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M Cakmakçi

Publications and source records attributed to M Cakmakçi.

11 recordsLinked to original sources
PubMed1998

Arterial thrombosis leading to intestinal infarction in a patient with Behçet's disease associated with protein C deficiency.

Behçet's disease may be a possible cause of both occlusive and aneurysmal arterial involvement as well as recurrent venous thrombosis. A case of Behçet's disease complicated with vascular involvement leading to intestinal infarction is presented. A 41-yr-old man suffering from Behçet's disease for 15 yr presented with a 2-day history of severe abdominal pain and bloody diarrhea. Intestinal infarction secondary to thrombosis of the superior mesenteric artery had been diagnosed during surgical exploration 3 yr previously. He was started on anticoagulation with nutritional support. The patient was readmitted with severe diarrhea and malabsorption symptoms 3 yr after intestinal resection. A thrombus located in the posterior wall of the infrarenal portion of aorta was detected by aortography and ultrasonography. Although thrombosis is a relatively common complication of Behçet's disease caused by vasculitis, protein C deficiency, which is a pertinent laboratory finding in this case, might be a secondary factor in the thrombotic event. This is the first case reported of mesenteric artery thrombosis leading to bowel infarction and abdominal aorta thrombosis associated with protein C deficiency.

Adult↗
PubMed1997

Evaluation of trauma care in a developing country highlighted by a major aircraft accident.

The aim of this study was to evaluate the day-to-day trauma care in a developing country highlighted by a major accident. In this accident, early management was not carried out according to triage principles. Scene mortality and in-hospital mortality were 72% (n = 55) and 14% (n = 3), respectively. Overall mortality rate was 76%. Five survivors were minor wounded. Three laparotomies, one thoracotomy and three tube thoracostomies were performed in the acute phase. Skeletal injuries, mainly rib fractures (43.3%) and haemothorax (10.8%), were the most frequent pathologies seen. One liver laceration, one splenic rupture, one intraabdominal bleeding due to rupture of mesenteric vessels, two major cranial traumas and an abruptio placenta were the other pathologies. The missed injury rate in this accident was 16% (n = 6). It is concluded that the missed injuries in this incident reflect the inadequacy of trauma care in the rural area of the developing country.

Accidents, Aviation↗
PubMed1997

Effect of omentectomy on peritoneal defence mechanisms in rats.

OBJECTIVE: To assess the effect of omentectomy on peritoneal defence mechanisms in rats. DESIGN: Randomised study. MATERIAL: Sixty Wistar Albino rats. INTERVENTIONS: Rats were divided in three groups of 20. All rats underwent midline laparotomy and 10 rats in each group had omentectomy. Samples were taken two hours (early period) and 30 days (late period) after omentectomy. MAIN OUTCOME MEASURES: Effect of omentectomy on bactericidal activity of peritoneal fluid (PBA), chemotactic indices (CI) of polymorphonuclear leucocytes (PMNL), phagocytic activity of PMNL in the peritoneal fluid (PHA), total cell counts, and cell types of peritoneal washing fluid. RESULTS: In the early period omentectomy reduced total cell counts from 3440 (1400-4800) x 10(6)/10 ml to 1480 (800-2080) x 10(6)/10 ml (p = 0.0022), and the CI of PMNL from 2.86 (2.32-4.02) to 1.43 (1.29-1.77) (p = 0.0002), and increased the PHA from 11.9 (8.3-17) to 17 (16-19) (p = 0.0006). The PBA was not significantly altered. The proportion of macrophages decreased (p = 0.0001), while the proportion of lymphocytes increased in the peritoneal fluid (p = 0.0002). In the late period total cell counts in the control and omentectomy groups were 3440 (1400-4800) x 10(6) and 3160 (1040-5120) x 10(6)/10 ml fluid, respectively (p = 0.52). Omentectomy reduced the CI of PMNL from 2.86 (2.32-4.02) to 2.01 (1.82-1.49) (p = 0.0003). The difference between the proportion of PHA of either group was not significant (p = 0.06). PBA in the control and omentectomy groups was 99.03 (70-100) and 99.48 (71.5-100), respectively (p = 0.97). Although the total cell count in the peritoneal fluid did not differ, the proportion of macrophages decreased (p = 0.0003) while the proportion of lymphocytes increased (p = 0.0002). The proportion of PMNL did not change in either of the experimental settings. CONCLUSIONS: The omentum has an important role in local peritoneal defence mechanisms in experimental conditions. Its removal may effect some of these mechanisms adversely.

Animals↗
PubMed1997

Factors that may increase morbidity in a model of intra-abdominal contamination caused by gallstones lost in the peritoneal cavity.

