Sürdürülebilir Kalkınma Amaçları
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- 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 - ArticleAçık Erişim2014Preventive Effect of Intrathecal Paracetamol on Spinal Cord Injury in Rats
Sahin, Murat; Sayar, Ilyas; Peker, Kemal; Gullu, Huriye; Yildiz, Huseyin
Background: Ischemic injury of the spinal cord during the surgical repair of thoracoabdominal aortic aneurysms might lead to paraplegia. Although a number of different mechanisms have been proposed, the exact cause of paraplegia has remained unknown, hampering the development of effective pharmacologic or other strategies for prevention of this condition. A number of studies suggested that cyclooxygenases (COX) contribute to neural breakdown; thus, COX inhibitors might reduce injury. Objectives: We aimed to assess the preventive effect of intrathecal (IT) pretreatment with paracetamol on spinal cord injury in a rat model. Materials and Methods: This experimental study was performed in Ataturk University Animal Research Laboratory Center, Erzurum, Turkey. Adult male Wistar rats were randomly allocated to three experimental groups (n = 6) to receive IT physiologic saline (controls), 50 mu g of paracetamol, or 100 mu g paracetamol one hour before induction of spinal cord ischemia. Six other rats were considered as the sham group. For the assessment of ischemic injury, motor functions of the hind limbs and histopathologic changes of the lumbar spinal cord were evaluated. Additional 20 rats were divided into two equal groups for the second part of the study where the survival rates were recorded in controls and in animals receiving 100 mu g of paracetamol during the 28-day observation period. Results: Pretreatment with 100 mu g of paracetamol resulted in a significant improvement in motor functions and histopathologic findings (P < 0.05). Despite a higher rate of survival in 100 mu g of paracetamol group (70%) at day 28, the difference was not statistically significant in comparison with controls. Conclusions: Our results suggest a protective effect of pretreatment with IT paracetamol on ischemic spinal cord injury during thoracolumbar aortic aneurysm surgery.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2014Diagnosis and Laparoscopic Repair of Obturator Hernia with Intestinal Obstruction
Somuncu, Erkan; Gökcal, Fahri; Çarkman, Sinan; Peker, Kemal
Obturator hernia is a very rare abdominal hernia that is located in the anterior pelvis. Patients apply to a hospital with a clinical intestinal obstruction table in this type of hernia. Prognosis in obturator hernia remains quite poor because of delayed diagnosis and surgical management. Nowadays, radiological techniques, especially computed tomography, are very advanced. Nevertheless, obturator hernia is a serious problem with its increased mortality, because it is detected quite hardly. We tried to offer an 82-year-old woman with acute abdomen that was considered on mechanic intestinal obstruction table for us in this article. Computed tomography is useful on these patients, just as it is useful in this article. For this reason, we scanned computed tomography and recognized a strangulated obturator hernia on the left. Afterwards, we planned a surgical operation and repaired the obturator hernia laparoscopically. The patient was transferred to the intensive care unit because of respiratory failure after the operation was finished. The patient, who was followed in the intensive care unit, died five days later because of acute respiratory failure. Obturator hernia is a rare cause of acute intestinal obstruction. Therefore, increased mortality rates should be remembered in elderly patients because of delayed diagnosis and accompanying chronic diseases.
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 Erişim2014The effect of lateral internal sphincterotomy on resting anal sphincter pressures
Peker, Kemal; Yilmaz, Ismayil; Demiryilmaz, Ismail; Inal, Abdullah; Işik, Arda
Background/aim: Anal fissures are one of the most common proctologic disorders. This study aimed to investigate alterations in anal sphincteric resting pressures after lateral internal sphincterotomy, which was performed for chronic anal fissure treatment. Materials and methods: Fifty-six (68.3%) male and 26 (31.7%) female patients were included in this study. Patients complicated with fistula-in-ano, abscess, cancer, inflammatory bowel disease, dermatitis, poor general condition, allergy to any of the standard medications, previous history of anal trauma, previous anal surgery, or diagnosis of a neurological disease and patients who did not give consent to the trial were excluded from the study. Two groups were formed: a control group with 41 healthy volunteers and a study group with 41 chronic anal fissure patients. Preoperative and postoperative manometric anal measurements were compared. Results: Preoperative mean resting anal sphincter pressure was 51.29 mmHg for the control group and was 59.99 mmHg for the patient group. Although resting anal sphincteric pressures of the patient group remained within the physiological range, when compared with the control group there was a statistically significant difference. Postoperative mean resting anal sphincteric pressures of the patient group was 32.43 mmHg. Conclusion: Lateral internal sphincterotomy decreases resting anal sphincter pressures effectively in chronic anal fissure patients.
