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Biomedical subjects

A Okten

Publications and source records attributed to A Okten.

At least 55 records · Page 3Linked to original sources

[Are devascularization-transsection operations in treatment of bleeding esophageal varices still indicated?].

Sugiura procedure and its modifications were performed in 43 patients who were not suitable for shunt surgery. Four types of devascularisation-transection procedures on the technical basis of Sugiura operation were carried out. Thirteen patients died in the early postoperative period. Highest mortality was recorded in the standard Sugiura procedure (4/8 or 50%) and the lowest in modified Sugiura III (1/7 or 14%) which is the simplest form of all. Mortality in the early postoperative period was higher in emergency procedures. No variceal hemorrhage and hepatic encephalopathy were recorded in the early postoperative period. Based on our experience in relatively limited number of cases, the Sugiura operation and its modifications are not advantageous in emergency conditions and patients with poor liver function. However, these procedures can be performed in Child A-B cases. Limiting the extent of the operation by modifications affects the outcome positively.

Adult↗

Hydatid cysts of liver and portal hypertension.

Two cases of portal hypertension due to hydatid cysts of the liver are reported. In one of the patients, symptoms were secondary to obstruction of inferior vena cava and hepatic outflow tract. The other patient was operated on with a diagnosis of extrahepatic presinusoidal portal hypertension caused by extrinsic compression of the liver by an hydatid cyst. Although hydatidosis is a benign disease, it can produce serious complications as in these reported cases. Therefore hydatidosis should be remembered amongst the causes of portal hypertension in countries where the disease is endemic.

Budd-Chiari Syndrome↗

[Sporadic kala-azar in the Black Sea region].

Visceral leishmaniasis is a disease, also called kala-azar, caused by species of Leishmania, which is known as intracellular parasite. Disease show a broad spectrum on the clinical symptoms. This infection is seen classically in Mediterranean countries, in same Asian countries between 30th-48th north parallels and in South America. In Mediterranean countries the parasite causing the visceral Leishmaniasis is Leishmania donovani. Turkey is also a Mediterranean country taking place between 36th-42nd north parallels.

Child, Preschool↗

Brucellosis in a child complicated with multiple brain abscesses.

A 4-year-old boy developed symptoms consistent with brucellosis and was treated with combined streptomycin and tetracycline. He had a high brucella agglutinin titer. However, he continued to have headache and papilledema. A brain CT revealed 6 large abscesses. Brucella melitensis was isolated from abscess material. The boy recovered completely after drainage therapy.

Brain Abscess↗

Treatment of liver hemangiomas by enucleation.

Nine patients with hemangiomas of the liver were treated by enucleation between 1976 and 1985 at the Surgical Department of Istanbul (Turkey) Medical School. The tumors were removed by dissecting the plane between the capsule of the hemangioma and normal liver tissue. The diameters of the tumors ranged from 8 to 23 cm. There was no mortality and no massive bleeding. It is suggested that hemangiomas can be removed by an enucleation technique with low mortality and morbidity, rather than by liver resection.

Adult↗

Choledochoduodenostomy for intrabiliary rupture of hydatid cysts of liver.

Frank intrabiliary rupture is an important complication of liver hydatid cysts and its incidence is between 5 and 25 per cent. The main principles of management are the surgical treatment of the cyst with removal of all cystic elements and drainage of the biliary tree. Accurate pre- and intra-operative diagnosis and permanent drainage of the biliary tree by a wide choledochoduodenostomy are important to reduce morbidity and mortality. In this report 28 cases of frank intrabiliary rupture of hydatid cysts treated by choledochoduodenostomy are presented.

Adult↗

Congenital primary hypoparathyroidism presented with extensive cutaneous and subcutaneous calcifications.

Congenital primary hypoparathyroidism is very rare in infancy. It may be isolated or associated with other developmental defects, arising from the third and fourth pharyngeal pouches such as DiGeorge syndrome. Initial symptom of isolated primary hypoparathyroidism in an infant is usually generalized convulsion due to hypocalcemia. However, the clinical spectrum of DiGeorge's anomaly is highly variable. We report a two-hour-old neonate with congenital hypoparathyroidism presenting with extensive cutaneous and subcutaneous calcifications. To our knowledge, extensive calcification of the skin and subcutaneous tissue as a presenting feature of congenital primary hypoparathyroidism in an infant is reported for the first time.

