Biomedical subjects
Publications and source records attributed to N Eren.
Two cases of late-diagnosed esophageal perforation were successfully treated with near-total esophageal exclusion, using cervical T-tube esophagostomy with circumferential suture fixation of the lower arm of the T-tube. Esophageal stricture developed at the site of catgut or dexon tie. This complication can be managed with esophageal dilation. Drainage-tube gastrostomy proved to be unnecessary.
Twenty-four patients with mild-to-moderate hypertension (19 women, 5 men; mean age of 49 +/- 9.1 years) completed a 2-week washout phase followed by 1 week of single-blind placebo. Patients were then given isradipine at 2.5 mg twice daily, which was increased to up to 7.5 mg twice daily according to the blood pressure response, over a 12-month period. Thirteen patients completed the trial. The supine and sitting blood pressure decreased to normal levels within 6 weeks of starting active treatment. Heart rate remained unchanged. Plasma cholesterol and triglycerides did not change significantly. Plasma high-density lipoprotein (HDL) cholesterol increased significantly (p less than 0.05) and a decrease (NS) was observed in low-density lipoprotein (LDL) cholesterol and in the LDL/HDL cholesterol ratio. Very-low-density lipoprotein (VLDL) cholesterol did not change, nor did other biochemical laboratory tests, or electrocardiographic and echocardiographic parameters. The most notable side effects were headache (n = 1), flushing (n = 1), palpitations (n = 3), and pretibial edema (n = 1). In conclusion, our results indicate that isradipine is safe and effective in the long-term treatment of mild-to-moderate hypertension. It also appears to have beneficial effects on lipid metabolism.
We report 94 arterial injuries in 91 children treated at the Department of Thoracic and Cardiovascular Surgery, Medical School of Dicle University, between 1978 and 1988. The average age was 10.3 (range, 3 to 14) years. Stab wounds were seen in 37 patients (40%). Gunshot wounds were seen in 21 patients (23%), and two cases were caused by iatrogenesis. Vein damage was present in 39 patients (44.4%), and nerve loss was observed in 20 patients (21.2%). Twenty-one cases (23.3%) were associated with fractures. Diagnosis of arterial injury was made by clinical findings. Arteriography was used in 15 patients (16.5%) as the diagnostic method. The surgical interventions performed for arterial repair in our series were end-to-end anastomosis in 61 (64.5%), interposition of autogenous reversed saphenous vein grafts in 22 (23.4%), lateral suture in 8 (8.3%), and ligation in 3 (3.9%) patients. Four patients (5.3%) underwent limb amputation.
Sixty-seven cases treated for peripheral vascular injuries associated with fractures between the years of 1977 and 1988 in the Department of Thoracic and Cardiovascular Surgery of the Dicle University, Faculty of Medicine, were reviewed retrospectively. The cause of injury was blunt trauma in 37 cases (55%) and penetrating wounds in the others, 29 gunshot injuries and one case with a stab wound. The maintenance of vessel continuity was aimed at in all patients. The ratio of limb amputation was 13% in patients operated upon within the first 8 hours after the injury. The same ratio was 39% in cases where the surgical intervention was delayed beyond 8 hours.
196 cases of peripheral arterial injury presented to our clinic between 1976 and 1986 are summarised. Most of the cases were between 11 and 30 years of age and most of the injuries were by fire-arms and sharp weapons. The most common localisations were a. femoralis (29% cases), a. poplitea and branches (28%), a. brachialis injury (20%). The most common surgical measures were end-to-end anastomosis (43% cases) and venous orthograft replacement (17%). There were 5 mortalities. Factors affecting treatment success are discussed.
Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simultaneous affection of the right lung and the liver. The diagnosis of concomitant liver cyst was made from radiographic dumbbell elevation of the diaphragm (3 cases), by preoperative ultrasound scan and computed tomography in (5 cases), and by intraoperative palpation through the diaphragm (1 case). The hepatic cysts were removed via the thoracotomy performed for removal of the lung cyst in seven patients and via thoracolaparotomy in two. The postoperative course was satisfactory and no recurrence of cyst has been observed, although mebendazole was not given. In cases of hydatidosis of the right lung, preoperative search should be made for subdiaphragmatic concomitant liver cyst which can be removed through the same thoracotomy.
A series of 460 surgically treated cases of hydatid cyst of the lung is presented. Radiologic preoperative diagnosis was made in 90% of the patients. Cystotomy with subsequent capitonnage was performed in 395 cases, wedge resection in 27, lobectomy in 15 and segmental resection in 23 cases. After careful hemostasis, two drains were placed in the thorax and the thoracic cavity was closed. There were three postoperative deaths (0.6%) and two recurrences of cyst (0.4%) during follow-up investigation for periods up to 10 years.
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Cardiac hydatic cyst is rarely encountered. In this article, a case of hydatid cyst localized in the left ventricle causing cerebral emboli is reported.
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