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Öğe The effects of nitroglycerin in the zone of stasis in a rat burn model [Sıçanlarda deneysel yanık modelinde oluşan staz zonunda nitrogliserinin etkisi](Turkish Association of Trauma and Emergency Surgery, 2020) Gündüz M.; Sekmenli T.; Uğurluoğlu C.; Çiftçi İ.BACKGROUND: Studies evaluating the recovery of the zone of stasis is an important issue in burn research. In this study, we aimed to evaluate and compare the efficiency of an anti-ischemic and vasodilatory agent, a topical agent containing 2% nitroglycerin with 1% silver sulfadiazine, and bacitracin-neomycin sulfate in the zone of stasis histomorphologically and immunohistochemically. METHODS: We conducted an experimental study using 30 Wistar-Albino rats, each weighing 250–300 grams. The rats were divided randomly into five groups (six rats in each group). In this study, the “comb model,” which was deemed to be the most appropriate experimental model to produce an injury with predictable zones and was first described by Regas and Erhlich, was used. The following were applied to the zone of stasis after creating a burn model in 0, 24, and 48 hours: topical 2% nitroglycerin, 1% silver sulfadiazine, bacitracin-neomycin sulfate, and Vaseline-lanolin (sham). After 72 hours, biopsies were performed from the zone of stasis and evaluated by histomorphological and immunohistochemical CD 34 (expressed in human endothelial and hematopoietic cells) and D 2–40 (expressed in the endothelium of lymphatic capillaries) methods. The results were evaluated using the chi-square test. RESULTS: Compared with the other groups, a statistically significant difference was found in edema, inflammation, and vascular proliferation in the nitroglycerin group. Significantly more intense staining for CD 34 was found in the nitroglycerin group compared with the other groups. Immunohistochemical staining for D 2-40 was also found statistically significant in the nitroglycerin group (p<0.05). CONCLUSION: A topical containing 2% nitroglycerin increases vascular proliferation in the zone of stasis affects the recovery and may be used as a new agent in burn injury treatment. © 2020 Turkish Association of Trauma and Emergency Surgery.Öğe Gastric volvulus associated with paraesophageal hernia, Morgagni hernia and liver cyst: A very rare picture of acute abdomen [Gastrik volvulus ile birlikte paraözefageal herni, Morgagni hernisi ve karaci?er kisti: Nadir görülen bir akut batin tablosu](Gulhane Medical School, University of Health Sciences, 2011) Gündüz M.; Yurtçu M.; Günel E.Gastric volvulus may develop primarily as a result of looseness or lack of gastric ligaments or secondarily to paraesophageal or diaphragmatic hernias. Gastric volvulus associated with paraesophageal hernia, Morgagni hernia, and liver cyst is a very rare cause of acute abdomen, and requires prompt surgical intervention. In this article the association of gastric volvulus, paraesophageal hernia, Morgagni hernia and liver cyst is being discussed under the light of current literature data. © Gülhane Askeri Tip Akademisi 2011.Öğe How safe is anastomosis near the ileocecal valve in distal ileal pathologies? [Distal ileum patolojilerinde ileoçekal valve yakın anastomoz ne kadar güvenli?](Logos Medical Publishing, 2016) Sekmenli T.; Gündüz M.; Çiftci I.Aim: We aimed to evaluate the operative findings, and follow-up of a patient who had partial ileal necrosis due to brid ileus,who had ileo-ileal anastamoses 5 cm proximal to ceacum. Case report: A 1.5 year old boy was admitted to the pediatric emergency department of our hospital with abdominal pain and vomiting. The image of flat soft tissue mass at abdominal midline on standing direct radiograms was observed. During the abdominal examination, a palpable painful mass sense was present. In exploration, an adhesion band involving approximately 60 cm of the terminal ileum and squeezing the mesentery vessels was seen, and excised. As the lukewarm water compress for 5-10 minutes did not reverse the ischemia, we decided to resect, and remove gangrenous ileal segments. Considering the current toxic condition, a temporary double-barrel ileostomy was made using the distal loop at a 5 cm proximal to terminal ileum and proximal viable