Biomedical subjects

Cengizhan Yigitler

Publications and source records attributed to Cengizhan Yigitler.

6 recordsLinked to original sources

PubMed2006

Giant unilateral abdominoscrotal hydrocele in association with crossed testicular ectopia.

Abdominoscrotal hydrocele and transverse testis ectopia are rare clinical conditions. This case report describes the combination of these two rare entities. An azoospermic and infertile adult man presented with left abdominoscrotal hydrocele and a right impalpable testis. He was treated with left orchiopexy, right orchiectomy, and excision of the abdominoscrotal hydrocele. We discuss the diagnosis and treatment of this combination, which has not been previously reported.

Adult↗

PubMed2006

Lower extremity venous changes in pneumoperitoneum during laparoscopic surgery.

BACKGROUND: The effect of pneumoperitoneum on veins of the lower limbs related to the intra-abdominal working pressures during laparoscopic cholecystectomy has not been thoroughly investigated. We tested the hypothesis that working pressures do not affect the venous haemodynamics in the lower limbs. METHODS: The cross-sectional area and peak flow rates of femoral and saphenous veins in the right groin were measured in 60 patients divided into two groups according to the intra-abdominal working pressures (11 vs 14 mmHg). All measurements were carried out preoperatively and at predetermined periods during and after laparoscopic cholecystectomy by colour Doppler ultrasonography. One-way anova and chi(2) test were used for the analysis of demographic data. For the repeated measures, anova and Student's t-test were used for statistical analysis. The probabilities less than 0.05 were accepted as statistically significant. RESULTS: The cross-sectional area of the veins increased, whereas the peak flow rate in veins decreased during pneumoperitoneum. Comparing the peak flow rate in the saphenous vein at the third intraoperative measurement, there is statistically significant difference between the two groups (P < 0.05). CONCLUSION: The degree of intra-abdominal pressure affects the haemodynamics of the peripheral veins. Pneumoperitoneum during laparoscopy causes stasis in the peripheral veins. It is reasonable to use routine prophylaxis for deep vein thrombosis, in the light of these findings.

Cholecystectomy, Laparoscopic↗

PubMed2005

Successful ABO-incompatible liver transplantation with pre- and postoperative plasmapheresis, triple immunosuppression, and splenectomy for fulminant hepatic failure.

Fulminant hepatic failure continues to be a challenge to hepatologists and surgeons. Because of the rapid deterioration in the clinical condition of patients with fulminant hepatic failure and the scarcity of available grafts, an ABO-incompatible liver donor may be the only choice for a patient with life-threatening hepatic insufficiency. Here, we report a patient with fulminant hepatic failure who received an ABO-incompatible liver transplantation who was treated with pre- and posttransplantation double-volume total plasma exchange, splenectomy, and triple immunosuppression (tacrolimus, mycophenolate mofetil, and prednisone) in July 2003. At 26 months' follow-up, the patient's postoperative course has been uneventful. Using protocols aimed at removing existing isohemagglutinins and reducing further antibody production, ABO-incompatible liver transplantation may be performed as a life-saving procedure in patients with fulminant hepatic failure.

ABO Blood-Group System↗

PubMed2004

Effect of mesalazine, metronidazole and gentamicin on bacterial translocation in experimental colitis.

