Biomedical subjects

A Calik

Publications and source records attributed to A Calik.

18 recordsLinked to original sources

PubMed2005

Pheochromocytoma combined with pre-clinical Cushing's syndrome in the same adrenal gland.

Pheochromocytoma (PHEO) occasionally associates with pathological lesions of the adrenal cortex. In most of them, ectopic adrenocorticotropic hormone (ACTH) produced by PHEO resulted in bilateral adrenocortical hyperplasia. The coexistence of PHEO and pre-clinical Cushing's syndrome (PCS) of the same adrenal gland has rarely been reported. We report on a patient and discuss the peculiar diagnostic aspects of this entity. A 52-yr-old Turkish woman was hospitalized at Farabi Hospital for further examinations of a right adrenal mass that was incidentally discovered by abdominal ultrasonography during examinations for abdominal bloating and "gas" in other hospital. The patient had a history of palpitations, nervousness, sweating and heat intolerance. On admission, her blood pressure was 140/90 mmHg. A physical examination revealed no signs of an excessive production of adrenocortical steroids such as in CS. Tension Holter monitoring revealed paroximal hypertension attacks (183/105 mmHg). Urinary catecholamines were markedly increased. Her serum cortisol concentrations ranged from 5 to 17 microg/dl, whereas ACTH levels were undetectable. Cortisol was not suppressed on the overnight 1 mg oral dexamethasone suppression test (DST), 2-day low-dose dexamethasone suppression test (DST). Abdominal computed tomography and magnetic resonance imaging studies revealed a solid round tumor approximately 4 cm in diameter, located in the right adrenal gland. A 131 lodine-metaiodobenzylguanidine (131 I-MIBG) scan revealed uptake within tumor in the right adrenal gland. Right adrenalectomy was performed; the surgical specimen revealed PHEO and adrenocortical hyperplasia. To our knowledge, the present report is a rare case of PHEO combined with PCS in the same adrenal gland.

Adrenal Cortex↗

PubMed1999

Effects of octreotide on acute pancreatitis of varying severity in rats.

OBJECTIVE: To find out the effects of the octreotide on the course of acute pancreatitis in rats. DESIGN: Prospective laboratory study. SETTING: Medical school, Turkey ANIMALS: 184 Sprague-Dawley rats, 120 of which were randomly allocated into 8 groups of 15 each for the survival study, and the remainder of which were randomly allocated into 8 groups of 8 rats each for assessment of biochemical variables and histological score. INTERVENTIONS: The same 8 groups were used for the two parts of the study: saline alone (control), octreotide alone (control), oedematous pancreatitis induced by cerulein with and without octreotide, moderate pancreatitis induced by low-dose glycodeoxycholic acid and cerulein with and without octreotide, and severe pancreatitis induced by high-dose glycodeoxycholic acid and cerulein with and without octreotide. MAIN OUTCOME MEASURES: Mortality, results of biochemical tests, and histological score. RESULTS: No rats in the control groups died. Of those with oedematous pancreatitis 1 died that had not been given octreotide (7%) and 2 that had (13%). In the moderate pancreatitis groups 4 that had not been given octreotide died (27%) compared with one that had (7%). In the severe pancreatitis group 7 that had not had octreotide died (46%) compared with 6 that had (40%). Octreotide caused a reduction in serum amylase and lactate dehydrogenase activity in all groups, but reduced aspartate aminotransferase only in those rats with moderate pancreatitis. It prevented hypocalcaemia in rats with severe pancreatitis, but had no effect on serum electrolyte concentrations, alkaline phosphatase activity, or blood gas analyses. Rats with moderate pancreatitis that had been given octreotide had less tissue oedema, acinar necrosis, and inflammatory cell infiltration. In those with severe pancreatitis there was less tissue oedema but more acinar necrosis. CONCLUSION: If octreotide is given early in the course of the disease it may result in improved outcome, but it seems to be ineffective in severe pancreatitis in which acinar necrosis is already established.

Acute Disease↗

PubMed1999

Laparoscopic abdominal observation method without anesthesia for preventing unnecessary second-look procedures: short report.

