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Öğe Akut Kolesistit İçin Erken Laparoskopik Kolesistektomi(2009) Tekin, Ahmet; Küçükkartallar, Tevfik; Belviranlı, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; 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 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 Akut kolesistit için erken laparoskopik kolesistektomi(2009) Tekin, Ahmet; Küçükkartallar, Tevfik; Belviranlı, Metin; Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; Kartal, AdilAMAÇ: Bu çalışmada, erken laparoskopik kolesistektomi (LK) ile tedavi edilen akut kolesistitli (AK) hastaların klinik sonuçları değerlendirildi. GEREÇ VE YÖNTEM: Selçuk Üniversitesi Meram Tıp Fakültesi’nde Ocak 1994 ile Aralık 2006 yılları arasında 3876 hastaya LK yapıldı. Bunlardan 182 hastaya (101 kadın, 81 erkek) semptomların başlamasından itibaren ilk üç gün içinde kolesistektomi uygulandı. Hastaların dosyaları klinik, biyokimyasal, radyolojik ve ameliyat bulguları, ameliyat sonrası komplikasyon ve morbiditeye etkisini saptamak için geriye dönük olarak değerlendirildi. BULGULAR: Akut kolesistli olgularda açığa geçme oranı 31 (%17,03) idi. Ameliyat sonrası hastanede kalış süresi başarılı LK grubunda 4, açık kolesistektomiye geçilen grupta 7 gün olarak saptandı. Laparoskopik tamamlanan ve açığa geçilen kolesistektomi grupları arasında hastanede yatış süresi ve safra kesesi duvar kalınlığı yönünden istatistiksel olarak anlamlı fark bulundu. Çalışmamızda açığa geçme ile ilgili faktörler; erkek cinsiyeti, ultrasonografide perikolesistik sıvı gözlenmesi, gangrenöz tip kolesistit ve safra kesesi duvar kalınlığının 1 cm ve üzerinde olması idi. SONUÇ: LK, seçilmiş AK’li hastalarda güvenli bir yaklaşımdır. Erkek cinsiyeti, ultrasonografide perikolesistik sıvı gözlenmesi, gangrenöz kolesistitler ve safra kesesi duvar kalınlığının 1 cm ve üzerinde olması yüksek açık cerrahiye dönme riski ile beraberdir.Öğe Axillary Lymph Node Status in Multicentric Breast Tumors and Breast Tumors with Nipple Involvement(KARGER, 2012) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Vatansev, Celalettin; Aksoy, Faruk; Kartal, Adil; Tuncer, Fatma B.Background: Axillary lymph node dissection plays an important role in breast cancer management in terms of staging, prediction of prognosis, determination of adjuvant therapy, and local control of the primary tumor. The objective of this study was to evaluate the axillary lymph node involvement in multicentric breast tumors and breast tumors with nipple involvement in comparison with unifocal tumors. Patients and Methods: We reviewed the records of 267 patients with stage I or IIA disease. The rates of axillary lymph node metastasis (ALNM) in patients with unifocal tumors, multicentric tumors, or nipple involvement were compared. Results: 209 (78%) patients had unifocal tumors, 24 (8%) had multicentric tumors, and 34 (12%) had nipple involvement. The incidence of ALNM was 9.76% in patients with unifocal tumors, 24.84% in patients with multicentric tumors, and 36.71% in patients with nipple involvement. Hence, the incidence of ALNM was significantly higher in patients with nipple involvement or multicentric tumors than in patients with unifocal tumors. Conclusion: Our data suggest that compared to unifocal tumors, breast tumors with nipple involvement or multiple foci show a significantly higher incidence of ALNM which is a predictor of a poor prognosis.Öğe Clinical analysis of the our confirm of breast cancer of 307 cases of the between 1990 and 2000 years(2002) Borazan, Ali; Aksoy, Faruk; Ecirli, Şamil; Vatansev, CelalettinThe files of the 307 patients with breast cancer who were diagnosed and treated of the department of Internal Medicine and General Surgery, Medical faculty of the Selçuk University, in the between years january 1990 and june 2000 were reviewed retrospectively. The median age of the patients was 49.23±12.2 years, with the range of 18 and 90 years. The most frequently interval age was between 40-49 years. The most frequently symtom and physical examination was found in breast massed. Primary breast cancer in both breast was diagnosed in 307 women, 163 in the left breast first, and 142 in the right breast first, and 2 in