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Öğe Diphenhydramine and Hyaluronic Acid Derivatives Reduce Adnexal Adhesions and Prevent Tubal Obstructions in Rats(ELSEVIER SCIENCE BV, 2003) Avsar, Ayşe Filiz; Avsar, Fatih Mehmet; Şahin, Mustafa; Topaloğlu, Serdar; Vatansev, Hüsamettin; Belviranli, MetinObjective: The purpose of this study is to investigate the effects of diphenhydramine-HCl and Na-hyaluronate derivatives on the development of postoperative peritoneal adhesion and tubal obstruction. Study design: Forty female rats of Sprague-Dawley type were used in the study. The rats were divided into four groups, each comprising 10 subjects. After all the rats were anaesthetized with 50 mg/kg ketamine HCl, their abdomens were opened with a lower midline incision. Injury was induced on the right pelvic peritoneum and on the peritoneal surface of left uterine tube. No additional procedure was applied to the first group. 10 mg/kg diphenhydramine-HCl was given to the second group intravenously. In the third group, 0.25 mg/kg Orthovisc(R), a Na-hyaluronate derivative was diluted with 2 ml physiological saline and poured into the abdomen. For the fourth group, Seprafilm(R), a Na-hyaluronate derivative was covered in a layer of 0.7 cm x 3 cm over the left uterine tube. After 14 days, the rats were anaesthetized with ketamine HCl again, and 5 cm(3) blood sample was taken with cardiac puncture. The abdomen was opened with an incision transverse to the upper end of the midline incision, and the presence of adhesions was investigated. Detected adhesions were staged according to the Mazuji classification. Tubal patencies were inspected by injecting methylene blue from the uterine corpus into the lumen using an injector. A piece of abdominal wall of 4 cm x 4 cm was removed by extending the incision in the reverse U shape. The tensile strength and bursting pressure of the suture line were determined using the Peacock method. One gram of tissue was taken from the incision line, and hydroxyproline levels were determined by the Bergman-Loxley method. Aspartate aminotransferase (AST) levels were measured. Results: All of the rats completed the study. AST levels, tissue hydroxyproline levels and tensile strength and bursting pressure test results were found to be similar in all groups. While adhesion rates in the groups were 100, 40, 40 and 30%, respectively, adhesion stages were found to be, respectively as 2.1 +/- 1.7, 0.6 +/- 0.67, 0.6 +/- 0.67 and 0.5 +/- 0.85. Adhesion stages in the study groups were significantly lower (P < 0.05). Tubal obstruction rates were found to be 70, 30, 30 and 20%, respectively. Conclusion: Diphenhydramine, Orthovisc(R) and Seprafilm(R) significantly reduce postoperative peritoneal adhesion development, and they allow the uterine tubes to remain open. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Early laparoscopic cholecystectomy for acute cholecystitis(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2009) Tekin, Ahmet; Kucukkartallar, Tevfik; Belviranli, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Sakir; Kartal, AdilBACKGROUND The aim of this study, was to assess the clinical results of treatment by laparoscopic cholecystectomy (LC) in patients with acute cholecystitis. METHODS Between 1994 and 2006, LC was performed in 3876 patients in Selcuk University Meram Medicine Faculty. The clinical, biochemical, radiologic, and operative data of 182 (101 F, 81 M) consecutive patients with acute cholecystitis operated 3 days after the onset of symptoms were analyzed retrospectively to determine the complications and morbidity after operation. RESULTS The conversion rate was 31 (17.03%) in acute cholecystitis. Postoperative length of stay was found as 4 days in the successful LC group and 7 days in the conversion group. For acute cholecystitis, we found a statistical difference between the successful LC group and the conversion group in terms of length of postoperative hospitalization time and gallbladder wall thickness. We identified the following factors as associated with conversion: male gender, pericholecystic collection L seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm. CONCLUSION LC is a safe approach in selected patients with acute cholecystitis. Male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.Öğe Effectiveness of collagenase in preventing postoperative intra-abdominal adhesions(ELSEVIER SCIENCE BV, 2013) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Yilmaz, Huseyin; Belviranli, Metin; Kartal, AdilIntroduction: The purpose of this study is to investigate the effectiveness of Collagenase clastridiopeptidase an enzyme preparation used in enzymatic debridement in preventing adhesions brought about by peritoneal damage. Methods: The study covers a total of 40 rats in 4 groups each having 10 rats. Group 1: The control group. Group 2: Normal saline group. Group 3: Sterile Novuxol (R) group. Group 4: The group where the intraperitoneal and systemic effects of sterile Novuxol (R) were investigated. Adhesion frequency and grades were scored on the post-op 11th day according to Granat. Blood work including hemoglobin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, and albumin level measurements were performed. Toxicity was investigated histopathologically through samples taken from the liver and the peritoneum from Group 4. Results: Adhesion frequency was found to be 80% on the right and 90% on the left for Group 1, while it was 50% on both left and right for Group 2, and 30% on the right and 10% on the left for Group 3. Adhesion stages were found to be 1: 2.35 +/- 1.42 for Group 1, 0.31 +/- 1.15 for Group 2, and 0.20 +/- 0.41 for Group 3. Adhesion stage of the Sterile Novuxol (R) Group was lower than all the other groups (p < 0.05). Biochemical and hematological parameters were similar in all groups (p > 0.05). Histopathological analysis revealed no hepatotoxicity. Conclusions: According to the results of our study, we believe that Sterile Novuxol (R) can be a good anti-adhesive agent considering its ease of use, non-toxicity, and effectiveness. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Internal herniation as a major cause of intestinal obstruction(KARGER, 2008) Tekin, Ahmet; Kuecuekkartallar, Tevfik; Aksoy, Faruk; Vatansev, Celalettin; Belviranli, Metin; Tekin, Sakir; Yol, SerdarObjectives: To evaluate internal herniation as a rare cause of intestinal obstruction. Materials and Methods: Files of 18 cases, operated due to internal herniation between 2000 and 2006 at Selcuk University, Meram School of Medicine, General Surgery Department, were reviewed retrospectively. Sixteen patients (88.8%) were male (mean age: 58.2 years; range: 42-67) and 2 were female (mean age: 56.5 years; range: 52-61). Cases were grouped according to the location of internal herniation, and the clinical findings and applied treatment strategies were evaluated. Results: All patients were taken into surgical operation after preoperative preparations were completed. Findings were as follows: 6 cases of paraduodenal internal herniation, 4 of internal herniation through a defect in the terminal mesoileum, 2 of herniation through a defect in the falciform ligament, 2 of herniation through a defect in the omentum majus, 1 of herniation to the recessus over the bladder, 2 of herniation through a defect in the transverse mesocolon and 1 iatrogenically caused internal herniation through a defect in the mesojejunum. Conclusion: In an adult patient with findings of intestinal obstruction, diagnosis is difficult. Most cases presented to date are incidental findings during laparotomy, and surgical treatment is necessary. Copyright (c) c 2008 S. Karger AG, Basel.Öğe Penis replantation after self-mutilation(SPRINGER, 2009) Ozturk, Ahmet; Kilinc, Mehmet; Guven, Selcuk; Gormus, Niyazi; Belviranli, Metin; Kaynar, Mehmet; Arslan, MehmetIn this case report, the procedure of penis replanting and its complications after genital self-mutilation in a male adult are explained.
