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Karagoz H.,Surgery Academy | Ulkur E.,Surgery Academy | Kerimoglu O.,Marmara University | Alarcin E.,Marmara University | And 3 more authors.
Microsurgery | Year: 2012

The most commonly used surgical technique for repairing segmental nerve defects is autogenous nerve grafting; however, this method causes donor site morbidity. In this study, we sought to produce prefabricated nerve grafts that can serve as a conduit instead of autologous nerve using a controlled release system created with vascular endothelial growth factor (VEGF)-loaded poly(lactic-co-glycolic acid) (PLGA) microspheres. The study was performed in vitro and in vivo. For the in vitro studies, VEGF-loaded PLGA microspheres were prepared. Thirty rats were used for the in vivo studies. Vein grafts were sutured between the tibial and peroneal nerves in all animals. Three groups were created, and an epineural window, partial incision, and microsphere application were performed, respectively. Walking track analysis, morphologic, and electron microscopic assessment were performed at the end of the eight weeks. Microspheres were produced in spherical shapes as required. Controlled release of VEGF was achieved during a 30-days period. Although signs of nerve injury occurred initially in the partial incision groups according to the indexes of peroneal and tibial function, it improved gradually. The index values were not affected in the other groups. There were many myelinated fibers with large diameters in the partial incision and controlled release groups, while a few myelinated fibers that passed through vein graft in the epineural window group. Thereby, prefabrication was carried out for the second and third groups. It was demonstrated that nerve graft can be prefabricated by the controlled delivery of VEGF. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012. Copyright © 2012 Wiley Periodicals, Inc.

Hazer B.,Kasimpasa Military Hospital | Karakas D.O.,Military Hospital
Ulusal Travma ve Acil Cerrahi Dergisi | Year: 2013

Various kinds of foreign bodies causing appendicitis have been reported. However, a needle contained in the appendix is very rare, especially in adults. We report an unusual case of a twenty year old man who had ingested a needle ten days prior and presented with signs and symptoms of acute abdominal pain. An abdominal computed tomography scan revealed acute appendicitis. The patient was successfully treated with laparoscopic surgical intervention. In cases of a foreign body in the gastrointestinal tract that cannot be removed endoscopically, the emergence of non-specific symptoms may be early symptoms of acute problems in the abdomen. © 2013 TJTES.

Bozkurt I.H.,Kasimpasa Military Hospital
JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons | Year: 2012

Retroperitoneal laparoscopic pyelolithotomy was performed in an ectopic pelvic kidney with renal pelvis calculi. Laparoscopic pyelolithotomy was successfully performed in an ectopic pelvic kidney by using the retroperitoneal route. The total operation time was 130 minutes, and the estimated blood loss was < 50 mL. The patient was discharged on the second postoperative day without any complications. Laparoscopic pyelolithotomy is an effective treatment option for management of stones in the pelvis of an ectopic pelvic kidney. The retroperitoneal route may help to avoid intraoperative and postoperative complications.

Coskun O.,Gulhane Medical Academy | Erdem H.,Kasimpasa Military Hospital | Avci A.,Gulhane Medical Academy
Turkish Journal of Medical Sciences | Year: 2011

Aim: Community acquired acute bacterial cystitis (CA-ABC) is one of the most common infectious presentations in the community. This paper aims to provide a rational approach in the management of CA-ABC based on local Turkish data. Materials and methods: The publications evaluating the microbiological data obtained from CA-ABC cases were searched in both Turkish and international databases. Results: Fosfomycin and nitrofurantain appear to be baseline antibiotics while the empirical use of trimethoprim sulfamethoxazole, amoxicillin clavulanate, and first and second generation cephalosporins seems to be unreliable in Turkey. Moreover, quinolones seem to be at the edge with resistance rates up to 20%. On the other hand, aminoglicosides, third and fourth generation cephalosporins, and piperacillin-tazobactam look more trustworthy. Conclusion: According to local Turkish data, caution is really indicated in rational antibiotic use in the community since the traditional drugs used in the management of CA-ABC are being lost steadily. © TÜBİTAK.

Topuz A.K.,GATA Haydarpasa Training Hospital | Eroglu A.,GATA Haydarpasa Training Hospital | Atabey C.,GATA Haydarpasa Training Hospital | Cetinkal A.,Kasimpasa Military Hospital
Ulusal Travma ve Acil Cerrahi Dergisi | Year: 2013

BACKGROUND In this retrospective study, we present the results and outcomes in our clinic of 28 patients over 8 years who received surgical treatment for peripheral nerve lesions due to gunshot injury. METHODS The patients came to our clinic between January 2002 and February 2010. All came within 1-6 months after the initial gunshot injury and underwent surgery due to the diagnosis of peripheral nerve lesion. Preoperative and postoperative electromyographic analysis (EMG) and motor strength rating were performed on all patients. All patients were called for postoperative follow-up at 1, 6 and 12 months after surgery. RESULTS The mean time after initial injury before being seen at our clinic was 3.6 months (1 day - 6 months). The most commonly injured nerve was the sciatic nerve, in 14 cases (50%). Of the patients, 23 came due to a bullet injury (9 were civilian injury with a gun, 14 were military injury with a rifle) and 5 came due to shrapnel injury. Since in all cases integrity of the nervous tissue was fully intact, nerve grafting was not required during surgery. Relatively improved EMG findings, and recovery in motor functions were detected in cases who had undergone postoperative external epineurolysis plus decompression. CONCLUSION We recommend surgical treatment within the first six months in neural lesions, depending on gunshot injury, on the condition that surgical technique rules are obeyed (except infection, skin defect, vascular injury, and the presence of bone fracture).

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