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T Colak

Publications and source records attributed to T Colak.

At least 55 records · Page 3Linked to original sources
PubMed2001

The value of 99mTc-HMPAO labelled white blood cell scintigraphy in acute appendicitis patients with an equivocal clinical presentation.

Various imaging studies can be performed in the evaluation of patients with a clinical presentation equivocal for acute appendicitis. One of these studies is technetium-99m hexamethylpropylene amine oxime (HMPAO) labelled white blood cell (WBC) scintigraphy. The aim of this study was to evaluate the accuracy and clinical value of 99mTc-HMPAO WBC scintigraphy in the aforementioned group of patients. Forty-one patients who had acute right lower quadrant abdominal pain with a clinical presentation equivocal for acute appendicitis were included in the study. The anterior abdomen and pelvis were imaged up to 4 h after the injection of 125-300 MBq 99mTc-HMPAO WBCs and the results were immediately reported to the surgeon before a decision was taken on whether to perform laparotomy. Diagnostic accuracy was established by the intra-operative findings and the histopathology in operated patients. In non-operated patients, absence of abdominal symptoms 1 month after scintigraphy and/or identification of another cause of abdominal pain was used to rule out acute appendicitis. There were 16 patients with positive scintigraphy and 81% of these patients were positive within 2 h post injection. There were no false-positive or false-negative results. We operated on 17 (41.4%) patients, and only one patient (5.9%) underwent unnecessary laparotomy. We conclude that 99mTc-HMPAO WBC scintigraphy is a rapid, highly accurate method for the exclusion of acute appendicitis and that its use can lower the unnecessarily high laparotomy rate in patients with an equivocal clinical presentation.

Acute Disease↗
PubMed2001

Pancreatic injury: an unusual complication of laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is a popular method for managing symptomatic gallstone disease. Decreased morbidity and mortality rates make this procedure an attractive alternative to conventional cholecystectomy. However, unusual complications still occur. We report a case of pancreatic injury that occurred during laparoscopic cholecystectomy. The case was complicated with posttraumatic pancreatic inflammation and bowel necrosis.

Adult↗
PubMed2001

The effects of cefephim, G-CSF, and sucralfate on bacterial translocation in experimentally induced acute pancreatitis.

The preventive effects of granulocyte colony-stimulating factor, cefephim, and sucralfate on bacterial translocation in experimentally induced acute pancreatitis were investigated. Forty male Wistar albino rats were used in this study. For each rat, the pancreatobiliary ductus was ligated and hence acute pancreatitis was induced. In the control group, no further procedure was performed. Meanwhile, cefephim as an antibiotic, filgrastim, which is a colony-stimulating factor, and sucralfate were given to the other groups at the specified doses. To inhibit bacterial translocation by preserving the bowel barrier, sucralfate, which is known to have a cytoprotective effect on the gastrointestinal system, was used in high doses. Cefephim 30 mg/kg per day (intramuscularly) in group II, filgrastim 10 mg/kg per day (subcutaneously) in group III, and sucralfate 50 mg/kg per day by 8-F feeding tube gavage into the stomach in group IV were given. The number of bacteria translocated into the mesenteric lymph nodes, pancreas, liver, and spleen in the control group significantly increased in comparison with the other groups (P < 0.05). The average number of leukocytes (per mm3) in the control group was significantly higher than that of other groups (P < 0.0001). Regarding the average serum amylase levels, the values of all groups clearly decreased in comparison with the control group (P < 0.0001). Although in the cefephim, filgrastim, and sucralfate groups, (+) pancreatitis was generally seen, in the control group (+++) pancreatitis was detected. Bacterial translocation to the mesenteric lymph nodes and pancreas was partially prevented by filgrastim and sucralfate, and was completely prevented by cefephim. We conclude that in the management of acute pancreatitis, the use of the prophylactic antibiotics, sucralfate and filgrastim, may be advantageous.

Acute Disease↗
PubMed2001

Diagnostic value of 99mTc MIBI scintimammography in patients with breast lesions.

This study has aimed to determine the diagnostic value of the scintimammography with 99mTc-MIBI in the detection of primary breast cancer and to verify its clinical usefulness. Sixty-three female patients (age range 27-83) with breast lesions detected by physical examination, ultrasonography, and/or mammography were prospectively included in this study. An anterior and prone lateral planar 99mTc-MIBI scintimammography was performed on all patients. The final diagnosis was achieved by histopathological examination in 49 patients and clinical followup (at least one year) in 14 patients. Histopathological diagnosis confirmed that 15 lesions were malignant and 34 lesions were benign. All the malignant lesions were larger than 1 cm. The 99mTc-MIBI scintimammography showed increased focal uptake in 17 lesions (two of them were benign and the other 15 were malignant). The diffuse heterogeneous uptake pattern was considered as benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values for breast carcinoma were calculated as 100%, 96%, 88%, 100%, 97%, respectively. We concluded that 99mTc-MIBI scintimammography could be a valuable method in the differentiation of malignant breast neoplasm larger than 1 cm size from benign ones, especially when the uptake pattern was considered.

Adult↗
PubMed2001

Gamma probe-guided resection and scanning with TC-99m MIBI of a local recurrence of follicular thyroid carcinoma.

A 30-year-old woman underwent two operations for multinodular goiter and follicular thyroid carcinoma. The residual thyroid tissue was ablated by I-131 therapy. After 7 years of follow-up, Tc-99m MIBI and I-131 scintigraphy were performed, because her serum thyroglobulin level was much higher compared with the control analysis performed in the sixth year. Tc-99m MIBI showed pathologic accumulation, which could be consistent with a local recurrence, whereas the results of I-131 scintigraphy were negative. The locally recurring follicular thyroid carcinoma was resected using a gamma probe and Tc-99m MIBI. The thyroglobulin level decreased to a normal level after surgery. This case shows that the intraoperative use of a gamma probe with Tc-99m MIBI allows localization of recurrent thyroid tissue in the scarred area in patients with increased radionuclide accumulation, and scanning of the affected area using the gamma probe may be helpful in determining whether resection is complete.