the bilateral breast first. The most frequently stage were included in stage IIA (29.6%), and stage IIB (24.1%) clinical stage of diseases. The most frequently histologically examination was found in (92.2%) infiltratif ductal carcinoma. The multiple positive axillary nodes were found in 66.7% patients. Primary therapeutic options was included 76.5% surgical therapy, 19.5% systemic chemotherapy, and 4% radiotherapy. The estrogen reseptor was examinated 153 of the 307 patients and the positive estrogen reseptor was found in the 63 of the 153 patients. The chemotherapy was used after surgical therapy all patients and Tamoxifen was used reseptorpositive patients. 5-year survival rate of 122 patients was 62.3%.Öğe A Comparison of the Hemodynamic and Metabolic Effects of Extraperitoneal Carbon Dioxide and Nitrous Oxide Insufflation(EXCERPTA MEDICA INC, 2001) Aksoy, Faruk; Belviranlı, Metin; Vatansev, Celalettin; Tuncer, Sema; Yol, Serdar; Özergin, Ufuk; Atabek, MustafaBackground: The aim of the present study was to compare the hemodynamic and metabolic effects of extraperitoneal carbon dioxide (CO2)and nitrous oxide. (N2O) insufflation. Material and methods: Fourteen dogs were used in the experiment. All the animals were intubated under general anesthesia. A catheter was placed into the right juguler vein for central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), and heart rate (HR) monitorization. End-tidal CO2 pressure was measured by a capnometer connected to the endotracheal tube. Another catheter was inserted into the left femoral artery for arterial blood gas analysis and blood pressure monitorization. The preperitoneal dissection was made from a 1.5 cm subumbilical incision by using a preperitoneal dissection balloon. A laparoscope was placed in the preperitoneal space and the gas insufflation was kept at a constant pressure of 12 mm Hg throughout the experiment. All the study parameters were measured at the beginning of the insufflation and at every 15 minutes for 1 hour. Results: Mean artery pressure increased with time in both groups, but the increase was only significant in the CO2 group. PWP, CVP, PAP, and HR increased slightly in both groups, but there was no significant difference between the groups. The end-tidal CO2 increased in the CO2 group but decreased from the baseline in the N2O group. A significant acidosis was observed in only the CO2 group. PaCO2 significantly increased in the CO2 group; hence, PaCO2 slightly decreased in N2O group. The difference between the groups was significant. Conclusions: N2O insufflation of the extraperitoneal space in dogs avoided the unwanted metabolic and hemodynamic side effects of CO2 insufflation. Thus, N2O insufflation in the extraperitoneal space is a safer alternative to CO2 insufflation experimentally, and can be preferred especially in patients with cardiac and pulmonary diseases.Öğe Diaphragmatic rupture in abdominal trauma(2003) Vatansev, Celalettin; Aksoy, Faruk; Tekin, Şakir; Tekin, Ahmet; Belviranl, Metin; Kaynak, AdnanBACKGROUND: The aim of the study is to evaluate the patients with diaphragmatic rupture due to penetrating or blunt abdominal trauma. METHODS: Thirty-eight patients with diaphragmatic rupture due to penetrating or blunt abdominal trauma were investigated retrospectively. RESULTS: The average age was 41,72 and there were 31 male and seven female patients. The injury forms were penetrating trauma in 22 (58%) and blunt trauma in 16 (42%) cases. Associated abdominal organ injuries were found in 27 (71%) cases. Among 47 diaphragmatic ruptures, 27 (57%) were on the left and 20 (43%) were on the right side. The average diameter of the rupture was 5,45 (1-20) cm. Management of the diaphragmatic rupture and other associated organ injuries were accomplished through laparotomy. Morbidity was developed in 18 cases and mortality in four cases with associated abdominal organ injuries. CONCLUSION: Diaphragmatic rupture results in high morbidity and mortality due to associated organ injuries.Öğe Does Estrogen Cause Low Conversion Rates in Laparoscopic Cholecystectomies for Acute and Chronic Cholecystitis in Women?