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Biomedical subjects

N Yücel

Publications and source records attributed to N Yücel.

16 recordsLinked to original sources
PubMed2006

[Postoperative pain relief is an important factor for the patients' selection of a clinic. Results of an anonymous survey].

AIM: The aim of the survey was to elucidate the significance of postoperative pain therapy for the patient and its influence on the choice of hospital. METHODS: This prospective, anonymous survey of consecutive patients in a general surgical clinic was performed by an independent study nurse. RESULTS: A total of 161 patients were included; 90% of the surgical patients considered "good pain therapy" as a highly important factor, and three of four patients would admit themselves more likely to a clinic well known for "good pain therapy." If the patients could choose their hospital, factors such as "medical care by the physicians" are most important (rank 1; rank 1 most important, rank 10 most unimportant) followed by quality of "nursing care" (mean rank 2.6) and "good pain therapy" (mean rank 3.6). Older patients (> or = 60 years) preferred a hospital with known "good pain therapy" more often for surgical therapy than younger patients (< 60 years). CONCLUSION: It can be concluded that postoperative pain relief is an important factor for the patients' selection of a clinic and is influenced by an age of > or = 60 years.

Health Surveys↗
PubMed2004

[Is implant removal after percutaneous iliosacral screw fixation of unstable posterior pelvic ring disruptions indicated?].

The aim of this study was to examine the indication for implant removal (IR) after percutaneous iliosacral screw fixation of unstable posterior pelvic ring disruptions by systematic literature analysis and clinical follow-up examination. Retrospective identification revealed 27 operatively stabilized patients [12 females, mean age: 35 years, ISS 22 points (range: 14-37)] between January 1996 and July 2001. Patient characteristics, AO classification, Hannover fracture scale pelvis, ISS, and DGU pelvis score points were analyzed. All cases showed a C-type lesion (C1:67%, C2:33%). A total of 21 patients were seen at follow-up, 12 with and 9 without IR. In ten cases with IR, clinical outcome improved after surgery according to the DGU pelvis score ( p=0.001, Wilcoxon's test). These mostly young patients also showed a better outcome compared with those cases without IR. Due to the good clinical results, implant removal seems to be beneficial for selected individual patients, especially when pain is present.

Adolescent↗
PubMed2004

[Special aspects of implant-associated infection in orthopedic surgery. From the pathophysiology to custom-tailored prevention strategies].

One of the most important risk factors in orthopedic surgery is implant-associated infection. Adhesion and colonization mediated implant infections are extremely resistant to antibiotics and host defences and frequently persist until the biomaterial or foreign body is removed, which is standard therapy. Tissue damage caused by surgery and foreign body implantation increases the susceptibility to infections, activates host defences and stimulates the generation of inflammatory mediators including radicals that are further aggravated by bacterial activity and toxins. Nearly one third of implant-related infections can be prevented by strictly following established infection control guidelines. However, a significant number of implant-associated infections remains. The escape of bacteria from host defence and antibiotic therapy makes the development of infection-resistant materials as anti-microbial drug delivery systems feasible. This concept consists of the sustained delivery of antimicrobial drugs into the local microenvironment of implants avoiding systemic side effects exceeding usual systemic concentrations by magnitudes of order.

Anti-Bacterial Agents↗
PubMed2004

Transuterine migration as a complication of intrauterine contraceptive devices: six case reports.

OBJECTIVES: We retrospectively analyzed six cases between 1986 and 2002 that had been operated within our unit with the diagnosis of migration of an intrauterine contraceptive device (IUD). Although an IUD is an effective contraceptive method, the migration of one is a rare but serious complication. The aim of this report is to emphasize the management and therapy of this complication. CASES: Out of six patients, three patients with occurring pregnancy, two with pelvic pain and one with a missing IUD incidentally diagnosed during a routine follow-up gynecological examination, were admitted to our clinic. The diagnosis of perforation and transuterine migration of the IUD was confirmed with a plain abdominal X-ray with a hysterometer placed in the uterus, hysterosalpingography and ultrasound. One patient was diagnosed as having a perforated rectosigmoid bowel intraoperatively and one presented with perforation of the bladder. In the remaining four cases, the IUD only migrated into the abdominal cavity without any organ perforations. One IUD was extracted laparoscopically, one was removed through the vagina by colpotomy and, in the other four cases, a laparotomy had to be performed. Patients were discharged without any complications. CONCLUSION: The most serious potential complication of IUD use is uterine perforation and this can cause severe morbidity. When an IUD is located in the abdominal cavity, it should be carefully managed and removed, even in an asymptomatic patient.

