Ali İhsan Uzar

Post-gastrectomy anemia: evaluation of 72 cases with post-gastrectomy anemia.

Abstract Anemia is common in patients following gastrectomy. The purpose of this study was to document causes of anemias developing during the post-gastrectomy period and to determine the importance of complete blood count parameters on types of anemia. A total of 72 patients (23 women and 49 men) who had previously undergone gastrectomy in the past and who were admitted for the evaluation of anemia were enrolled in study. The patients who were evaluated and treated for anemia in the post-gastrectomy period were excluded. Iron deficiency anemia was present in 68 (94.4%) of72 gastrectomized patients with anemia. Deficiencies of vitamin B12 and folate were present in 57 (79.2%) and in three patients, respectively. The most common cause of anemia was the combination of iron and vitamin B12 deficiencies. Iron deficiency was present in the majority of patients, followed by vitamin B12 deficiency in frequency. In all combinations of iron deficiency, the values of mean cell hemoglobin and mean cell hemoglobin concentration were either normal or low. In cases who had low white blood cell and platelet counts vitamin B12 deficiency was frequent, while in cases who had high numbers of white cells or platelets iron deficiency was more frequent. In conclusion, gastrectomized patients should be followed for anemia and treated appropriately based on the cause of anemia.

PERCUTANEOUS TREATMENT OF HEPATIC HYDATID CYST IN PREGNANCY

Abstract. A 20 cm hepatic hydatid cyst with daughter cysts, was diagnosed in a primigravida in the fifteenth week of pregnancy and was managed percutaneously. No complications occurred and the patient subsequently gave birth to a healthy baby.

Is Removal of the Stent at the End of 2 Weeks Helpful to Reduce Infectous or Urologic Complications After Renal Transplantation

OBJECTIVE Ureteral stents are used to reduce urologic complications after renal transplantation. However, they predispose to infection. The optimal time to keep them in the urinary tract has not yet been defined. The aim of this study was to evaluate the effect of early removal at the end of 2 weeks on urinary tract infections and early urologic complications (within 3 months), such as ureteroneocyctostomy leakage as well as ureteral anastomosis stricture or obstruction. METHODS We retrospectively analyzed the medical records of 48 patients who underwent renal transplantation using a ureteral stent. The patients were divided into two groups according to the time of stent removal: at the end of 2 weeks (group A; n = 10) versus at a later time (group B; n = 38). RESULTS The urologic complication rate was 0% in group A and the urinary tract infection rate, 2%. The urologic complication rate was 0% in group B and the urinary tract infection rate, 35%. CONCLUSION Early removal of the stent at the end of 2 weeks after renal transplantation is decreased the rate of urinary tract infections.

Effects of Prevention of Oxidative and Nitro-Oxidative Stress on Experimental Rat Colon Anastomosis using Acetylcysteine, Ebselen and 1400w

Abstract Oxygen radicals and radicals derived from nitrogen metabolism are important in wound and anostomotic healing. In particular, nitrous oxide, originating from induced nitrous oxide synthetase, retards the wound healing process by producing peroxynitride. Therefore induced nitric oxide synthase (INOS) inhibitors and peroxynitride cleansing agents seem helpful in promoting healing. The purpose of this study was to investigate the effects of N-acetylcysteine (antioxidant), ebselen (peroxynitride cleansing agent) and 1400w (INOS inhibitor) on experimental colonic anastomot-ic wound healing. Material and methods: 45 randomized Sprague-Dawley rats received colonic anastomosis, and all animals were treated for four days with drugs specific for each group except for the sham and control groups. All rats were given a relaparatomy on the fifth day of the study and evaluated for study parameters indicating anastomotic healing, burst pressure, tissue malondialdehit (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx) and hydroxyproline (OH-proline). Results: when compared to the control group, increased (p < 0.01) burst pressure, OH-proline and decreased MDA, and SOD levels were noted in the 1400w group. Furthermore, the GPx levels were higher (p < 0.05) in rats given NAC therapy. Conclusions: the positive results of selective INOS inhibition using 1400w in this study confirm the adverse effects of the INOS enzyme on anastomotic wound healing. Therefore, we have concluded that 1400w may be helpful in promoting anastomotic healing.

