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Samsun, Turkey

Kirkil C.,Firat University | Bulbuller N.,Ataturk Teaching and Education Hospital | Ilhan Y.S.,Firat University | Aygen E.,Firat University | And 2 more authors.
Journal of the Pakistan Medical Association

Objective: To analyse outcomes of variable management strategies for the treatment of Acute Cholecystitis in relation to morbidity, mortality and conversion to open surgery. Methods: The retrospective study was conducted at Firat University Hospital, Turkey and comprised records of Acute Cholecystitis patients admitted between 2005 and 2011. Patients were divided into subgroups according to admission time as well as American Society of Anaesthesiologists score. The outcomes of early cholecystectomy, interval cholecystectomy, delayed cholecystectomy, 'cooling-off' therapy and percutaneous cholecystostomy were evaluated. Mortality, morbidity, and conversion to open surgery were calculated as measures of success. Data was analysed using SPSS. Results: Of the 1557 patients, 1052(67.6%) were female. The overall mean age was 42.4±14.7 years. Success rates of 'cooling-off' therapy and percutaneous cholecystostomy were 89.3% and 96.3%, respectively. The conversion rate following delayed cholecystectomy was 30%, which was higher than that of both early and interval cholecystectomy (0.2% and 0%, respectively; p<0.001 each). Mortality and morbidity rates of delayed cholecystectomy (57.1% and 7.1%, respectively) were also significantly higher than early and interval cholecystectomy (5% and 0.1%; 5.6 and 0%, respectively). Conclusion: Early laparoscopic cholecystectomy and interval cholecystectomy shared similar outcomes and rates of efficacy. Percutaneous cholecystostomy was a successful treatment option for high-risk patients, while delayed cholecystostomy correlated to the highest rates of conversion to open surgery, mortality and morbidity. © Pakistan Medical Association. All rights reserved. Source

Acikgoz A.,Gazi State Hospital | Gokce E.,Maternity and Childrens Hospital | Asci R.,Ondokuz Mayis University | Buyukalpelli R.,Ondokuz Mayis University | And 2 more authors.
International Journal of Impotence Research

Peyronie's disease is postulated to be initiated by repetitive minor traumas to the fully or partially erect penis. We investigated Peyronie's disease prospectively in cases treated for penile fracture (PF) within the last 20 years. Medical records of 63 cases treated for PFs were reviewed. Subjects were required to self-assess their current penile morphologies and sexual functions. Penile nodules and Peyronie's plaques were also evaluated with physical examination, ultrasonography and magnetic resonance imaging (MRI), and penile curvatures with auto-photography, and sexual function with international erectile function index (IIEF). Of the 63 cases (mean age 37 years), 46 who had mean follow-up of 63 months were re-evaluated. The mean IIEF-5 score was 23.23.1. Painful erections (n5), penile nodules (n5) and also penile curvatures 20° (n2) were investigated. No Peyronie's plaque was palpated in any of the cases. Ultrasound and MRI showed fibrotic nodules of 5 mm in diameter, which extended into the subtunical area in the rupture site in 54% of the cases, although any thickening and Peyronie's plaque were not found in the tunica albuginea and intracavernosal septum of the cases examined. In PF patients treated surgically, the erectile function and penile morphology were preserved. In our cases PFs did not induce the development of Peyronie's disease. © 2011 Macmillan Publishers Limited All rights reserved. Source

Asci R.,Ondokuz Mayis University | Acikgoz A.,Gazi State Hospital | Buyukalpelli R.,Ondokuz Mayis University
Turk Uroloji Dergisi