Adult↗
PubMed2003

Port function after laparoscopic adjustable gastric banding for morbid obesity.

BACKGROUND: Laparoscopic adjustable gastric banding (LGB) has gained wide popularity, but information on port function is limited. METHODS: In a prospective nonrandomized study, we analyzed port function and related symptoms in 50 consecutive patients with severe obesity. All patients underwent LGP in a five trocar technique. In 11 patients, the port was placed subcutaneously in the subxiphoid region. In 39 patients, the port was implanted in the left upper abdomen. Mean duration of follow-up was 2.8 years. RESULTS: Patients (12 males and 38 females) had an initial body mass index (BMI) of 47.1 kg/m2. Puncturing the subxiphoidal port was without problems in all 11 patients. However, seven women reported pain and inconvenience when wearing a brassiere. Two underwent port reimplantation in the left upper abdomen (one due to infection; one due to pain). Among the 39 patients with abdominal port implantation, nine patients required port correction (two of them twice). The causes were port dislocation (four cases), difficult puncturing (three), tube leakage (three), and infection (one). CONCLUSION: The high number of complications suggests that the port is the Achilles' heel of LGB. Ports at the subxiphoid site were easier to puncture, but frequently caused pain in female patients.

Adult↗
PubMed2003

[Psoas abscesses. Genesis, diagnosis, and therapy].

BACKGROUND: A psoas abscess is a rarely encountered entity with various etiologies and nonspecific clinical presentation, frequently resulting in delayed diagnosis, increased morbidity, and prolonged or recurrent hospitalization. PATIENTS AND METHODS: Between January 1996 and January 2002 we treated ten patients (approximately 54.8, 5 males,5 females). These cases were analyzed retrospectively relative to a review of the literature. RESULTS: CT scanning was decisive in the final diagnosis of psoas abscess. Primary psoas abscess occurred in four cases and six patients had secondary abscesses. In all except one case, the psoas abscess was located on the right side. The causes of primary abscesses were retroperitoneal perforated appendicitis, paravertebral injections for lumboischialgia, Pott's disease, and repeated intravenous drug application in the groin. Five patients underwent retroperitoneal open drainage and four patients CT-guided drainage. One patient with retroperitoneal perforated appendicitis was treated by laparotomy. Staphylococcus aureus, Bacteroides fragilis, and Escherichia coli were the most common infective agents. There was no postoperative mortality and no cases of abscess recurred. CONCLUSIONS: CT scan is a diagnostic "gold standard" for psoas abscess. CT-guided drainage is the method of first choice, but is not possible in all cases. Open retroperitoneal drainage is a standard method of treatment. Postoperative antibiotic therapy is obligatory and should be adapted individually.

Adult↗
PubMed2003

Pharmacokinetics of the antimicrobial agents rifampicin and miconazole released from a loaded central venous catheter.

The time course of rifampicin and miconazole concentrations after insertion of a polyurethane catheter loaded with these antibiotics were studied. Data from controlled release experiments in vitro were used, and the concentration time courses of the antimicrobials in serum were calculated by pharmacokinetic simulations. Systemic therapy using typical dosages (rifampicin 600 mg/day iv, miconazole 3 x 200 mg/day iv) results in rifampicin concentrations between 54 and 8424 microg/L, and miconazole concentrations between 3567 and 4676 microg/L. After insertion of a polyurethane catheter loaded with these antibiotics, the maximal concentrations after catheter placement were determined as 6 microg/L at 10.7h for rifampicin, and 13 microg/L at 28.6 h for miconazole. Assuming that the total amount of antibiotics incorporated in the catheter matrix were bioavailable ('worst case'), the resulting maximal concentrations calculated by simulation are 10 microg/L for rifampicin and 65 microg/L for miconazole. Maximal concentrations of rifampicin or miconazole resulting from the insertion of a polyurethane catheter loaded with these antibiotics are, therefore, far below the concentrations resulting from a systemic therapy with the same antimicrobial agents. Even in the worst case, the danger of selecting resistant bacterial strains seems remote because the systemic drug levels are magnitudes of order below subinhibitory concentrations.

Biological Availability↗
PubMed2003

Laparoscopic gastric bypass for morbid obesity with linear gastroenterostomy.

