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Öğe Acute Mesenteric Ischemia: Clinical Experience(Aves, 2009) Aslan, Ahmet; Temiz, Muhyittin; Semerci, Ersan; Ozkan, Orhan Veli; Yetim, Ibrahim; Fansa, Iyad; Beyaz, FikretBACKGROUND: Acute mesenteric ischemia (AMI) is a life threatening vascular emergency which requires prompt diagnosis and treatment. The prevention of this cause of high mortality and morbidity depends on early clinical suspicion end timely intervention. In the present study we aimed to analyze the acute mesenteric ischemia cases treated in Mustafa Kemal University Department of General Surgery between January 2004 and December 2008. MATERIAL/METHODS: The clinic records of all the patients who underwent surgical treatment for AMI between January 1, 2004, and December 2008, were retrospectively reviewed. The data from operative records, postoperative complications, mortality, and hospital stay were recorded. RESULTS: The study group included 18 patients. Mean age was 69. There was comorbidity in all patients and cardiac disease and hypertension were the most common ones. The most common laboratory abnormalities were leukocytes, hypoalbuminemia, hyperamylasemia. There was superiorly vascular necrosis in 16 patients; inferior vascular necrosis in one patient. One patient had non occlusive mesenteric ischemia. Segmentery resection was performed to 13 patients. Abdominoperineal resection was performed to the patient with inferior mesenter artery occlusion. We performed duodenotransversostomy on two patients and only laparotomy on two patients. Re-operation was required in 5 patients. Causes of death were multiorgan insufficiency in 7 cases, cardiac death in 2 cases. One patient died due to short intestine syndrome. CONCLUSION: Acute mesenteric ischemia is highly mortal emergency which should always be suspected in elderly patients with cardiac disease suffering from abdominal pain.Öğe Akut mezenter iskemi : Klinik deneyimlerimiz(2009) Aslan, Ahmet; Temiz, Muhyittin; Semerci, Ersan; Özkan, Orhan Veli; Yetim, İbrahim; Fansa, İyad; Beyaz, FikretAMAÇ: Akut mezenterik iskemi (AMİ) erken tanı ve tedavi gerektiren hayatı tehdit edici bir vasküler acildir.Günümüzde hala yüksek mortalite ve morbidite ile seyretmekte olan bu hastalığın önlenmesi erken klinik şüphe ve zamanında müdahaleye bağlıdır. Bu çalışmada Mustafa Kemal Üniversitesi Tıp Fakültesi Genel Cerrahi kliniğinde Ocak 2004- Aralık 2008 tarihleri arasında mezenter iskemi tanısıyla takip edilip opere edilen olgularımızın özelliklerini analiz etmeyi amaçladık. GEREÇ-YÖNTEM: Operasyonda AMİ tanısı konulan olgular retrospektif olarak değerlendirildi. Preoperatif, operatif ve postoperatif bulgular SPSS 16.0 programına yüklenerek istatistiki olarak incelendi. BULGULAR: Değerlendirmeye 18 olgu alındı. Yaş ortalaması 69 idi. En sık Kalp hastalıkları ve Hipertansiyon olmak üzere bütün hastalarda ek morbidite mevcuttu. Lökositoz, Hiperglisemi, Hiperamilazemi, Hipoalbüminemi ve kreatinin yüksekliği saptandı. 16 hastada Superior mezenter vasküler nekroz, 1 hastada İnferior mezenter vasküler nekroz ve 1 olguda nonoklüzif mezenter iskemi saptandı. 13 olguya segmenter rezeksiyon uygulanırken, İnferior Mezenter arter embolisi saptanan hasta abdominoperineal rezeksiyon uygulandı. 2 olguya düodenotransversostomi, 2 olguya sadece eksplorasyon uygulandı. 4 olguya tekrar iskemi gelişmesi, 1 olguda insizyonel evisserasyon nedeniyle reoperasyon uygulandı. Toplam 7 olgu postop multiorgan yetmezliğinden ve 2 olgu kardiyak patoloji nedeniyle eksitus olmuştur. SONUÇ: Mezenter iskemi erken tanının çok önemli olduğu halen yüksek mortalite oranları taşıyan, özellikle kardiyak patolojisi olan karın ağrılı hastalarda ayırıcı tanıda mutlaka düşünülmesi gerekli bir hastalıktır.