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Biomedical subjects

A Keskin

Publications and source records attributed to A Keskin.

At least 19 recordsLinked to original sources
PubMed2004

[The role of pain in operative strategy].

As minimally invasive surgical procedures have become widespread, postoperative patient comfort has also gained importance for surgeons. Unfortunately, the issue of pain has not received the attention it deserves. Laparoscopic operations are not the only means of decreasing postoperative pain, as different techniques for open procedures have proven to result in different degrees of pain. The degree of postoperative pain should take place in the selection criteria for surgical techniques for many diseases, as well mortality, morbidity and recurrence rates.

Humans↗
PubMed2003

Remodelling in young sheep: a histological study of experimentally produced defects in TMJ.

QUESTIONS UNDER STUDY: In this study, experimentally induced surgical defects of the mandibular condyle were evaluated histologically 3, 6 and 9 months postoperatively to investigate the capacity for remodelling which is one of the most important features of the temporomandibular joint. METHODS: In three healthy sheep standardised surgical defects were produced on each right condylar head. The left temporomandibular joints served as controls. No treatment was performed on the surgical defects and function was not restricted postoperatively. At the end of the experimental period the sheep were sacrificed and a histological evaluation was carried out. RESULTS: Histologically, no disturbance was observed during the healing process in bone and cartilage. Although function was not limited throughout the study, it was observed that the experimental surgical defects had healed completely. CONCLUSIONS: This result points to the condyle's high capacity for repair and remodelling.

Animals↗
PubMed2001

The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysiologic study.

OBJECTIVES: To determine the clinical usefulness of an electrophysiologic method for evaluating dysphagia and to identify the effects of various head and neck positions on oropharyngeal swallowing. DESIGN: Experimental, with control group. SETTING: An electromyography laboratory. PARTICIPANTS: Patients with neurogenic dysphagia (n = 51) and healthy controls (n = 24). Patients were divided into 2 groups: those patients with unilateral lower cranial lesions (n = 9) and those without laterality in the function of the oropharyngeal muscles (n = 42). INTERVENTIONS: Subjects were instructed to swallow doses of water, gradually increasing in quantity from 1 to 25 mL under 5 conditions: neutral, chin up, chin tucked, head rotated right, and head rotated left. MAIN OUTCOME MEASURES: Change in dysphagia limit through specified head and neck postures. Oropharyngeal swallowing was evaluated by laryngeal movements that were detected by a piezoelectric sensor and electromyography of the submental muscle complex. Laryngeal sensor signals occurring within 8 seconds of a swallow were accepted as a sign of the dysphagia limit. RESULTS: In the control group, dysphagia limit did not change significantly with changes in head and neck postures, except for the chin-up posture (p <.05) in which piecemeal deglutition occurred when subjects swallowed volumes less than 20 mL. Dysphagia limit improved significantly (p <.05) in 67% of the patients with unilateral lower cranial lesions when the head was rotated toward the paretic side. In dysphagic patients with bilateral symptoms, a significant (p <.01) improvement in dysphagia limit occurred in 50% of patients in chin-tuck position, but in the chin-up position, 55% of the patients experienced a significant (p <.01) decrease in dysphagia limit. CONCLUSION: The electrophysiologic method of measuring dysphagia limit confirms neurogenic dysphagia and its severity in the neutral head position. Changes in head and neck positions do not significantly alter dysphagia limit in unimpaired subjects except for the chin-up position. Although the results obtained were not compared with other techniques (eg, videofluoroscopy), this simple electrophysiologic method for describing dysphagia limit may have a place in the evaluation of dysphagia and its variability in various head and neck positions.

Adolescent↗
PubMed2001

Remodelling following condylar fractures in children.

PURPOSE: In this study, 18 children with 21 subcondylar fractures sustained during their growth period (age at trauma from 4-11 years, mean 7.7 years) have been followed-up. MATERIAL AND METHODS: All patients were treated by custom-made arch bars and intermaxillary fixation for 12-17 days, then kept on a liquid diet for 15 days without fixation. The mean follow-up was 4.7 years. The conservative treatment has been evaluated with clinical, radiographic, and functional parameters. RESULTS: Remodelling of the condylar head was good in 17, whilst moderate remodelling occurred in the other four condyles. In four patients, a slight deflection (less than 2 mm) to the side of the fracture on wide mouth opening was seen. There was no malocclusion or ankylosis. CONCLUSION: Conservative treatment of condylar fractures during growth resulted in good function and good remodelling of the condyle. Functional treatment after intermaxillary fixation for 12-17 days proved to be quite acceptable.