BACKGROUND: Laparoscopic gastric bypass (LGBP) is a well-established procedure for the surgical management of morbid obesity. Most surgeons create the gastroenteral anastomosis by using the circular EEA stapler. We describe an alternative laparoscopic anastomotic technique using the EndoGIA linear stapling device. METHODS: The stomach was proximally transected with a linear stapler (45 mm, Endo-GIA) to create a 15 to 20 ml pouch. Next, an antecolic Roux-en-Y gastroenterostomy was performed, using the 45 mm Endo-GIA. The proximal loop of the intestine was then separated from the anastomotic site by the Endo-GIA. Finally, the Endo-GIA was used for the intraabdominal creation of a side-to-side enteroenterostomy. RESULTS: Between June and August 2001, 5 patients with mean BMI 56.7 kg/m(2)+/-7.3 underwent LGBP. All patients were seen 6 months post-surgery. Operating time was 7.5 and 6.5 hours for the first 2 operations, but was under 4.5 h for the next 3 cases. 1 patient suffered from perioperative hypoxia leading to long-term artificial respiration. 6 weeks after surgery, 1 patient developed obstruction due to torsion of the enteroenterostomy and required open revision. The 3 remaining patients made an uneventful recovery. All patients lost considerable weight (mean 36.5 kg; [range 32 to 45] after 6 months). No stenosis or anastomotic leakage was noted. CONCLUSIONS: A linear stapled anastomosis is an alternative to the use of the circular stapler.

Adult↗
PubMed2002

[Benign peptic stricture of the middle third of the esophagus].

By means of a case report classification, etiology and pathogenesis of benign esophageal strictures are discussed. In the presented case an endobrachyesophagus with peptic stricture of the middle third of the esophagus was found. The most common conservative treatment consists of esophageal bouginage combined with long-term medication of proton pump inhibitors as was also done in this case. Depending on the physical status of the patient surgical treatment is given if repeated bouginage of the stricture during at least 3 months becomes necessary. Resection of the stricture or antireflux surgery in combination with bouginage of the stricture are current surgical options.

Barrett Esophagus↗
PubMed2002

[The role of preoperative oesophageal manometry in patients with gastro-oesophageal reflux disease].

BACKGROUND: Oesophageal manometry has become a standard investigation in the management of functional disorders of the oesophagus. However, the importance of the various manometry parameters for the surgical management of patients with gastro-oesophageal reflux disease (GERD) has not yet been studied adequately. AIM: This study examined the importance of manometric findings on surgical treatment results in patients with GERD. PATIENTS AND METHODS: Between January 1995 and January 2000, 123 consecutively referred patients with GERD symptoms were studied. Ninety-seven of these (52 women and 45 men, mean age 48 years) underwent Nissen fundoplication in conventional or laparoscopic technique. Preoperatively, each patient received stationary oesophageal manometry with a water perfusion catheter, gastroduodenoscopy and 24h-pH-metry of the oesophagus. Independent of manometric results, patients received 360 degrees fundoplicatio with 2 cm cuff ("floppy Nissen"). RESULTS: Eighty-five of the 97 patients (88 %) had an incompetent lower oesophageal sphincter. Hypomotility was diagnosed in 17 (18 %). Amotile achalasia and diffuse oesophageal spasms were seen in two and one patient, respectively, who were not operated on. Follow-up data were available for 92 % of patients (mean follow-up time 1.8 years). Five and 8 patients (1 and 2 of these with hypomotility) postoperatively developed persistent dysphagia and GERD recurrence, respectively (relative risks 1.2 and 1.6). Two patients (one with hypomotility) required surgical revision. CONCLUSIONS: Preoperative oesophageal manometry in GERD patients is useful only for determining the position of the upper boundary of the lower oesophageal sphincter and for ruling out specific motility disorders. In patients with oesophageal hypomotility, "floppy Nissen" fundoplicatio can be performed without an excess risk of dysphagia.

Deglutition Disorders↗
PubMed1999

The isolation of certain pathogen microorganisms from raw milk.

In this research, a total of 211 raw milk samples in different areas of Ankara were collected from various dairy plants. Each of these samples was tested for the presence of Yersinia enterocolitica, Listeria monocytogenes and Campylobacter spp. From a total of 14 (6.63%) Y. enterocolitica and Y. enterocolitica-like organisms were isolated. 8 (3.79%) of the total isolation were identified as Y. enterocolitica whereas 6 (2.84%) of these were found to be Y. enterocolitica-like organisms. In addition L. monocytogenes and Campylobacter were detected in 2 (0.94%) and 17 (8.05%) same raw milk samples. Distribution of these patogenic microorganisms was evaluated according to the season. 6 of a total 14 Yersinia spp. were isolated in winter, eight in spring and summer. One of the L. monocytogenes was isolated in winter whereas the other one was isolated in spring 7 of a total of 17 Campylobacter were isolated in the summer months.

