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Öğe A Difficult Decision-Hashimoto's Thyroiditis or Subacute Thyroiditis? [Zor Bir Karar - Hashimoto Tiroiditi mi Yoksa Subakut Tiroidit mi?](Turkiye Klinikleri, 2011) Ipekci S.; Öztürk K.; Çakir M.Subacute thyroiditis generally presents with pain in the thyroid region, fever, thyrotoxicosis and elevated markers of acute inflammation. On the other hand, Hashimoto's thyroiditis is most frequently diagnosed in the hypothyroid phase with positive antithyroid autoantibodies. Here, we describe the case of a patient who presented with clinical features of subacute thyroiditis but laboratory and pathological features compatible with Hashimoto's thyroiditis. The patient was finally diagnosed with painful Hashimoto's thyroiditis.Öğe Exploratris laparotomy (How laparotomies should be performed?) [Eksploratris laparotomi (Laparotomiler nasil yapilmali?)](2006) Özer Ş.; Çakir M.In this article the steps of laparotomy and important views are discussed. In these preceeding articles, we combined our personal opinions with my colleagues and teachers on this subject. All abdominal operations are diagnostic laparotomies. Abdominal exploration never replaces cautious clinical examination, appropriate lab. tests, endoscopy, radiology and modern imaging techniques. Laparotomy allows us to enter abdominal cavity but only shows us the outer side of the organs. Sterile USG probe must be ready at operation. Laparoscopy without prior endoscopy is not acceptable. You may have witnessed that some chronic pancreatitis patients are consultated to psychiatry. If an abdominal abcess is encountered white abdominal exploration it must be drained as soon as possible. In adults vertical incisions allows beter exploration. By laparoscopy colon wall can be examined better with colonsoscopy light's illumination. Neonatal obstruction is another special problem and diagnosed with clinical and radiological investigation. Supraumblical transvers incision is generally adviced and it is satisfying. Every surgeon encounters different indications for laparotomy.Öğe Graves' Disease With Unilateral Involvement: A Rare Entity [Tek Taraflı Tutulum Görülen Graves Hastalı?ı: Nadir Bir Vaka](Turkiye Klinikleri, 2011) Gönülalan G.; Çakir M.Graves' disease usually affects both lobes of the gland, thus, unilateral Graves' hyperthyroidism has been reported very rarely. Here, we report a case of Graves' disease presenting with unilateral involvement of the thyroid gland. Thyroid function tests revealed thyrotoxicosis and scintigraphy with technetium-99m showed increased diffuse unilateral radioisotope uptake in the right lobe with suppressed activity in the left lobe. The patient underwent oral antithyroid drug treatment. Graves' disease may present with asymmetrical uptake on thyroid scan similar to asymmetrical Graves' ophthalmopathy.Öğe Osteogenesis imperfecta in adult twins responded to treatment with pamidronate [Osteogenezis i?mperfektalı erişkin i?kizlerin pamidronat tedavisine olumlu cevabı](Turkiye Klinikleri, 2011) Öztürk M.; Çakir M.Bisphosphonates are strong inhibitors of bone resorption and are used in the treatment of osteoporosis. Bisphosphonates are known to be effective in prevention of fractures, improvement of bone mineral density as well as in relieving bone pain in osteogenesis imperfecta (OI) patients. Recent studies have shown that especially intravenous pamidronate may be more effective when given in childhood and adolescence. This effect was also shown in adult OI patients in some clinical trials. 22-year-old twin brothers known to have OI were admitted to our endocrinology and metabolism outpatient clinic. On medical history, OI was diagnosed at the age of three and for the last eight years, they were not able to walk and were using wheelchairs. On physical examination, blue sclerae and dentinogenesis imperfecta were detected in both patients. According to the expanded Sillence classification of OI, the clinical findings were consistent with type IV OI. Intravenous pamidronate treatment was given three times at four-month intervals, according to Montreal protocol. During this period, the patients were also doing isometric exercises and were on physical therapy, diet, and bioresonance therapy. At the end of one year, bone pain regressed significantly in both patients and they were able to walk independently. These outcomes demonstrate that in selected adult OI patients, intravenous pamidronate treatment may be beneficial in preventing bone fractures and relieving pain.Öğe Pre-operative pneumoperitoneum application in giant inguinal hernia repair [Dev ingunal fitik onariminda ameliyat öncesi pnömoperitoneum uygulamasi](Gulhane Medical School, University of Health Sciences, 2013) Çakir M.; Tekin A.; Kaynak A.Hernia repair is one of the most frequent operation surgeons apply. One of the undesired problems in hernia surgery is compartment syndrome which can occur when giant hernia content is pushed into the abdomen. In order to prevent this problem, we used pneumoperitoneum method in giant inguinal hernias and we found it to be worth of discussing. wia catheter placed under direct ultrasonographic vision We applied pneumoperitoneum to repair giant inguinal hernia in our 70 year-old patient with pain and tubercle in the inguinal and dysuria complaints. We applied pneumoperitoneum for 12 days at 15mmHg with catheter placed under direct ultrasonographic vision. The patient on whom tension-free mesh hernioplasty operation was performed was discharged on the postoperative 5th day. Pneumoperitoneum can be used as an effective method in the prevention of abdominal compartment syndrome in the repair of giant inguinal hernias. © Gülhane Askeri Ti{dotless}p Akademisi 2013.Öğe The relation between mesh thickness and mesh reaction m abdominal wall(2011) Küçükkartallar T.; Sahin M.; Çakir M.; Kafali E.; Saygun O.; Tekin A.; Ünlü Y.Aim. The aim of this study is to compare the severity of tissue reaction in anterior abdominal wall caused by synthetic meshes in different fiber thickness. Methods. In all rats, abdominal wall along the midline, skin and subcutaneous tissue was incised 2 cm along and a 3x3 cm2 area was dissected. Group I: Only dissection was applied. Group II: A 2x2 cm2 diameter mesh with 320 micron mesh thickness was placed on the dissected area. Group III: A 2x2 cm2 diameter mesh with 600 micron mesh thickness was placed on the dissected area. Results. Infection and seroma frequency in incision line was defined as, In Group I (15 %) in three rats, in Group II (25 %) in 5 rats and in Group III (35 %) in 7 rats. Measured plasma IgE levels in rats were found meaningfully high compared to that of control group (p<0.05). The value of thin mesh group was found meaningfully low compared to that of thick mesh group (p<0.05). A meaningful difference was not observed among the leucocytes values of the groups (p<0.05). The fibrosis measurements in group III was higher than that of the other group (p<0.05). Conclusion. Reaction has occurred for both meshes. It has been observed that the reaction occurred in thin mesh group was meaningfully lower compared to the thick mesh group as a result of serological tests, electron and light microscopic examinations. Referencing this, it has been understood that the reaction occurred has shown parallelism with the mass of mesh.Öğe Successful combined pentoxifylline and intralesional triamcinolone acetonide treatment of severe pretibial myxedema(2007) Engin B.; Gümüel M.; Özdemir M.; Çakir M.[Abstract not Available]