Öğe Candida albicans’a bağlı Fournier gangreni(2008) Temiz, Muhyittin; Çetin, Meryem; Aslan, AhmetFournier gangreni perineal, genital veya perianal bölgenin fulminan nekrotizan fasiiti ile karakterize olup genellikle aerop ve anaerop bakterilere bağlı olarak gelişir. Idiyopatik olduğu düşünülse de, diyabetli, uzun süre alkol kullanan ve immün yetmezliği olan hastalar daha fazla etkilenmektedir. Etken genellikle üriner sistem, alt gastrointestinal sistem veya ciltte yerleşmektedir. Gangrenin ortaya çıkışı ve ilerlemesi çok hızlı olup, çoklu organ yetmezliği ve ölümle sonlanabilir, Bu raporda Candida albicans'in sebep olduğu bir Fournier gangreni olgusu sunulmaktadır. Elli dokuz yaşında bir kadın hasta, üç hafta önce oluşan travma sonrası sağ kalçada gelişen şişlik ile hastanemize başvurmuştur. Hastanın öyküsünden, diabetes mellitus, esansiyel trombositopeni, kronik hastalık anemisi ve hipertansiyon nedeniyle daha önceden dört kez hastaneye yatırıldığı öğrenilmiştir. Sağ trokanterik kırık saptanan hasta, kırığa ikincil anaerobik yumuşak doku enfeksiyonu ön tanısı ile operasyona alınmış ve yaygın nekroz nedeniyle geniş debridman uygulanmıştır. Ampirik olarak sefalosporin ve metronidazol tedavisi verilen hastanın yara yeri ve kan kültürü örneklerinde primer etken olarak C.albicans üremesi saptanmış, bunun üzerine tedaviye flukonazol eklenmiştir. Ancak hasta, fungal sepsisten kaynaklanan çoklu organ yetmezliğine bağlı olarak postopera-tif 25. gün eksitus olmuştur. Bu olgu, diabetik hastalarda gangrenli dokularda mayaların da patojen etkenler arasında düşünülmesi gerektiğinin vurgulanması amacıyla sunulmuştur.Öğe Çocuklarda anorektal travma sonucu gelişen rektum perforasyonu : İki olgu sunumu(2011) Temiz, Abdülkerim; Akçora, Bülent; Temiz, Muhyittin; Aslan, AhmetAnorektal yaralanma çocuklarda nadir görülen bir klinik tablodur. Rektum ve diğer intrapelvik organların yaralanmaya eşlik etmesi açısından da önemlidir. Olgu 1: Karın ağrısı ve kusma şikayetleri ile başvuran 9 yaşındaki erkek hastada, karında yaygın hassasiyet ve defans tespit edildi. Ayakta karın grafisinde diyafragma altında serbest hava izlendi. Ameliyatta rektum ve mesane perforasyonu tespit edildi. Yara onarımı ve sigmoid kolostomi yapıldı. Olgu 2: Altı yaşında kız hasta, ağaçtan düşme sonrası gelişen perineal yaralanma nedeniyle kliniğimize başvurdu. Fizik muayenesinde perinede anal kanaldan yaklaşık 4 cm uzaklıkta, 2 cm çaplı, derin planda ilerleyen perineal yara tespit edildi. Ayakta karın grafisinde diyafragma altında serbest hava gözlendi. Ameliyatta rektum perforasyonu tespit edilen hastada, perforasyon onarımı ve sigmoid kolostomi yapıldı. Anorektal yaralanmalarda morbidite ve mortalitenin azaltılması için erken ve doğru tanı, yaralanmanın şekli ve tipinin doğru belirlenmesi, ek organ yaralanmaların tespiti ve uygun yöntemle tedavisi gereklidir. Tedavide gereken olgularda kolostomiden kaçınılmaması gerektiğini düşünüyoruz.Öğe Comparison of Recovery Characteristics, Postoperative Nausea and Vomiting, and Gastrointestinal Motility With Total Intravenous Anesthesia With Propofol Versus Inhalation Anesthesia With Desflurane for Laparoscopic Cholecystectomy: A Randomized Controlled Study(Elsevier Science Inc, 2009) Akkurt, B. Cagla Ozbakis; Temiz, Muhyittin; Inanoglu, Kerem; Aslan, Ahmet; Turhanoglu, Selim; Asfuroglu, Zeynel; Canbolant, ElifBACKGROUND: Clinical effects, recovery characteristics, and costs of total intravenous anesthesia with different inhalational anesthetics have been investigated and compared; however, there are no reported clinical studies focusing on the effects of anesthesia with propofol and desflurane in patients undergoing laparoscopic cholecystectomy. OBJECTIVE: The aim of this study was to determine the effects of total intravenous anesthesia with propofol and alfentanil compared with those of