OBJECTIVE: To assess the effect of intraperitoneal gallstones with and without Escherichia coli and sterile bile on the incidence of intraperitoneal complications in mice. DESIGN: Prospective randomised study. SETTING: Teaching hospital, Turkey. MATERIAL: 180 Swiss albino mice in five groups, n = 20 in the control group, and n = 40 in each of the experimental groups. INTERVENTIONS: Group A laparotomy alone (controls); group B, laparotomy amd intraperitoneal instillation of E. coli 4 x 10(6) 0.1 ml; group C, laparotomy and insertion of sterilised gallstones; group D, laparotomy, insertion of gallstones and instillation of E. coli 4 x 10(6) 0.1 ml; and group E, laparotomy, insertion of gallstones, and instillation of E. coli 4 x 10(6) 0.1 ml and sterile bile 0.1 ml. A quarter of each group was killed after 1, 2, 4, and 8 weeks. MAIN OUTCOME MEASURES: Intra-peritoneal abscesses, adhesions, perforations, fistula, or obstruction. RESULTS: No mice died. Adhesions were found in 3(15%), 7(18%), 30(75%), 25(63%), and 24(60%) in the five groups, respectively. No mice in groups A, B, or C developed an abscess, but 8 did in each of groups D and E (20%). One mouse in group D developed obstruction. Logistic regression showed that abscess formation was significantly increased by the addition of gallstones and E. coli to the peritoneal cavity (p < 0.001) but the addition of bile had no effect. Gallstones increased the rate of adhesions more than nine fold (p < 0.001) but E. coli with or without bile had no effect (p = 0.75). CONCLUSIONS: Free gallstones within the peritoneal cavity with or without E. coli or sterile bile, or both, increased the rate of formation of both abscesses and adhesions in mice. These results suggest that efforts should be made retrieve gallstones that are dropped into the peritoneal cavity during laparoscopic cholecystectomy, particularly in patients with acute cholecystitis.

Abdominal Abscess↗
PubMed1993

Neutropenic enterocolitis in patients without leukemia.

BACKGROUND: Neutropenic enterocolitis is a serious complication involving the bowel in patients with severe neutropenia. Most of the patients are undergoing chemotherapy for acute leukemia. METHODS: This is a report of three cases of nonleukemic neutropenic enterocolitis. In these cases neutropenia was caused by an analgesic (dipyrone), chemotherapy for multiple myeloma, and chemotherapy for lung carcinoma. Two patients were treated by surgery, one medically. RESULTS: The patient with multiple myeloma who was treated by exteriorization of the sigmoid colon died on the tenth postoperative day of multiple organ failure caused by sepsis. The other two patients survived. CONCLUSIONS: A review of the literature revealed 14 other patients without leukemia who had neutropenic enterocolitis. The cause, diagnosis, and possible treatment options of this entity are discussed.

Adolescent↗
PubMed1992

[Honey-induced poisoning].

Because of the increasing preference for natural products intoxications induced by consumption of honey will reappear, especially with products bought directly from the beekeeper. In the hospital of Trapezunt about 8 cases of intoxications induced by honey were reported per year. The courses observed appear to be identical to those already described by Xenophon 2400 years ago. Symptoms begin acutely but last rarely for more than 24 hours. Fatal cases are extremely rare. Most prominent symptoms are loss of consciousness, weakness, severe salivation, sweating, vomiting and diarrhea. Beside these symptoms circumoral paresthesias and bradyarrhythmia may occur. Intoxication is induced by certain diterpenes, so called gray-anotoxins, that appear in flowers of different species of rhododendron. Next to close surveillance only symptomatic therapy is generally necessary.

Diterpenes↗
PubMed1992

Risk factors in perforated peptic ulcer disease: comparison of a new score system with the Mannheim Peritonitis Index.

OBJECTIVE: To construct a score that would accurately predict outcome for patients with perforated peptic ulcers. DESIGN: Retrospective study. SETTING: University Hospital. SUBJECTS: 173 patients who were operated on for perforated peptic duodenal ulcers over a 14 year period. MAIN OUTCOME MEASURES: Results of multivariate discriminant function analysis of derived set of clinical variables known to be associated with high mortality, and comparison with the Mannheim Peritonitis Index. RESULTS: Serious coexisting medical illness, acute renal failure, white cell count of more than 20 x 10(9)/l, and male sex were the most significant factors influencing mortality. The Hacettepe score for perforated peptic ulcer was established using these four variables. The sensitivity was 83%, the specificity 94%, and the overall predictive accuracy 93%. The corresponding figures for the Mannheim Peritonitis Index were 75%, 96%, and 94% respectively. CONCLUSION: The Hacettepe score is useful in predicting whether a patient will survive after perforation of a peptic duodenal ulcer.

Chi-Square Distribution↗
PubMed1992

Prophylactic effect of albendazole in experimental peritoneal hydatidosis.

To determine the effectiveness of prophylactic short-term administration of albendazole in experimental peritoneal hydatidosis this substance was given at a dose of 15 mg/kg for 96 hours prior to scolex implantation. In contrast to the 81.8% of the controls, only 11.1% of the experimental animals developed intraperitoneal hydatidosis over a period of 18 weeks (p < 0.001). The newly defined cyst index was also decreased from 2.09 to 0.22 by the administration of albendazole (p < 0.005). It is concluded that albendazole, when given for 96 hours prior to any suspected intraperitoneal spillage of viable hydatid cyst contents could significantly reduce secondary peritoneal hydatidosis.

Albendazole↗
PubMed1986

The effect of prophylactic mebendazole in experimental peritoneal hydatidosis.

The primary treatment of hydatid disease is surgical. The most important complication of the surgical treatment is secondary hydatidosis due to spillage of the cyst contents. Medical treatment, with mebendazole, has been used extensively. This study was undertaken to evaluate the prophylactic effect of mebendazole in experimental peritoneal hydatidosis. Mebendazole was given for 96 hours in a dose of 40 to 65 milligrams per kilogram per day before the inoculation of scolices intraperitoneally. This prophylactic therapy decreased the intraperitoneal formation of cysts significantly from 80 to 11 per cent (p less than 0.005). The preoperative administration is recommended to prevent secondary hydatidosis due to spillage of scolices during the operative intervention.

Animals↗