Calcinosis↗

Asplenia in a patient with Fanconi's anemia-like congenital aplastic anemia.

Fanconi's anemia (FA) is an autosomal recessive disease manifested by pancytopenia resulting from bone marrow failure, variable physical anomalies and cancer susceptibility. A seven-year-old girl with Fanconi's anemia-like congenital aplastic anemia and concurrent asplenia without the congenital heart defects or the abdominal heterotaxia is reported. Asplenia was indicated using denatured red cells labelled with 51Cr, abdominal ultrasonography and computerized tomography. Immunological studies showed immunoglobulins (IgG, IgA, IgM), C3 and C4 levels within normal limits and the percentage of CD3, and C4 cells and the CD4/CD8 ratio decreased. The patient had not been exposed to recurrent pneumococcal infections. We think that isolated asplenia may occur in patients with Fanconi's anemia-like congenital aplastic anemia without the congenital heart diseases or abdominal heterotaxia.

Anemia, Aplastic↗

A rare complication of endoscopic injection sclerotherapy: thrombosis of subclavian vein.

A 28-year-old man with compensated cirrhosis of the liver (Child B) and after 4 episodes of esophageal variceal bleeding received prophylactic endoscopic variceal sclerotherapy in our Gastroenterology Clinic for 8 consecutive months. Sclerotherapy of the esophageal varices had been performed at monthly intervals until variceal obliteration was achieved. Both the intravariceal and paravariceal injection techniques were used and injections were repeated periodically as necessary. On the 8th month, 1 week after the 4th sclerotherapy procedure, the patient complained of swelling on his right shoulder and on his right arm. There was jugular congestion and swelling of his right arm and right shoulder. The patient was hemodynamically stable. An X-ray of brachial venography revealed an obstruction of the vena subclavia dextra. During follow-up, the jugular congestion and swelling of his right arm gradually subsided spontaneously over a 6-month period without any need for medication. There has been no recurrence of his symptoms during the 1-year follow-up period. Now, he is still well clinically. This experience suggests that endoscopic injection sclerotherapy may cause thrombosis of the subclavian vein which have been never seen before.

Adult↗

Sepsis and multiple brain abscesses caused by Salmonella paratyphi B in an infant: successful treatment with sulbactam-ampicillin and surgical drainage.

Abscess formation by Salmonella species is an uncommon but significant manifestation of salmonellosis, because this type of infection has high morbidity and mortality rates and is a potential nosocomial hazard. In infants, history of consumption of contaminated water should be especially quired. We report a case who had sepsis and multiple brain abscesses due to Salmonella paratyphi B and who responded to sulbactam-ampicillin (SAM) therapy. Sulbactam-ampicillin combination may be preferable due to its immunomodulator effect.

Ampicillin↗

Persistently normal alanine transaminase levels in chronic C hepatitis: what does it tell us?

BACKGROUND/AIMS: We evaluated the demographic, clinical, histological and serological characteristics of chronic hepatitis C infection with persistently normal serum alanine transaminase levels and compared the results with those obtained in a group of chronic hepatitis C infection with serum alanine transaminase levels above normal. METHODOLOGY: Twenty-one patients who had chronic hepatitis C infection with normal alanine transaminase during the follow-up period and 34 patients who had chronic C infection with serum alanine transaminase levels above normal were included in this study. Demographic, clinical, histological and serological parameters of these two groups were evaluated. RESULTS: There were no significant differences in age, gender, known route of infection, viral load and genotype distribution between the two groups (P > 0.05). The gamma-glutamyltransferase and gamma-globulin levels were significantly higher in the serum alanine transaminase levels above normal group (P < 0.01 and P < 0.05). Among the patients with normal alanine transaminase, liver biopsy findings were normal in eight patients (38%). None of the patients with serum alanine transaminase levels above normal had normal liver biopsy findings. Histologic activity index was significantly higher in serum alanine transaminase levels above normal group (9.7 +/- 2.2 vs. 6.4 +/- 1.9; P < 0.001). Histologic activity index and alanine transaminase levels correlate with the stage of the disease (P < 0.05). CONCLUSIONS: For a definite diagnosis in patients with HCV-RNA+ and normal alanine transaminase liver biopsy is necessary and significant liver disease may be present in such patients irrespective of viral load, genotype and alanine transaminase levels.

Adult↗