Spinal cord injuries (SCIs) may cause predictable abnormalities in genital sexual arousal and changes in the ability to achieve orgasm. In this review, sexual dysfunction and reproductive abnormalities and their treatment possibilities in male and female patients with SCI were reviewed. Literature from 1982-2011 examining the neuroanatomy of sexual functions, sexual dysfunction and reproductive abnormalities and their treatment alternatives both in male and female patients with SCI was reviewed with PubMed. In both genders, the sympathetic, parasympathetic and motor-sensory innervations of genitals are localized at the T11-L2, and S2-4 and S2-3 spinal cord levels, respectively. Patients with lesions above or at level of T11- L2 have reflex erections but no psychogenic erections. Patients with lesions in between levels of L2 and S2 spinal segments have reflex and psychogenic erections. Patients with lesions at level of S2-3 or below can have psychogenic erections but no reflex erections. Patients with lesions above the T10 level have autonomic, somatic, vibration and electroejaculations but no nocturnal ejaculation. Patients with lesions at the level of the thoracolumbar (T11-L2) region can have electroejaculation but no autonomic, somatic, vibration and nocturnal ejaculations. Patients with lesions below the L2 levels can produce emissions and electroejacula- tion but no other type of ejaculation. Reproductive dysfunction in men with SCI is due to a combination of ED, ejaculatory failure, and abnormal semen parameters. Women with no lesions at the T11-L2 levels may have psychogenic genital vasocongestion, while reflex lubrication and orgasm is more prevalent in women who have preserved the sacral reflex arc (S2-S5). A better knowledge of neuroanatomy and neurophysiology in SCI patients provides a more predictable understanding of sexual and reproductive dysfunctions. © 2012 by Turkish Association of Urology. Source

Nar G.,Aksaray State Hospital | Inci S.,Aksaray State Hospital | Aksan G.,Gazi State Hospital | Soylu K.,Ondokuz Mayis University | And 2 more authors.

Aim This study aims to evaluate the relationship between atrial electromechanical delay (AEMD) times and CHA2DS2-VASc scores in patients diagnosed with paroxysmal atrial fibrillation (PAF). Materials and Methods The study included a total of 74 patients, 34 of whom were diagnosed with PAF and 40 were included in the control group. The CHA2DS2-VASc score was calculated for each patient. Additionally, blood samples were taken from all patients and transthoracic echocardiographic measurements were made. Left atrial mechanical functions and AEMD were calculated. Results Mean CHA2DS2-VASc score measured was 2.24 ± 1.53 in PAF group. There was no significant difference between the groups when the patients were evaluated for baseline characteristics and laboratory parameters (P > 0.05) The echocardiographic evaluation of LA mechanical functions showed that only LA minimum volume (19 ± 6.4 vs. 16.7 ± 4.6, P = 0.02) and LA presystolic volume (28.9 ± 7 vs. 25.1 ± 5.7, P = 0.01) were higher in the PAF group. When AEMD was compared between the groups; lateral PA, septal PA, tricuspid PA, Interatrial EMD, and intraatrial EMD were significantly extended compared to control group (P < 0.001) CHA2DS2-VASc score was correlated with Lateral atrial PA (P < 0.001, r = 0.524), Septal atrial PA (P < 0.001, r = 0.45), Interatrial EMD (P < 0.001, r = 0.54), and intraatrial EMD (P < 0.001, r = 0.51) times. Conclusion The present study shows that AEMD times increase in patients with PAF compared to the control group. Furthermore, this study revealed a correlation between AEMD times and CHA2DS2-VASc score, as well showed that extended AEMD time may be associated with thromboembolism risk. © 2014, Wiley Periodicals, Inc. Source

Garca M.F.,Yuzuncu Yil University | Aslan M.,Yuzuncu Yil University | Tuna B.,Yuzuncu Yil University | Kozan A.,Gazi State Hospital | Cankaya H.,Yuzuncu Yil University
Journal of Membrane Biology

It has been suggested that oxidative stress may play an important role in the pathogenesis of chronic otitis media (COM), but the role of oxidative stress in the pathogenesis of COM has not yet been fully explored. Therefore, the aim of this study was to investigate serum myeloperoxidase (MPO) activity, 4-hydroxynonenal (4-HNE), malondialdehyde (MDA), total antioxidant capacity (TAC) and nitric oxide (NO) in patients with COM. Sixty-one patients with COM and 30 controls were enrolled in the present study. Patients were divided into two groups according to the presence (n = 21) or absence (n = 40) of cholesteatoma. Serum MPO activity and 4-HNE, MDA and NO levels were significantly higher in patients with COM than controls (for all, p < 0.001), while TAC levels were significantly lower (for all, p < 0.001). Serum MPO activity and MDA, 4-HNE and NO levels were significantly higher in patients with cholesteatoma than in those without cholesteatoma, while TAC levels were significantly lower; but the difference between groups was not statistically significant (p > 0.05). Increased oxidative stress seems to be associated with decreased antioxidant levels in patients with COM. Thus, increased oxidative stress may play a role in the pathogenesis of COM. It is believed that the administration of antioxidant vitamins such as A, C and E may be useful in preventing and treating COM. © 2013 The Author(s). Source

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