Second-look operations after massive intestinal resections secondary to mesenterovascular occlusion are a frequent practice. In about one half of patients who undergo second-look procedures, no intraabdominal intervention is necessary. We present a laparoscopic abdominal observation method to prevent unnecessary laparotomies. In the first operation, two laparoscopic trocars, 5 and 10 mm in diameter, were left in the abdominal wall. After an appropriate time interval, the abdomen was explored laparoscopically through these trocars without anesthesia. If obvious intestinal gangrene and anastomotic leaks were observed laparoscopically, the patients were reoperated on while under general anesthesia; otherwise, the procedure was terminated with removal of the trocars. This method was performed on six patients. Unnecessary relaparotomies were prevented in four patients; intestinal gangrene and anastomotic leaks were not missed in the remaining two patients. A larger patient sample is needed to assess the advantages of this method in preventing unnecessary laparotomies.

Anesthesia↗

PubMed1997

Effects of total parenteral nutrition using a solution enriched with branched-chain amino acids on experimental pancreatitis in rats.

The main purpose of this study was to investigate the influence of total parenteral nutrition enriched with branched-chain amino acids (BCAA) on acute pancreatitis (AP) induced by sodium taurocholate in rats. Total parenteral nutrition (TPN) increased the survival rate and serum calcium, and reduced serum urea, liver transaminase, acid phosphatase and lactate dehydrogenase levels, but it did not change the degree of pancreatic damage or serum amylase. Total plasma amino acid concentration and the concentrations of glutamate, glycine, alanine, taurine, valine, leucine, isoleucine, phenylalarine increased significantly after the induction of AP, but there was no difference between the control and therapy groups. Hyperglycemia occurred during the use of TPN. BCAA-enriched TPN can be used in the treatment of AP with few side effects.

Amino Acids↗

PubMed1996

Intestinal obstruction caused by splenic volvulus: report of a case.

Torsion of a wandering spleen is rare, usually presenting as acute abdomen, and is commonly misdiagnosed. In special cases, ultrasonography, arteriography, and additional scintigraphy are extremely valuable in the preoperative diagnostic management. We herein present an unusual case of torsion of a wandering spleen in a 19-year-old female. The presenting symptom was acute gastrointestinal obstruction due to pressure of the enlarged and ptotic spleen in the pelvis. The intestinal obstruction with signs of peritonitis made a laparatomy with removal of the infarcted spleen imperative. After the operation, the patient made a complete recovery.

Adult↗

PubMed1995

Influence of thyrotropin-releasing hormone on experimental pancreatitis in rats.

The main purpose of this study was to investigate the influence of thyroid releasing hormone on acute sodium-taurocholate-induced pancreatitis in rats. Thyroid-releasing hormone did not change the survival rate, serum amylase, glucose calcium, liver transaminases levels or the degree of pancreatic damage, but reduced lactate dehydrogenase. Our findings suggest that the use of thyroid-releasing hormone has no beneficial effect on the course of acute experimental pancreatitis.

Acute Disease↗

PubMed1995

Solitary extramedullary plasmocytoma of the breast with kappa monoclonal gammopathy.

We report a case of solitary extramedullary plasmocytoma of the breast in a 85 year old woman. This is the third case of solitary breast plasmocytoma in the world's literature. This disorder is very rare and it was associated with a serum monoclonal protein. A similar case is presented and its clinical presentation and pathology discussed.

Aged↗

PubMed1994

The intrabiliary rupture of hydatid cyst of the liver.

The intrabiliary rupture of hydatid cyst of the liver is a severe and relatively frequent complication. In this study six similar cases are presented. 4 of the cases had hydatid cyst surgery before the admission. The obstructive jaundice, cholangitis and unclosed bile fistula are the most frequent clinical findings. Ultrasound is very useful for the diagnosis. In the cases of space occupying lesions of the liver with wide choledochus (1.1 cm >) the intrabiliary rupture of hydatid cyst can be suspected by ultrasonographic examinations. Surgical therapy as the capitonnage combined with the resection of the projecting dome of the cyst and T tube application remains a method which gives good results and has low mortality and morbidity.