(2001) Kartal, Adil; Aksoy, Faruk; Vatansev, Celalettin; Şahin, Mustafa; Yılmaz, Osman; Belviranlı, Metin; Karahan, ÖmerLaparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis. Severe local inflammation and scar formation are commonly responsible for conversion to open surgery. Fibrosuppressive effects of estrogen on peritoneal inflammatory conditions could provide low, dense fibrosis or scar formation around the gallbladder and make laparoscopic cholecystectomy easier in women and we believe that male sex is a conversion factor in laparoscopic cholecystectomy.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 Effect of Ascitic Media Formed by Glycerin on the Prevention of Peritoneal Adhesions(KARGER, 2009) Aksoy, Fatih; Vatansev, Celalettin; Tekin, Ahmet; Pamukcu, A.; Küçükkartallar, T.; Yılmaz, Hüseyin; Vatansev, HüsamettinAim: We aimed to investigate whether or not artificial ascites media formed using glycerin are effective in the prevention of intraperitoneal adhesions. Methods: Thirty-six Wistar albino male rats were used in the study. The rats were divided into 3 groups as follows. Group I: control group; group II (isotonic group): 3 ml of 0.9% NaCl was injected into the peritoneal cavity, and group III (glycerin group): 0.5 ml of liquid glycerin and 3 ml of 0.9% NaCl was injected into the peritoneal cavity. Results: There were serious adhesions in the control group. Adhesion rates were lower in the isotonic group compared with the control group, but the difference was not statistically significant (p > 0.05). When adhesion rates of the glycerin group were compared with the control and isotonic groups, significant differences were found, especially between the glycerin and control groups (p < 0.05). Conclusions: According to the results of our study, the use of isotonic solution and liquid glycerin decreases postoperative adhesions. We suggest that glycerin was more effective as it has the chemical ability to draw water to its media. As such, the formation of adhesions may be decreased by increasing the amount of physiological liquid inside the abdomen. Copyright (C) 2009 S. Karger AG, BaselÖğe The Effects of Different Hernia Repair Methods on Postoperative Pain Medication and CRP Levels(Lippincott Williams & Wilkins, 2002) Vatansev, Celalettin ; Belviranlı, Metin; Aksoy, Faruk; Tuncer, Sema; Şahin, Mustafa; Karahan, ÖmerAlthough tension-free techniques of hernia repair using synthetic meshes have yielded encouraging results, the best method of inguinal hernia repair is still unclear. The aim of this study was to compare the responses of inflammatory mediators and postoperative pain relief following laparoscopic total extraperitoneal (TEP) hernioplasty, open tension-free mesh hernioplasty (Lichtenstein), posterior preperitoneal mesh hernioplasty (Nyhus procedure), and Bassini procedure. Patients with primary inguinal hernia were randomized in the operating room to undergo one of these repair techniques. Group I comprised 24 patients treated by Lichtenstein procedure; Group If comprised 21 patients treated by Nyhus procedure; Group III comprised 19 patients treated by Bassini procedure; and Group TV comprised 20 patients treated by laparoscopic TEP mesh hernioplasty. Postoperative pain levels following hernia repair were compared by measuring the use of patient-controlled analgesia (PCA) during the 24 hours after surgery. Serum samples withdrawn before surgery and 48 hours after surgery were assayed for C-reactive protein (CRP) content. Patient characteristics, operating time, and operative and early complications were noted. Serum CRP levels rose markedly following Nyhus (184.5 +/- 41.6 mg/L), Lichtenstein (138.4 +/- 72.5 mg/L), and Bassini repair (137.2 +/- 55.9 mg/L) compared with that of patients who underwent TEP mesh hernioplasty (55.5 +/- 41.2 mg/L). There were also significant differences in the postoperative need for analgesics via PCA among patients undergoing Nyhus (382.9 +/- 189.1 mg), Bassini (303.2 +/- 173.7 mg), and Lichtenstein (253.9 +/- 129.3) procedures compared with 196.6 +/- 148.8 mg for the TEP mesh hernioplasty group. Patients in the Lichtenstein group also had significantly less need of analgesics than those in the Nyhus and Bassini groups. In conclusion, TEP mesh hernioplasty is less traumatic and yields less postoperative pain than the Nyhus, Lichtenstein, and Bassini procedures.