Duodenum birinci kısım divertikülünden kaynaklanan nadir bir schwannom olgusu

Bu yazıda periferal sinir schwann hücrelerinden köken alan nadir bir duodenal schwannoma olgusu sunulmuştur. 57 yaşında bayan hasta anemi tetkiki sırasında ateş ve karın ağrısı şikayeti ile başvurdu. Fizik muayenesinde karın sağ üst kadranda hassasiyet tespit edildi. Laboratuar değerlerinde 15 300/l olan lökositoz haricinde anormallik yoktu. Tüm tümör belirteçleri normal değerlerdeydi. Ultrasonografide duodenuma yapışık hipoekoik kitle tespit edildi. Bilgisayarlı tomografi ve manyetik rezonans incelemede aynı lokalizasyonda 4x3 cm'lik kitle ve 8x11x12 cm'lik karaciğer sağ lobda abse bulundu. Hepatik abse drenajı ve duodenal divertikülektomi yapıldı. Histopatolojik incelemede şekil ve büyüklükte hafif derecede değişiklikler gösteren kesişen iğsi hücre kümeleri içeren tümöral kitle görüldü. İmmünohistokimyasal olarak tümör hücrelerinin S100 protein ile kuvvetli pozitiflik vermesi nedeni ile duodenal schwannoma tanısı kondu. Ameliyat sonrası dönemi sorunsuz geçen hasta 8. gün taburcu oldu.A case of duodenal schwannoma, a rare tumor arising from schwannian cells of peripheral nerves is presented. A 57-year-old woman was admitted with abdominal pain and fever during investigation of anemia. Physical examination revealed tenderness in the right side of the upper abdomen. Laboratory tests showed no abnormality except for leucocytosis of 15 300/l. All tumor markers were negative. Ultrasonography revealed a hypoechoic mass adjacent to the duodenum. Computed tomography and magnetic resonance imaging showed a 4x3 cm mass in the same region and an abscess with dimensions of 8x11x12 cm in the right lobe of liver. Hepatic abscess drainage and duodenal diverticulectomy was performed. Histopathological examination revealed a tumorous mass composed of interlacing bundles of spindle cells, showing mild variations in nuclear shape and size. Immunohistochemically tumor cells were positive for S100 protein, thus, schwannoma of the duodenum was diagnosed. The postoperative course was uneventful and the patient was discharged on the eighth day of operation

The Weight and Height Percentiles in 6−18 Year Old Children in Kayseri and Comparison with Istanbul Data

Background: One of the mostly used and preferred method in following the growth of children is to plot weight and height values of the children on standard percentile charts. It is essential for each country to use its own populations’ updated percentile curves. However, data on the growth of children living in different regions are also needed for comparison with the national standards

Peritonitis karsinomatozayı taklit eden abdominal tüberküloz olgusu

Abdominal tüberküloz nadir bir durumdur ve bulguları çoğu zaman nonspesifiktir. Birçok değişik patolojik durumu taklit edebilir. Abdominal tüberküloz tüm gastrointestinal sistemi, mezenteri ve peritonu tutmasının yanı sıra, solid organlar olan dalak, karaciğer ve pankreasıda tutabilmektedir. Karın içinde kitle nedeniyle ameliyat edilen ve ameliyat sırasında makroskopik olarak peritonitis karsinomatoza tanısı düşünülen 42 yaşındaki kadın hastaya ilişkin olgu literatür bilgileri eşliğinde sunuldu.Abdominal tuberculosis is a rare disease, with non-specific findings. Abdominal tuberculosis can mimic different pathologies. Abdominal tuberculosis could affect the entire gastrointestinal tract, peritoneum, mesentery as well as the solid organs like liver, spleen and pancreas. We present a 42-year-old woman with intra-abdominal mass of unknown origin which was interpreted as peritoneal carcinomatosis intraoperatively

Neonatal Hypopituitarism: Approaches to Diagnosis and Treatment

Hypopituitarism is defined as a decreased release of hypophyseal hormones, which may be caused by disease of the pituitary gland disease or hypothalamus. The clinical findings of neonatal hypopituitarism depend on the causes and on presence and extent of hormonal deficiency. Patients may be asymptomatic or may demonstrate non-specific symptoms, but may still be at risk for development of pituitary hormone deficiency over time. Patient history, physical examination, endocrinological, radiological and genetic evaluations are all important for early diagnosis and treatment. The aim of this paper was to present a review of etiological factors, clinical findings, diagnosis and treatment approaches in neonatal hypopituitarism