desflurane and alfentanil on recovery characteristics, postoperative nausea and vomiting (PONV), duration of hospitalization, and gastrointestinal motility. METHODS: Patients classified as American Society of Anesthesiologists physical status I or II undergoing elective laparoscopic cholecystectomy due to benign gallbladder disease were enrolled in the study. Patients were randomly assigned at a 1:1 ratio to receive total intravenous anesthesia with propofol (2-2.5 mg/kg) and alfentanil (20 mu g/kg) or desflurane (4%-6%) and alfentanil (20 mu g/kg). Perioperative management during premedication, intraoperative analgesia, relaxation, ventilation, and postoperative analgesia were carried out identically in the 2 groups. Extubation time, recovery time, PONV, postoperative antiemetic requirement, time to gastrointestinal motility and flatus, duration of hospitalization, and adverse effects were recorded. Postoperative pain was assessed using a visual analogue scale. RESULTS: Sixty-eight patients were assessed for inclusion in the study; 5 were excluded because they chose open surgery and 3 did not complete the study because they left the hospital. Sixty patients (33 women, 27 men) completed the study. Recovery time was significantly shorter the propofol group (n = 30) compared with the desflurane group (n = 30) (8.0 [0.77] vs 9.2 [0.66] min, respectively; P < 0.005). Fifteen patients (50.0%) in the propofol group and 20 patients (66.7%) in the desflurane group experienced nausea during the first 24 hours after surgery. The difference was not considered significant. In the propofol group, significantly fewer patients had vomiting episodes compared with those in the desflurane group (2 [6.7%] vs 16 [53.3%]; P < 0.005). Significantly fewer patients in the propofol group required analgesic medication in the first 24 hours after surgery compared with those in the desflurane group (10 [33.3%] vs 15 [50.0%]; P < 0.005). Patients in the propofol group experienced bowel movements In a significantly shorter period of time compared with patients in the desflurane group (8.30 [1.67] vs 9.76 [1.88] hours; P = 0.02). The mean time to flatus occurred significantly sooner after surgery in the propofol group than in the desflurane group (8.70 [1.79] vs 9.46 [2.09] hours; P = 0.01). The duration of hospitalization after Surgery was significantly shorter in the propofol group than in the desflurane group (40.60 [3.49] vs 43.60 [3.56] hours; P = 0.03). CONCLUSION: Total intravenous anesthesia with propofol and alfentanil was associated with a significantly reduced rate of PONV and analgesic consumption, shortened recovery time and duration of hospitalization, accelerated onset of bowel movements, and increased patient satisfaction compared with desflurane and alfentanil in these patients undergoing laparoscopic surgery who completed the study. (Curr Ther Res Clin Exp. 2009;70:94-103) (C) 2009 Excerpta Medica Inc.Öğe Determination of the Knowledge Levels on Hepatitis B Virus of Residents at Mustafa Kemal University Hospital(Galenos Yayincilik, 2007) Cetin, Meryem; Temiz, Muhyittin; Aslan, Ahmet; Turhan, EbruThe purpose of this study was to determine the general knowledge levels of the residents in Mustafa Kemal University Hospital on hepatitis B virus (HBV) infection. A total of 60 residents were asked to fill in a questionnaire. It was observed that 31 out of 60 (51.7%) answered the question correctly on the general knowledge, 9 out of 60 (15%) on transmission routes, 5 out of 60 (8.3%) on prevention measures, and 59 out of 60 (98.3%) on risk factors of HBV infection. A significant difference was observed between the knowledge scores of the participants with sex and employment duration whereas no difference was determined between the knowledge scores, with age and departments of the participants. The result of this study demonstrates that the residents, who were under the risk of HBV infection, did not have enough knowledge on the overall characteristics, transmission routes, and prevention measures of HBV infection. It was concluded that, periodic workshops are necessary after graduation from the medical school to keep doctors informed and updated on this particular infection.