Öğe The Effects of Increased Intraabdominal Pressure on Colonic Anastomoses(Springer-Verlagspringer-Verlag, 2002) Polat, C.; Arıkan, Y.; Vatansev, Celalettin; Akbulut, G.; Yılmaz, S.; Dilek, F. H.; Gökçe, O.Background: This experimental, randomized, controlled study was designed to investigate the effects of increased intraabdominal pressure (IAP) on colocolic anastomoses. To our knowledge, this is the first study to address this important issue. Methods: For this study, 50 Wistar albino rats were randomized into five groups. The animals in all the groups underwent laparotomy and colocolic anastomosis. The rats in the control group were not subjected to increased IAP. Accordingly, IAP's of 14, 20, 25, and 30 mmHg were established by carbon dioxide insufflation and maintained for 60 min in study groups 1, 2, 3 and 4, respectively. Colocolic anastomosis was realized after these periods of IAP in the study groups. Half of the surviving rats in all the groups were sacrificed on postoperative days 7 and 14 to allow comparison between the control and study groups with respect to their mean body weights, mean anastomosis bursting pressures, and histopathologic characteristics of their anastomosis sites. Results: The mean body weights of all the groups were comparable at all times during the study. The anastomosis bursting pressures of the animals subjected to increased IAP were lower than that of the control group with the differences reaching statistical relevance for the animals subjected to an IAP of 20 mmHg or higher on postoperative day 7 (p < 0.0005 for study groups 2, 3, and 4 vs the control group) and becoming more pronounced by the day 14 (p < 0.0005 for study groups 2, 3, and 4 vs the control group). The anastomosis bursting pressure showed an inverse correlation with IAP. The adequacy of mucosal layer formation at the anastomosis line was lower and the degree of inflammation was higher in the groups exposed to an IAP of 20 mmHg or higher in the control group (p < 0.05 for both comparisons among study groups 2, 3, and 4 vs the control group). Conclusions: An IAP increased to 20 mmHg and higher was found to result in impaired strength and wound healing in colocolic anastomoses, as reflected by the decreased bursting pressure and mucosal layer formation, and by the increased inflammation at the anastomosis sites of animals subjected to high IAP values.Öğe Endoskopi Yapılan Olgularda Helicobacter Pylori Prevalansı, Tanı Metodları ve Hastalıklarla Olan İlişkisi(2002) Karataş, Ahmet; Polat, Hakkı; Aksoy, Faruk; Vatansev, CelalettinAMAÇ: Özefagogastroduodenoskopi yapılan hastalarda Helikobakter pilori (Hp) sıklığını, hastalıklarla olan ilişkisini ve Hp tanısında kullanılan testlerin duyarlılığını araştırmak. GEREÇ VE YÖNTEM: Selçuk Üniversitesi Tıp Fakültesi İç Hastalıkları ve Genel Cerrahi Endoskopi Ünitesine endoskopi yapılması için gönderilen 302 olguda Hp varlığı ve endoskopik tanılarla olan ilişkisi araştırıldı. Tüm olgularda antrumdan üç adet biyopsi ve 5 cc venöz kan alındı. Biyopsi örnekleri Giemsa ve Hematoksilen-Eosin ile boyanarak incelendi. Bir örnek üreaz testinde kullanıldı. Kan örneğinden ELİSA yöntemi ile spesifik IgG ve IgA tayini yapıldı. İstatistiki incelemeler SPSS 10.0 programı yardımıyla Ki-kare ve Mc Nemar testleri ile değerlendirildi. BULGULAR: Olguların yaş ortalaması 47.316.1 olup, kadınlar %58 erkekler %42 oranındaydı. Endoskopik tanıda ilk sırada %38.4 ile gastrit saptandı. Mide kanseri %5'di. Tüm olgularda Hp serolojik yöntemle %74.5, üreaz ve/veya histolojik metotla %67.5 müspet bulundu. Yaş grupları ve cinsler arasında anlamlı farklılık bulunmadı. Duodenal ülserli hastalarda Hp pozitifliği tüm yöntemlerde anlamlı olarak yüksek (p0.05) bulundu. Meslek guruplarında Hp varlığı yönünden anlamlılık yoktu. En yüksek sensitivite serolojik yöntemde(%83.2), en yüksek spesifite üreaz testinde saptandı. SONUÇ: Endoskopik tanılar ile patolojik tanılar arasında gözlenen uyum %76.8 olarak tespit edildi.