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Biomedical subjects

O Bulut

Publications and source records attributed to O Bulut.

12 recordsLinked to original sources
PubMed2006

Transanal stent in anterior resection does not prevent anastomotic leakage.

OBJECTIVE: A defunctioning transanal stent may theoretically reduce the leakage rate after anterior rectal resection. We present a randomized open study with the aim of comparing the leakage rate after anterior resection with a loop ileostomy, a transanal stent, both or neither. PATIENTS AND METHODS: Randomized open trial of 194 patients operated in 11 hospitals during September 2000 to September 2003 with anterior resection for a mobile rectal tumour, 115 men and 79 women, median age 68 years (range 37-90 years). The surgeon decided upon the use of a protective ileostomy, and after completion of the operation the patients were randomized in two groups with and without a transanal stent. RESULTS: A clinically significant leakage was diagnosed in 25 patients (13%). No significant difference was found 17 of 98 patients with a stent and 8 of 96 without (P = 0.09), or in 9 of 44 ileostomy patients with a stent and in 3 of 45 without (P = 0.07). Several leaks over a short time led to an interim analysis after inclusion of 194 of 448 planned patients. The analysis showed no significant protective effect of the stent, and more leakages in the stent group, although not statistically significant. On this basis it was decided to discontinue the study prematurely for ethical reasons. CONCLUSION: Decompression of the anastomosis with a transanal stent does not reduce the risk of anastomotic leakage after anterior resection.

Aged↗
PubMed2006

Extracorporeal shock wave treatment for defective nonunion of the radius: a rabbit model.

PURPOSE: To investigate the effect of extracorporeal shock wave treatment (ESWT) on bony union using volume analysis of the callus mass by computed tomography and histology. METHODS: Both radii of 13 rabbits were osteotomised and a defective bony nonunion created by placing a polyethylene pad between the osteotomy site for 40 days. Nonunion was confirmed by radiography using Lane-Sandhu criteria. ESWT (14 kW, 0.46 mJ/mm(2), 1000 shock waves) was applied to the right radius of the rabbits. The left radius served as a control. Five rabbits were killed 4 weeks after ESWT (group 1) and 8 after 6 weeks (group 2). Volume analysis of the callus mass was performed using computed tomography and the bone healing process was assessed by histology. RESULTS: In group 1, callus volume on the treated side was invariably greater than that on the control side; the difference being statistically significant (p=0.032). In group 2, the callus volume of the treated side was greater than that of the control side, except in rabbits 4 and 9. Only after excluding the findings from the latter did the difference attain statistical significance (p=0.020). Histology confirmed that the bone-healing process was faster in the treated side. CONCLUSION: ESWT enhanced the bone-healing process by increasing both volume and speed of callus formation.

Animals↗
PubMed2006

One-stage combined surgery with or without preoperative traction for developmental dislocation of the hip in older children.

PURPOSE: To compare one-stage combined surgery with and without preoperative traction, in older children with developmental dislocation of the hip (DDH). METHODS: Records of 9 children who underwent combined surgery for DDH with preoperative traction in 12 hips (group 1) and 12 undergoing the same procedure without preoperative traction in 16 hips (group 2) were retrospectively reviewed. The surgery consisted of open reduction, Salter's innominate osteotomy and femoral shortening with derotation varus osteotomy. The mean age of the patients at the time of operation was 5.8 years. The mean follow-up period was 5.9 years. RESULTS: At final follow-up, clinical outcome in group 1 was worse than that in group 2, though radiographic assessment demonstrated no significant difference between the groups. CONCLUSION: One-stage combined surgery without preoperative traction is effective in the treatment of DDH in older children, and has a lower complication rate, but radiographically the groups did not differ.

Bone Diseases, Developmental↗
PubMed1995

[Hydatidosis. A survey].