Öğe Effect of mesalamine on healing in experimental colon anastomosis: A randomised experimental study(2008) Aslan, Ahmet; Temiz, Muhyittin; Hakverdi, Sibel; Polat, Gurbuz; Tumer, Cemil; Temiz, Abdulkerim; Canbolant, ElifObjective: We aimed to investigate the effect of mesalamine on healing of experimental colon anastomosis model. Material/Methods: Forty adult male Wistar albino rats were performed segmentary colonic resection and end-to-end anastomosis. Animals were randomly divided into four groups: group I, anastomosis group, received no treatment (GI, n = 8); group II, anastomosis + oral mesalamine group (100 mg/kg/day); group III, anastomosis + rectal mesalamine (2 mL) group, (GIII, n = 8); group IV, anastomosis + oral mesalamine + rectal mesalamine (GIV, n = 8) group. A sham group (n = 8) was constituted and was performed laparotomy. Bursting pressure, hydroxyproline levels and histopathological characteristics of the anastomosis were analyzed. Results: Although it was not statistically significant, there was an increase in the burst pressure of the mesalamine group. When hydroxyproline measurements were compared there were statistically significant difference between the non-treated colon and all groups. There were significant differences between GI and GIII-GIV, GII and GIV. The differences between group I and II and group II and III were not statistically significant. When we compared the median amount of the histopathological changes, we found significant difference between the anastomosis and the mesalamine groups (P < 0.05). But when mesalamine groups were compared with each other we did not observe a significant difference. Conclusion: Mesalamine had positive effects which were not statistically significant on bursting pressure and statistically different significant effects on hydroxyproline (HP) levels based on the way of administration and statistically significant positive effects on histopathologic anastomotic healing in experimental anastomosis model. © 2007 Surgical Associates Ltd.Öğe Effect of propolis on healing in experimental colon anastomosis in rats(Springer, 2008) Temiz, Muhyittin; Aslan, Ahmet; Canbolant, Elif; Hakverdi, Sibel; Polat, Gurbuz; Uzun, Semire; Temiz, AbdulkerimIntroduction: Propolis is the generic name for the resinous substance collected by honeybees, which is known to have antioxidant, anti-inflammatory, apoptosis-inducible effects. Anastomotic dehiscence after colorectal surgery is an important cause of morbidity and mortality. We aimed to assess the effect of propolis on healing in an experimental colon anastomosis in rats. Methods: Forty adult male Wistar albino rats were randomly assigned into 5 treatment groups with 8 rats in each: Group I, anastomosis+no treatment; Group II, anastomosis+oral propolis ( 600 mg/ kg/ d); Group III, anastomosis+oral ethyl alcohol ( 1 cc/ d); Group IV, anastomosis+rectal propolis ( 600 mg/ kg/ d); Group V, anastomosis+rectal ethyl alcohol ( 1 cc/ d). The bursting pressures, hydroxiproline levels and histopathological changes in each group were measured. Results: When bursting pressures were compared between groups, we observed that they were increased in the groups treated with propolis in contrast to all other groups. Hydroxiproline levels in the propolis groups were also significantly increased in contrast to the other groups. There was also a statistically significant difference in histopathological changes between the treatment types. When propolis administration methods were compared, we did not observe a statistically significant difference. Conclusion: Propolis has a significantly favourable effect on healing in experimental colon anastomosis, independent from the method of administration.