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Oral Saygun Serdar Topaloglu Fatih M Avsar Hakan Ozel Sema Hucumenoglu Mustafa Sahin Suleyman Hengirmen 《Canadian journal of surgery》2006,49(2):107-112
BACKGROUND: Most duodenal injuries are managed with primary repair, but the degree of duodenal-wall injury may threaten the integrity of the primary repair. Therefore, we evaluated whether the primary repair site could be reinforced with histoacryl glue (HAG) or HAG with an expanded polytetrafluoroethylene (ePTFE) mesh. METHODS: Grade 3 duodenal injury in the second portion of the rat duodenum was chosen as a standard trauma model. Thirty-three male rats were divided into sham (n = 3), 2-layer primary repair (n = 10), 1-layer primary repair plus HAG application (n = 10) and ePTFE attached with HAG over the 1-layer primary repair site (n = 10) groups. Ten-day survival, adhesion grades and histological assessment were taken as outcome measures. RESULTS: A significant survival advantage was identified in the group that had an ePTFE graft attached with HAG over a 1-layer repair when compared with the group that had a 2-layer primary repair. Adhesion grades were found to be particularly increased in the group that had an ePTFE graft attached with HAG over the primary repair site, moderately increased in the primary repair plus HAG application group and lower in the 2-layer primary repair group. ePTFE graft application was found to be beneficial to coverage of the HAG-dependent empty spaces in the serosal layer. CONCLUSIONS: A primary repair site after duodenal trauma or a difficult duodenal stump can be reinforced with the application of HAG or ePTFE graft implantation with HAG. 相似文献
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T. Ozturk Kaygusuz I. Kaygusuz S. S. Kilic S. Yalcin S. Felek 《Clinical microbiology and infection》2005,11(7):559-563
This study aimed to determine the effect of acute brucellosis on the auditory system. Forty-two patients with acute brucellosis were evaluated clinically, and with serological and audiological tests, before and after treatment. Hearing threshold averages were calculated at 11 different frequencies (250-8000 Hz) of the auditory airway, and statistical analysis was performed. The average hearing thresholds were > 20 dB, with standard audiometry at 6000-8000 Hz, and < 20 dB at all other frequencies. After treatment, the average auditory threshold decreased to < 20 dB at 6000-8000 Hz (p < 0.0001). Pure-tone hearing thresholds were improved at all frequencies after treatment, with statistically significant differences at all frequencies except 12,000, 14,000 and 16 000 Hz (p < 0.05). There was no permanent hearing loss caused by acute brucellosis, and hearing thresholds were restored after treatment. It was concluded that acute brucellosis affects the auditory system, especially at high frequencies, and that patients with all forms of brucellosis should be evaluated for hearing loss. 相似文献
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Vedat Davutoglu Serdar Soydinc Abdullah Aydin Metin Karakok 《Journal of the American Society of Echocardiography》2005,18(2):185-187
The exposure to Aspergillus organisms/spores is likely common, but disease caused by tissue invasion with these fungi is uncommon and occurs primarily in the setting of immunosuppression. We report a case of rapidly advancing invasive endomyocardial aspergillosis secondary to prolonged usage of multiple broad-spectrum antibiotics in a nonimmunocompromised host. A 36-year-old cotton textile worker presented to our institution with a 3-month history of weight loss and fatigue. He reported receiving prolonged use of multiple broad-spectrum antibiotic treatment. The echocardiogram demonstrated multiple endomyocardial vegetations and a mass in the left atrium. Myocardial biopsy specimen revealed an invasive endomyocardial aspergillosis. The patient was investigated for immune deficiency including HIV, and this workup was negative. Treatment was started with amphotericin B and heparin for presumed left atrial thrombus. The patient died because of a rupture of mycotic aneurysm that resulted in cerebral hemorrhage. This case illustrates the risk of an invasive fungal infection in a nonimmunocompromised host who is a prolonged user of antibiotics in the setting of environmental exposure of opportunistic invasive fungal infections. 相似文献
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Stereological evaluation of liver volume in living donor liver transplantation using MDCT via the Cavalieri method. 总被引:4,自引:0,他引:4