Waist Circumference and Mid−Upper Arm Circumference in Evaluation of Obesity in Children Aged Between 6 and 17 Years

Objective: The purpose of this study was to determine the cut−off values for waist circumference (WC) and mid−upper arm circumference (MUAC) and to assess their use in screening for obesity in children

Growing Degree Day and Seed Yield Relationships in Mustard (Brassica juncea L.) Under Different Sowing Seasons and Locations of Turkey

Mustard is grown in mild winter regions as late fall and in hard winter regions as late spring crop. Mustard has high degree of adaptability under wide range of climatic conditions in Turkey. Temperature is an important weather parameter affecting the growth and development of the mustard. The sum growing degree day (GDD) for a growing season is related to plant development which is depends on the accumulation of heat. The aim of this study was to determine the adaptation of mustard, under sowing seasons (spring and fall sowing) and locations in terms of crop growth (emergence, 50% flowering, physiological maturity, and sum growing degree days) and seed yield of mustard. Two-year field experiments in a split-plot design with four replications were carried out during 2013-14 and 2014-15 growing seasons at eight different ecological locations. These locations included Ankara, Aydin, Erzurum, Eskisehir, Isparta, Tekirdag, Tokat and Sanliurfa provinces of Turkey-as classified by Koppen-Geiger ecological conditions. The Brassica juncea L. (mustard seeds) were collected from wild conditions in the Konya province of Turkey. The results showed that, sowing seasons and locations significantly affected seed yield and GDD. The maximum seed yield of 3754.9 kg ha(-1) was obtained from Tokat (warm humid) during fall sowing with total accumulated GDD of 1512.1 degrees C for mustard. Sum growing degree-days accumulated in different sowing seasons and locations occurred between 1132.0 degrees C and 2285.1 degrees C depending on the related ecological conditions. Fall season crop in Aydin location had the maximum growing degree days. Overall, fall season accumulated more growing degree days due to longer period of sunshine in comparison to spring season with less sunshine days resulting in longer vegetation period

Our experiences on retrograde intrarenal surgery

Objective: To evaluate outcomes of the cases who had undergone retrograde intrarenal surgery (RIRS) in our clinics. Methods: Outcomes of 100 cases who had undergone RIRS because of renal stones between February 2012, and May 2013 were retrospectively evaluated. Results: Study population consisted of 35 female and 65 male patients with a mean age of 36.81(1-76) years. RIRS was performed with the indication of rest double J (D-J) stent (n=1), and renal stone (n=99). Mean stone size was 15.26 (5-27) mm. Preoperatively, 61 cases (61%) had preexisting D-J stents, while 39 (39%) cases were stentless. Access sheaths were used in 86 (86%) cases, while in 14 (14%) cases the procedure was applied without using an access sheath. Mean operative, and fluoroscopy times were 52.72 (10-120) minus, and 57.32 (10-180) seconds, respectively. Postoperatively D-J stents were implanted in 88 (88%) cases, and 12 (12%) cases were stent-free. Mean hospital time was 1.3 (1-7) days. After one month postoperatively, stone-free rate was achieved in 87 (87%) patients. Clinically insignificant residual stone fragments (CIRF) 6 (6%), and residual stones 7 (7%) were also detected. The latter group consisted of cases with horseshoe kidney (n=1), pelvic kidney (n=1), and kyphoscoliosis (n=1). Also in two case procedure was terminated prematurely, because of blurring of the vision secondary to bleeding. Apart from these patients, any preoperative complication did not develop. During follow-up period, urinary tract infection developed in 3 patients with resultant renal parenchymal damage in one patient. In one patient, D-J stent migrated into ureter. Conclusion: Retrograde intrarenal surgery is an effective and safe technique in the management of renal stones

Combined Effects of Tauroursodeoxycholic Acid and Glutamine on Bacterial Translocation in Obstructive Jaundiced Rats:

