioplasty causes increases in abdominal and anal pressures, but this increase is not of a pathological level.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2014Bone marrow metaplasia in multinodular goiter with primary hyperparathyroidism
Sayar, Ilyas; Isik, Arda; Akbas, Emin Murat; Eken, Huseyin; Demirtas, Levent
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Importance of metastatic lymph node ratio in non-metastatic, lymph node-invaded colon cancer: A clinical trial
Isik, Arda; Peker, Kemal; Firat, Deniz; Yilmaz, Bahri; Sayar, Ilyas; Idiz, Oguz; Cakir, Coskun; Demiryilmaz, Ismail; Yilmaz, Ismayil
Background: The aim of this study was to evaluate the prognostic importance of the metastatic lymph node ratio for stage III colon cancer patients and to find a cut-off value at which the overall survival and disease-free survival change. Material/Methods: Patients with pathological stage III colon cancer were retrospectively evaluated for: age; preoperative values of Crp, Cea, Ca 19-9, and Afp; pathologic situation of vascular, perineural, lymphatic, and serosal involvement; and metastatic lymph node ratio values were calculated. Results: The study included 58 stage III colon cancer patients: 20 (34.5%) females and 38 (65.5%) males were involved in the study. Multivariate analysis was applied to the following variables to evaluate significance for overall survival and disease-free survival: age, Crp, Cea, perineural invasion, and metastatic lymph node ratio. The metastatic lymph node ratio (<0.25 or ≥0.25) is the only independent variable significant for overall and diseasefree survival. Conclusions: Metastatic lymph node ratio is an ideal prognostic marker for stage III colon cancer patients, and 0.25 is the cut-off value for prognosis.
RDL Kalıcı Kaydıİncele - ArticleYayıncıda açık erişim2014The use of fibrin glue without surgery in the treatment of pilonidal sinus disease
Isik, Arda; Eryilmaz, Ramazan; Okan, Ismail; Dasiran, Fatih; Firat, Deniz; Idiz, Oguz; Sahin, Mustafa
Pilonidal sinus disease is a common disabling condition affecting the natal clefts of the buttocks. We analyze the role of fibrin glue in the treatment of selected patients with pilonidal sinus disease. Forty patients diagnosed with pilonidal sinus disease at Vakif Gureba Training and Research Hospital were treated between December 2007 and December 2011. Recurrence was noted in four patients (10%). Ninety percent of patients had no recurrence one year later (95% confidence interval: 0.85-0.95). This procedure is suggested as a first line of treatment for patients with no prior history of infection and who have only one sinus orifice.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014The diagnostic importance of matrix metalloproteinase-7 and nestin in gastrointestinal stromal tumors
Peker, Kemal; Sayar, Ilyas; Gelincik, Ibrahim; Bulut, Gülay; Ünal, Tuba Dilay Kökenek; Şenol, Serkan; Gökçe, Aysun; Isik, Arda
Background: The importance of the matrix metalloproteinase-7 (MMP-7) and nestin immunomarkers, C-kit proto-oncogene (CD117), and the efficiency of the Ki-67 proliferation index for gastrointestinal stromal tumors were evaluated. Material/Methods: This study was conducted by examining the microscope slides of 72 patients with gastrointestinal stromal tumors that were sent to the pathology laboratory between 2007 and 2012. Immunohistochemical staining for CD117, MMP-7, nestin, and marker of proliferation Ki-67 was performed. The correlations between the positive results for Ki-67, CD117, MMP-7, and nestin were evaluated relative to the tumor characteristics of size, localization, grade, cellular type, cellularity, cytology type, growth pattern, ulceration, necrosis, hemorrhage, invasion depth, and lymph node metastasis. Results: The tumor was localized in the stomach in 42 of the patients, the intestines in 19, the colon in 7, and the rectum in 4. Comparisons among the groups showed that MMP-7 was correlated with the tumor grade (p<0.001), cellularity (p<0.009), cytologic atypia (p<0.001), ulceration (p=0.002), necrosis (p<0.001), and tumor size (p=0.001). Nestin was correlated with the tumor grade (p=0.013), and tumor size (p=0.024). Correlations among CD117, MMP-7, nestin, and Ki-67 were examined. Nestin and Ki-67 were both significantly correlated with CD117 and MMP-7 [(r=0.279, p=0.018), (r=0.322, p=0.006), (r=0.386, p=0.001), (r=0.386, p=0.002)], respectively. Conclusions: MMP-7 and nestin may be beneficial as markers, given their sensitivity to gastrointestinal stromal tumors.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Familial multiple lipomas coexisting with celiac disease: A case report