Adult↗

PubMed1994

A modified technique for performing anterior gastropexy in Stamm gastrostomies.

We describe herein a new modified technique for performing the anterior gastropexy step of the Stamm gastrostomy procedure. In this method, anterior gastropexy was carried out with four 2-0 silk or propylene sutures. These sutures were secured through the whole layer of the abdominal wall from out to within. Then, after passing the seromuscular layer of stomach, they return to skin through the abdominal wall from within to out and tied over the skin surface. This modified technique which provided better exposure and an excellent seal of the stomach and parietal peritoneum, was successfully performed on 23 patients, none of whom developed any peritoneal leakage and peritonitis. The only complications that arose were wound infection in one case and skin excoriation in two others, and these were easily managed.

Adult↗

PubMed1993

The management of enterocutaneous fistulas with parenteral hyperalimentation.

During a period of nine years, all patients with enterocutaneous fistula who received parenteral nutrition as part of therapy were evaluated retrospectively. Twenty-three patients were studied. Peptic ulcer was the most common primary disease, with the fistula arising in 78 percent of the cases from the breakdown of an anastomosis and in the remainder from a direct trauma to the bowel. The most common site of the fistulas was the ileum followed by the duodenum. All the patients were treated conservatively with total bowel rest and parenteral nutrition, and in 56.5 percent of the cases spontaneous closure occurred within an average of 29.6 days. In five patients, the fistula failed to close, and surgery was performed. The mean surgical closure time overall 36.4 days, but this varied from 20.8 days for the duodenum to 39 days for the jejunum and ileum, and 19.7 days for the large intestine. Five patients (22.7%) died, four from sepsis, the fifth from systemic malignancy. Mortality was related to the location and output of the fistula, with jejuno-ileal high-output fistulas in particular figuring prominently in the mortality.

Adolescent↗

PubMed1991

Volvulus of the sigmoid colon.

Between 1983 and 1986, 18 patients with colonic volvulus (94.4% sigmoid, 5.6% caecal) were seen at Karadeniz Medical Faculty. There were 11 male and 7 female patients, with a mean age of 68 years. In 66.6% and 22.2% of patients respectively a palliative procedure or a Hartmann operation were performed. The recurrence rate in the palliative group was 30%. The mortality rate for all patients with volvulus was 16.8%. The palliative procedures were successful in patients in good general condition and without bowel necrosis, whereas the Hartmann operation gave successful results in patients with bowel necrosis.

Adult↗

PubMed1990

Rupture of a choledochal cyst during postpartum period.

A 25 year old female was operated on three times due to a choledochal cyst rupture occurring on the 6th postpartum day. In the last operation, a hepaticojejunostomy with Braun's anastomosis was performed and a temporary internal stent was applied. The internal stent was removed on the 70th postoperative day. The patient is still living with the risk of secondary biliary cirrhosis and cholangitis.

Adult↗

PubMed1990

[Prevention of wound infection in elective colon surgery by the use of systemic ceftriaxone and ornidazole].

In this study prophylactic effects of ceftriaxone and ornidazole on the patients undergoing elective colon surgery was studied in the surgical clinics, Medical Faculty of Karadeniz Technical University. Colon cleaning with Nichol's method was performed in all cases. But kanamycin and metronidazole were given instead of erythromycin and metronidazole. One hour before the operation ceftriaxone 1 gr. and ornidazole 500 mg. (IV, IM) were administered. Those antibiotics were followed by ceftriaxone 2 gr. daily and ornidazole 1 gr. daily (IV, IM) three days after operation. The wound infection were observed in the postoperative period (5%). The average hospitalization time of the cases were 12 days. This period was 18 days and 21 days in the cases having infection. Side effects related the drugs were not observed and there were no significant laboratory changes.

Adolescent↗

PubMedDate not supplied

Intraductal papilloma and papillomatosis.

The benign papillary neoplasms of the breast are still controversial topics in general surgery. There are two forms of the benign papillary lesions, solitary intraductal papilloma and multiple intraductal papilloma. These disorders are very rare and their clinical behaviour is different in each case. In this study, two cases of the multiple intraductal papilloma are presented and clinical findings and surgical therapy are discussed.

