36 research outputs found

    Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy

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    Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LS

    Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy

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    Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LS

    The effect of carnitine on kidney cold ischemic injury

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    Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.YÖK Tez No: 242285Amaç: University of Wisconsin solüsyonunun soguk iskemiye karsı korumadaaltın standart olarak kabul edilmesine ragmen, soguk iskemi zamanının arttırılmasınıamaçlayan çalısmalar devam etmektedir. Bu deneysel çalısma, böbrek sogukiskemisinde karnitinin koruyuculugunu arastırmak için planlandı.Yöntem: Yirmi dört Wistar-Albino sıçan kontrol grubu (n=6; Ringer Laktat),karnitin ilave edilmis Ringer Laktat (n=6), University of Wisconsin (n=6) ve karnitinilave edilmis University of Wisconsin (n=6) grubu olmak üzere dörde ayrıldı.Böbreklerin saklama solüsyonuyla perfüzyonu sonrasında organlar 10ml'lik saklamasolüsyonlarına konuldu. 0,24,48,72. saatlerde saklama solüsyonunda Laktatdehidrogenaz aktiviteleri ölçüldü. Aynı zamanda 72. saatte alınan doku örneklerindeMalondialdehid degerleri çalısıldı. Doku zedelenmesi histopatolojik olarakHemotoksilen-eosinle boyanmıs parafin bloklardan alına kesitlerin(0.4?m)incelenmesi ile degerlendirilip skorlandı.Bulgular: Karnitin+ University of Wisconsin grubunda ortalama dokuMalondialdehid degeri belirgin olarak düsük bulundu (15,79±5,15'e karsı9,60±2,59nMol/mg, p=0,001) Saklama sıvılarındaki Laktat Dehirogenaz seviyelerindebelirgin bir farklılık izlenmedi. Histopatolojik incelemede karnitin ilave edilmis RingerLaktat grubunun toplam zedelenme skoru düsük olarak bulundu.Sonuçlar: University of Wisconsin solüsyonuna karnitinin eklenmesi böbreksoguk iskemisinde hasarı azaltıcı etkiyi artırmaktadır.Background and aim: However, University of Wisconsin solution is acceptedas the gold standart in the preservation from cold ischemia injury, studies that wasaiming to prolong the cold ischemia time is stil persist. This experimental study isaiming to investigate the effect of carnitine on kidney cold ischemic ınjuryMethods: Twenty four Wistar-Albino rats were divided to four groups as;control group (n=6; Ringer lactate), Ringer lactate with carnitine (n=6), University ofWisconsin (n=6) and University of Wisconsin with carnitine (n=6). After the perfusionof the kidneys with preservation solution, they put into the preservation solutionsabout 10ml. Lactate Dehydrogenase levels at 0th,24th,48th,72th hours weremeasured. At the same time Malondialdehyde levels were measured from tissuesamples that were taken at the 72th hour. To determine the tissue injury, the slices(0.4?m) that were taken from parafin blocks stained with Haemotoxilen-eosin werehistopathologically scored.Results: Mean tissue Malondialdehyde levels were significantly low in thegroup; Carnitine with University of Wisconsin (15,79±5,15 vs 9,60±2,59 nMol/mg,p=0,001) There were no significant differences in Lactate Dehydrogenase levelsbetween preservative solutions. At the histopathological evaluation, total tissue injuryscore was found low at the carnitine with Ringer lactate group.Conclusion: Supplemention of carnitine to University of Wisconsin solutionincrease the detractive effect of cold ischemic injury of kidney

    CLINICAL IMPORTANCE OF SOLITARY SOLID NODULE OF THE THYROID IN ENDEMIC GOITER REGION

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    Context: Endemic area and iodine supplementation may affect the pathogenesis of the nodule which commonly occurs in endemic thyroid enlargement due to iodine deficiency. Aims: To establish pathological changes in solitary solid and larger nodule of the thyroid in endemic area. Setting and Design: Retrospective study in Surgical Department of University Hospital. Methods and Material: We determined 44 surgically treated patients with solitary solid nodule in endemic goiter area in which the population routinely receives iodinated salt. The thyroid nodule was preoperatively evaluated with blood chemistry, ultrasound, nuclear scanning and FNAC. The results of preoperative evaluation, surgical interventions, and histopathological examination were analyzed. Statistical analysis: Student t test and Fisher′s exact test. Results: Twenty (45%;20/44) patients with hot (autonomous) nodule have received the diagnosis of toxic adenoma. Twenty four patients had solitary solid and cold nodule. Total thyroidectomy was performed on two patients with papillary cancer (PTC) diagnosed by FNAC from cold nodules. Forty two patients have been treated with total excision of the lobe including hyper or hypoactive solitary solid nodule. Pathological examination has reported two more cases of PTC and one case of insular cancer arising from cold nodules. Completion thyroidectomy was performed on these 3 patients. Conclusions: Solitary solid and large nodule is a common indication for thyroid surgery in endemic goiter area. High incidence of hyperthyroidism due to single autonomous nodule, and high rate of malignant change (mainly papillary cancer) in solitary hypoactive nodule arises from this series in endemic thyroid enlargement