Cihan Duran Bulent Aydinli Yaman Tokat Yildiray Yuzer Mecit Kantarci Metin Akgun Kamil Yalcin Polat Bünyami Unal Refik Killi S Selcuk Atamanalp 《Liver transplantation》2007,13(5):693-698
In living donor liver transplantation (LDLT), obtaining the precise volume of the graft is very important to decrease volume-related postoperative complications, especially in cases with suspected small-for size grafts. We used stereology based on the Cavalieri method (CM), a new method to measure liver graft volume, and compared the results with those obtained through intraoperative measurement (IOM) and through multidetector computed tomography (MDCT) measurement. Liver volumes estimated using the 3 methods were well-correlated with each other (r(2) = 0.94 and P < 0.001 for IOM and CM; r(2) = 0.91 and P < 0.001 for IOM and MDCT, and r(2) = 0.95 and P < 0.001 for CM and MDCT); however, they were different from each other (in descending order, 908 +/- 124 cm(2), 861 +/- 121 cm(2), and 777 +/- 168 cm(2) for MDCT, CM, and IOM, respectively). Although MDCT and CM overestimated the volumes, the results of CM were almost similar to those obtained via IOM. In conclusion, our results suggest that CM measured the liver graft volume more reliably. Thus, its use, particularly in cases with suspected small-for-size graft, may prove useful. 相似文献
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G?khan Tun?bilek Serdar Nasir Omer Ozkan Aycan Kayik?io?lu Emin Mavili 《Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi》2004,38(2):94-99
Defects in the sacrococcygeal and ischial soft tissues can be treated with gluteus maximus and posterior thigh V-Y advancement flaps. However, late complications include recurrence and dehiscence of the suture line. Increasing the amount of the soft tissues over the bony prominences and multilayered closure may have an advantage for long-term durability. We modified the V-Y advancement technique by de-epithelialising the medial parts of the flap and burying them under the opposing edge of the wound or the flap. Sixteen patients with various defects of the sacrococcygeal and ischial soft tissues were operated on using this technique. All the flaps healed well with no partial or complete loss of the flap. Three patients developed complications. The main advantage of our technique is the use of healthy tissues to obliterate the dead spaces under the edges of the wound or the opposing flap. In this way, not only the defect in the skin but the defect in the subcutaneous tissue, with its iceberg tip at the surface, is treated effectively. To have an additional layer of tissue between the bone and the superficial tissues provides an extra cushion of soft tissue and avoids putting the suture line directly over the bony prominences. We used this modification safely for both unilateral and bilateral flaps. It could also be used successfully in other parts of the body. 相似文献
10.
Mehmet Oguz Yenidunya Mustafa Erol Demirseren Serdar Gorkem Bulent Adil Tasbas Candemir Ceran 《European journal of plastic surgery》2007,29(7):327-330
Nonunion in the forearm following a radioulnar fracture is one of the nightmares of the orthopedic surgeon. Fortunately, it
is rare. We treated a large bone defect of the forearm, using a vascularized fibular graft after excision of the unhealed
bone segment in a 10-year-old boy with neurofibromatosis. This situation followed a double fracture that had been operated
on several times using conventional methods. Following the debridement of the unhealthy tissues in the pseudoarthrotic region,
the vascularized fibula was placed on the dorsal surface of the proximal radius fragment. The distal fragment of the radius
was inserted into the fibular cavity and fixation was established with a Kirschner wire distally and with a plate proximally.
Only two screws were used to fix the plate. The peroneal artery was anastomosed with the radial artery; one of its venae comitantes
was anastomosed with the cephalic vein in an end-to-end fashion. After surgery, the elbow was immobilized at 90 degrees of
flexion with a splint for 6 weeks. One year after surgery, forearm stabilization and elbow and hand functions were very satisfactory.
However, because the distal epiphyses of the bones were destroyed following the repeated surgery and the original trauma itself,
a very prominent difference between the two forearms occurred, suggesting the need for bone lengthening in the future. By
presenting this case we would like to conclude that one can expect good bone healing with a vascularized bone transfer in
these cases when there is not enough space to place screws, but support can be provided by an external splint and K wire. 相似文献