Increased damage from rifle wounds of the chest caused by bullets striking commonly carried military equipment

BACKGROUND The purpose of this study was to investigate the fragmentation effect of the bullet that passes through the radio or ammunition magazine, which are essential pieces of equipment for a soldier, in thoracic gunshot injuries. METHODS Twelve adult pigs were used. The pigs were separated into three groups (each group contained four pigs). The first group was shot without any obstacle between muzzle and subject. The second group was shot through a cartridge magazine placed in front of the subjects thoracic cage. The third group was shot with a radio in front of the subjects thoracic cage. RESULTS It was observed that there was a large bullet entrance and fragmentation in the pigs that were shot with a radio or magazine placed over them, and there was no fragmentation in those that were shot without any obstacle. CONCLUSION Metal equipment that soldiers carry causes bullet fragmentation. Fragmented bullets may cause excessive tissue disruption of intrathoracic vital organs.

The wounding potential and legal situations of air guns - experimental study

Despite their wounding potential, air guns are accepted as low-profile weapons or toys, and are not considered as lethal weapons. The aims of this study are to determine the wounding potential of air guns and to increase the consciousness about the dangers of the air guns. The kinetic energy limits are mentioned in 11 different countries’ legislations are evaluated with respect to test results. Twelve Kraton RTM G1 (15%) Transparent Ballistic Candle Blocks were prepared as the artificial soft-tissue test media in three different test models. A 4.5 mm air pistol and a 5.5 mm air rifle were used in the tests, which were performed in 1 and 10 m ranges. The mean penetration depth of the air pistol shots was 25.60 mm and the air rifle penetration was 79.14 mm from the 1 m range for three test models. In the 10 m range, the mean penetration depth of air pistol shots was 25.30 mm, while 79.19 mm was recorded for the air rifle. Considering these penetration depths, shots at especially the neck, eyes and thorax regions, can cause fatal injuries. For that reason, the kinetic energy limits should be the main point of air gun restrictions.

A rare localization of giant symplastic leiomyoma: Perianal region

Giant symplastic leiomyoma of the gluteal region is a rarely seen situation. It is accepted as a benign illness. A 36-year- old woman presented to general surgery clinic because of a mass on her right thigh. On physical examination, there was a 7 x 6 cm mass that was mobile and bulging up from the surface of skin, 3 cm from her anus. Pathologic examination revealed symplastic leiomyoma. Leiomyomas are benign smooth muscle tumors. After excision, dermal lesions have a 40% recurrence rate. Even if mitotic activity can be shown microscopically, follow-up is important and unnecessary treatment for symplastic leiomyoma must be avoided.

The wounding potential of free-falling bullets

BACKGROUND It was aimed in this study to clarify the wounding potential of free-falling bullets fired at 90° or close to right angles. MEHTOHDS In this study, 9x19 mm and 7.65x17 mm bullets, which are commonly used among civilians, were used. The muzzle velocities of these ammunitions were measured. According to the muzzle velocity data, the free-falling motion and strike velocity of the 9x19 mm and 7.65x17 mm bullets were simulated using the EBV4® External Ballistics Software at angles of 65°-90° with firings at 5° intervals. The simulation results were compared with critical velocity of tissues. In addition, the judicial records and press reports on this type of wound were examined and evaluated in light of the literature. RESULTS The strike velocity and kinetic energy of free-falling bullets, which were fired into the air at 5° intervals between 65°-90°, were measured. The average strike velocity and kinetic energy of 9x19 mm bullets were 92.25 m/sec and 34.05 J and of 7.65x17 mm bullets were 79.66 m/sec and 14.91 J, respectively. As a result of the archives examination, 65 such wounds were detected between 2000 and 2012, and 27 of them resulted in death. DISCUSSION According to these results, the strike velocity of free-falling 9x19 mm and 7.65x17 mm bullets, which were fired into the air, exceeds the threshold and critical velocity limits of skin and flat bones, and the kinetic energy of the bullets is able to cause significant wounding. Even though the symptoms and features of these types of wounds may not be similar to those of ordinary gunshot wounds in the first medical examination, the first responders should be aware of the possibility of gunshot wounds, and they should take into account the criminal investigation phase during the treatment process; the necessary precautions should be taken in order to preserve the evidence.

An unusual case of glaucoma: traumatic glaucoma probably caused by shock waves.

Ocular traumas often result in multiple structural alterations within the eye.1 High velocity blunt objects such as balls, stones, or airbags often cause direct trauma to the eye. The damage from the impact of a blunt object is mediated through structural injury associated with rapid compression of the ocular tissue resulting in rapid elongation along the equatorial plane.1 Penetrating ocular injuries, on the other hand, have different mechanisms of action and are commonly combined with injuries of various ocular tissues such as cornea, sclera, iris, lens, vitreous, retina, and choroid. Damage or obstruction of the trabecular meshwork by the effect of these injuries can lead to the development of posttraumatic glaucoma.2 We report an unusual case in which posttraumatic glaucoma has developed after injury to the eyebrow area with a gunshot. This case had a glaucoma that might have an unusual mechanism of development.