    Bir akt ileus olgusunda apendiko-ileal fistül

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    Appendiko-ileal fistül akut ileus tablosu ile nadir görülür. Bu yazıda mekanik barsak tıkanıklığı nedeni ile laparatomi uygulanan apendikoileal fistüllü 46 yaşında erkek olgu sunuldu. Cerrahi sırasında apendiks lümeni ile terminal ileum arasında bir fistül olduğu gözlendi. Ayrıca proksimal ileal ve jejunal ansların gergin olduğu da saptandı. Apendektomi, segmental ileum rezeksiyonu ve uçuca anastomoz cerrahi işlem olarak uygulandı. İnce barsak tıkanıklığı ile akut ileus tablosu gelişen hastalarda, apendiko-ileal fistülün akılda bulunması gerektiğini düşünmekteyiz.Appendico-ileal fistula is a rare condition with acute ileus. We report a case of appendico-ileal fistule in a 46-year-old man patient who has undergone laparatomy for intestinal mechanical obstruction. Intraoperatively, an appendix with a lumen was found with a fistula to the terminal ileum. It has been observed that proximal ileal and jejunal intestinal anses were distended. Appendectomy, segmental ileum resection and end-to-end anastomoses were performed as a surgical procedure. This case describes an elderly man with acute ileus presenting with small bowel obstruction. We conclude that, appendico-ileal fistula should be kept in mind in cases with acute ileus presenting with small bowel obstruction

    Appendico-ileal fistula in an acute ileus patient [Bİr Akut İleus Olgusunda Apendİko-İleal Fİstül]

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    Appendico-ileal fistula is a rare condition with acute ileus. We report a case of appendico-ileal fistule in a 46-year-old man patient who has undergone laparatomy for intestinal mechanical obstruction. Intraoperatively, an appendix with a lumen was found with a fistula to the terminal ileum. It has been observed that proximal ileal and jejunal intestinal anses were distended. Appendectomy, segmental ileum resection and end-to-end anastomoses were performed as a surgical procedure. This case describes an elderly man with acute ileus presenting with small bowel obstruction. We conclude that, appendico-ileal fistula should be kept in mind in cases with acute ileus presenting with small bowel obstruction

    Ameliyat sonrasi karin içi yapişiklik oluşumunda ba?irsak kan akimindaki de?işiklikler ve endotelin-1 blo?unun rolü

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    PubMed ID: 16676248BACKGROUND: The current study was planned to investigate intestinal blood flow alterations and the role of ET-1 receptor blockade in the formation of postoperative intraperitoneal adhesion formation. METHODS: Twenty-eight adult Wistar Albino rats weighing between 250 g and 300 g were divided into four groups. Control group (group 1; n=7) did not undergo any operation. Sham group (group 2; n=7) had only laparotomy. In the adhesion group (group 3; n=7), peritoneal patch (1x1 cm) excision from the right abdominal wall and cecal abrasion were done as "adhesion model operation". One week following this, treatment group (group 4; n=7) received a non-selective ET-1 receptor blocking agent bosentan (30 mg/kg, IP) intra-abdominally, once a day for four days. Intestinal blood flow through the superior mesenteric artery was measured, on postoperative seventh day. Adhesion severity and extension as well as myeloperoxidase activity in the adhesion were calculated. RESULTS: Mean intestinal blood flow significantly increased in adhesion group (81.9±5.6 ml/100 g) when compared to group 1 (65.5±1.2 ml/100 g). Bosentan caused a significant decrease (44.3±6.9 ml/100 g) in intestinal blood flow when compared to group 1 and group 2. Sham group (62.2±1 ml/100 g) had similar blood flow level with the control group (65.5±1.2 ml/100g). Adhesion scores were similar in adhesion and Bosentan groups. Sham group had almost no adhesions. Myeloperoxidase activity in adhesion tissue was significantly higher in bosentan group. CONCLUSION: Non-selective ET-1 receptor blockade has no effect on prevention of the formation of intra-abdominal adhesion, but causes a decrease in intestinal blood flow. Adhesion formation increases intestinal blood flow. Adhesion formation is accompanied by increased polymorphonuclear infiltration despite bosentan treatment

    Kolonik anastomoz düzeylerinin sivi faz mide boşalma hizina etkileri

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    The aim of this study was to investigate the effect of colonic anastomoses at different levels on liquid phase gastric emptying rate. Initiation of oral feeding after colorectal surgical procedures depends on the beginning of bowel movements. We hypothesize that surgical procedures which are performed at different colonic levels, may affect gastric motility and may alter the oral feeding starting time. Liquid phase gastric emptying rates of 49 adult male Wistar Albino rats were measured with methyl cellulose phenol red test. Two groups of 14 rats underwent ascending colon or colorectal anastomosis. We also studied a sham-op group (n=14) with laparotomy only and a control group (n=7) with no surgery. Half of each group underwent gastric emptying test on postoperative first (n=7) or tenth (n=7) days. The gastric emptying rates on the first postoperative day were (34.9±1.5%), (50.9±5.2%), and (58.3±4.5%) in colorectal anastomosis, ascending colon anastomosis, and sham-op groups, respectively. While gastric emptying rates returned to the control group levels (71.5±5.7%) on postoperative tenth day, in ascending colon anastomosis (72.5±2.1%) group and sham-op (69±1.8) group, it was still significantly lower in colorectal anastomosis (49.9±7.8%) group compared to the control group level. This study shows that colorectal anastomosis causes a delay in liquid phase gastric emptying rate compared to ascending colon anastomosis. Our findings also imply that the influence of colonic anastomosis on gastric emptying rate appears to be related to the site of colonic anastomosis
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