Loop end colostomy: a new technique.
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Biomedical subjects
Publications and source records attributed to C Bumin.
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A relatively low success rate in recurrent incisional hernia repair has prompted us to review the effects of certain risk factors on the long-term outcome of our cases. In this study, 109 recurrent incisional hernias were repaired and reviewed between 7 and 92 months after the operation. The recurrence rate was 45.0%. Many conditions that have been implicated as causal factors in the occurrence of incisional hernias were not found to be associated with recurrence after repair. However, chronic constipation was determined to be the most prominent risk factor associated with late recurrence.
The quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and equipment. The results suggest that women who obtain abortions in public sector hospitals have a higher abortion rate than the general population. They are likely to receive a vacuum aspiration with minimal pain control medication. Clinical infection control procedures are insufficient, as are interpersonal communication practices including counseling on reproductive health issues and providing factual information. Links with family planning services are strong and the majority of abortion patients who desire family planning receive a contraceptive method, either through direct provision of postabortion contraceptives or referral.
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To investigate the pathogenesis of post-thyroidectomy hypocalcemia calcium, phosphate, calcitonin, parathormone, albumin, triiodothyronine and thyroxine levels were monitored during operation and postoperatively in 25 female patients undergoing bilateral subtotal thyroidectomy for non-toxic nodular goiter. A highly significant fall in uncorrected serum calcium and albumin levels started with the completion of lobectomies and a significant correlation between the course of serum calcium and albumin levels were seen, an early peak in calcitonin corresponded well with the a drop in corrected calcium and inorganic phosphate levels. An overt parathyroid response to hypocalcemia was not observed. We conclude, on the basis of the postoperative hypoalbuminemia, that a calcitonin leak triggered the early onset of hypocalcemia while an insufficient parathyroid response contributed to the post-thyroidectomy hypocalcemia.
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Somatostatin and its long-acting analog octreotide (SMS 201-995) inhibit several gastrointestinal functions. Their effects have been studied in the treatment of small numbers of external pancreatic, intestinal and biliary fistulas. We treated 8 biliary, 4 pancreatic and 5 intestinal cutaneous fistulas with octreotide. Mean decreases in fistula output before octreotide treatment were not significant (p > 0.01 for each group). On the 1st day of octreotide treatment, mean fistula output decreased from 412 +/- 60.4 to 234 +/- 57.7 ml in the biliary, from 457.5 +/- 57.5 to 217.5 +/- 11.8 ml in the pancreatic and from 564 +/- 49.2 to 217.5 +/- 11.8 ml in the enterocutaneous fistula groups (p < 0.01 for each). No serious side effects were recorded. We conclude that octreotide is an important adjunct in the conservative treatment of external biliary, pancreatic and intestinal fistulas, by decreasing their output.
Carcinoid tumors which arise from enterochromaffin cells are usually found in the appendix, ileum, bronchus and rectum. Biliary duct carcinoids are exceedingly rare. Pre-operative diagnosis is very difficult because they mimic the signs and symptoms of choledocholithiasis. We report a case of biliary duct carcinoid. A 38-year-old woman admitted with signs and symptoms of obstructive jaundice. ERCP demonstrated an obstruction in the common bile duct. A choledochotomy T drainage was performed. Histopathologically the mass which was removed from the common bile duct was a carcinoid tumor. There are only nine cases of biliary duct carcinoid in the literature to date. These cases are reviewed.
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In our experimental animal model, 50 Winstar-Albino rats were divided into five groups in a randomized manner. After all were anesthesized with ether, laparotomy was performed on each one and the caecum and terminal ileum were scrubbed with a toothbrush until serosal petechial bleedings were seen. In the first group, the abdomen was closed after this procedure. In the second group, the abdomen was closed after application of 0.9% NaCl solution intraperitoneally. In the third group, the abdomen was closed after LMWH (low molecular weight heparin) was given intraperitoneally. In the fourth group, LMWH was given in prophylactic dosage subcutaneously on the day of operation and for the following seven days. In the fifth group, abdomen was closed after heparin was given intraperitoneally. On the fourteenth postoperative day, the rats were sacrificed and intraperitoneal adhesions were scored according to the "Mazuji's Scale". There was a statistically significant difference between group I and group III. No statistically significant difference could be found between group I and group IV (p > 0.05). Between group I and V a statistically significant difference was found (p < 0.005). Again a statistically significant difference was found both between group III and IV (p < 0.05), and between group IV and V (p < 0.001). No such difference was observed between group IV and V (p < 0.05). As a result, in this animal model, LMWH given intraperitoneally to prevent adhesions was found to be more effective than subcutaneous and intraperitoneal heparin application.
Thirty-eight patients were treated for acute sigmoid volvulus in 9 years. Non operative decompression treatment was performed in 7 patients, and 31 patients underwent exploratory laparatomy (25 for suspected bowel necrosis and 6 for unsuccessful non operative treatment). Sigmoid resection and reanastomosis was performed in 5 of the 12 cases with gangrenous bowel and 10 of the 19 with viable bowel. There were no mortality and no morbidity related to the anastomoses. The results have shown that reanastomosis after sigmoid resection could be performed safely in selected cases of acute sigmoid volvulus even if there is bowel gangrene.