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A Numanoglu

Publications and source records attributed to A Numanoglu.

10 recordsLinked to original sources
PubMed2001

Detection of caustic oesophageal injury with technetium 99m-labelled sucralfate.

BACKGROUND/PURPOSE: Radiolabelled sucralfate has been used to show the extent and severity of reflux oesophagitis, peptic ulceration, and inflammatory bowel disease. Endoscopy under general anaesthetic has been the preferred method to assess the injury after caustic ingestion. The aim of this study was to assess whether sucralfate has an affinity for the chemically injured oesophageal mucosa and, if so, to assess the accuracy of radiolabeled sucralfate as an indicator of presence and extent of oesophageal injury. METHODS: A prospective study was conducted of 22 patients with mean age of 30 months (range, 13 to 90) admitted consecutively with a history of caustic ingestion between January 1998 and January 2000. A sucralfate-labelled scan followed by endoscopic assessment of upper gastrointestinal tract with documentation of extent and grade of injury was performed in all patients within 24 hours of admission except the first 6 who underwent scan after the endoscopy. The sucralfate was labelled by the direct stannous reduction method. Oesophageal transit was studied by recording 120 images (64 x 64 matrix size) at 1 image per second while the child swallowed 5 mL of labelled sucralfate containing 2 to 3 MBq Technetium 99m. Retention of radiolabelled oesophageal activity was considered abnormal. RESULTS: The caustic substances ingested were household cleaners in 18, potassium permanganate in 3, and pool chlorine in 1. There were 11 scans that showed residual activity in the oesophagus, which correlated exactly with endoscopic findings. The other 11 patients had normal oesophageal mucosa, but 2 were found to be falsely positive on scanning. In 2 cases repeat sucralfate scan results correlated well with the healing process assessed endoscopically. CONCLUSIONS: The results indicate that technetium 99m sucralfate swallow is an accurate technique for assessing oesophageal injury after ingestion of caustic substances. In addition, it may be used to document healing.

Burns, Chemical↗
PubMed1999

Psoas abscess.

Explore the source record for details and available documents.

Child, Preschool↗
PubMed1998

Prediction of outcome in congenital diaphragmatic hernia.

The case records of 59 patients with congenital diaphragmatic hernia (CDH) who presented between 1984 and 1997 were studied retrospectively. Included in the study were infants born with CDH who required respiratory support within the first 6 h of life. Twenty-three were excluded from the study for various reasons; 36 were enrolled in the study; the male-to-female ratio was 18:18. Twenty-nine hernias were left-sided and 7 were right-sided. All patients were ventilated using conventional techniques. Arterial blood gases were measured on average 1.76 h following admission and the initial period of resuscitation (range 1-4 h). Three formulae were applied in an attempt to predict outcome: ventilation index against PCO2, alveolar-arterial oxygen gradient, and a newly derived formula from this institution (Red Cross formula) that comprises respiratory rate x PCO2 x FiO2 x mean airway pressure/PaO2 x 6000. Seventeen patients (47.2%) survived and 19 died (52.8%); 21 became stable enough to undergo surgery. The average time from presentation until surgery was 1.98 days (range 6 h to 4 days). The Red Cross formula, with a 100% predictive value for mortality, 85% predictive value for survival, and an overall predictive value of 91.6%, appeared to be superior to the other formulae studied. The availability of a highly accurate predictive formula may facilitate management of this frequently lethal disease.

Blood Gas Analysis↗
PubMed1998

Effects of hematoma on the short-term fate of experimental microvenous autografts.

The early effects of hematoma on the healing pattern of interpositional vein grafts were studied in 60 rats. In all animals, vein grafts approximately 10-mm in length were used to bridge defects created in the femoral artery and vein on the same side, with a 1:1 graft-to-host diameter match. Grafted vessels were completely covered with hematoma and separated from the surrounding tissue in 30 animals, while the other 30 rats served as controls. Both groups were divided into six subgroups of five animals each, according to the age of the grafts: 1, 3, 5, 7, 14, and 21 days. Graft patency and healing were assessed both clinically and histologically 20/30 (66.6 percent) of the interarterial and 27/30 (90 percent) of the intervenous vein grafts in Group 1 (hematoma group), and 28/30 (93.3 percent) of the interarterial and 29/30 196.6 percent) of the intervenous vein grafts in Group 2 (controls) were found patent. The patency rate of the interarterial vein grafts in the hematoma group was statistically significantly lower than in the control group and than in the intervenous vein grafts of the same group (p<0.005). The majority of interarterial vein-graft failures occurred after postoperative day 7 in Group 1. Patent specimens were examined under scanning electron and light microscopy. The authors concluded that perivascular hematoma caused spasm and flow disturbance, prolonged vessel-wall ischemia, and severe vessel-wall injury in the arterial circulation of the microvenous grafts. It also delayed the healing process and subjected the grafts to the development of occlusive mural thrombus. In contrast, the healing pattern of the intervenous vein grafts was not markedly influenced by perivascular hematoma, and equilibrium between thrombogenic and antithrombogenic factors on the graft surface was restored over a short period of time.