Background: Bacterial Translocation is believed to be an important factor on mortality and morbidity in Obstructive Jaundiced. .Aims: We investigated the probable or estimated positive effects of tauroursodeoxycholic acid, which has antibacterial and regulatory effects on intestinal flora, together with glutamine on BT in an experimental obstructive jaundiced rat model. Study Design:Animal experimentation.Methods: Forty adult, male, Sprague Dawley rats were used in this study. Animals were randomised and divided into five groups of eight each: sham (Sh); control (common bile duct ligation, CBDL); and supplementation groups administered tauroursodeoxycholic acid (CBDL+T), glutamine (CBDL+G), or tauroursodeoxycholic acid plus glutamine (CBDL+TG). Blood and liver, spleen, MLN, and ileal samples were taken via laparotomy under sterile conditions for investigation of bacterial translocation and intestinal mucosal integrity and hepatic function tests on the tenth postoperative day. Results: There were statistically significant differences in BT rates in all samples except the spleen of the CBDL+TG group compared with the CBDL group (p=0.041, p=0.026, and p=0.041, respectively). Conclusion: It is essential to protect hepatic functions besides maintaining intestinal mucosal integrity in the active struggle against BT occurring in obstructive jaundice. The positive effect on intestinal mucosal integrity can be increased if glutamine is used with tauroursodeoxycholic acid, which also has hepatoprotective and immunomodulatory features

Rectal foreign bodies: A report of three cases

Yaşları 25, 66 ve 67 olan üç erkek hastada rektumda yabancı cisim saptandı. Yabancı cisimler; demir çubuk, ağaçtan şekillendirilmiş özel çubuk ve çay bardağı idi. Cisimler, iki olguda genel anestezi altı nda litotomi pozisyonunda, birinde lokal anestezi ve sedasyon desteği altında diz dirsek pozisyonunda anal dilatasyon sonrası dışarı çıkarıldı. iki olguda uygulanan tedavi yöntemiyle ilgili komplikasyon gözlenmezken, bir olguda rektum mukozası nda yüzeysel laserasyonlar meydana geldi. Hastalar 24 saat süreli gözlemden sonra sorunsuz taburcu edildi. Rektum ve sigmoid kolonda yerleşen yabancı cisimler son yıllarda giderek artan oranda görülmekte ve yol açtığı komplikasyonlar nedeniyle önemli acil cerrahi sorunlardan birini oluşturmaktadı r.Different foreign bodies were found in rectum in three male patients, whose ages were 25, 66 and 67. These foreign materials were iron stick, special wooden stick and tea cup. In two patients, materials were taken out under general anesthesia in lithotomy position and the other one in knee-elbow position by anal dilatation under local anesthesia with sedation. In two patients there were not any complications related with the treatment method but one of them had superficial lacerations on rectal mucosa. All of the patients were discharged after 24 hours observation. Foreign bodies in rectum and sigmoid colon is increasingly being seen recently and is one of the significant surgical emergency problems due to the complications it may cause

Perforated primary small bowel lymphoma: A case report

İnce bağırsak malign tümörleri nadir görülen ve tanı aşamasındaki güçlükler nedeniyle ileri evrelerde tanı konan tümörlerdir. Lenfoma gastrointestinal sistem malign tümörlerinin %1'ini oluşturur. Primer gastrointestinal lenfoma ender görülür ve ameliyat öncesi tanı konması oldukça zordur. Primer gastrointestinal lenfoma tanısı genellikle laparotomi ile konur. Bu yazıda, subileus tanısı ile takip edilmekteyken akut karın kliniği gelişen ve acil cerrahi eksplorasyona alınarak ince bağırsak tümör perforasyonu saptanan 77 yaşında erkek hasta sunuldu. Hastaya geniş ince bağırsak rezeksiyonu ve uç uca çift kat ince bağırsak anastomozu yapıldı. Histopatolojik inceleme sonucu indolent B-hücreli non-Hodgkin lenfoma olarak bildirildi. İnce bağırsak tümörlerinin nadiren subileus tablosu ile karşımıza çıkabileceği ve tanının çoğu zaman gecikebileceği unutulmamalıdırMalignant tumors of the small bowel are rarely seen and are usually diagnosed in advanced stages because of the difficulties in diagnosis. Lymphomas account for %1 of malignant gastrointestinal system tumors. Primary gastrointestinal lymphoma is very rare and its preoperative diagnosis is difficult. Its diagnosis is usually made through laparotomy. A 77-year-old male patient developed acute abdomen during observation for partial mechanic intestinal obstruction. Emergent explorative laparotomy revealed perforation of a small bowel tumor. A wide small bowel resection was performed with a double-layer end-to-end anastomosis. Histopathological examination of the surgical specimen was reported as indolent B-cell non–Hodgkin's lymphoma. It should be kept in mind that small bowel tumors can present as mechanic intestinal obstruction, resulting in delayed diagnosis