Öğe The effect of propolisis and mesalazine on bacterial translocation in an experimental colitis model(Saudi Med J, 2007) Aslan, Ahmet; Cetin, Meryem; Temiz, Muhyittin; Sahinler, Nuray; Besirov, Elmir; Aban, Nedim[Abstract Not Available]Öğe Effectiveness of mesalamine and propolis in experimental colitis(Springer, 2007) Aslan, Ahmet; Temiz, Muhyittin; Atik, Esin; Polat, Gurbuz; Sahinler, Nuray; Besirov, Eimir; Aban, NedimThis study was conducted to investigate the effects of propolis and mesalamine on experimental colitis in rats. Distal colitis was induced in rats by intracolonic instillation of 2 mL of 4% acetic acid. The animals were randomly assigned to 5 groups: group 1, control, (n=8); group 2, colitis, received no treatment (n=8); group 3, colitis+mesalamine, 2 mL once a day via an enema (n=8); group 4, colitis+propolis, 600 mg/kg once a day via intragastric lavage (n=8); and group 5, colitis+ mesalamine+propolis for 1 wk (n=8). Levels of nitric oxide were statistically significantly different in comparisons between groups 1 and 2, groups 2 and 3, and groups 4 and 5. Malondialdehyde levels were significantly different when group 2 was compared with groups 3, 4, and 5. A significant difference was observed when group 3 was compared with group 4 for myeloperoxidase. Most propolis-treated rats had normal histology; mesalamine-treated and propolis+mesalamine-treated rats had inflammatory cell infiltration at rates of 50% and 33%, respectively. The investigators concluded that propolis and mesalamine are efficient independently and in combination, but that their combined effect was not observed to be additive in experimental colitis.Öğe The Effects of Low-Dose Erythropoiesis-Stimulating Agents on Peritoneal Fibrosis Induced by Chemical Peritonitis and on Peritoneal Tissue MMP-2 and TIMP-2 Levels in Rats(Taylor & Francis Ltd, 2009) Yildirim, Ayse; Ozkan, Orhan Veli; Aslan, Ahmet; Koseoglu, Zikret; Borazan, AliAim. The objective of the present study was to investigate the effect of low-dose erytropoesis-stimulating agents (ESA) on the development of peritoneal fibrosis in chlorhexidine gluconate-induced peritoneal sclerosing rats and to assess the peritoneal tissue levels of MMP-2 and TIMP-2, which may be regarded as factors in the development of peritoneal fibrosis. Subjects and methods. Twenty-four Wistar albino rats were divided into three groups. The control group received 0.9% saline (3 ml/d) intraperitoneally, the CH group received 3 ml daily injections of 0.1% chlorhexidine gluconate (CH) intraperitoneally, and the CH+ESA group received 3 ml daily injections of 0.1% CH intraperitoneally and epoetin beta (3 x 20 IU/kg/week) subcutaneously. On the twenth-first day, rats were sacrificed, and parietal peritoneum samples were obtained from the left anterior abdominal wall. Pathological samples were examined using Hematoxyline & Eosin (HE) stains. The thickness, vascular proliferation, and inflammation were determined by light microscopy. MMP-2 and TIMP-2 were studied immunohistochemically by monoclonal antibody staining. Results. Inflammation, vascular proliferation, and fibrotic area percentages were not statistically significant between groups. Histopathologically control, CH, CH+ESA groups peritoneal thickness were 8.02 +/- 2.89, 146.74 +/- 26.1, and 48.12 +/- 16.8 micrometers, respectively. The decrease in thickness of parietal peritoneum in CH+ESA group was statistically significant when compared to CH. Immunohistochemically, interferon was shown to decrease MMP-2 expression on parietal peritoneum than group CH, but has no effect on TIMP-2. Discussion. Low-dose ESA histopatologically reduces peritoneal fibrosis induced by chlorhexidine gluconate. However, from dosage and duration points of view, we need extended clinical and experimental studies.