Öğe Farklı Tekniklerle Tedavi Edilen Pilonidal Sinüs Olgularının Sonuçlarının Karşılaştırılması(2007) Küçükkartallar, Tevfik; Tekin, Ahmet; Vatansev, Celalettin; Aksoy, Faruk; Erenoğlu, BülentAmaç: Pilonidal sinüs intergluteal bölgede, özellikle genç erkeklerde daha sık görülen, akut ağrılı veya kronik şekli olan bir hastalıktır. Bu hastalığın tedavisinde çok sayıda cerrahi teknik ve tıbbi metod tanımlanmıştır. Bu prospektif çalışmada kliniğimizde 4 farklı cerrahi tedavi metodu uygulanan pilonidal sinüslü hastaların takip sonuçlarını sunmayı amaçladık. Yöntem: Ocak 2004-Ağustos 2005 yılları arasında Selçuk Üniversitesi Meram Tıp Fakültesi Genel Cerrahi Kliniği’nde pilonidal sinüs nedeniyle değişik tekniklerle opere edilen 92 hasta 15 gün, 1 ay, 3 ay, 6 ay ve 1 yıl sonra kontrole çağırılarak sonuçlar değerlendirildi. 44 (% 48) hastaya eksizyon Limberg flep, 26 (% 28) hastaya eksizyon primer sütür, 14 (% 15) hastaya eksizyon marsüpializasyon, 8 (% 9) hastaya eksizyon Karidakis flep uygulandı. Bulgular: 81 (% 88) hasta ortalama 1 yıl takip edildi. Erken dönemde primer kapama ile tedavi edilen hastalardan 6’sında, Karidakis flep uygulananların 1’inde, Limberg flep ve marsüpiyalizasyon yapılan hastaların ise 2’sinde yüzeyel infeksiyon gelişti. Hastalar antibiyoterapi ve pansuman ile tedavi edildi. 1 ay sonraki yapılan kontrollerinde marsüpiyalizasyon yapılan hastalar hariç diğerlerinin yaralarının tamamen iyileştiği ve hiçbir hastada erken nüks gelişmediği izlendi. 6 ay sonra primer kapama yapılan 3 hastada, marsüpiyalizasyon yapılan 1 hastada nüks tesbit edildi. 1 yıl sonra daha önce nüks tesbit edilen hastalar dışında hiçbir problem olmadığı görüldü. Sonuç: Pilonidal sinüs hastalığının cerrahi tedavisinde erken dönemde yara infeksiyonunun, geç dönemde rekürrensin ve günlük hayata dönme süresinin daha az olması nedeniyle flep kullanılarak yapılan kapama yöntemleri diğer cerrahi girişimlere göre üstün ve etkilidir.Öğe Gaucher Hastalığı (Olgu Sunumu)(2001) Aksoy, Faruk; Vatansev, Celalettin; Borazan, Ali; Bilgiçli, NesrinGaucher disease is a rarely seen autosomal recessive disorder associated with enzyme defect. Most commonly seen among Ashkenazian Jewish and its incidence in U.S.A is between 1110.000-20.0000. Our case is a female patient of 25 years old admitted with the diagnosis of hypersplenism. On investigating of Gaucher cells seen in the bone marrow, the diagnosis of Type I Gaucher disease is obtained. Splenectomy has been done. Hematological values returned to normal levels on the 5th. postoperative day. The case was presented because of its rarity and its clinical improvement after splenectomy.Öğe Glutatyon S-transferaz (GST) Izoenzimlerinin Çeşitli Kanser Vakalarında Araştırılması(2000) Aköz, Mehmet; Vatansev, Hüsamettin; Gürbilek, Mehmet; Akkuş, İdris; Vatansev, Celalettin; Kaptanoğlu, BünyaminAmaç: Bu çalışmada glutatyon S-transferaz (GST) izoenzimlerinden GST-a, GST-p, GST-m’nin kanser hastaları ve sağlıklı kontrollerde araştırılması amaçlarmıştır. Yöntem: 29-90 (5713) yaşları arasında 66 (22 kadın, 44 erkek) kanserli hasta ile yaşları 23-59 (3611) arasında 32 (16 kadın,16 erkek) sağlıklı kişide GST-a, GST-p ve kanserli hastalarda GST-m düzeyleri araştırıldı. Bulgular: Kanser vakalarında sırasıyla GST-a ve GST-p değerleri gastrointestinal sistem (GİS) kanserlerinde 5.603.74 ng/ml ve 37.2410.74 ng/ml, karaciğer kanserinde 6.202.56 ng/ml ve 35.339.57 ng/ml, mide kanserinde 5.734.91 ng/ml ve 39.7713.18 ng/ml, diğer kanserlerde 4.623.46 ng/ml ve 22.9913.46 ng/ml, kontrol grubunda ise 4.773.24 ng/ml ve 23.479.97 ng/ml olarak bulundu. GST-m düzeyleri ise kanserli hasta grubunda % 59.52 oranında negatif olarak belirlendi. Tüm hasta grupları ile kontrol grubuna ait GST-a değerleri arasında istatistiksel olarak önemli bir fark bulunmazken, GST-p düzeyleri arasında önemli fark olduğu görüldü. Sonuç: GST-p nin özellikle gastrointestinal sistem, mide ve karaciğer kanserlerinin teşhisinde önemli bir belirleyici olabileceği, GST-m yokluğunun ise kanser açısından risk faktörü oluşturabileceği kanaatine varıldı.Öğe Glycogen-rich carcinoma of breast: A case report(2013) Aksoy, Faruk; Gündeş, Ebubekir; Küçükkartallar, Tevfik; Vatansev, CelalettinMemenin Glikojen rich karsinomu nadir görülen meme tümörlerindendir ve genellikle kötü prognozlu olarak bilinmektedir. Tüm meme karsinomları içe- risinde görülme sıklığı %1,4-3 arasındadır. Glikojen-rich karsinomu nedeniyle mastektomi yapılan 48 yaşında bir bayan hasta olgu sunumu olarak hazırlandı. Lenf nodu metastazı yoktu ve tümörde östrojen ve progesteron reseptörleri pozitifti. Hastaya kemoterapi uygulandı ve aromataz inhibitörü ile tedaviye devam edildi. 