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Öğe Analysis of tractor-related deaths(Taylor & Francis Inc, 2013) Erkol, Zehra Zerrin; Büken, Bora; Hekimoğlu, Yavuz; Erkol, Mehmet Hayri; İnce, HalukThe aim of the study was to evaluate the properties of tractor-related death cases and discuss the precautions in order to prevent such events. For this aim, reports made between 2006 and 2009 by the First Specialty Board of Council of Forensic Medicine (FSBCFM), Turkey, were evaluated retrospectively. Forty-one tractor-related death cases were included in this study. Thirty-five (85.4%) of the cases were male. The mean age was 42.52 +/- 25.1 (with a range between 1 and 84 years old). The average time interval between the incident and death was 13.76 +/- 33.53 days (range: 0176 days) and 20 (48.8%) cases died on the incident spot or during transportation to the hospital. Among the cases, 34.1% (n=14) were drivers, whereas 39.0% (n=16) were passengers and the remaining were pedestrians (26.9%, n=11). The accident was caused by the tractor rolling over in 34.1%, the victim being run over in 22.0%, and the victim falling from the tractor or trailer in 22.0% of the cases. Most of the events (56.1%) occurred on the road. In conclusion, tractors must not be used as a transportation vehicle for passengers. Periodic training of drivers can be useful for reducing tractor-related accidents.Öğe Collision tumour of trichofolliculoma and basal cell carcinoma(Blackwell Publishing, 2007) Boran, Çetin; Parlak, Ali Haydar; Erkol, Mehmet HayriA 52-year-old woman presented with a 2-year history of a reddish nodule on the right nasolabial sulcus. Histopathological examination revealed that the nodule was composed of trichofolliculoma and basal cell carcinoma. There was no transitional zone between the two neoplasms. The diagnosis was made as a collision tumour of trichofolliculoma and basal cell carcinoma.Öğe A combination of plasma DAO and citrulline levels as a potential marker for acute mesenteric ischemia(Taylor & Francis Ltd, 2013) Çakmaz, Rıdvan; Büyükaşık, Oktay; Kahramansoy, Nurettin; Erkol, Mehmet Hayri; Çöl, Cavit; Boran, Çetin; Buğdaycı, GülerIntroduction: There is no valid and reliable diagnostic test for early diagnosis of acute mesenteric ischemia (AMI). The aim of this study was to measure the plasma levels of diamine oxidase (DAO) and citrulline in AMI to gain insight into its early diagnosis. Material and methods: A total of 21 Wistar albino rats were divided into three groups, that is, control group, short-term ischemia group, and prolonged ischemia group. The superior mesenteric artery was occluded for 15 min in the short-term ischemia group and for 12 h in the prolonged ischemia group. Twelve hours later, the experiment was terminated and plasma DAO and citrulline levels were measured. Intestinal tissue was evaluated for the histopathological changes. Results: Compared to the control group, the short-term and prolonged ischemia groups showed significant increases in the plasma levels of DAO, whereas the plasma citrulline levels decreased significantly. Prolonged ischemia caused a larger increase in the plasma DAO levels and a larger decrease in the plasma citrulline levels compared to the short-term ischemia (p =0.011 and p =0.021, respectively). Intestinal damage was shown to develop more in the prolonged ischemia group (p =0.001). Conclusion: In the early period of AMI, the plasma DAO levels increase while citrulline levels decrease, and the extent of these changes depends on the duration of ischemia.Öğe Detection rate of thyroid papillary micro-carcinoma in multinodular goiter surgery(Coll Physicians & Surgeons Pakistan, 2019) Özer, Bahri; Şit, Mustafa; Aktaş, Gülali; Keyif, Muhammet Fatih; Bolat, Ferdi; Erkol, Mehmet HayriObjective: To determine the frequency of papillary thyroid micro-carcinoma (PTMC) in multinodular goiter (MNG) surgery, as well as in opposite thyroid lobule of the dominant nodule. Study Design: Descriptive study. Place and Duration of Study: General Surgery Department, Abant Izzet Baysal University Hospital, between January 2010 and December 2016. Methodology: The data of 1300 patients who underwent thyroidectomy analyzed. Patients with single nodule in preoperative sonography, and patients with malignancy or suspected malignancy in fine needle aspiration cytology were