Öğe Fibroadenom ile karışabilen büyük meme hamartomu(2008) Temiz, Muhyittin; Aslan, Ahmet; Bozkurtoğlu, Hakan; Atik, Esin; Beyaz, Fikret; Canbolant, Elif; Beşirov, Elmir; Aban, Mahmut NedimMeme hamartomları memenin nadir görülen iyi huylu kitleleridir. Genellikle iyi sınırlı, ağrısızdır. Cilt veya pektoral kaslarla bağlantısı yoktur ve aynı taraf memede asimetrik büyümeye sebep olurlar. Hareketli olup histoljik olarak değişik oranlarda yağ, gland, f bröz veya kas dokusu içerebilirler. Spesifik olmayan sitolojik bulgularından dolayı bu lezyonların preoperatif tanısı zordur. Radyolojik olarak mamografide ‘meme içinde meme' karakteristik bulgusu olup, tanıya gitmede ultrason ve magnetik rezonans görüntülemeden de faydalanılır. Tanıda iğne biopsileri çok faydalı olmaz. Tanımlamadaki zorluk, lezyonun klinik radyolojik ve patolojik değerlendirmesinin beraber yapılması ile aşılabilir. Tedavisi cerrahi eksizyondur. Bu makalede, nadir görülen bu lezyonu, yayınlanmış olguların pek çoğundan daha büyük bir olgu ile literatür eşliğinde tartışmak istedik.Öğe FOURNIER'S GANGRENE CAUSED BY CANDIDA ALBICANS(Ankara Microbiology Soc, 2008) Temiz, Muhyittin; Cetin, Meryem; Aslan, AhmetFournier's gangrene characterized by fulminant necrotizing fasciitis of the perineal, genital or perianal regions, is generally caused by aerobic and anareobic bacteria. Although it is thought to be an idiopathic process, Fournier's gangrene has been shown to have a predilection for patients with diabetes, long term alcohol misuse and immunocompromised patients. The focus of infection is usually located in the urinary tract, lower gastrointestinal tract or skin. The development and progression of the gangrene is often fulminating and can rapidly lead to multiple organ failures and death. Here, we present a Fournier's gangrene case caused by Candida albicans. A 59 year-old woman was admitted to hospital with the complaint of swelling on the right thigh following a trauma occurred three weeks ago. Her history revealed that she had been hospitalized previously for four times due to diabetes mellitus, essential thrombocytopenia, chronic disease anemia and hypertension. Right trochanteric fracture was detected and the patient was taken under surgical debridement with the pre-diagnosis of secondary anaerobic soft tissue infection. Empirical treatment was started with cephalosporin and metronidazole. Since wound and blood cultures revealed C.albicans as the primary microorganism, fluconazole was added to the therapy. However, the patient died on the post-operative 25(th) day because of multi-organ disfunction secondary to fungal sepsis. This case has been reported to emphasize that yeasts should be considered as pathogenic agents in diabetic patients with gangrene.Öğe Fournier's gangrene caused by Candida albicans(2008) Temiz, Muhyittin; Çetin, Meryem; Aslan, AhmetFournier's gangrene characterized by fulminant necrotizing fasciitis of the perineal, genital or perianal regions, is generally caused by aerobic and anareobic bacteria. Athough it is thought to be an idiopathic process, Fournier's gangrene has been shown to have a predilection for patients with diabetes, long term alcohol misuse and immunocompromised patients. The focus of infection is usually located in the urinary tract, lower gastrointestinal tract or skin. The development and progression of the gangrene is often fulminating and can rapidly lead to multiple organ failures and