Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Objectives and background:Hysterectomy is the most commonly performed major gynecological operation for both benign and malign gynecologic conditions. After hysterectomy, although some investigators have declared an increased incidence of urinary and anorectal dysfunction, some others could not show any connection. Methods: The voluntary patients were divided in two groups: abdominal hysterectomy (Group 1) and vaginal hysterectomy (Group 2). Anal manometry and all the other examinations of the patients were performed at the Department of General Surgery Endoscopy Unit of Ankara University, Faculty of Medicine. Results: When the quality of life of the patients was assessed before the operation and on the 12 th post-operative month via the SF-36 form; it can be seen that body pain parameters of the patients in Group 1 had significantly improved and there is no statistical difference in other parameters. When the effect of hysterectomy on the quality of life of the patients was evaluated by the “Cleveland Clinic Global Quality of Life” form, the statistically significant improvement in the quality of life of the patients in Group 2 was observed. Conclusion: If the type of operation (vaginal or abdominal) is performed due to benign causes, it does not affect the urinary and anorectal functions of the patients. Depending on the decrease of complaints of the patients, it has a positive effect on the quality of life. © 2018 Birsen et al

The place of D-dimer and L-lactate levels in the early diagnosis of acute mesenteric ischemia

INTRODUCTION: Acute mesenteric ischemia (AMI) is an abdominal-vascular emergency which is rare and has high mortality rates (60-80 %) due to late diagnosis (1-3). Although it is known that extravascular reasons like intestinal intussusception, volvulus, strangulated hernias and obstructions can cause intestinal gangrene, these are rarely the cause of AMI (1). MATERIALS AND METHODS: In this study, we used male Wistar-Albino rats weighing 250-300 grams obtained from Pamukkale University Experimental Research Laboratory. Animals were exposed to light-dark cycles for 12 hours and had free access to food and water. They were kept in cages for 7 days to stabilise their intestinal flora. In animals of group I, nothing was made other than taking 0.5 ml blood intracardially. In other animals, abdomen was reached with midline laparotomy and superior mesenteric artery (SMA) was located. In group II (operative control group), SMA was isolated and manipulated but was not ligated. In Group III (intestinal ischemia group), SMAwas isolated and ligated with 3/0 silk tie distally to the aorta. After this process, intestinal ischemia was achieved which was confirmed by paleness and pulselessness of intestines, caecum and right colon. Later on, abdomen was closed with double 3/0 polyglactin sutures. At postoperative 1st, 4th and 6th hours 0.5 ml blood was taken intracardially from the animals in groups II and III in order to quantify D-dimer and L-lactate levels. LABORATORY TESTS: D-dimer: Blood samples which were put into tubes containing sodium citrate, were seperated from plasma with centrifugation at 4000 rpm for 7 minutes. L-lactate: Blood L-lactate levels were determined from blood taken into capillary tubes with the help of immobilised enzyme electrode technology using YSI 1500 Sport portative lactate analyzer (Yellow Springs Instruments Inc., Ohio-USA). HISTOPATHOLOGIC VERIFICATION: Two cm long intestinal samples were taken from animals in which SMA was ligated in order to achieve mesenteric ischemia and these samples were fixed in 10 % formol. DISCUSSION: As a result, in rats with SMA occlusion serum D-dimer levels were not increased significantly when compared either in the group or with the basal values of the control group and values in operative control group. Therefore, it is concluded that D-dimer is not a useful marker for early diagnosis of AMI. On the other hand, it is revealed that blood L-lactate levels began to increase significantly following 4th hour of mesenteric ischemia and it is shown that this increase continued at the 6th hour. In addition, considering the utmost importance of the early diagnosis in patients with the clinical suspicion of AMI, L-lactate seems to be a suitable marker to use in emergency departments because it is achieved with a portable device that gives fast and accurate results. Nevertheless, our results are need to be supported by clinical studies with larger patient series (Tab. 2, Fig. 11, Ref. 39). Text in PDF www.elis.sk

The effect of melatonin on bacterial translocation following ischemia/reperfusion injury in a rat model of superior mesenteric artery occlusion