excluded. PTMC was labelled as less than 10 mm in diameter. Results: After exclusion of such patients, 1,197 subjects with benign MNG were included in the study. There were 1,134 patients in benign group and 63 subjects in PTMC group, according to the postoperative pathology results. In PTMC group, 53 (84%) of subjects had one tumor and 10 (16%) has more than one cancerous nodules. Thirty-six (57%) of cancers in PTMC group were right sided and 27 (43%) were left sided. Cancer and dominant nodule were in the same thyroid lobe in 62% (n = 39) subjects in PTMC group. However, 24 subjects had cancer in the lobe opposite to the largest nodule. Conclusion: Total bilateral thyroidectomy should be preferred in MNG surgery due to high probability of multicentric disease.Öğe Effect of "an innovative technology" active warming and passive warming on unplanned hypothermia during perioperative period: a clinical trial(Mary Ann Liebert, Inc, 2018) Soysal, Ganime Esra; İlçe, Arzu; Erkol, Mehmet HayriPatients are at risk for unplanned hypothermia during the perioperative period due to many reasons, including anesthesia, low room temperature, cold intravenous fluid, and blood transfusion. This study was conducted to examine the effect of active and passive warming methods applied in patients during the perioperative period on unplanned hypothermia. This study is a case-control type study. The population of this study is composed of the patients hospitalized in surgical clinic and undergone abdominal region-related operations. Ninety patients were accidentally included in the study. The first group of patients were actively warmed during the perioperative period (carbon fiber resistive system - W-500D + 190 x 50 cm), the second group was passively warmed at least for 20 minutes during preoperative period (with blanket, socks etc.), and the third group was followed up as the control group. It was established that body temperature average of the active warming group has significantly increased during perioperative period (p < 0.001), and this temperature was significantly higher than the other groups until the third hour. It was found that the body temperature average of all groups was equal to 36.2 +/- 0.26, 35.4 +/- 0.49, and 35.2 +/- 0.47, respectively, at the end of operation, and the difference among them was statistically significant (p <= 0.001). The active warming method applied with carbon fiber resistive system during the perioperative period is an effective method.Öğe Effect of beta-glucan in lung damage secondary to experimental obstructive jaundice(Aves, 2012) Erkol, Mehmet Hayri; Kahramansoy, Nurettin; Kordon, Özgür; Büyükaşık, Oktay; Serin, Erdinç; Kükner, AyselBackground/aims: This study aimed at investigating the protective effects of beta-glucans on the lungs in obstructive jaundice. Methods: In total, five groups -Sham (1), control (2) and treatment groups (3,4,5)- were established; each comprising randomly selected seven Wistar Albino rats. Beta-glucan was given after choleduct ligation in Group 3 while it was given before and after the choleduct ligation in Group 4. As pre-treatment beta-glucan was given before ligation in Group 5. Beta-glucan was administered in a single dose of 50 mg / kg / day by gavage for a ten-day period. Superoxide dismutase, and myeloperoxidase levels in serum; malotzdialdehyde, lipid hydroxyperoxidase and glutathione levels in lung tissue; lactate dehydrogenase levels in bronchoalveolar lavage fluid were measured. Results: The blood polymorphonuclear leukocytes level was highest in the control group and lower in the sham and treatment groups. Serum superoxide dismutase and tissue glutathione values were significantly higher in Groups 3 and 4 (p <= 0.04) whilst Groups 3 and 4 did not differ from each other. In Groups 3 and 4 malondialdehyde, lipid hydroxyperoxidase, and myeloperoxidase values were significantly lower. However, Groups 3 and 4 did not differ for malondialdehyde or lipid hydroxyperoxidase values. Lactate dehydrogenase level in the bronchoalveolar lavage fluid was significantly lower in all of the treatment groups (Groups 3,4,5) (p <= 0.008). When compared to the control group, it was observed that lung damage was much more limited in the treatment groups (p<0.001). Conclusion: This study suggests that beta-glucan exhibits protective effect in pulmonary tissue against oxidative damage in obstructive jaundice.