Bone Remodeling↗
PubMed2000

Lower motor neuron disease associated with myelofibrosis.

We present a patient who has signs pointing to the involvement of lower motor neurons and myelofibrosis. To our knowledge, unlike lymphoproliferative disorders, co-occurrence of myelofibrosis and lower motor neuron disease (MND) has not been reported so far. A 64-year-old male patient was admitted to our hospital with the complaint of painful cramps in his neck and forearms. On physical examination marked hepatomegaly and splenomegaly were found. On neurologic examination nasal quality of the voice and slight palatal weakness were detected. There were generalised slight weakness and atrophy in both proximal and distal muscle groups. Fasciculations were observed especially in forearm muscles and it was observed that he had been avoiding head movements because of painful muscle cramps. Deep tendon reflexes were hypoactive. Nerve conduction studies were normal. By needle electromyography, giant motor unit action potentials (amplitudes up to 8 mV), fibrillation potentials, positive sharp waves and fasciculation potentials were detected in all muscles which were investigated. A hypercellular bone marrow (100%) was determined by bone marrow biopsy. In addition to increased production of the myeloid and megakaryocytic lines, abnormal aggregation and grouping of megakaryocytes were seen. Reticular fibers were increased. He had some benefit of dyphenilhydantoin treatment given for the painful cramps in his neck and forearm muscles. Hydroxyurea treatment was started for myelofibrosis. Six months later, his general condition was better, and the painful cramps were completely resolved. No marked deterioration has been detected in neurologic examination and electromyography for 1 year.

Atrophy↗
PubMed2000

Effect of mucosal anaesthesia on oropharyngeal swallowing.

The effect of the topical anaesthesia of the oropharyngeal mucosae was studied in order to evaluate the role of the mucosal sensory receptors on the oropharyngeal swallowing in 12 adult volunteers. Laryngeal vertical movements were detected by a piezoelectric sensor and electromyography of the submental muscle complex were simultaneously recorded. All subjects were instructed to swallow doses of water, gradually increasing in quantity from 3-20 mL and any recurrence of the signals related to swallowing within 8 s was accepted as a sign of dysphagia and its limit value measured. Before the topical anaesthesia of the oropharyngeal mucosae by xylocaine puffs; the dysphagia limit was never observed with less than 20 mL water. During topical mucosal anaesthesia lasting 4-6 min among the subjects, the dysphagia limit was less than 20 mL water and the recurrence of swallows two or more times was mainly recorded with 3-5 mL water. Five of the subjects demonstrated the clinical and electrophysiological signs of laryngeal aspiration at the earlier period of the topical anaesthesia. It is concluded that the sensory inputs from the mucosal receptors are important to trigger voluntary swallowing and their absence or dysfunction may contribute to oropharyngeal dysphagia and laryngeal aspiration.

Adult↗
PubMed2000

Premarital screening of beta-thalassemia trait in the province of Denizli, Turkey.

A premarital screening program aiming at reducing the incidence of thalassemia major was started under the auspices of the Regional Health Administration in 1995 in the city of Denizli in the Aegean region of Turkey. In this report we assessed the 4-year results of the screening program. All couples who applied for marriage procedures were screened for beta-thalassemia trait by automatic red cell indices and Hb A(2) determination. The couples at risk were counseled and offered prenatal diagnosis and termination of pregnancy in case of an affected fetus. From October 1995 to August 1999, a total of 19,804 subjects (9,902 couples) were recruited for this study. The prevalence of beta-thalassemia trait with increased Hb A(2) was found to be 2.6% (514/19,804). In addition to the thalassemia trait, 22 patients (0.11%) had sickle trait. In 15 of the 9,902 couples, both partners were found to be carriers of the beta-thalassemia trait. After genetic counseling, 2 of the 15 planned carrier marriages were canceled. Seven couples declared that they do not want to have a child at present. Prenatal diagnosis was sought by 6 couples. One fetus was found to be normal, 4 had thalassemia minor and 1 had thalassemia major; this pregnancy was terminated by elective abortion. This study indicated that premarital screening is a very useful tool for detecting carrier couples and an effective way of controlling thalassemia major.