Background: Acute mesenteric ischemia is a life-threatening vascular emergency resulting in tissue destruction due to ischemia-reperfusion injury. Melatonin, the primary hormone of the pineal gland, is a powerful scavenger of reactive oxygen species (ROS), including the hydroxyl and peroxyl radicals, as well as singlet oxygen, and nitric oxide. In this study, we aimed to investigate whether melatonin prevents harmful effects of superior mesenteric ischemia-reperfusion on intestinal tissues in rats. Methods: Rats were randomly divided into three groups, each having 10 animals. In group I, the superior mesenteric artery (SMA) was isolated but not occluded. In group II and group III, the SMA was occluded immediately distal to the aorta for 60 minutes. After that, the clamp was removed and the reperfusion period began. In group III, 30 minutes before the start of reperfusion, 10 mg/kg melatonin was administered intraperitonally. All animals were sacrified 24 hours after reperfusion. Tissue samples were collected to evaluate the I/R-induced intestinal injury and bacterial translocation (BT). Results: There was a statistically significant increase in myeloperoxidase activity, malondialdehyde levels and in the incidence of bacterial translocation in group II, along with a decrease in glutathione levels. These investigated parameters were found to be normalized in melatonin treated animals (group III). Conclusion: We conclude that melatonin prevents bacterial translocation while precluding the harmful effects of ischemia/reperfusion injury on intestinal tissues in a rat model of superior mesenteric artery occlusion. © 2015 Ozban et al.; licensee BioMed Central

Böbrek nakli alıcısında splenik arter anevrizması

In this article, we present the first case of SAA (Splenic Artery Aneurysm) in a kidney transplantation recipient, which was incidentally detected during the preparation of the transplantation and successfully treated. A 25-mm SAA was detected at kidney transplant recipient during the preparation examination by abdominal ultrasonography. Splenic artery ligation and aneurysmectomy was performed before the transplantation. Intraoperative Doppler ultrasonography revealed that there were no abnormalities of the spleen blood supply. During the first month of follow-up, the patient remained asymptomatic and laboratory investigations revealed no abnormalities. Selective ligation and resection of SAAs combined with spleen preservation is a safe treatment modality for selected cases with favorable short and long-term results, allowing the permanent treatment of the SAA, while preserving the splenic function.Bu yazıda, böbrek nakli alıcısında, nakil hazırlığı sırasında tesadüfen tespit edilen ve başarıyla tedavi edilen ilk SAA (Splenik Arter Anevrizması) vakasını sunuyoruz. Karın ultrasonografi ile yapılan hazırlık incelemesinde böbrek nakli alıcılarında 25 mm SAA saptandı. Nakil öncesi splenik arter ligasyonu ve anevrizmektomi yapıldı. İntraoperatif Doppler ultrasonografi ile dalak kan akışında herhangi bir anormallik olmadığı gösterildi. Takibin ilk ayında hasta asemptomatik kaldı ve laboratuvar incelemelerinde herhangi bir anormallik görülmedi. Dalak korunarak SAA'ların seçici ligasyonu ve rezeksiyonu, splenik fonksiyonu korurken SAA'nın kalıcı tedavisine izin veren, olumlu kısa ve uzun vadeli sonuçları olan seçilmiş vakalar için güvenli bir tedavi yöntemidir

Effects of abdominal and vaginal hysterectomy on anorectal functions along with quality of life of the patient

Objectives and background:Hysterectomy is the most commonly performed major gynecological operation for both benign and malign gynecologic conditions. After hysterectomy, although some investigators have declared an increased incidence of urinary and anorectal dysfunction, some others could not show any connection. Methods: The voluntary patients were divided in two groups: abdominal hysterectomy (Group 1) and vaginal hysterectomy (Group 2). Anal manometry and all the other examinations of the patients were performed at the Department of General Surgery Endoscopy Unit of Ankara University, Faculty of Medicine. Results: When the quality of life of the patients was assessed before the operation and on the 12 th post-operative month via the SF-36 form; it can be seen that body pain parameters of the patients in Group 1 had significantly improved and there is no statistical difference in other parameters. When the effect of hysterectomy on the quality of life of the patients was evaluated by the “Cleveland Clinic Global Quality of Life” form, the statistically significant improvement in the quality of life of the patients in Group 2 was observed. Conclusion: If the type of operation (vaginal or abdominal) is performed due to benign causes, it does not affect the urinary and anorectal functions of the patients. Depending on the decrease of complaints of the patients, it has a positive effect on the quality of life. © 2018 Birsen et al