Öğe Evaluation of the Ratio of Positivity of HBs-Ag, Anti-HCV and Anti HIV in Patients Admitted to Surgery(2015) Kargi, Ertugrul; Şit, Mustafa; Erkol, Mehmet Hayri; Yaman, SemihAim: Contact with bloodborne pathogens constitutes a critically serious occupational risk for health care professionals. Among them, the most important and the most contagious pathogens are hepatitis B (HBV), hepatitis C (HCV) and human immune deficiency viruses This study has been realized with the intention to determine seroprevalences of HBV, HCV and HIV during preoperative period in our patients so as to increase awareness of the health care professionals about risks of haematogenous infections in their daily working environments in addition to emphasizing the importance of protective measures. Material and Methods: Hepatitis B surface antigen (HBsAg), anti-HCV and anti-HIV test results and demographic data of the patients undergoing elective surgery who were operated in the Department of General Surgery of Bolu Abant Izzet Baysal University between January 2012 and December 2014 were retrospectively reviewed. Statistical analysis was performed with the chisquare test. Results: Data of a total of 659 study patients who had been operated in the Clinics of General Surgery could be accessed. The study population consisted of 659 patients (men, n=330; 50.07 %; women, n=329; 49.93%). HBsAg positivity was detected in 7 (2.1%) patients. Three (0.9%) male patients with anti-HCV positivity were detected. One patients were positive for anti-HIV Conclusion: In conclusion, health care professionals in duty are under a higher risk of contracting HBV, HCV and HIV infections. To minimize occupational infection training of the health care personnel and vaccination against HBV, HCV and HIV infections carry utmost importance.Öğe Gender differences in trauma mechanisms, and outcomes in a rural hospital which is not designed as trauma centre(Bmj Publishing Group, 2013) Kahramansoy, Nurettin; Gürbüz, Necla; Kurt, Feyzi; Erkol, Mehmet Hayri; Boztaş, GüledalObjectives This study aimed to investigate how trauma characteristics and outcomes differ between genders in a rural hospital. Methods Records of trauma patients admitted to a state emergency department (ED) in eastern Turkey, between January 2006 and December 2007 were reviewed and data were analysed based on gender. Results In total, 5379 (87.0%) men and 806 (13.0%) women, totalling 6185 patients, were assessed. Mean age was 26.5 (1 month - 80 years) years for men and 24.7 (2 month - 81 years) years for women. Men comprised 90.2%, 81.3% and 77.3% of the patients injured by assault, motor vehicle incidents and falls, respectively. Women comprised a significantly larger share of suicide attempts (70.8%) than men. Of the men injured, 90.6% were discharged after treatment in the ED. The per cent of hospitalised women (5.8%) was increased compared with the per cent of hospitalised men (p=0.011). There was a higher frequency of transfer among women (8.6%) when compared with men (p<0.001). Women had a mortality frequency of 1.2%, which was similar to the mortality per cent calculated for men. Conclusions Men were at an increased risk for trauma, especially assault. The percentage of women injured and admitted to the ED due to assault was low compared with statistics reported in the literature. However, assault is the most common cause of trauma among women. The high per cent of hospitalisation and transfer among women may indicate that women are exposed to more severe trauma, and therefore experience increased morbidity compared with men.Öğe Hipertiroidi nedeniyle yapılan tiroidektomi sonrası hipokalsemi(2009) Hasdemir, Ahmet Oğuz; Türkeli, Vildan; Kahramansoy, Nurettin; Kordon, Özgür; Erkol, Mehmet HayriTiroid cerrahisi sonrası postoperatif hipokalsemi yaygındır ve sıklıkla geçicidir. Bu durum hastanede kalış süresini ve biyokimyasal tetkik ihtiyacını arttırdığından tiroidektominin maliyetini de yükseltmektedir. Abant Izzet Baysal Tıp Fakültesi'nde 2003-2007 yılları arasında opere edilen 111 hastada tiroidektomi sonrası kalıcı hipoparatirodizm ve hipokalsemi insidansı retrospektif olarak değerlendirildi. Çalışmada postoperatif hipokalsemili hastaların erken biyokimyasal ve klinik bulguları, uzun dönem sonuçlarla ilişkilendirildi. Hastaların 44'ünde postoperatif kalsiyum düzeyinin 8mg/dl altında olduğu gözlendi. On hastada hipokalsemi semptomatikti. Cerrahi girişimden 6 ay sonra 3 (%2.7) hastada kalıcı hipokalsemi mevcuttu. Hipertiroidisi olan hastaların geçici hipokalsemi yönünden daha yüksek risk taşıdığı saptandı (p=0031). Hipertiroidisi olan hastalardaki hipokalsemide, hipoparatiroididen daha çok 'Aç Kemik Sendromu'nun etkisi önemli olabilir. Operasyon öncesi, antitiroid tedavi osteodistrofiyi geri döndürebilir, bu geridönüş haftalar alabilir, oysa hastalarımızın çoğu daha kısa sürede hazırlandı.