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 - ArticleAçık Erişim2014A comparison of total thyroidectomies carried out through ligasure and harmonic scalpel: A retrospective study
Peker, Kemal; Dumanli Özcan, Ayça Tuba; Şahin, Murat; Inal, Abdullah; Kiliç, Kemal; Özçiçek, Fatih
Aim: Both LigaSure (LS) and Harmonic Scalpel (HS) are new surgical technologies that have been used to secure hemostasis in various fields of surgery. There is little information in the literature about the use of LS and HS in thyroid surgery. The aim of this study was to report our experience with LS and HS in thyroid surgery. Materials and methods: In this nonrandomized retrospective study 326 consecutive patients who underwent primary thyroid surgery were reviewed. HS was used in 136 patients and LS was used in 126 patients. A conventional technique was used in 64 patients. The were 42 male patients (12.9%) and 284 female patients (87.1%); their ages varied between 19 and 72 years (mean 42.8 ± 12.4). Data regarding each patient's demographics, thyroid pathology, operation time, and complications were collected throughout the study. Results: Te 3 study groups had similar demographics (age, female/male ratio) and thyroid pathology. Permanent hypocalcemia developed in 2 (1.6%) patients in the patient group operated on through LS, of which 1 was male and the other was female. In the HS group, postoperative hematoma developed in 2 (1.5%) patients. Conclusion: Te results of this retrospective clinical study showed that LS and HS thyroidectomy can be a useful and fast alternative for conventional thyroidectomy. Te main advantage of these devices is that they simplify the procedure and eliminate the need for clips and suture legations while achieving efficient hemostasis.
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 - ArticleAçık Erişim2014The approach of general surgeons to oncoplastic and reconstructive breast surgery in Turkey: A survey of practice patterns
Emiroğlu, Mustafa; Sert, İsmail; İnal, Abdullah; Karaali, Cem; Peker, Kemal; İlhan, Enver; Gülcelik, Mehmet; Erol, VarlıK; Güngör, Hilmi; Can, Didem
Background: Oncoplastic Breast Surgery (OBS), which is a combination of oncological procedures and plastic surgery techniques, has recently gained widespread use.; Aims: To assess the experiences, practice patterns and preferred approaches to Oncoplastic and Reconstructive Breast Surgery (ORBS) undertaken by general surgeons specializing in breast surgery in Turkey.; Study Design: Cross-sectional study.; Methods: Between December 2013 and February 2014, an elevenquestion survey was distributed among 208 general surgeons specializing in breast surgery. The questions focused on the attitudes of general surgeons toward performing oncoplastic breast surgery (OBS), the role of the general surgeon in OBS and their training for it as well as their approaches to evaluating cosmetic outcomes in Breast Conserving Surgery (BCS) and informing patients about ORBS preoperatively.; Results: Responses from all 208 surgeons indicated that 79.8% evaluated the cosmetic outcomes of BCS, while 94.2% informed their patients preoperatively about ORBS. 52.5% performed BCS (31.3% themselves, 21.1% together with a plastic surgeon). 53.8% emphasized that general surgeons should carry out OBS themselves. 36.1% of respondents suggested that OBS training should be included within mainstream surgical training, whereas 27.4% believed this training should be conducted by specialised centres.; Conclusion: Although OBS procedure rates are low in Turkey, it is encouraging to see general surgeons practicing ORBS themselves. The survey demonstrates that our general surgeons aspire to learn and utilize OBS techniques.
