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Öğe ALTI YAŞINDAKİ BİR OLGUDA AKUT MARJOLİN ÜLSERİ(Türk Plastik Rekonstrüktif ve Estetik Cerrahi Derneği, 2010) Bozkurt, Mehmet; Kuvat, Samet Vasfi; Baykan, Halit; Kapı, Emin; Özekinci, SelverMarjolin ülseri, yanık ya da posttravmatik skar alanlarından gelişen, yayılım oranı yüksek, sık tekrarlama eğilimi gösteren, tedavisi bu nedenle zorluk teşkil eden ölümcül ve kötü huylu bir tümördür. Kronik yaralardan sonra malign dönüşüm gözlenmesi sıklıkla orta ve ileri yaşlarda ortaya çıkar. Pediatrik yaşta ortaya çıkan akut Marjolin ülserleri ise çok nadir gözlenir. Bu çalışmada 6 yaşındaki erkek olguda, alt ekstremitede ülsere ve iyileşmeyen lezyon nedeniyle uygulanan cerrahi tedavi ve elde edilen bulgular sunulmaktadır. Olgunun anamnezinden lezyonun sekonder iyileşmeye bırakıldığı, travma sonrası 1 yıl içinde hiperplazi geliştiği öğrenildi. Cerrahi rezeksiyon sonrasında lezyon histopatolojik olarak skuamöz hücreli hiperplazi tanısı aldı. Operasyon sonrası 1. yılda nüks gözlenmedi. Literatürde Marjolin ülserlerinde sıklıkla yassı hücreli karsinom tanıları elde edilmekte ise de, farklı histopatolojik tanılarla da karşılaşılabilmektedir. Olgumuz, pediatrik yaşta olmasına rağmen kısa bir latent periyoda sahip olması nedeniyle oldukça ilgi çekicidir.Öğe The association between cellular morphological changes in peripheral blood smear and complications in pediatric burn cases(Turkish Assoc Trauma Emergency Surgery, 2011) Bozkurt, Mehmet; Kuvat, Samet Vasfi; Kapi, Emin; Karakol, Percin; Ozel, Abdulkadir; Baykan, HalitBACKGROUND Mortality and morbidity in burn cases can be reduced with early diagnosis. Many markers are used for early diagnosis of burn complications like sepsis. In this current study, the relationship between numerical/morphologic granulocyte abnormalities and complications was investigated in pediatric burns. It was aimed to introduce histopathologic marker(s) for burn-related complications. METHODS Thirty-two pediatric burn cases hospitalized between December 2006 and December 2009 were included in the study. A total of 192 complete blood count and peripheral blood smear results were analyzed comparatively. Findings were used to identify any correlation among white blood cell count and peripheral blood smear changes (the appearance of immature granular cells, toxic granulation, purple granules and Dohle bodies) and complications such as bacteriemia, sepsis, wound infections, severe anemia, and graft failure. RESULTS White blood cell count changes and the appearance of immature granular cells were not suitable for use as a diagnostic marker for complications. Nevertheless, there was a statistically significant correlation between the appearance of toxic granulation, purple granules and Dohle bodies and subsequent complications (p: < 0.0001, 0.041, 0.001, respectively). CONCLUSION Toxic granulation, purple granules and Dohle bodies appear to be helpful in predicting burn-related complications. Therefore, peripheral blood smear is a suitable test for predicting future complications.Öğe Effect of sildenafil citrate in nicotine-induced ischemia: An experimental study using a rat model(Pulsus Group Inc, 2013) Baykan, Halit; Ozyazgan, Irfan; Selcuk, Caferi Tayyar; Altiparmak, Mehmet; Ozkose, Mehmet; Ozyurt, KemalRecent experimental and clinical studies have demonstrated the negative effects of nicotine on the viability of skin flaps. Necrotic damage to skin flaps can result in significant complications including delayed wound healing, dehiscence and wound contraction. Phosphodiesterase type 5 inhibitors, such as sildenafil citrate, have a protective effect in ischemic injuries of the brain, kidney, myocardium, spinal cord, ileum and testes. In the present study, the authors evaluated the effect of sildenafil citrate on the viability of skin exposed to nicotine-induced ischemia in Sprague Dawley rats. In the preoperative period, the rats were divided into three groups of 10 rats each. Group C was treated with subcutaneous saline and group S and group N were treated with 2 