Animals↗
PubMed1997

The relationship between umbilical artery Doppler findings, fetal biophysical score and placental inflammation in cases of premature rupture of membranes.

BACKGROUND: To assess the relationship between placental inflammation, umbilical artery Doppler waveforms and fetal biophysical profile score, umbilical artery Doppler studies and fetal biophysical evaluations were performed in 24 preterm pregnants with premature rupture of membranes (PPROM). SUBJECTS: After delivery, the placentas were microscopically examined and two subgroups were formed including noninflamed or inflamed placentas. RESULTS: In the first group, which includes 14 cases with no histological signs of placental inflammation, we found increased systolic/diastolic ratio only in one patient, whereas in the second group including ten cases with microscopically proven inflammation, nine were found to have increased systolic/diastolic ratios (p < 0.05). Mean systolic/diastolic ratio in the first and the second groups were 2.74 +/- 0.18 and 4.64 +/- 0.93 respectively (p < 0.001). Mean biophysical profile score was 9 +/- 1.04 in the first group and 7 +/- 1.05 in the second group (p < 0.001). CONCLUSION: Abnormal biophysical profile scores along with increased arterial systolic/diastolic ratios have been shown to be the markers of impending clinical infection.

Adolescent↗
PubMed1990

[Use of various cell culture antigens in the indirect fluorescent antibody test for the detection of antinuclear antibodies].

Cell culture antigens were prepared from Vero, BHK-21 and Hep-2 cells which were propagated on slide, for detection antinuclear antibody (ANA) in sera with indirect fluorescent antibody test (IFAT). ANA were investigated in 55 sera which were positive at 1/20 titer with KB IFAT ANA test kits (Virgo), by using these cell culture antigens. 50 sera (91%) with Vero antigens, 46 sera (83%) with BHK-21 antigens and 44 sera (80%) with Hep-2 antigens were found positive at 1/20 titer. As conclusion Vero cell culture which is propagated on slide can be used as antigen for detection of ANA with IFAT.

Animals↗
PubMed1988

[Rubella virus IgG and IgM antibody levels in 17-20 year old female students using ELISA and fluorescent antibody tests].

In this study Rubella virus antibody levels were investigated by using ELISA and IFAT in 94 sera obtained from girl students in Gülhane Military Medical Academy nursing college. We have propagated Rubella virus in BHK-21 cell line for production Rubella virus antigen in order to use IFAT. 81 sera IgG (86.2%) and 29 sera IgM (30.9%) were found positive in ELISA. However 76 sera (80.9%) IgG and 27 sera (28.7%) were positive in IFAT. On the other hand we have obtained suspected results in 8 sera (8.5%) with 1/10 dilution in IgG ELISA and in 3 sera (3.2%) with the same dilution in IgM ELISA. One of 29 sera which are ELISA IgM positive have established 80 IU/ml RF. We can say that ELISA is more reliable sensitive and practical than IFAT. It may be considered 29 student who have Rubella IgM antibody may be infected or reinfected by Rubella virus with in the last six months. On the other hand they may also infected with Parvovirus or some other viruses. We believe that the causes of false positive Rubella IgM antibody results should be investigated well enough.

Adolescent↗
PubMedDate not supplied

Endobronchial low-grade MALT lymphoma causing unilateral hypertranslucency.

Mucosa-associated lymphoid tissue-derived lymphoma (MALT lymphoma) arises not only from the stomach but also from various non-gastrointestinal sites. A thirty two year old woman, suffering from breathlessness for one year, had been treated for bronchial asthma. A chest radiograph showed a mediastinum and heart transposition to the right side and emphysema of the left lung. In the thorax spiral tomography, a mass narrowing left main bronchi, five centimeters in length from the carina, was seen. A fiberoptic bronchoscopy revealed millimetric polypoid lesions those nearly totally obstructed the left main bronchi. The bronchoscopic biopsy showed a diagnosis of MALT lymphoma. She was seen for check-ups following chemotherapy but no further treatment has been carried out.

Adult↗