[Show abstract][Hide abstract] ABSTRACT: Objectives:
Breast density increases the risk of breast cancer, but also in the interpretation of mammography is also important. This study examine the risk factors affecting breast density in postmenopausal women.
Between January 2013 and January 2014, 215 patients admitted to The Clinics of Gynecology and Obstetrics with complaints of menopause were taken. According to the results of mammography, Group I (non-dense, n = 175) and Group II (dense, n = 40) were created. The informations of the caseswere analyzed retrospectively.
In Group I, body mass index (BMI), number of pregnancies, parity were significantly higher than group II (P < 0.05). In group II, the withdrawal period of menstruation and progesterone levels were significantly higher (P < 0.05). In logistic regression analysis, BMI for dense breasts and number of pregnancies were found to be an independent risk factor (P < 0.05).
Increased BMI, pregnancy and parity, result of reduction in density , but longer duration of menopause and increased progesterone cause an increase in density. BMI and the number of pregnancy was found to be independent risk factors for reducing breast density.
[Show abstract][Hide abstract] ABSTRACT: Background. The diagnosis of intestinal malrotation is established by the age of 1 year in most cases, and the condition is seldom seen in adults. In this paper, a patient with small intestinal malrotation-type intraperitoneal hernia who underwent surgery at an older age because of intestinal obstruction is presented. Case. A 73-year-old patient who presented with acute intestinal obstruction underwent surgery as treatment. Distended jejunum and ileum loops surrounded by a peritoneal sac and located between the stomach and transverse colon were determined. The terminal ileum had entered into the transverse mesocolon from the right lower part, resulting in kinking and subsequent segmentary obstruction. The obstruction was relieved, and the small intestines were placed into their normal position in the abdominal cavity.
Conclusion. Small intestinal malrotations are rare causes of intestinal obstructions in adults. The appropriate treatment in these patients is placement of the intestines in their normal positions.
[Show abstract][Hide abstract] ABSTRACT: Background:
To investigate the protective effect of ethyl pyruvate (EP), an anti-oxidant agent, against ischemia-reperfusion injury in a rat model of ovarian torsion, considering biochemical and histopathological aspects.
Forty Wistar Albino rats were divided into five groups: Group I, sham operation; Group II, ischemia alone, Group III, ischemia-reperfusion; Group IV, ischemia-reperfusion+50 mg/kg EP; and Group V, ischemia-reperfusion+100 mg/kg EP. Through laparotomy, 360° torsion was performed and maintained for 3 h, and detorsion was maintained for a further 3 h. Intraperitoneal EP was given 30 min before the surgical procedure. Ovarian tissues and blood samples were obtained after surgery. Malondialdehyde (MDA) and asymmetric dimethyl arginine (ADMA) levels were measured in both plasma and tissue samples. Tissue sections were evaluated histopatologically. Analysis of variance was used for statistical analyses.
In both serum and tissue samples, ADMA and MDA levels were found to be significantly lower in the EP groups compared with the ischemia alone and ischemia-reperfusion groups (p=0.0001). However, no significant difference was found between groups treated with 50 mg/kg or 100 mg/kg EP. On histopathological evaluation, the total tissue injury score was found to be lower in rats treated with EP. No significant difference was detected between groups treated with 50 mg/kg or 100 mg/kg EP.
Ethyl pyruvate may exert positive effects in ischemia-reperfusion injury in cases of ovarian torsion. However, no difference was detected between 50 mg/kg and 100 mg/kg EP.
No preview · Article · Sep 2014 · European Journal of Obstetrics & Gynecology and Reproductive Biology
[Show abstract][Hide abstract] ABSTRACT: We aimed to compare the effectiveness of linezolid in preventing intraperitoneal adhesions with hyaluronic acid + carboxymethylcellulose (Seprafilm).
Thirty rats were divided randomly into 3 groups: Group I (control), untreated; Group II (Seprafilm); and Group III (linezolid). All rats were sacrificed on the 14th day after surgery. Macroscopic adhesion, inflammation, and fibrosis were evaluated.
The multiple comparisons between groups showed a statistically significant difference for adhesion. There were statistically significant differences between Group I and II and I and III, but no statistically significant difference between Group II and III. The multiple comparisons between the groups showed a statistically significant difference for inflammation and fibrosis. For inflammation and fibrosis, there was a statistically significant difference between Group I and II and I and III, but no statistically significant difference between Group II and III.