mg/kg nicotine, administered subcutaneously twice per day for 28 days. McFarlane flaps were created in all experimental animals using an incision measuring 7 cm x 3 cm. Postoperative treatment varied among the groups: group S was treated with 20 mg/kg/day sildenafil citrate, while group C and group N were treated with equivalent doses of saline for seven days. A laser Doppler flow meter was used to monitor the microvasculature. Preoperative measurements of the microvasculature revealed decreased blood flow in group N and group S, both of which were treated with subcutaneous nicotine. During the postoperative evaluation, a trend toward increased blood flow was observed in group S compared with the group with nicotine-induced ischemia treated with saline alone post-operatively (group N). A visual fluorescein dye test was used to predict skin viability and demonstrated diminished skin viability in group N and group S (P<0.05) during the preoperative period. Following treatment with sildenafil for seven days, a statically significant improvement in skin viability was observed in group S (P<0.05). Nicotine decreased blood flow within the skin and impaired skin viability, while postoperative application of sildenafil significantly ameliorated the ischemic effects of nicotine and improved skin viability. Future studies will be required to evaluate the clinical use of sildenafil for the improvement of blood flow in ischemic injury of the skin.Öğe İleri derece yaşlı hastada mini doz bupivakain ile spinal anestezi(Modestum Publishing Ltd., 2010) Çelik, Feyzi; Tüfek, Adnan; Yıldırım, Zeynep Baysal; Karaman, Haktan; Baykan, Halit; Kavak, Gönül Ölmez; Temel, VildanKalça ve alt ekstremite cerrahisi uygulanan hastaların büyük bir çoğunluğu ileri yaş grubundadır. Bu yaş grubundaki hastalarda kardiyak, endokrin, renal, serebral ve respiratuvar hastalıkların varlığı, peroperatif ve postoperatif morbidite ve mortalite riskini artırmaktadır. Bu olguda sağ kalça protezi operasyonu yapılan 106 yaşındaki erkek hastanın anestezi yönetimi sunulmuştur. Klin Den Ar Derg 2010; 1(3): 214-215.Öğe Pediyatrik yanık olgularının periferik kan yaymasında hücresel morfolojik değişiklikler ve komplikasyonlarla ilişkisi(2011) Baykan, Halit; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Karakol, Perçin; Özel, Abdülkadir; Kapı, EminAMAÇ Yanık olgularında mortalite ve morbidite erken tanı ile azaltılabilir. Sepsis gibi yanık komplikasyonlarının erken tanısı için çok sayıda belirteç kullanılır. Bu çalışmada, yanık olgularında sayısal/morfolojik granülosit anormallikleri ve komplikasyonlar arasındaki ilişki araştırıldı. Bu sayede, yanık ilintili komplikasyonlar için histopatolojik belirteç/ lerin ortaya konulması amaçlandı. GEREÇ VE YÖNTEM Kasım 2006 ve Kasım 2009 yılları arasında hastanede yatırılan 32 pediatrik yanık olgusu çalışmaya dahil edildi. Toplam 192 tam kan sayımı ve periferal kan yayması sonuçları karşılıklı analiz edildi. Bulgular, beyaz kan hücresi sayımı, periferal kan yayması değişiklikleri (immatür granüler hücreler, toksik granülasyon, granül ve Döhle cisimciklerinin görünümü) ve bakteriyemi, sepsis, yara enfeksiyonu, ileri anemi ve greft kaybı gibi komplikasyonlar arasındaki olası korelasyonun saptanmasında kullanıldı. BULGULAR Beyaz kan hücresi sayısındaki değişiklikler ve immatür granüler hücrelerin görülmesinin komplikasyonlar için tanısal belirteç olarak kullanımı uygun değildir. Bununla beraber, toksik granülasyon, granül ve Döhle cisimciği görülmesi ile komplikasyonla karşılaşılması arasında istatistiksel olarak anlamlı korelasyon bulunmaktaydı (p: 0,0001<, 0,041, 0,001). SONUÇ Toksik granülasyon, granül ve Döhle cisimciğinin, yanık ilintili komplikasyonların tahmininde yardımcı olabileceği görünmektedir. Bundan dolayı, periferik kan yaymaları gelecek komplikasyonların tahmininde uygun tetkiklerdir.