Sayar, Ilyas; Demirtas, Levent; Gurbuzel, Mehmet; Isik, Arda; Peker, Kemal; Gulhan, Baris
Case presentation. A 35-year-old Caucasian man with gluten enteropathy, familial multiple lipomas and seborrheic keratosis was seen in our clinic. After confirmation of the diagnosis, he was advised to follow a gluten-free diet. His clinical improvement was evaluated and confirmed with biopsy.; Conclusion: Celiac disease is known to be associated with many systemic diseases and skin lesions but its association with familial multiple lipomas has not yet been reported.; Introduction. Gluten enteropathy (celiac disease) is a chronic disease and presents as diarrhea, weight loss and anemia.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Clear cell variant of follicular thyroid carcinoma with normal thyroid-stimulating hormone value: A case report
Sayar, Ilyas; Peker, Kemal; Gelincik, Ibrahim; Demirtas, Levent; Isik, Arda
Introduction. Clear cell carcinomas of the thyroid gland with normal thyroid-stimulating hormone value are very rare, but clear cell changes are described in most reported cases of thyroidal lesions. Case presentation. In this report, we describe the case of a 50-year-old Caucasian woman with a normal thyroid-stimulating hormone level who underwent surgery to treat a multi-nodular goiter. The pathology was a clear cell variant of follicular thyroid carcinoma. The tumor was 1cm in diameter and consisted of pure clear cells. Conclusion: Clear cell variants of follicular thyroid carcinoma are rarely seen, especially it is misdiagnosed with metastatic renal cell carcinoma. In this report, we describe the case of a patient with a clear cell variant of follicular thyroid carcinoma with an interesting pathology.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014A case report of esophageal perforation: Complication of nasogastric tube placement
Isik, Arda; Firat, Deniz; Peker, Kemal; Sayar, Ilyas; Idiz, Oguz; Soytürk, Mehmet
Objective: Unusual clinical course Background: Esophageal perforation is a well-defined and severe clinical condition. There are several etiologies of esophagus perforation. Case Report: We report the case of a 70-year-old Caucasian man who underwent an emergency cholecystectomy due to acute cholecystitis. Two days after surgery, his condition deteriorated. Thorax computerized tomography revealed an esophageal perforation. Conclusions: Esophageal perforation due to nasogastric application is relatively rare but the consequences are potentially serious. The anatomy of the upper gastrointestinal system should be understood by all healthcare professionals involved in the treatment.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease
Demiryilmaz, Ismail; Yilmaz, Ismayil; Peker, Kemal; Celebi, Fehmi; Cimen, Orhan; Isik, Arda; Bicer, Senol; Firat, Deniz
Pilonidal sinus disease is a common disease of young adults, which most frequently occurs in the sacrococcygeal region on the skin's midline. Various procedures, ranging from simple incision and curettage to complex flaps for natal cleft obliteration, have been described in the literature. Material/Methods: We aimed to present the dermographic characters, post-operative complications, length of stay in hospital, time of return to daily activities, and recurrence rates of the patients in which we applied sinus excision and fasciocutaneous V-Y advancement flap due to primary complicated or recurrent sacrococcygeal pilonidal sinus disease. Results: Patients with primary complicated and recurrent pilonidal sinus received a fasciocutaneous V-Y advancement flap in the general surgery service of our hospital. Eleven patients had recurrent disease. Thirty-seven patients received a unilateral V-Y flap and 8 patients received a bilateral V-Y flap. None of the patients had post-operative flap necrosis or wound opening. Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing. The mean time required to return to daily activities was 7 days, and return to work took 17 days. In the mean 25-month follow-ups of the patients, no recurrences were detected. Conclusions: We think that fasciocutaneous V-Y advancement flap is an easily learned and practicable method that reduces the recurrences in the patients with primary complicated and recurrent pilonidal sinus, length of stay in hospital, and time to return to daily activities and work in the post-operative period.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Efficacy of glycerol and fax seed oil as anti-adhesive barriers after thyroidectomy