Adult↗

PubMedDate not supplied

A comparison of the simple ligation and ligation inversion of the appendiceal stump after appendectomy.

In this article, we present 80 noncomplicated acute appendicitis that we operated. The patients was separated into two groups. The first group, appendiceal stump was tied and dropped in abdominal cavity in 40 cases and second group, it was tied and inverted into the cecum in the other 40 cases. The cases were observed in the postoperative period concerning intraabdominal abscess, brid ileus, incisional wound infection and hospitalization duration. No significant difference has been found between these two groups.

Acute Disease↗

PubMedDate not supplied

Complicated marginal ulcers after surgery for duodenal ulcer.

During a period of 10 years, 10 cases of marginal ulcer (MU) after surgery for duodenal ulcer were evaluated retrospectively. The most common cause of MU was inadequate gastric resection plus incomplete vagotomy; the second common cause was incomplete vagotomy. In one case, the MU could be ascribed to malignant gastrinoma. In eight of the ten cases epigastric pain was a major symptom. MU was complicated with perforation, massive bleeding, gastrojejunocolic fistula and afferent loop obstruction in 2, 2, 2, and 1 cases, respectively. Gastroscopy was very useful for the diagnosis except in emergency cases. Hollander test was used in six of the 10 patients to evaluate if the vagotomy had been complete. The mean acid output by insulin induction was found 32 meq/h. As a surgical therapy, total gastrectomy (2 cases), truncal vagotomy (2 cases), truncal vagotomy plus 60% gastric resection or reresection and Roux Y gastrojejunostomy were performed. Postoperative complications (enterocutaneous fistula, intraabdominal abscess and delayed gastric emptying) occurred in 33 patients. One patient was lost after total gastrectomy in the malignant gastrinoma and gastrojejunocolic fistula case, due to sepsis. The patients were followed up for 4.4 years on the average. No recurrence was seen.

Adult↗

PubMedDate not supplied

Complications of 867 thyroidectomies performed in a region of endemic goiter in Turkey.

This article aims to define the incidence of complications in 867 thyroidectomies performed by residents with attending surgeons' supervision as part of a training programme, in a region of endemic goiter. Seven hundred and nine patients were female and 158 were male. The age of the patients ranged between 6 and 76 and mean age was 32.5. Cases were divided into two groups according to their disease nature. Group 1 included 805 patients with nodular colloidal goiter (NCG) and adenomas. The remaining 62 cases, 25 with recurrence of goiter (RG), 21 with thyroid malignancy (TM) and 16 with thyroiditis formed group 2. While the overall complication rate was 11.3% (93 cases) in group 1, it was 20.9% (13 cases) in group 2. The mortality rate was zero in both groups. The incidence of complications of 867 thyroidectomies performed by residents with the attending surgeons' supervision was within acceptable limits especially as far as group 1 was concerned. However we suggested that attending surgeons themselves, disregarding residents training, should perform the operation in special cases such as recurrent goiters, thyroid carcinomas with positive regional lymph nodes and thyroiditis with regional adhesions.

Adolescent↗

PubMedDate not supplied

The effects of variously performed vagotomies on gastric secretion and gastric emptying in rats.

The main purpose of this study was to investigate the effects of (i) truncal vagotomy + pyloroplasty, (ii) proximal cell vagotomy and (iii) anterior proximal cell vagotomy + posterior truncal vagotomy on the gastric secretion and gastric emptying in rats. After vagotomy basal and 2-deoxy-glucose stimulated gastric secretion decreased significantly in all three vagotomy groups. Gastric secretion on the other hand was significantly higher in the proximal cell vagotomy group than on the other vagotomy groups. The rate of gastric emptying in proximal cell vagotomy and anterior proximal cell vagotomy + posterior truncal vagotomy groups was delayed. The best results were found in the truncal vagotomy + pyloroplasty group when the gastric secretion and the rats of gastric emptying are concerned.

Animals↗