The efficiency of linezolid in reducing the formation of intraperitoneal adhesions was statistically significant compared with the control group.
Full-text · Article · Mar 2014 · American journal of surgery
[Show abstract][Hide abstract] ABSTRACT: The aim of this experimental study was to compare the effectiveness and reliability of lovastatin and hyaluronic acid + carboxymethyl cellulose(Seprafilm).
Thirty two female Wistar-Albino rats weighing between 250 and 300 g were used in the study. The rats were divided into four groups as sham, control, lovastatin and Seprafilm each of which contained 8 rats. All rats were sacrificed on the 14th day after surgery. Macroscopic adhesion, microscopic adhesion and tPA, MDA and NO values were evaluated.
Macroscopic adhesion formation was significantly lower in the sham and study groups than in the control group (p< 0.05). Microscopic classification adhesion formation was significantly lower in the sham and study groups than in the control group (p< 0.05), and the tPA, MDA and NO values showed statistically significant differences among the groups.
Lovastatin and Seprafilm were equally effective in preventing postoperative intra abdominal adhesions. The study groups were showed significant superiority to the control group.
Full-text · Article · Dec 2013 · International Journal of Surgery (London, England)
[Show abstract][Hide abstract] ABSTRACT: Animal-related injury is a serious health problem for people living in rural areas. This type of injury could be of great consequence and life-threatening. There are insufficient data regarding this issue. The purpose of this study was to evaluate the causes and treatment outcomes of large animal injuries. We reviewed the medical records of 157 patients with large animal-related injuries in a State Hospital in Northeastern Turkey, between September 2004 and April 2007. Demographic and etiological characteristics of patients and injury and outcome data were analyzed. A total of 157 patients were included in the study. One hundred and thirty-two (84.1 %) of them were male and 25 (15.9 %) female. The mean age of patients was 29.1 years (range 3–83 years). One hundred and twelve patients (71.3 %) had horse-related injuries and 45 patients (28.7 %) had bovine-related injuries (P = 0.096). Twenty-one (13.4 %) patients were referred to a tertiary center due to their need for intensive care, whereas 1 (0.6 %) patient died. Large animal-related injuries constitute an important health problem for people living in rural areas. This type of injury could be serious and mortality could be observed.
Full-text · Article · Jun 2013 · Indian Journal of Surgery
[Show abstract][Hide abstract] ABSTRACT: Objectives:
The authors aimed to investigate the effect of β-Glucan on healing of an experimental left-sided colon anastomosis model.
Material and methods:
Twenty adult male Wistar albino rats were randomized into two groups which had colonic transection and end-to-end anastomosis. Group I (Control): anastomosis group, received no treatment (n = 10); group II, anastomosis + β-Glucan (50 mg/kg/day within seven days after surgical procedure). Bursting pressure, hydroxyproline levels and histopathological characteristics of the anastomosis were analyzed.
The average burst pressure of Groups I and II were 106.67 ± 5.00 and 148.00 ± 11.35 mmHg and hydroxyproline levels were 0.85 ± 0.14 and 1.45 ± 0.46 µg/mg, respectively. Both the burst pressure and hydroxyproline levels in group II were statistically significantly higher (p < 0.05). Histopathological examination revealed less epithelial damage in group II (p < 0.05). Though not statistically significant, less edema and damage to the submucosal-muscular layer was seen in Group II (p = 0079).
Due to significant increases in anastomotic bursting pressures and tissue hydroxyproline levels and considering the inhibitory effect of β-Glucan on epithelial damage, edema, and submucosal-muscular layer damage, β-Glucan was thought to contribute to the healing of the anastomosis.
No preview · Article · May 2013 · Advances in Clinical and Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: Background:
Spigelian hernia is an uncommon and rare abdominal wall defect. We present our series of patients with Spigelian hernia and a literature review.
We carried out a retrospective review of patients operated on from 2005 to 2011 at Ondokuz Mayis University Medical Faculty Department of General Surgery. Epidemiological aspects, diagnostic methods, surgical techniques, morbidity, hospital stay, recurrences and follow up were analyzed.