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 - 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 Erişim2014How could such a wide piece of tree root pass through the narrow pyloric orifice? An extremely rare case
Işik, Arda; Deniz Firat, Y.; Peker, Kemal; Sayar, Ilyas; Idiz, Oguz; Soyturk, Mehmet; Demiryilmaz, Ismail; Yilmaz, Ismayil
Objective: Rare disease Background: Phytobezoars are a common type of bezoar known to accumulate in the gastrointestinal system. Case Report: A 30-year-old mentally retarded woman was operated on due to small bowel obstruction. A piece of tree root was extracted from the ileum. The patient was discharged from the hospital on postoperative day 7. Conclusions: Due to difculties in determining the nature of the bezoar preoperatively, small bowel obstruction due to a phytobezoar is not a common diagnosis. For bezoars, prevention is considered preferable to treatment.
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 - ArticleYalnız künye2013A comparison of the efficacy of dimethyl sulfoxide (DMSO) and synovial fluid in the prevention of peritoneal adhesions: Experimental rabbit model
Kılıç, Nergiz; Özaydın, İsa; Yayla, Sadık; Dağ, Serpil; Kılıç, Engin; Ermutlu, Celal Şahin; Kılıç, Kemal; Peker, Kemal
Bu çalışmada, tavşanlarda deneysel olarak oluşturulan ventral herni modelinde mersilen mesh kullanımına bağlı gelişebilecek peritoneal adezyonların önlenmesinde dimetil sülfoksit ve sinovial sıvı etkinliğinin karşılaştırılması amaçlandı. Çalışmada kullanılan 40 tavşan 4 gruba ayrıldı (n: 10). Operasyon xylazin HCI (5mg/kg im) sedasyonunu izleyerek ketamin HCI (20 mg/kg intratekal) ile elde edilen intratekal anestezi altında gerçekleştirildi. Operasyon masasına sırtüstü pozisyonda yatırılan tavşanlara median deri insizyonu yapıldıktan sonra linea alba düzeyinde 2 cm çaplı daire şeklinde bir defekt oluşturuldu. Defekt önceden disk şeklinde hazırlanan mersilen mesh ile onarıldı. Postoperatif 7. güne kadar; I. gruba 10 ml serum fizyolojik (SF) ve 1.5 g/kg DMSO, II. gruba 7 ml SF, 3 ml synovial sıvı (SS) ve 1.5 g/kg DMSO, III. Gruba 7 ml SF ve 3 ml SS, IV. gruba (kontrol: K) ise yalnızca 10 ml SF intraperitoneal olarak uygulandı. Tavşanlara 10. günün sonunda relaparotomi uygulanarak peritoneal adezyon varlığı ve derecesi Jenkins (1983)in görsel yapışıklık skalasına göre değerlendirildi. Çalışmadan elde edilen tüm veriler Minitab-16 paket programı kullanılarak istatistiksel olarak değerlendirildi. Greft uygulanan bölgeye ait doku örnekleri Hematoksilen-Eozin (HE) ve Crossmanın üçlü boyama yöntemi ile boyanarak ışık mikroskobunda değerlendirildi. Nonparametrik olarak değerlendirilen yapışıklık skala sonuçları Kruskal-Wallis testi ile istatistiki olarak hesaplandı ve gruplar arasında anlamlı bir fark bulunmadı (P>0.05). Histopatalojik inceleme sonuçları ise tüm gruplarda greftin üzerini örten dokunun fibröz doku karakterinde olduğunu gösterdi. Bununla birlikte fibrozisin DMSO grubunda, ES-DMSO, ES ve SF grubuna göre daha zayıf olduğu tespit edildi. Sonuçta gerek relaparotomik makroskobik bulgular gerekse histopatolojik bulgular dikkate alındığında synovial sıvının tavşanlarda postoperatif peritoneal adezyonların önlenmesinde etkili olduğu sonucuna varıldı.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Doxycyclin induced esophageal injury: A Case series
Yılmaz, İsmayil; Sekban, Nurdan; Şahin, Atalay; Peker, Kemal; Demiryılmaz, İsmail