Öğe Reconstruction of Full-Thickness Nasal Alar Defects Using Cartilage-Supported Nonfolded Nasolabial Flaps(Lippincott Williams & Wilkins, 2012) Selcuk, Caferi Tayyar; Ozalp, Burhan; Durgun, Mustafa; Bozkurt, Mehmet; Baykan, HalitThe difficulties faced in the reconstruction of the nasal alar defects are still continuing because of their unique anatomy, free margin, and triple-layered complex structure. In this study, we would like to present the results of the cartilage-supported nonfolded nasolabial flap reconstruction method that we applied to full-thickness alar defects involving the alar rim. Between March 2009 and October 2011, 5 patients with full-thickness alar defects underwent cartilage graft-supported nasolabial flap reconstructions. Three of the patients were men, whereas 2 patients were women. Their median age was 54.2 years (range, 43-62 y). The defects were caused by either tumor excision or trauma. According to the method we applied, cartilage grafts were placed into the pouches formed between the skin and the adipose tissue to provide cartilaginous support to the nasolabial flaps to be adapted to the defect areas. The deep surfaces that were going to form the nasal mucosa were grafted using postauricular full-thickness skin grafts. Patients were followed up for a median period of 7.3 months (range, 3-21 mo). In all patients, the flaps fully fitted the defect areas and provided enough coverage over the defects. Although minimal graft contractions were observed in the later phase because of the cartilage support placed within the pouches formed in the flaps, no nasal airway constrictions were observed. The technique we applied is a simple and reliable method providing adequate framework support, full color and texture harmony, an open nasal passage, and a single-session reconstruction in most cases.Öğe SIX YEARS A CASE OF ACUTE MARJOLIN' ULCER(Medknow Publications & Media Pvt Ltd, 2010) Bozkurt, Mehmet; Kuvat, Samet Vasfi; Baykan, Halit; Kapi, Emin; Ozekinci, SelverMarjolin's ulcer is a deadly and malignant tumor that develops in burn or posttraumatic scar areas; it spreads aggressively and has a tendency to recurrence. Malignant transformation is frequently observed in middle and advanced ages. Marjolin's ulcer occuring during pediatric age is rarely observed. In this study, surgical treatment performed due to ulcer and non-healing lesions in lower extremities of a 6 years old male patient and results obtained from this treatment are presented. Based on the patient's anamnesis it was discovered that the lesion was left to go through secondary healing and hyperplasia had developed within one year of the trauma. After surgical resection, squamous cell hyperplasia diagnosis of the lesion was obtained histopathologically. After the operation, no recurrence was observed during the first year. Although in Marjolin's ulcers, squamous cell carcinoma diagnosis is obtained frequently, different diagnosis may also be encountered. Our case is quite interesting since the patient has a latent period although he is at a pediatric age.Öğe Tissue necrosis following intramuscular diclofenac injection(Dicle Üniversitesi Tıp Fakültesi, 2010) Baykan, Halit; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Kapı, Emin; Çelik, FeyziFollowing intramuscular drug injections, livedoid dermatitis (also known as embolia cutis medicamentosa or Nicolau Syndrome), characterized by pain, skin discoloration, and cutaneous necrosis, may rarely be observed. In the present study, we present a 32-year-old male patient who developed Nicolau Syndrome after intramuscular injection of single-dose diclofenac sodium 75 mg due to renal colic pain. The physical examination revealed skin discoloration in his left gluteal region, and a skin necrosis. Case is very interesting because of rarelyÖğe Üretrada nadir rastlanan bir yabancı cisim nedeni: Elektrik teli(Dicle Üniversitesi Tıp Fakültesi, 2010) Baykan, Halit; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Kapı, Emin; Penbegül, Necmettin; Çelik, FeyziErişkinlerde üretral yabancı cisim nedeniyle hastaneye yapılan başvurular genellikle mental bozukluk, psikiyatrik problemler ya da seksüel davranış bozukluğu bulunan olgularda görülür. Bu yazıda, kocası tarafından üretrasına elektrik kablosu yerleştirilen bayan olgu sunulmaktadır.