We have treated 9 patients, 7 female and 2 male, with a mean age of 64 (range 47-81) years. Right side was the most frequent location. Risk factors were present in 77.8% of patients. Diagnosis was made clinically in 7 of 9 cases but preoperative imaging was made in all patients for obtain detailed information about the defect. Open hernioplasty with polypropylene mesh placed over the external oblique aponeurosis constitutes the most frequent technique (44.5%) used by repair with a primary suturation (33.3%). The remaining 22.2% of cases were laparoscopic hernioplasty placing intraperitoneal position a mesh (22.2%). Mean hospital stay was 5.1 days (range 2-9), however if we look the laparoscopic cases the time decreased to 2.5 days. One recurrence was noted during the 15th month of follow-up, which has already been operated on. The mean follow-up period of this study was 58 months. No mortality was observed among patients.
Spigelian hernia is rare and requires a high index of suspicion given the lack of consistent symptoms and signs. The physician should secure the diagnosis combining a proper history and physical examination with the preoperative imaging. Surgical technique depends on patient characteristics, type of hernia and surgeon experience.
No preview · Article · Nov 2012 · Annali italiani di chirurgia
[Show abstract][Hide abstract] ABSTRACT: The importance of the alteration of tumor infiltrative lymphocytes (CD4(+), CD8(+), CD16(+), and CD56(+)) in colorectal cancer prognosis is well known. In this study, we analyzed the effect of preoperative immunonutrition and different nutritional models on the clinical condition of colorectal cancer patients.
Twenty-eight colorectal cancer patients were grouped into 4 groups according to their nutrition regimens randomly and were given immunonutrition (IMN), standard enteral (SE), total parental nutrition (TPN), and normal nutrition (NN) regimens, all of which contained the same calorie-nitrogen content within a 7-day preoperative period. All patients had an endoscopic biopsy before and after the regimen, and the lymphocyte population infiltrating mucosal parts of the resected tumor tissue were evaluated. Immunohistochemical analysis of the tissue specimens was performed by staining with antihuman CD4(+), CD8(+), CD16(+), and CD56(+) antibodies.
After nutrition, there were significant increases in each of the 4 groups of CD4(+) and CD8(+) cells within the tumor. Comparing the rates of augmentation, the increased rates of the CD8(+) cells infiltrating the tumor after nutrition in the patients who were fed with IMN were significantly more than the ones in other groups (P = .01). CD16(+) cell infiltration was significantly higher in all groups except the SE and IMN groups. The SE group had increased CD56(+) cell infiltration compared with the other groups.
In the colorectal cancer patients who had nutrition in the 7-day preoperative period, except for the SE nutrition group, there were significant increases of infiltration of CD56(+) cells at the mucosal part of the tumor tissue within the CD4(+) and CD8(+) cell population. When postnutrition values were compared, there was a marked increase of CD8(+) cells in the IMN group.
No preview · Article · Oct 2012 · American journal of surgery
[Show abstract][Hide abstract] ABSTRACT: Surgical resection remains the principal treatment for advanced gastric cancer, but one of the difficulties in a curative or extended gastrectomy is the identification of the vascular supply of the stomach.
A patient had gastric cancer hospitalized for planning and performing his surgical therapy. A multidetector-row computed tomography scan showed us a large tumor mass and numerous lymph nodes invading perigastric and second tiers of stomach and revealed a left gastric artery and right hepatic artery in which branched directly from aorta. A 3-dimensional construction showed a demonstrative vascular anomaly as well during operation.
We were able to perform total gastrectomy and D2 lymph node dissection as surgical therapy for patient. The patient's postoperative clinical course was uneventful, and after postoperative 36 months, there was no evidence of recurrence.
We recommend that a multidetector-row computed tomography scan is very useful for the preoperative staging in gastric cancer patients because of its diagnostic value for showing any vascular anomaly and aiding in decision making on the appropriate surgical strategy.