death. Here, we present a Fournier's gangrene case caused by Candida albicons. A 59 year-old woman was admitted to hospital with the complaint of swelling on the right thigh following a trauma occurred three weeks ago. Her history revealed that she had been hospitalized previously for four times due to diabetes mellitus, essential thrombocytopenia, chronic disease anemia and hypertension. Right trochanteric fracture was detected and the patient was taken under surgical debridement with the pre-diagnosis of secondary anaerobic soft tissue infection. Empirical treatment was started with cephalosporin and metronidazole. Since wound and blood cultures revealed C.albicans as the primary microorganism, fluconazole was added to the therapy. However, the patient died on the post-operative 25th day because of multi-organ disfunction secondary to fungal sepsis. This case has been reported to emphasize that yeasts should be considered as pathogenic agents in diabetic patients with gangrene.Öğe Gastric infection by Strongyloides stercoralis : A case report(2009) Yaldız, Mehmet; Hakverdi, Sibel; Aslan, Ahmet; Temiz, Muhittin; Çulha, GülnazStrongyloides stercoralis is an intestinal nematode with a complex life cycle that involves colonizing and reproducing in the upper small intestinal mucosa. In a healthy host, the parasite usually does not cause any symptoms. We report a gastric infection case of S. stercoralis. A 72-year-old Turkish man was admitted to the Department of General Surgery with complaints of epigastric pain, nausea and vomiting for five days. Upper gastrointestinal endoscopy evidenced a diffuse infiltrate in the stomach, causing decreased distensibility. Microscopically, superficial chronic inflammation with hyperplastic reactive changes and damaged surface was observed. Histopathological examination of the gastric mucosa showed numerous cross-sections of adult worms, eggs and rhabditiform larvae of S. stercoralis developing in the gastric crypts.Öğe Gastric infection by Strongyloides stercoralis: A case report(Aves, 2009) Yaldiz, Mehmet; Hakverdi, Sibel; Aslan, Ahmet; Temiz, Muhittin; Culha, GuelnazStrongyloides stercoralis is an intestinal nematode with a complex life cycle that involves colonizing and reproducing in the upper small intestinal mucosa. In a healthy host, the parasite usually does not cause any symptoms. We report a gastric infection case of S. stercoralis. A 72-year-old Turkish man was admitted to the Department of General Surgery with complaints of epigastric pain, nausea and vomiting for five days. Upper gastrointestinal endoscopy evidenced a diffuse infiltrate in the stomach, causing decreased distensibility. Microscopically, superficial chronic inflammation with hyperplastic reactive changes and damaged surface was observed. Histopathological examination of the gastric mucosa showed numerous cross-sections of adult worms, eggs and rhabditiform larvae of S. stercoralis developing in the gastric crypts.Öğe Gebelikte ileusa neden olan sigmoid kolon kanseri : İki olgunun sunumu(2008) Temiz, Muhyittin; Aslan, Ahmet; Hakverdi, Sibel; Güngören, Arif; Canbolat, ElifGebelikte kolorektal kanser çok nadir olup bildirilen insidans %O.OO1-O.1'dir. Gecikmiş tanı ve hastalığın ilerlemesi nedeni ile prognozu kötüdür. Sigmoid kolon tümörüne bağlı akut batın gelişmesi çok nadirdir. Gebelik esnasında ileus ile kendini gösteren iki sigmoid kolon kanseri olgusunu literatür eşliğinde sunduk. Biri 35, diğeri 32 yaşında ve sırası ile 32 ve 27 haftalık gebe iki kadın hasta karın ağrısı ve ileus tablosu ile başvurdular. Her ikisinde de eksploratif laparotomide tıkayıcı sigmoid kolon kanseri tespit edildi. Uterus büyüklüğü izin vermediği için vakaların birinde kolon mezo disseksiyonu geniş olarak yapılamadı. Aynı vakada kolon polipoid lezyonlarla dolu idi. Gebelerde sigmoid kolon tümörüne bağlı akut batın gelişmesi çok nadirdir ve cerrahi esnasında eksplorasyori tam olarak yapılmazsa tümör kolaylıkla atlanabilir. Klinik şüphe tanıyı koymakta çok önemlidir.