Adenocarcinoma, Follicular↗
PubMed2001

[The factors affecting morbidity and mortality in surgical treatment of severe necrotizing pancreatitis].

Necrotizing pancreatitis is the most severe form of acute pancreatitis with high morbidity and mortality rates. In this retrospective study we report our experience with 22 patients (17 men, 5 women with a mean age of 52.714) who were operated on at Akdeniz University School of Medicine Department of General Surgery, from February 1993 to July 2000 and define the factors affecting the morbidity and mortality in surgical treatment of NP. Diagnosis of NP and decision of laparotomy was performed by clinical findings and contrast-enhanced abdominal computed tomography (CT). The patients with pancreatic and peripancreatic necrosis confirmed intraoperatively included to the study. All patients had required intensive care therapy. The relationship between mortality/morbidity and with demographic and clinical data of patients, APACHE II score, presence of multiple organ dysfunction (MOD), and local-regional complications (LRC) was examined. The Fischer Chi-Square test was used to evaluate statistical significance and p < 0.05 was accepted as meaningful. The mean number of reoperations were 4.44.9 (1 to 23). Local-regional complications were observed in 17 (77%) patients and mostly consisted of intra-abdominal abscess (15 patients). The overall hospital mortality rate was 36% (8 of 22 patients died). In the 7 patients with low APACHE-II score on admission (< or = 10) no mortality was encountered. Eight of 15 patients with high APACHE-II score (> 10) on admission were died. Multiple-organ dysfunction developed in 7 (32%) patients and 6 (86%) of them died. Two of the 15 patients (13%) died without MOD. In conclusion, poor outcome was associated with high APACHE-II score (> 10) on admission (p = 0.02), and progression of MOD (p = 0.002) during the treatment. Local-regional complications increase the hospital stay and frequency of surgical interventions but these complications do not effect the mortality in negative manner in the surgical treatment of NP.

APACHE↗
PubMed2001

[Is seat belt sign a predictor for physicians in management of trauma patients in emergency settings?].

Seat belt sign (SBS) is frequently seen as a clinical finding in motor vehicle accidents. The purpose of this study is to determine the diagnostic value of SBS. All adult patients presenting with an history of motor vehicle accident to a tertiary care university hospital emergency department was included in this prospective, observational study covered the time period between July 01, 1999 and February 01, 2000. 213 patients were included in this study; 135 (63.4%) were male, and 76 patients (35.7%) were seat-belted. SBS was seen on 27 (35.5%) belted patients. Fourteen of seat-belted had rib fractures nine of those patients with rib fractures were found to have SBS. There was a statistically significant difference between the patient groups with or without SBS in rib fractures (p = 0.0128) While no significant differences were detected between groups regarding the frequency of intra-cranial, intra-thoracic, intra-abdominal and extremity injuries three of four patients who had sternum and clavicular fractures took place in SBS(+) group (p = 0.090). The presence of SBS in trauma patients may create a high index of suspicion for thoracic injuries, especially for rib fractures. It is widely accepted that any delay in the diagnosis may increase morbidity and mortality following thoracic injuries. Further studies are needed to investigate the possible role of SBS in the prediction of the severity of injuries following thoracic trauma.

Accidents, Traffic↗
PubMed2000

Unusual origin of the right renal artery: a case report.

An anomalous origin of the right renal artery was observed in a 50-year-old male cadaver. The importance of this variation of the right renal artery and superior mesenteric artery arising from a common trunk is emphasised.

Aorta, Abdominal↗
PubMed1999

Multiple variations of the azygos venous system.

In a dissection performed in our department, we observed multiple variations of the azygos venous system. The hemiazygos vein was absent. The posterior 8th, 9th, and 10th intercostal veins united and their common trunk crossed the vertebral column obliquely lying anterior to the aorta and posterior to the esophagus and opening into the azygos vein at the level of T7-T8 vertebrae. The 7th left posterior intercostal vein also crossed the column anteriorly and joined the common trunk. The present report identifies the variable positions and courses of the veins related to the azygos system. It is important to keep in mind that different courses of the azygos system do exist, so that extra caution is required during surgery of the mediastinum and also in appropriately interpreting the radiographs.

Aged↗
PubMed1999

Influence of age on prognosis and management of patients with colorectal carcinoma.

OBJECTIVE: To see if the prognosis and management differed in patients with carcinoma of colon and rectum above and below 65 years of age. DESIGN: Retrospective study. SETTING: University hospital, Turkey. SUBJECTS: 822 consecutive patients with colorectal carcinoma operated on between 1984 and 1994, 565 of whom were less than 65, and 257 of whom were 65 or more. MAIN OUTCOME MEASURES: Factors that affected prognosis and management. RESULTS: There were no significant differences between the two groups in mode of presentation, site and type of tumour, histological grade, incidence of curative and palliative operations, and postoperative morbidity and mortality. Obstruction and perforation were more common in the elderly group (p<0.0001). The postoperative (30 day) mortality was 3% in the younger group (20/565) and 7% in the older group (17/257). It was higher in those who were operated on as emergencies but was not significantly related to age. The actuarial five- year survival rates for older and younger patients were 33% and 45%, respectively (p<0.05). CONCLUSION: Age alone has no characteristic effect on the treatment of colorectal carcinoma.

Adenocarcinoma↗