Abortion, Induced↗
PubMed2000

The incidence of cysts and tumors around impacted third molars.

The objective of this retrospective analysis was to determine the incidence of the development of cysts and tumors around third molars and to discuss some relevant issues in relation to the removal of asymptomatic, impacted third molars. 9994 impacted third molars, removed in 7582 patients, formed the basis of this study. The analysis revealed 231 cysts (2.31%) and 79 tumors (0.79%), including 7 benign tumors (0.77%) and two malignant tumors (0.02%). The incidence of cysts and tumors around impacted third molars was 3.10%.

Adolescent↗
PubMed1999

Hydatid cyst of the abdominal aorta and bilateral common iliac arteries. A case report.

Hydatid disease, a parasitic infestation, is endemic in live-stock raising countries where the custom of feeding offal to dogs prevails. Though infestation of any part of the human body can occur, arterial involvement is a rare affliction. We report here the first case in which abdominal aorta and bilateral iliac arteries were totally occluded with intraluminal cysts.

Adult↗
PubMed1998

Beneficial effect of Iloprost on impaired colonic anastomotic healing induced by intraperitoneal 5-fluorouracil infusion.

PURPOSE: 5-Fluorouracil is the most effective chemotherapeutic agent in the management of patients with systemic colorectal cancer. Studies in recent years discussed the gradually increasing benefits of 5-fluorouracil within adjuvant chemotherapy protocols after complete surgical resections. However, many studies also have demonstrated that 5-fluorouracil impairs wound-healing on colonic anastomoses. METHODS: In our experimental study, we examined the influence of intraperitoneal 5-fluorouracil on healing of colonic anastomoses and, also, attempted to discover whether Iloprost (PGI2 analog, a potent vasodilator with confirmed cytoprotectivity and inhibitor of thrombocyte aggregation) counteracts impaired wound-healing induced by 5-fluorouracil. A total of 80 Wistar-Albino male rats were separated into four groups. From the day of the operation, Group A received intraperitoneal saline solution, Group B received 20 mg/kg 5-fluorouracil intraperitoneally, Group C received 20 mg/kg 5-fluorouracil plus 2 microg/kg Iloprost intraperitoneally, and Group D received 2 microg/kg Iloprost intraperitoneally. Each group was divided into two subgroups, and both subgroups were killed on the third and seventh postoperative days, respectively. The subjects were measured for anastomose bursting pressures and tissue hydroxyproline levels, and wound-healing was evaluated histopathologically. Statistical evaluations among each group were made with Student's t-test and Pearson's chi-squared tests. RESULTS: Iloprost had an accelerating effect on normal colonic anastomose wound-healing histopathologically, had no significant difference on bursting pressures and hydroxyproline levels, and significantly improved the impaired healing effect of 5-fluorouracil. CONCLUSIONS: Our study showed a positive effect of Iloprost on the healing of colon anastomosis and, more importantly, if wound-healing is impaired by a chemotherapeutic agent, Iloprost counteracts and reverses the effect. [Key words: 5-Fluorouracil; Healing of colon anastomoses; Iloprost

Anastomosis, Surgical↗
PubMed1998

Spinal cord compression secondary to extramedullary hematopoiesis in thalassemia intermedia.

Extramedullary hematopoiesis associated with thalassemia causing spinal cord compression is an extremely rare event in the course of the disease. Documentation with an imaging technique, such as MRI, is mandatory. A patient with thalassemia intermedia, who developed paraparesis in spite of transfusion, underwent surgical decompression. Rapid neurological improvement was observed postoperatively and this neurological condition was protected with adequate hemoglobin level. Management of these patients remains controversial. Various modes of therapy such as surgical decompression, radiotherapy, and transfusion are discussed and the related literature is reviewed.

Adult↗
PubMed1998

Myocardial hemodynamic and metabolic changes during abdominal insufflation with carbon dioxide.