BACKGROUND AND AIM: In inflammatory bowel disease it has been established that enteric microorganisms are present in the final stage of the active inflammatory process. The purpose of the present study was to investigate the effects of mesalazine, and metronidazole-gentamicin combination, on bacterial translocation in an animal colitis model. METHODS: Fifty rats were stratified into five groups. The control group (group NC) was given only 2 mL saline enema and the remaining four groups were given 2 mL acetic acid enema. Group CC was the diseased control group. The treatment regimens started on the fifth day: mesalazine enema in group MesC, metronidazole-gentamicin in group MGC, and mesalazine + metronidazole + gentamicin in group MesMGC. After death on day 10, 2.5-cm colonic segments from all groups were weighed separately. In all rats, histopathological scoring was done, and samples from feces, blood, liver and spleen underwent microbiological analyses. RESULTS: For all diseased rats, both mean weight loss and colonic segment weight/bodyweight ratio was significantly higher than that in the sham group. As compared with other groups, body and colonic segment changes as well as histopathological scoring in rats receiving mesalazine enema either solely or in combination with the antibiotics were lower. No bacterial growth was found in the blood, liver and spleen of the rats in the control group while enteric bacteria, mainly Escherichia coli (35%) were the most common bacteria translocated to that in the latter. Antibiotic combination, alone or in combination with mesalazine was effective in reducing the bacterial translocation while mesalazine administration did not properly influence its regression. CONCLUSIONS: Gram-negative enteric bacteria, predominantly E. coli, was the most common bacteria isolated in bacterial translocation occurring in acetic acid-induced colitis. This trial showed that mesalazine alone did not incorporate the reduction of infectious events, despite its beneficial effect on inflammatory changes in experimental colitis. Metronidazole and gentamicin combination given intraperitoneally was more effective than topical mesalazine in decreasing bacterial translocation.

Animals↗

PubMed2004

[Acute abdomen due to spontaneous renal angiomyolipoma rupture].

Renal Angiomyolipoma (AML) is a rare benign tumor As it is usually asymptomatic and small, AML sometimes may cause acute abdomen by spontaneous rupture and hemorrhage that may be life threatening in some cases for which surgical management is necessary. A 58-year-old female patient was admitted for right side and right upper abdominal pain, nausea and vomiting. Right upper abdominal and right side sensitivity were remarkable on physical examination. Whole blood count revealed the ongoing with steady remarkable decrement in hematocrite and hemoglobin. Radiological examination showed right kidney mass with retroperitoneal hematoma. Patient underwent a right nephrectomy with mass excision. Her postoperative period was uneventful. On this case report we conclude that; angiomyolipoma may cause serious complications by the spontaneous rupture and life threatening hemorrhage. In case of massive hemorrhage and/or whole renal involvement, nephrectomy is the most feasible surgical treatment of all the other treatment methods.

Abdomen, Acute↗

PubMed2003

The small remnant liver after major liver resection: how common and how relevant?

The maximum extent of hepatic resection compatible with a safe postoperative outcome is unknown. The study goal was to determine the incidence and impact of a small remnant liver volume after major liver resection in patients with normal liver parenchyma. Among 265 major hepatectomies performed at our institution (1998 to 2000), 138 patients with normal liver and a remnant liver volume (RLV) systematically calculated from the ratio of RLV to functional liver volume (FLV) were studied. Patients were divided into five groups based on RLV-FLV ratio from </=30% to >/=60%. Kinetics of postoperative liver function tests were correlated with RLV. Postoperative complications were stratified by RLV-FLV ratios. Ninety patients (65%) underwent resection of up to four Couinaud segments. The RLV-FLV ratio was </=60% in 94 patients (68%) including only 13 (9%) with RLV-FLV </=30%. There was no linear correlation between the number of resected segments and the RLV-FLV. Postoperative serum bilirubin but not prothrombin time correlated with extent of resection. The incidence of complications including liver failure was not different among groups. Analysis of the four groups with a RLV-FLV ratio <60% showed a trend toward more complications and a longer intensive care unit stay in patients with the smallest RLVs. After major hepatectomy in patients with normal livers, the proportion of patients with a small remnant liver is low and not directly related to the number of segments resected. Although the rate of postoperative complications, including liver failure, did not directly correlate with the volume of remaining liver, the postoperative course was more difficult for patients with smaller remnants. Therefore preoperative portal vein embolization should be considered in patients who will undergo extended liver resection who have (1) injured liver or (2) normal liver when the planned procedure will be complex or when the anticipated RLV-FLV will be <30%.

Adolescent↗