ileal segment. The preoperative body weight of the case decreased for 14 kg due to the intensive loss of fluid from the stoma, despite medical support from the pediatric gastroenterology department, after 14 days to 11.5 kg. Then closure of the stoma was decided on the 16th postoperative day In order to preserve ileocecal valve end- to-end anastomosis was performed, 5 cm proximal to terminal ileum. Stool frequency decreased, and its content became denser, and at the 12th postoperative day patient was discharged without any problems. During the control visit in the 1st month following hospital discharge the clinical findings of the case were normal and the patient weighed 14.5 kg. Conclusions: In cases well prepared before the operation and intervened with the most appropriate surgical technique and appropriate surgical materials, we consider that anastomosis close to the terminal ileum will not lead to any problems clinically. We believe that anastomosis preserving ileocecal valve will increase the quality of life especially in children with longer life expectancy. However larger series are necessary to verify the findings of the present study. © Cocuk Cerrahisi Dergisi. All rights reserved.Öğe An improved leach protocol for indoor wireless sensor networks(IEEE Computer Society, 2014) Tümer A.E.; Gündüz M.This paper proposed a EELP (Energy Efficient LEACH Protocol) routing protocol based on LEACH. LEACH (Low Energy Adaptive Clustering Hierarchy) is seminal work in the area of clustering-based protocol, proposed by W.B. Heinzelman. In EELP, all nodes are organized sequentially in the rooms of the apartments of a multi-story building. In this protocol, cluster head (CH) selection is determined as the highest energy by the base station. Simulation results demonstrated that our protocol is more energy-efficient than the LEACH protocol. © 2014 IEEE.Öğe Letters to the editor [Cartas al editor](Sociedad Argentina de Pediatria, 2018) Sekmenli T.; Gündüz M.; Ciftci I.; Emirolu H.H.; Koplay M.[Abstract not Available]Öğe A new anastomosis technique for intestinal diseases with proximal dilated segments(Medknow Publications, 2016) Gündüz M.A number of techniques have been described for intestinal anastomosis. We describe a different, simple, and safe technique that can be used in patients with intestinal diseases, such as jejunoileal atresia and perforation that has proximal dilated segments. In this technique, an atraumatic bowel clamp was applied on the proximal dilated bowel at a 90° angle. In the narrow distal segment, we resected the bowel at a 0° angle and continued at a 30° angle from the antimesenteric side. Finally, a two-layer interrupted anastomosis was performed. We applied this technique to a 31-day-old patient who had a divided jejunostomy due to malrotation and perforation with a proximal dilated bowel. Neither anastomotic complications nor feeding and passage problems were seen postoperatively.Öğe What can be done within 600 days? [Alti yüz günde neler yapilabilir?](Logos Medical Publishing, 2017) Gündüz M.Aim: In our country recently graduated general practitioners and specialists are subject to compulsory public service for two years. We aimed to evaluate factors effecting operations performed by young pediatric surgeons during this period. Material and Methods: We retrospectively analysed the operations between February 2009-December 2011 performed by a pediatric surgeon under general anesthesia in Konya Education and Research Hospital. Results: A total of 452 patients were operated under general anesthesia.A total of 166 (36.7%) circumcisions were performed. Besides a total of 286(63.3%) patients were operated for the treatment of inguinal region pathologies (n=176; 61.5%), acute abdomen (n=73; 25.3%), urological disorders (n=27; 9.5%), neonatal diseases (n=8; 3%), and trauma (n=2; 0.7%). Conclusion: Pediatric surgeons are performing operations in parallel with the level of education they received, infrastructure, and facilities of the hospitals they are working. Experience and team work is very important. Patients with rarely seen complicated cases that need multidisiplinary evaluation should be referred to relevant centers of pediatric surgery. © 2017 Cocuk Cerrahisi Dergisi.All right reserved.