Idiz, Oguz; Aysan, Erhan; Firat, Deniz; Ersoy, Yeliz Emine; Cengiz, Merve Busra; Akbulut, Huseyin; Isik, Arda; Muslumanoglu, Mahmut
Background: We evaluated the effects of local fax seed oil and glycerol application for reducing adhesion formation after thyroidectomy. Material/Method: We randomly assigned 18 female Wistar albino rats (median weight: 275 g, median age: 4.5 mth) to 3 groups: 0.1 ml 0.9% NaCl, glycerol, and fax seed oil were sprayed in a perithyroidal area after thyroidectomy operation on all animals as anti-adhesive barriers. Rats were sacrificed on the postoperative 14th day and adhesions were evaluated macroscopically and microscopically. Results: The median macroscopic adhesion score was 3.0±0.0 in the 0.9% NaCl group, 1.33±0.52 in the glycerol group, and 1.67±0.53 in the fax seed oil group. The median histopathological fibrosis scores were 2.33±0.82, 0.67±0.52, and 0.83±0.75, respectively. Both glycerol and flaxseed oil group macroscopic and microscopic scores were significantly lower than the 0.9% NaCl group (p<0.05). There was no significant difference among the groups (p>0.05). Conclusions: Glycerol and fax seed oil both decrease the incidence of post-thyroidectomy adhesion in rats, but glycerol is more effective.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2013Effectiveness of Intragastric Balloon Treatment for Obese Patients: Retrospective Clinical Trial
Peker, Kemal; Isik, Arda; Çimen, Orhan; Demirtas, Levent; Kuyrukluyildiz, Ufuk
Objective: Obesity is a serious and chronic disease with genetic and environmental interference. Several treatment modalities exist such as medical treatment, surgical treatment, endoscopic interventions. Methods: Thirteen patients' data were evaluated retrospectively at the Erzincan University Medical Faculty Hospital Endoscopy Unit. Intragastric balloons were performed between 2012 January-2013 December. When patients gain the desired weight, approximately 8 to 12 months later; the balloons were removed. Results: The mean duration of gastric balloons in patients was 10.0 +/- 1.22 months. It was determined that the mean weight loss within the prescribed time was 25.1 +/- 5.5 kg. There is a statistically significant difference among the values when comparing the values before and after gastric balloon (p=0.001) Conclusion: Intragastric balloon replacement is a safe and effective procedure for weight reduction. The intragastric balloon can play a role for the temporary weight reduction of morbidly obese patients in diet supporting, as well as in the preoperative treatment of patient candidates for bariatric surgery or other surgical procedures in order to decrease morbidity and mortality.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2013Prevention of intraabdominal adhesions by local and systemic administration of immunosuppressive drugs
Peker, Kemal; Inal, Abdullah; Sayar, Ilyas; Sahin, Murat; Gullu, Huriye; Inal, Duriye Gul; Isik, Arda
Background: Intraperitoneal adhesion formation is a serious postsurgical issue. Adhesions develop after damage to the peritoneum by surgery, irradiation, infection or trauma. Objectives: Using a rat model, we compared the effectiveness of systemic and intraperitoneally administered common immunosuppressive drugs for prevention of postoperative intraperitoneal adhesions. Materials and Methods: Peritoneal adhesions were induced in 98 female Wistar-Albino rats by cecal abrasion and peritoneal excision. Rats were randomly separated into seven groups, each containing fourteen rats, and the standard experimental model was applied to all of rats. 14 days later, rats were euthanized, intraperitoneal adhesions were scored and tissues were examined histologically using hematoxylin/eosin and Masson's trichrome staining. Results: Throughout the investigation, no animal died during or after surgery. In all of experimental groups, decrease in fibrosis was statistically significant. Decrease in fibrosis was most prominently in intraperitoneal tacrolimus group (P = 0.000), and decrease was least in intraperitoneal cyclosporine group (P = 0.022). Vascular proliferation was significantly decreased in all experimental groups (P < 0.05) except for systemic tacrolimus group (P = 0.139). Most prominent reduction in vascular proliferation was in intraperitoneal tacrolimus group (P = 0.000). Conclusions: Administration of immunosuppressive drugs is effective for prevention of intraperitoneal adhesions.
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