Colorectal injury in a personal watercraft (Jet Ski) passenger: A case report and review of the literature

As the popularity of the personal watercraft (PWC) or Jet Ski increases, injuries suffered from the usage of them become more common. Most severe injuries in this setting are typically related to blunt head trauma. Here we present an unusual case of hydrostatic injury to the rectum and sigmoid colon due to exposure to a high-pressure jet stream of water in a passenger thrown from the rear of a PWC. In addition, a review of the literature of similar cases is briefly discussed. © 2014 Medcom Limited. All rights reserved

Primer Hiperparatiroidi Tanısı İle Opere Edilen Olguların Analizi

Amaç: Primer hiperparatiroidizm, parathormonun aşırı salgılanması sonucu oluşan bir hastalıktır. Bu çalışmada, primer hiperparatiroidizm nedeni ile 2009-2012 yılları arasında, kliniğimizde ameliyat edilen 41 hastanının tedavi sonuçları literatür eşliğinde değerlendirildi. Gereç ve yöntem: Preoperatif tanı ve lokalizasyon amaçlı tüm hastalara boyun ultrasonografisi ve Tc 99 - sestamibi ile paratiroit sintigrafisi uygulandı. Hasta verileri retropsektif olarak değerlendirildi.Bulgular: Çalışmada 28 vakada adenom eksizyonu (%68,3), 5 vakada minimal invaziv paratiroidektomi, 2 vakada subtotal paratiroidektomi, 4 vakaya total paratiroidektomi + scm kası içine ototransplantasyon, 1 vakada lateral insizyonla ve 1 vakada ise sternotomi ile intratorasik adenom eksizyonu operasyonu uygulandı.Sonuç: Primer hiperparatiroidi hastalarının genel cerrahi, endokrinoloji, nükleer tıp ve radyoloji bölümleri tarafından, multidisipliner bir anlayışla değerlendirilmesi gereki

Hepatik portal venöz hava ve pnömatozis intestinalis

Hepatik portal venöz hava erişkinlerde nadiren görülen bir durumdur. Pnömatozis intestinalis bağırsak duvarında çok sayıda pnömotik kist varlığı ile karakterize bir patoloji olup, barsak duvarında nekroza bağlı hasar ile ilişkili bir durumdur. Bu yazıda, muhtemel bir mezenterik iskemiye bağlı hepatik portal vende hava ve pnömatozis intestinalis saptanan bir olgu sunuldu. Karın ağrısı şikayeti ile acil servise başvuran ve fi zik muayenesinde yaygın abdominal hassasiyeti olan erkek olgunun bilgisayarlı abdomen tomografi sinde batın içerisinde seviyelenme gösteren yaygın serbest hava ve sıvı, portal ve mezenterik venlerdeki intralüminal gaza bağlı olarak karaciğer ve dalak parankiminde dallanma gösteren hava dansiteleri ve tüm ince bağırsak duvarlarında pnömatozis intestinalis ile uyumlu hava görünümü izlendi. Hepatik portal vende hava ve pnömatozis intestinalis pek çok olguda yaşamı tehdit eden bir süreçtir. Bu yüzden şüphelenilen vakalarda eksplorasyon mutlaka yapılmalıdır

Spousal and living related kidney transplantation: Our center experience

Background Kidney transplantation is the most preferred type of renal displacement therapy for end stage renal disease (ESRD) patients. More patients developed ESRD. The most important source is the donations from unrelated spouses. In this study, we aimed to compare the transplantation data obtained from the spouses of the patients with the transplantation data obtained from other relatives. Methods The data including 167 living kidney transplantations performed between January 2006 and December 2019 were retrospectively collected. The patients were divided into two groups; spousal donor group (n: 53) and living-related donor group (n: 114). Results There was no significant difference in delayed graft function in both groups. There were no patients with acute rejection proven by biopsy or considered biochemically in the spousal donor group. With regard to 3-year results in the living-related donor group the patient survival rate was 100%, while it was 98.2% in terms of graft survival. Conclusions In conclusion, similar patient and graft survival rates between spousal donor kidney transplantation and living-related kidney transplantation has made spousal donor kidney transplantation, with possible problems in terms of tissue compatibility, an acceptable alternative to donor supply