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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 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 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 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 Hemşirelik Yüksek Okulu öğrencilerinin meme kanseri hakkında bilgi, tutum ve davranışları(2007) Aslan, Ahmet; Temiz, Muhyittin; Yiğit, Yılmaz; Can, Rana; Canbolant, Elif; Yiğit, FilizBu çalışmada, Hemşirelik Yüksekokulu öğrencilerinin meme kanseri hakkındaki bilgi, tutum ve davranışlarının saptanması amaçlanmıştır. Çalışma, Eylül 2006-Kasım 2006 tarihleri arasında, Mustafa Kemal Üniversitesi (MKÜ) Hemşirelik Yüksekokulu’nda gerçekleştirilmiştir. Yüksekokul öğrencilerinin (n=102) %98,0’ına (n=100) ulaşılmıştır. Çalışma, gözlem altında anket uygulama tekniği ile gerçekleştirilmiştir. Öğrencilerin meme kanseri ile ilgili bilgi kaynakları arasında %47 ile gazete-televizyon, %32 ile tıp kitapları ve internet ilk sıralarda yer almaktadır. Meme kanseri’da en sık görülen bulgulara ilişkin olarak verilen tüm yanıtlar arasında ilk sıralarda memede kitle (% 54,6), ağrı (% 24,1), meme başı çökmesi (% 12,8) yer almaktadır. Öğrencilerin %63’ü kendi kendine meme muayenesini (KKMM) yapmaktadır. KKMM yapanların 29’u (%46) aklına geldikçe, 26’sı (%41,3) ayda bir, 6’sı (%9,5) haftada bir sıklıkta yapmaktadır. KKMM %41,3 (26) ile okuldan, %22,2 (14) ile doktordan, %20,6 ile ebe/hemşireden, %9,5 (6) ile de tıp kitaplarından öğrenilmiştir. KKMM yapmama nedeni olarak, öğrencilerin %51,4’ü (19) bilgi yokluğu, %24,3’ü (9) ihmal, %8,1’i (3) kitle korkusu, %8,1’i (3) şikayet yokluğu ve %8,1’i de (3) gerekliliğine inanmamayı belirtmiştir. Öğrencilerin %95’i kliniksel meme muayenesini (KMM) hiç yaptırmamıştır. KMM yaptırmama nedeni olarak %53,7 (51) ile ihmal, %18,9 (18) ile bilgi yokluğu ve %8,4 (8) ile de gerek duyulmaması belirtilmiştir.Öğe Incarcerated rectal prolapsus causing rectal bleeding and laceration: Case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2008) Temiz, Muhyittin; Aslan, Ahmet; Erdogmus, Senem; Canbolant, ElifRectal prolapse is defined as the protrusion of the rectum from the mucosa of the anal canal. The etiology is not well known. There has been a wide spectrum of operations for treatment. Bleeding, perforation, incarceration, ischemia, necrosis and sepsis are rare fatal conditions which may require emergent surgery. In each case type of operation is decided on patients' base individually. We present an irreducible rectal prolapsus which caused perforation while trying to be reduced and thus taken under urgent surgery within the light of the literature.Öğe Late-onset traumatic rupture of the diaphragm: two case reports(Turkish Assoc Trauma Emergency Surgery, 2009) Temiz, Muhyittin; Aslan, Ahmet; Diner, Guevenc; Canbolant, ElifRuptured diaphragm as a result of blunt thorax or abdominal trauma can present acutely or late in the disease. Symptoms may be nonspecific and diagnosis can easily be missed. Patients may present with dyspnea, chest pain or cough. Chest radiograph, CT scan, and MRI are the primary diagnostic tools. Clinicians must have a high index of suspicion for prompt diagnosis, especially in patients with a history of trauma to the abdomen or thorax. The only treatment in diaphragm rupture is surgery. We report two cases of traumatic diaphragm ruptures presenting years after the trauma.Öğe Sigmoid colon cancer presenting with ileus in pregnancy: Two case reports(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2008) Temiz, Muhyittin; Aslan, Ahmet; Hakverdi, Sibel; Gungoren, Arif; Canbolant, ElifColorectal cancer during pregnancy is very rare with the reported incidence of between 0.001-0.1%. The prognosis is poor due to delayed diagnosis and secondary advanced disease. Acute abdomen due to sigmoid colon tumor is extremely rare. We report two cases presenting with ileus due to sigmoid colon cancer during pregnancy. Two women 35 and 32 years old with 32nd and 27th week of pregnancy respectively, presented with abdominal pain, obstructive symptoms and ileus. Exploratory laparotomy revealed obstructive sigmoid colon cancer in both. Extended mesocolon dissection was not possible in one of the cases due to enlarged size of the uterus. In the same case lumen of the colon was filled with polipoid lesions. Acute abdomen due to sigmoid colon tumor in pregnancy is extremely rare and the tumor can be easily missed if a complete routine exploration of the abdomen is not performed during surgery. Currently a high index of clinical suspicion is the only way to make the diagnosis.