Öğe Geç dönem saptanan travmatik diyafram yırtığı : İki olgu sunumu(2009) Temiz, Muhyittin; Aslan, Ahmet; Diner, Güvenç; Canpolat, ElifToraks ve karın bölgesinde, künt veya penetran travmalara bağlı olarak diyafram yırtığı meydana gelebilir. Belirgin işaretleri, fiziksel inceleme bulgusu ve radyografik görüntüsü bulunmayan olgularda diyafram yırtığında tanı kolaylıkla atlanabilir. Torako-abdominal bölge travması ile başvuran hastalarda diyafram yırtığı olabileceği akla getirilmelidir. Tanı konulamayan olgularda semptomlar geç dönem ortaya çıkabileceği gibi hiç bulgu vermeyebilir. Travmatik diyafram yırtığının tedavisi cerrahidir. Bu yazıda, travmadan yıllar sonra tanısı konan iki gecikmiş diyafram yırtığı olgusu sunuldu.Öğe A GIANT BREAST HAMARTOMA MIMICING FIBROADENOMA ( CASE REPORT)(Aves, 2008) Temiz, Muhyittin; Aslan, Ahmet; Bozkurtoglu, Hakan; Atik, Esin; Beyaz, Fikret; Canbolant, Elif; Besirov, ElmirHamartomas of the breast are rare, benign conditions of the breast. They tend to be well defined and painless. They are not related to skin or the pectoralis muscles and cause asymetrical enlargement in the breast. These mobile masses consist from varying proportions of fat, glands, fibroid or muscle tissues. Cytologic characteristic is not spesivic therefore preoperative diagnosis is difficult. 'breast inside breast' is the characteristic finding in the mammography yet ultrasonography and MRI can help with the diagnosis. Needle biopsy is not beneficial for the diagnosis. The challenge in the definition of the mass can be passed with clinical, radiologic and pathologic assessment of the tumor. Surgical excision is the treatment of the choice. In the present article we wanted to discuss this rare entity; with a larger case than most of the reported ones nad literature research.Öğe A giant serous cystadenoma developing in an accessory ovary(Springer Heidelberg, 2008) Temiz, Muhyittin; Aslan, Ahmet; Gungoren, Arif; Diner, Guevenc; Karazincir, SinemBackground Accessory ovaries are rare anomalies and cysts arising from accessory ovaries are extremely rare. Their reported incidence is 1/29,000-1/700,000. Establishing the diagnosis preoperatively is difficult. Radiologic methods are usually inadequate in recognizing the origin of these tumors. Thus, they are usually confused with other intraabdominal tumors. Case A 22-year-old nulliparous girl presented with abdominal pain and tumoral growth for 1.5 years. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The preoperative diagnosis was a mesenteric cyst. Diagnostic laparotomy revealed a giant cystic mass arising in an accessory ovary. The left tuba and fimbrias were adhered to the cyst. The tumor was totally removed and fimbrioplasty performed. Conclusion In spite of being rare entities, paraovarian anomalies should be considered in the differential diagnosis of intraabdominal tumors, especially when the origin is not identified by radiologic means. Case A 22-year-old single, nulliparious female was admitted to our hospital with abdominal pain, nausea and a growing abdominal swelling since 1.5 years. A tumoral mass was palpated on physical examination. Abdominal ultrasound and computed tomography revealed a 33 x 26 x 15 cm cystic mass filling the abdominal cavity. The origin of the tumor could not be detected. Operation revealed a giant cystic mass arising from an accessory ovary. Histopathologic diagnosis was serous cystadenoma. Conclusion Ovarian or accessory ovarian pathologies must be considered in the differential diagnosis of intraabdominal tumors, especially in young female population.