It is a well-known fact that laparoscopic procedures performed with carbon dioxide insufflation impair myocardial function. In this study, we aimed to determine the safety limitations of various intra-abdominal pressure values during abdominal insufflation with carbon dioxide. Of the 24 mongrel dogs, 6 were assigned to one of four different pressure groups (10, 15, 20 and 30 mm Hg), respectively. Cardiac output, right/left heart pressures, and the first derivative of ventricular pressure were monitored. Myocardial oxygen consumption, myocardial lactate/oxygen extraction, tissue lactate and adenosine triphosphate levels were determined. Measurements were performed initially as a control, at 15-min intervals during 1 h of insufflation and 1 h after desufflation. At 10 mm Hg carbon dioxide pressure, hemodynamic and metabolic parameters were not significantly different. Cardiac output decreased significantly in the 20 and 30 mm Hg groups (p < 0.05: 10, 15 vs. 20, 30 mm Hg). Although cardiac output did not change at 15 mm Hg, the dp/dt value was significantly reduced. Cardiac output at the 60th min was 1,960+/-75 ml/min in the 10 mm Hg group, 1,885+/-40 ml/min in the 15 mm Hg group, 1,770+/-45 ml/min in the 20 mm Hg group and 1,695+/-40 ml/min in the 30 mm Hg group. Myocardial oxygen consumption was reduced at 15, 20 and 30 mm Hg (p < 0.05: 10 vs. 15, 20 and 30 mm Hg). In the myocardial tissue, ATP decreased from 19+/-2 to 12+/-1.2 micromol/g at 15 mm Hg, from 19+/-1.9 to 9.4+/-1.3 micromol/g at 20 mm Hg and from 18+/-3.2 to 8.2+/-1.9 micromol/g at 30 mm Hg. Changes in hemodynamic and metabolic parameters of the heart are reversible and may not lead to any significant impairments in patients having normal cardiopulmonary function, but pose a risk in patients with respiratory disease and limited myocardial reserve.

Abdomen↗
PubMed1997

Undescended testes in adults: clinical significance of resistive index values of the testicular artery measured by Doppler ultrasound as a predictor of testicular histology.

PURPOSE: We evaluated the clinical significance of arterial impedance as a predictor of testicular histology in adults with undescended (inguinal) testes. MATERIALS AND METHODS: We performed arterial impedance and testicular diameter measurements with the use of color Doppler ultrasonography on 22 adults with undescended testes. Arterial impedance of the contralateral descended testes served as controls. All patients later underwent inguinal orchiectomy and the testes were examined histologically. RESULTS: Of the 22 undescended testes, 7 had arterial impedance values below 0.50, and the other 15 had values equal to or above 0.50. All testes with arterial impedance values below 0.50 had histologic scores between 2 and 3, whereas the others had scores of 3 and 8. Arterial impedance values and testicular volumes in the contralateral testes were significantly higher than the undescended testes. Although some of the testes with arterial impedance values above 0.50 had histologic score 3, testes with arterial impedance values below 0.50 never exceeded score 3. Volume differences of the undescended testes were not statistically significant. CONCLUSIONS: Arterial impedance of an undescended testis may have a predictive value and provide more accurate information about its histology than the volume measurement itself.

Adult↗
PubMed1997

Mesenteric panniculitis.

Mesenteric panniculitis is a non-neoplastic inflammatory process affecting the adipose tissue of the mesentery. It is an extremely rare disease. We report the case of a 30-year-old man with mesenteric panniculitis and describe the radiologic findings.

Adipose Tissue↗
PubMed1996

A biomechanical comparison between original and used titanium miniplates.

Four dogs were chosen for this study. An experimental fracture was made in the mandibular symphysis region of each dog. Two miniplates and eight screws were applied, and removed three and six months postoperatively. In this study, the surface and mechanical characteristics of titanium miniplates were evaluated. Study materials consisted of four groups. In each of the groups, there were six miniplates. The groups are as follows: Group A: Original plates (not used) as a control (i.e. used as a reference in comparisons) Group B: Original plates bent as in operation but not left in tissue Group C: Plates removed at third month postoperatively Group D: Plates removed at sixth month postoperatively. After evaluation of all groups, there was no difference in the microstructure of the surfaces but some differences in mechanical characteristics were apparent.

Animals↗