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    The effect of extracoporeal schock waves on intestinal anastomosis
    (2011) Pekin C.; Tekin S.; Kucukkartallar T.; Cakir M.; Tekin A.; Kartal A.
    Background and Objectives: To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis. Materials and Methods: Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3 rd, 5 th and 7 th days in three session each of which included 400 impulse with 14KV. On the 10 th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied. Results: The mean anastomoses explosion pressure for group III was 272±7.895 and the average anastomose explosion pressure was 220±6.831. The difference between the pressure means was significant (P < 0.05). Histological fibroblast/collagen ratio were 14.50±5.66, 274±66.21 and 416±52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80±3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (P < 0.05). Conclusion: From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing.
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    Injuries and deaths occurring as a result of bull attack
    (2008) Dogan K.H.; Demirci S.; Erkol Z.; Sunam G.S.; Kucukkartallar T.
    Persons whose occupations are in animal husbandry may be seriously injured or killed while tending to animals. Bulls are among the most dangerous of these animals. In this study, seven deaths and 23 traumatic injury cases caused by bull attacks and treated in the General Surgery and Chest Surgery Department of Selcuk University Meram Medical Faculty Hospital are presented. Of the 30 total cases, 24 were male and 6 were female. The ages of the cases ranged from 33 to 86 years and the average age was 60.3 ± 12.4 (mean ± standard deviation). All of the death and injury cases occurred while engaged in the care of bulls. It was also determined that the injuries were in the chest region of five (71.4%) and in the head of two (18.6%) out of seven death cases; and in the abdominal region of 14 (60.9%) and in the chest region of nine (39.1%) out of 23 traumatic injury cases. Of the 14 cases that were in the abdominal region and treated surgically, 11 were perforation of small/large intestines, whereas hemorrhages involving the intestinal mesentery, intraabdominal hemorrhage due to perforation of the abdominal wall, and splenic laceration were determined in one case each. There were one or multiple costal fractures in all nine chest injury cases, flail chest in five cases, and hemothorax, pneumothorax, or hemopneumothorax were determined in six cases. Of the chest injury cases, tube thoracostomy was performed in six whereas the other three cases were discharged from the hospital after supportive care. It was concluded that animals such as bulls might be the cause of serious trauma ending with death for those working in the animal husbandry. For this reason, caution is required while feeding and working with bulls. Risk can be reduced by chutes, gates, restraints, special housing, and confinement facilities. Also, wearing protective helmets would be useful especially for preventing head injuries. © 2008 by The Haworth Press. All rights reserved.