Full-text · Article · Aug 2011 · American journal of surgery
[Show abstract][Hide abstract] ABSTRACT: Purpose: Pilonidal sinus, especially seen in young men, is known to be a distressed condition both in preoperative and postoperative period. Many surgical methods are defined to have advantages against each other, in many different publications in the medical literature. In this study, we aimed to compare two different methods in terms of postoperative complications, recurrence and patients' quality of life. Patients and Methods: A total of 98 patients who have undergone surgical treatment for pilonidal sinus between February 2002 and August 2010 were included in this study. Patients were divided into two groups: Group I was treated by excision and primary repair and Group II was treated by Limberg flap. Results: When evaluated according to the characteristics of patients included in the study, there were no differences in mean age and gender between Group I and II (p=0.496, p=0.382). The duration of surgery was lower in Group I (p<0.001). Postoperat ive hospital stay, minor complications and the rate of recurrence did not differ between groups (p=0.712, p=1.000, p=1.000). The periods until walking without pain, sitting on toilet without pain and returning to work were lower in Group II, and the difference was statistically significant (p<0.001, p<0.001, p<0.001). However, the patients in Group I have expressed that they are more satisfied with the cosmetic results (p<0.001). Conclusion: We found that these two methods did not differ in terms of postoperative minor complications and the rate of recurrence. We observed that the patients were more satisfied with excision and primary repair, in cosmetic point of view. Therefore, we believe that it would be more appropriate to consider the patient's postoperative life and satisfaction as much as we consider the rate of recurrence while deciding the type of surgical method for pilonidal sinus.
Full-text · Article · Jan 2011 · Turkish Journal of Surgery
[Show abstract][Hide abstract] ABSTRACT: Hydatid disease is endemic in many areas of the world, where it is an important public health problem. The aim of this study was to describe a series of patients with atypically located primary hydatid disease, accompanied by a literature review.
Six male and four female patients with atypically located hydatid cysts who presented to the Kars State Hospital between September 2004 and March 2008 were evaluated. The mean age was 42.5 years (range 17-72 years). Hydatid cysts were identified by using a combination of serology tests, ultrasonography, and computed tomography (CT).
Six of the patients underwent surgical treatment. Three patients (two with pericardial hydatid involvement and one with pancreatic involvement) were sent to a tertiary medical center for surgery, and one patient died from cardiac and renal failure two days after diagnosis.
Although this disease is seen most often in the liver and lungs, it can be found in any part of the body. Hydatid disease must be considered in the differential diagnosis of cystic lesions, especially in patients who have spent time in endemic areas.
Full-text · Article · Aug 2010 · Surgical Infections
[Show abstract][Hide abstract] ABSTRACT: In this study, we present the demographic features of appendicitis and investigate the influence of several factors (season, temperature, humidity, altitude) on the development of the condition.
A total of 1871 patients operated between 2004 and 2007 were included and divided into two subgroups as perforated and non-perforated appendicitis. The demographic features and environmental factors were investigated. We compared the effects of environmental conditions with those observed in other countries.
Appendicitis was most frequent among males between 10 to 19 years of age. Perforated appendicitis was mostly seen between 0-9 years and after 50 years of age. The frequency of appendicitis was the highest during winter, but the rate of perforation was at its minimum during this season. During the coldest three months of the year, non-perforated appendicitis was mostly seen at temperatures of -8.8 degrees C; however, perforated appendicitis was mostly seen at -11.2 degrees C (p<0.01).
Our findings show that the frequency of appendicitis and perforation rate are influenced by sex and age. Environmental factors like season, temperature and altitude may also influence the frequency of appendicitis.
Full-text · Article · Jan 2010 · Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES
[Show abstract][Hide abstract] ABSTRACT: Summary Aim of this study is to investigate the impact of carboxymetylcellulose about adhesion formation, fibrosis and inflamation after thyroid region surgery in an animal model. Forty rats were grouped into four and a cervical midline skin incision was made. Both thyroid lobe were seen and they were sutured two times per lobe with silk suture in group I, II, III and IV. In addition this procesure a sheet of the Carboxymethylcellulose (CMC) membrane was placed on thyroid glands before closing in goup III and IV. Rats were sacrified at seventh day in groups I, III and at twenty-eighth day in groups II, IV. In all groups adhesion formation, fibrosis and inflamation were evaluated and compared statistically. The comparison of groups in terms of macroscopic adhesion, fibrosis and inflammation scores revealed a statistically significant difference between Group I and Group III, and Group II and Group IV. (P