Animals↗
PubMed1997

Delayed presentation of congenital diaphragmatic hernia.

Patients with congenital diaphragmatic hernias (CDH) usually present soon after birth with respiratory distress. Occasionally presentation is delayed. Twelve patients with delayed presentation (outside the neonatal period) of a total of 91 with CHD were seen over 17 years (1977-1994). Case records were reviewed to identify reasons for late presentation, evidence of morbidity, treatment and outcome. Age at presentation ranged from 6 weeks to 30 months (mean 8 months). Ten patients were aged 6 months or younger and there was an equal number of boys and girls. Seven cases were left-sided, 4 right-sided and 1 was anteriorly placed and bilateral. Ten patients presented acutely, 5 with small-bowel obstruction and 5 with respiratory distress, but all of the latter had a history of previous recurrent chest infection. Diagnosis was confirmed by radiographic examination of the chest in 10, barium meal in 1 and a 5-month-old patient had an inappropriate laparotomy and gastrojejunostomy for duodenal obstruction at an outlying hospital. Two had documented normal chest radiographs 3 and 6 months prior to diagnosis. Patients who presented with gastro-intestinal symptoms were older (mean age 1 year) compared with those with predominantly respiratory symptoms (mean age 19 weeks). None had any evidence of bowel strangulation. All were repaired via an abdominal approach. A hernial sac was found in half the cases (4/7 left and 2/5 right). Five had non-rotation of bowel. Primary repair without patch was carried out in all. One child with lung hypoplasia and multiple cardiac abnormalities died; the others recovered well. Delay in presentation of CDH is not uncommon (14% in this series). Most patients will have respiratory symptoms. A normal previous chest radiograph does not exclude the diagnosis. All patients with recurrent chest infection should have a contrast meal investigation early on. Long-term prognosis is favourable and postoperative morbidity is minimal, despite late presentation.

Child, Preschool↗
PubMed1993

Subepineural hyperplastic pacinian corpuscle: an unusual cause of digital pain.

A case is presented in which the patient's chief complaint was severe digital pain radiating to the arm. Even light touch was enough to produce unbearable pain, which prevented the patient from carrying out simple daily tasks. She had complete relief of her symptoms following removal of the hyperplastic pacinian corpuscle and returned to her normal life. A review of the literature revealed few reported cases of hypertrophied pacinian corpuscles in the hand. We believe that this diagnosis must be considered in the differential diagnosis of digital pain of unknown etiology.

Female↗
PubMed1993

Paired five-flap Z-plasty.

Web-like contractures may occur along both the outer borders of joints, creating double-parallel contracture bands that turn into webs during movements. A combination of two "five-flap z-plasties" lying in confrontation to each other was used to release such contractures. The two Vs face each other and meet at their upper ends, forming a rhomboid (Fig. 1, a and b) or hexagon (Fig. 1, c and d) whose position remains unchanged after the contractures have been released and all the flaps transferred or advanced. This method has been used to release a total of seven double-parallel web-like linear contractures with very satisfactory results. Paired five-flap z-plasty seems to be superior when release of double web-like contractures, with the presence of sufficient spared skin, is contemplated.

Adult↗
PubMed1992

The "lazy-V" de-epithelialised turn-over fasciocutaneous flap in the reconstruction of skin defects after tendo Achilles repair.

Few methods of closure of skin defects lying over the tendo Achilles have been described. The de-epithelialised turn-over flap is one of them but it cannot be used in the presence of a scar proximal to the defect. We describe a modification ("The Lazy-V") of the de-epithelialised turn-over flap which gives it a rotation arc, thus enhancing the versatility of the procedure. This modification is presented with an illustrative case report and a review of the literature.

Achilles Tendon↗