With the increased influx of foreign workers, refugees and immigrants, particularly from endemic areas, we will probably see more patients with hydatid disease, chiefly hydatid disease of the liver caused by E. granulosus. Thus it is important to bring the disease to the attention of the general surgeon. The diagnosis of hydatid disease is primarily made by ultrasound and serological examination. Other tests such as CT, angiography and ERCP are as a rule only important in surgical planning and in complicated cases. Treatment is principally surgical. The choice of surgical procedure should be individualized as much as possible due to the many aspects of the disease. Drainage of residual cavities should be avoided. Preoperative evaluation by ERCP is indicated in cases complicated by biliary communication. Percutaneous drainage can be indicated in cases of recurrence and in cysts of poor accessability. Medical treatment has its place primarily pre- and postoperatively. The preferred drug is albendazole. Mebendazole is now considered obsolete. It is not possible to monitor the effect of treatment with current serological methods.

Data Collection↗
PubMed1991

Relationship between the left spermatic vein diameter measured by ultrasound and palpated varicocele and Doppler ultrasound findings.

Fifty cases admitted to the urological clinics of Turkish State Railways Hospital, Ankara, were examined by scrotal ultrasonography in order to find the relationship between the left spermatic vein diameter measured by ultrasound and palpated varicocele and Doppler ultrasound findings. In the measured 5-6 mm spermatic vein diameters palpable varicocele and venous regurgitation were found in 100%, in the measured 3-4 mm diameters palpable varicocele was found in 50% and venous regurgitation in 64.5%, and in the measured 1-2 mm diameters palpable varicocele was found in 16% and venous regurgitation in 24%.

Adult↗
PubMed1991

Treatment of steroid-resistant renal allograft rejection with OKT-3 and plasmapheresis.

The murine monoclonal antibody (OKT-3) and plasmapheresis therapy were applied in combination to treat acute renal allograft rejection in 31 patients who were not responsive to conventional bolus steroid treatment. Six of them were living related but ABO incompatible; another 25 patients were ABO compatible (1 was from a cadaver, 7 were from living unrelated donors, and 17 were from living related donors). Of these 31 patients, 25 (80.65%) showed perfect improvement in their graft function. These 25 patients had a mean follow-up time of 8 months, and had mean creatinine values of 1.2 mg% (0.8-2.8 mg%). It is concluded that OKT-3 and plasmapheresis combination therapy is very effective in reversing steroid-resistant rejections in high-risk patients such as ABO-incompatible cases.

Adolescent↗
PubMed1991

Kidney transplantation from elderly living donors.

Because of the inadequate numbers of organ donors, transplant surgeons are obliged to search for new horizons. Also, traditional beliefs are changing. The shortage of organs for transplantation, has led us to try certain arrangements so that suitable elderly organ donors may be included, as in many other transplant centers. We have now done 34 kidney transplantations from living related donors, who were 60 years of age and older. Donor-specific transfusions and low-dose triple drugs were used for all recipients. The overall patient survival was 97.5% and graft survival was 85.29%. In the light of these results we conclude that elderly living donor kidneys can be used satisfactorily with low-dose triple therapy.

Age Factors↗
PubMed1987

A simple technique for wedge biopsy of the liver.

A technique for wedge biopsy of the liver is presented. By applying pressure on the liver, biopsy is performed. Cauterization of the bleeding surfaces in small areas provides hemostasis without need for sutures and hemostatic agents.

Biopsy↗
PubMedDate not supplied

Bilateral breast carcinoma: 28 years' experience.

From 1959 to 1987, a total of 1,182 histologically proven breast cancer patients were followed. Of these, 48 (4.06%) with bilateral breast carcinoma were reviewed. Eight patients (0.68%) had simultaneous breast carcinomas and the remaining 40 (3.38%) had nonsimultaneous breast carcinomas. The period between the development of the first and second primary carcinoma ranged from 17 to 200 months (mean, 86 months). The second primary carcinoma was found symmetrically located with the first primary carcinoma in only 34.5% of the cases. No significant differences were observed between the bilateral carcinoma patients and the unilateral carcinoma patients with respect to pregnancy, delivery, family history, and the size and localization of the carcinomas. Axillary metastasis was seen in a higher percentage of the second primary carcinomas (48% versus 37.5%). It was observed that the shorter the time interval between the presentation of the carcinomas, the shorter the survival.

Adult↗