Bir çok ilacın özefagus hasarlarına neden olduğu uzun zamandır bilinmektedir. Şimdiye kadar bildirilen vakalarınyaklaşık yarısı tetrasiklin grubu ilaçlara bağlıdır. İlaçların özefagusta oluşturduğu hasarlar, ilacın kendisine ve ilacı alan hastaya bağlı nedenlerle oluşmaktadır. Yazımızdadoksisiklin kullanımına bağlı endoskopik olarak tespit edi- len özefagus hasarları gelişen 5 hasta sunulmuştur. Has- taların yaş ortalaması 26 yıl idi. Dört hasta kadın, 1 hasta erkekti. Hastaların 3’ü akne nedeniyle, 2’si jinekolojik en-feksiyonlar nedeniyle bu ilacı kullanmaktaydı. Lezyonların 4’ü özefagus orta kesimde 1’i distale yakın yerleşimliydi.Ortak yakınmaları ilacı susuz veya az bir suyla alımın-dan hemen sonra başlayan retrosternal ağrı ve yutma güçlüğüydü. Hastaların tamamı semptomatik tedaviyle düzeldi. Sonuç olarak doksisiklin kullanan, ani başlayanretrosternal ağrı ve yutma güçlüğü tarifleyen hastalarda özefagus hasarı akla gelmeli ve tanıyı kesinleştirmek ve hasarın şiddetini değerlendirmek için mutlaka endoskopiyapılmalıdır. Tedaviden sonra endoskopik kontrol her za man gerekli değildir. Doksisiklin kullanan hastalara ilacısusuz kesinlikle içmemeleri önerilmelidir.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Soliter rektal divertikül: Olgu sunumu
Yılmaz, İsmayil; Kalkan, Mehmet Seyhan; Peker, Kemal; Demiryılmaz, İsmail
Rectal diverticulas are very rare and most of patients withrectal diverticula are diagnosed incidentally. Inflammatory processes may have developed at the time of thediagnosis. Here we report a case of rectal diverticulumwhich was developed after stapled transanal rectal resection procedure. Abdominal magnetic resonance imagingrevealed a giant diverticulum of the rectum. A fecalomais removed from rectum endoscopically.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2013Relationship between β -catenin expression and prognostic parameters of colorectal carcinomas
Aşoğlu, Mahmut B; Peker, Kemal; Gürsan, Nesrin
Amaç:Kolorektal karsinomlar gastrointestinal sistemin en sık görülen tümörleridir. Beta-catenin, kadherinlerle ilişkili, hücreler arası adezyonda görevli sitoplazmik bir proteindir. Aynı zamanda Wnt sinyal yolağının da önemli bir komponentidir. Son dönem çalışmalarında kolorektal karsinomlu hastalarda, supressör APC geni ve axin ile birlikte beta-katenin yapısında da bozulmalar olduğu gösterilmiştir. Bu çalışmada, kolore ktal karsinomlarda bir prognostik faktör olan β-katenin ekspresyonunu, diğer prognostik parametrelerle karşılaştırmayı amaçladık. Gereç ve Yöntem:Çalışmaya 1994 -2003 yılları arasında kolorektal karsinom tanısı ile opere edilmiş ol an 70 hasta dâhil edildi. Hastaların 59u (%84,3) erkek, 11i (%15,7) si kadın olup yaşları 24 ile 82 (ortalama 60,3±15,2) yıl arasında değişmekteydi. Parafin bloklardan hazırlanan kesitlere beta-katenin antikoru immünohistokimyasal olarak uygulandı. TNM sınıflamasına göre tümörün diferansiasyon derecesi, evresi, lenf nodu metastazı, vasküler invazyon ve tümörün lokal yayılımı ile boyanan nükleu s sayısı arasında değerlendirme yapıldı. Bulgular:Tümörün histolojik derecesine göre oluşturulan grupların, β-katenin ile boyanma şiddetleri ve pozitif boyanan nükleus sayıları, prognostik parametreler ile karşıl aştırıldığında; iyi diferansiasyon gösteren gruplarda boyanma şiddeti hafif (+), pozitif boyanan nükleus sayıları daha az iken, kötü diferansiyasyon gösteren gruplar da boyanma şiddetli (+++) ve pozitif boyanan nükleus sayısı daha fazla olarak tespit edildi. Beta-katenin ekspresyonu prognostik parametre olan diferansiyasyon derecesi, lenf düğümü metastazı, evre ve boyut ile ilişkili bulunurken, damar invazyonu ile ilişkisiz bulundu. Sonuç:Tüm bu bilgiler ışığında, beta-ka teninin hücredeki fonksiyonları ve APC geni ile olan ilişkileri nedeniyle kolorektal karsinogenezde önemli bir rolü olduğu açıktır.
RDL Kalıcı Kaydıİncele