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Öğe Is the increase in the number of pilonidal sinus surgery normal? [Pilonidal sinüs ameliyatlarindaki artiş normal mi?](2010) Karahan Ö.; Eryilmaz M.A.; Torun V.; Sevinç B.; Köksal H.; Aksoy F.; Ay S.Purpose: We have noticed the increase in pilonidal sinus operations (PSO) and performed this study to determine the extent of this change and if there is a difference between the number of pilonidal sinus surgery and outpatient and inpatient numbers. Material and Method: We scanned PSO, which was performed in three hospitals [medical faculty hospital (MFH), education and research hospital (ERH) and state hospital (SH)] in the same city, in the last 10 years between 1999 and 2008. We have determined the yearly distribution of cases, total number of operations performed, number of general surgery operations (GSO) at the same period and changes in staff of general surgery clinics. We reviewed the number of outpatients, inpatients and the middle group surgical procedures containing PSO as well, performed at the whole city and the country in the last 10 years. Results: The number of PSO was 234 and the number of GSO was 7.728 at MFHs in the first 5 years. These numbers were 259 and 10.384 in the second period, respectively. The increase was 11% for PSO and 72% for GSO. The increase in PSO was lower than GSO. In ERH there were 506 PSOs in the first 5 years and 760 PSOs in the second 5 years. The number of GSO had increased from 11.563 to 11.452 in the second 5 years. There was a 1% decrease in the number of GSOs, whereas the number of PSOs increased by 50% (p<0.001). The number of PSOs performed in SHs increased from 353 to 1.224, by 247%. Also, the number of GSO increased from 10.215 to 15.595, by 53%. The increase in the number of PSOs in two hospitals (ERH and SH) was statistically significant (p<0.001). The number of PSOs was 246 in 2005 and it became 1.341 in 2008, with an increase of 439% at the whole city. Considering Turkey, the number of PSOs performed was 12.415 in 2005 and it increased to 54.633 (340%) in 2008. Conclusion: There is a rapid increase in the number of PSOs performed at the state hospitals in Konya and all around Turkey. Absolute reasons for this increase should be investigated and preventive measures should be taken.Öğe The role of ischemia modified albumin in the evaluation of hemodynamic changes in the splanchnic area during laparoscopic cholecystectomy [Laparoskopik kolesistektomi süresince splanknik sahadaki hemodinamik de?işikliklerin de?erlendirilmesinde iskemi modifiye albuminin rolü](2010) Köksal H.; Kurban S.; Şahin M.Purpose: Elevation of intraabdominal pressure by means of gas insufflation produces hemodynamic disturbances in the peritoneal viscera, leading to splanchnic ischemia. Recently, ischemia modified albumin (IMA) has been used to investigate conditions such as myocardial and skeletal muscle ischemia. The purpose of this clinical investigation is to determine the role of IMA in the evaluation of alterations in blood flow of the splanchnic area and abdominal viscera during laparoscopic cholecystectomy. Patients and Methods: Twenty two patients (F/M: 21/1) undergoing laparoscopic cholecystectomy (Group I) and 10 patients (F/M: 7/3) undergoing various surgical procedures under general an- estheasia (Group II) were studied. No patient had any cardiovascular disease. Blood samples for IMA were collected at preoperative and intraoperative periods. A rapid, colorimetric assay was used to measure serum IMA levels. Results: In Group I, the preoperative and intraoperative IMA levels were 0.59±0.16 absorbance units (ABSU) and 0.74±0.17 ABSU, respectively. The intraoperative IMA levels were higher than the preoperative levels (p=0.025). In Group II, the preoperative and intraoperative IMA levels were 0.43±0.12 ABSU and 0.52±0.15 ABSU, respectively. The difference was not statistically significant (p=0.22). The intraoperative IMA levels in Group I were higher than Group II (p=0.003).Conclusion: IMA, a new sensitive marker for ischemia, can be helpful for determining alterations in blood flow of the splanchnic area and abdominal viscera during laparoscopic cholecystectomy. cholecystectomy, splanchnic area.