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Biomedical subjects

H Altun

Publications and source records attributed to H Altun.

5 recordsLinked to original sources

Laparoscopic cholecystectomy for renal transplants.

The diagnosis and management of cholelithiasis in renal transplant patients are subjects of debate. The purpose of this study was to evaluate the outcomes of laparoscopic cholecystectomy in renal transplant patients with symptomatic gallstone disease. The records of 155 kidney transplant patients were reviewed, including 16 patients who, underwent laparoscopic cholecystectomy. Shortest interval time between transplantation and cholecystectomy was 2 years. Surgical morbidity were seen in two patients (12.5%) with no mortality and no graft loss. In conclusion, laparoscopic cholecystectomy can be performed safely with low morbidity in renal transplant patients who have symptomatic gallstone disease. The morbidity rate is comparable to nontransplant patients.

Cholecystectomy↗

Hyperfunctioning parathyroid cysts: a case report.

Parathyroid cysts are infrequent lesions of which most are non-functional. They are often misdiagnosed as thyroid cysts. Pre-operative diagnosis and differentiation from thyroid cysts is generally difficult. We hereby report a case that was admitted to the emergency room and was diagnosed as hypercalcemic crisis. The mass found during the neck examination was thought to be a thyroid nodule. A right total and left subtotal thyroidectomy was performed. Palpable thyroid nodule was diagnosed as cystic parathyroid adenoma postoperatively. When a cystic lesion is found in the neck of a patient, a pararthyroid cyst should be considered.

Cysts↗

Evaluation of leukocyte arylsulfatase-A activity in patients with breast cancer and benign breast disease.

This study was planned to evaluate the feasibility of using the assay of leukocyte arylsulfatase-A (AS-A) activity as a non-invasive diagnostic tool in patients with benign and malignant breast disease. The leukocyte AS-A activity of a total of 81 women was analyzed, including 28 healthy women, 29 women with benign breast disease (BBD) and 24 patients with primary breast cancer (BC). The mean leukocyte AS-A activity in patients with BBD was slightly higher (14.3%) that observed in the healthy subjects, but the difference was not statistically significant. In patients with BC the enzyme activity was significantly higher than in the healthy subjects (60.3%, P<0.05) and in the benign group (40.2%, P<0.05). In addition, since no significant differences have been observed between premenopausal patients and their controls, it is suggested that the measurement of leukocyte AS-A activity may not be a reliable test for differential diagnosis of benign and malignant proliferation in mammary glands due to the possible interfering effect of gonadal hormones on AS-A activity. In contrast, since peri- and postmenopausal BC patients have negligible or no gonadal activity function, the elevation in the activity of leukocyte AS-A in these age groups of patients may only be expected to originate from malignant proliferation. Based on our results, it is concluded that in patients in whom high leukocyte AS-A activities were observed the possibility of the presence of malignancy might also be high. Therefore, this test might be valuable as a non-invasive biochemical technique in combination with other established markers for the identification of masses in the breast.

Adult↗

A case of acute pancreatitis in a patient with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an auto-immune disease which can affect multiple organs. It may also involve the pancreas and in rare cases may cause acute pancreatitis. The etiology of acute pancreatitis in SLE is a matter of controversy. We present a case diagnosed with SLE that developed acute pancreatitis while being treated with corticosteroids. During the course of the disease, pancreatic pseudocysts developed and were treated by percutaneous drainage. There are few reports in the literature about the therapy of acute pancreatitis and percutaneous drainage of pseudocysts in SLE. We discuss the pathogenesis and therapy for acute pancreatitis in SLE patients.

Acute Disease↗

Validation of MPI and PIA II in two different groups of patients with secondary peritonitis.

BACKGROUND/AIMS: There are several scoring systems designed to predict mortality in patients with peritonitis, which need validation in different patient populations. Our aim was to evaluate Mannheim Peritonitis Index (MPI) and Peritonitis Index of Altona (PIA II) in patients with postoperative peritonitis and other causes of secondary peritonitis. METHODOLOGY: The records of patients operated for intraabdominal infection between 1987-1996 in Hacettepe University Department of General Surgery, were reviewed retrospectively. A total of 473 patients were included in the study; 75 of them had postoperative peritonitis (POSTOP group) and the remaining 398 had secondary peritonitis due to other causes (OTHER group). Using multiple logistic regression, MPI and PIA II were combined in an equation and this new variable was called combined peritonitis score (CPS); CPS = -9 + (0.3 x MPI) + (-1.2 x PIA II). All patients were scored according to MPI, PIA II and CPS. Receiver-operator characteristic (ROC) curves and sharpness of scores were compared. Also mean scores in both groups, proportions of correct predictions of outcome according to scores and correlation of scores with mortality were compared. RESULTS: Overall mortality was 17.8% in OTHER group and 33.3% in POSTOP group (P = 0.0018). Higher MPI scores, lower PIA II scores and higher CPS scores were associated with higher mortality in both groups (P < 0.0001). Mean MPI values were higher, mean PIA II values were lower and mean CPS values were higher in POSTOP group (P < 0.001). The areas under ROC curves of CPS were bigger than MPI and PIA II in both groups. Sharpness of CPS was higher in both groups compared to MPI and PIA II (P < 0.05). Proportion of correct predictions of outcome was highest in CPS among the three scores (P = 0.0074). CPS had the best correlation with observed mortality. CONCLUSIONS: POSTOP group patients had higher MPI, lower PIA II and higher CPS values ending up with higher mortality. This may be because of the delay in diagnosis and treatment, resulting with higher organ failure rates. Generally the results of evaluations for MPI and PIA II are similar. When these two peritonitis scores are combined and used together in the form of CPS, all the parameters improve.

Abdomen↗