48 aylık takibinde nüks ya da metastaz tespit edilmedi.Öğe The impact of oral feeding on the severity of acute pancreatitis(CAHNERS PUBL CO, 1999) Şahin, Mustafa; Özer, Şükrü; Vatansev, Celalettin; Aköz, Mehmet; Vatansev, Hüsamettin; Aksoy, Faruk; Dilsiz, Alaattin; Yılmaz, Osman; Karademir, Mehmet; Aktan, MuratBACKGROUND: In the management of acute pancreatitis, oral feeding is prohibited and either enteral or parenteral feeding is commenced for the patients in an effort to not increase the secretion of the pancreatic enzymes. PURPOSE: This study was undertaken in an attempt to determine the impact of oral feeding on the severity of acute pancreatitis and to compare this impact with that of parenteral feeding. MATERIALS AND METHODS: Twenty-four female Sprague-Dawley rats were divided into two groups. In both groups, acute pancreatitis was induced by ligation of the main biliopancreatic duct. The rats in group I were fed orally and the rats in group II were fed parenterally, The rats were sacrificed at 48 hours, and blood samples were obtained from the heart upon exposure of the abdominal and thoracic cavities, The pancreas and the left lung were removed for histopathological examination, The levels of lactic dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), glucose, calcium and blood urea nitrogen, base deficit, partial oxygen pressure, leukocyte count, and hematocrit level among Ranson criteria and the level of amylase were measured, The pancreas and the lung were examined under a light microscope. RESULTS: The levels of LDH, SGOT, and calcium for the rats in group I were significantly higher when compared with the rats in group II (P <0.05), Similarly, the levels of amylase for the rats in group I were found to be higher when compared with the rats in group II, but the difference was not significant. Inflammatory changes observed in the pancreas were less severe whereas inflammatory changes observed in the lung were more severe for the rats in group I when compared with the rats in group II. CONCLUSIONS: The blood levels of the enzymes were adversely affected for the rats fed orally. In contrast, inflammatory changes observed in the pancreas were more severe for the rats fed parenterally, The study suggests that certain hormones released from the duodenum upon stimulation by oral nutrient intake lessens the severity of pancreatitis through protective effects on the pancreas, whereas the elevated levels of the enzymes cause endothelial damage resulting in destruction in distant organs such as the lung.Öğe The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure(HINDAWI LTD, 2015) Ece, Ilhan; Vatansev, Celalettin; Kucukkartallar, Tevfik; Tekin, Ahmet; Kartal, Adil; Okka, AndmehmetObjective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C) was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low), M (medium), and H (high pressure). Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery) using a contact tonometer. Results. Patients' gender, age, body mass index (BMI), American Society of Anesthesiology (ASA) class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P < 0.05). An increase in intraocular pressure was seen in groups M and H (P < 0.05). Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure.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 An Internal Iliac Artery Aneurysm Causing a Colonic Obstruction: Report of a Case(SPRINGER-VERLAG, 2001) Özergin, Ufuk; Vatansev, Celalettin; Durgut, Kadir; Özülkü, Mehmet; Görmüş, NiyaziAn 80-year-old male patient presented with the chief complaints of a sudden onset of pain in the right lower quadrant and constipation of 3 days' duration. In computerized tomographic examination an aneurysm of right internal iliac artery and an abnormally enlarged descending colon were seen. During an emergency operation a small rupture in the subserosa of the rectosigmoid junction was found.
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