Öğe İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri(2012) Kahramansoy, Nurettin; Büyükaşık, Oktay; Erkol, Mehmet Hayri; Çöl, CavitAmaç: Yaş ilerledikçe inguinal hernilerin görülme sıklığı ve yandaş hastalık oranı artmaktadır. Bu nedenle ileri yaştaki hastalarda herniorafi sırasındaki anestezi yöntemi önem taşımaktadır. Çalışmamızın amacı, yaşlı hastaların operasyonunda lokal anestezinin uygulanabilirliğini araştırmaktı. Gereç ve yöntem: İnguinal herni tanısı ile opere edilen hastalar retrospektif olarak incelendi. Hastalar, ileri yaşlılar (>60) ve daha gençler olarak iki gruba ayrıldı. Uygulanan anestezi yöntemleri, ek anestezi gereksinimi ve komplikasyonlar karşılaştırıldı. Bulgular: Toplam 177 hastanın %30,5’i yaşlı idi. İki grup arasında operasyon tipi, anestezi yöntemi ve operasyon risk skoru belirgin farklılık gösterdi. Yaşlı olgularda, yandaş hastalık oranı (%55,6) belirgin yüksek (p< 0,001) idi. Yaşlı olgular arasında, lokal anestezi uygulanan olguların spinal-genel anestezi uygulananlara göre yandaş hastalık oranı hafif yüksekti. Lokal anesteziyi tercih oranı, genç-orta yaş olgularda %34,1 iken yaşlı olgularda %70,4 idi. Lokal anestezi yapılan ileri yaştaki bir olguda (%2,6) genel anesteziye dönüş oldu. Postoperatif komplikasyona, ileri yaşta daha sık rastlandı. İleri yaştaki komplikasyon gözlenen beş olgu (%31,3), genel-spinal anestezi yapılan olgular idi (p=0,002). Sonuç: İleri yaş hastalarda yandaş hastalık oranı ve operasyon risk skoru (ASA kategorisi) yükselmektedir. Lokal anestezi altında inguinal herniorafi, komplikasyonsuz ve genel anesteziye dönüş olmadan yapılabilir.Öğe Is appendectomy a simple surgical procedure?(Cirugia Y Cirujanos, 2021) Çatal, Oğuz; Özer, Bahri; Şit, Mustafa; Erkol, Mehmet HayriObjective: Acute appendicitis is among the most applied surgical procedures around the world. One of the complications of appendectomy is stump appendicitis. The diagnosis of stump appendicitis is usually delayed. Material and method: In our study, we compiled cases with stump appendicitis after appendectomy. All cases with open and laparoscopic appendectomy were included in our study. Results: Between 2008 and 2020, 5620 appendectomy patients who were operated in the general surgery clinic were examined. Appendectomy was performed in five patients due to stump appendicitis. One of the patients with stump appendicitis presented with symptoms of generalized peritonitis, another with symptoms of ileus, the other with symptoms of incarcerated incision hernia at the McBumey incision, and the other two patients with symptoms of acute appendicitis. Conclusion: As it can be understood from our study, although appendectomy is the most common and easily seen surgical procedure in general surgical practice, it is a procedure that increases morbidity as we see in patients with stump appendicitis. Abdominal tomography appears to be the gold standard in diagnosis in stump appendicitis. Surgeons should definitely suspect stump appendicitis in patients whose symptoms have improved, even with open appendectomy scarring.Öğe Kahramanmaraş ili'nde cezaevi ölümleri(2006) Erkol, Zerrin; Büken, Bora; Yılmaz, Rıza; Erkol, Mehmet HayriCezaevinde meydana gelen ölümler, gerek ülkemizde gerekse yurtdışında özellik taşımaktadır. Çalışmada Kahramanmaraş İli'nde cezaevinde meydana gelen ölümlerin özelliklerinin ortaya konması amaçlanmıştır. 1992-2002 yılları arasında Kahramanmaraş İl Merkezi'ndeki cezaevinde tutuklu veya hükümlü olarak bulunan, ölümünü müteakip Kahramanmaraş Cumhuriyet Başsavcılığı tarafından ölü muayenesi ve otopsisi yapılan olgular, yaş, cinsiyet, işlediği iddia edilen suç, ölüm nedeni, ölüm yeri, ölüm orijini yönünden değerlendirildi. Toplam 8 olgunun tümü erkekti. Doğal nedenlerle kaybedilen 4 olgudan üçünün "kronik obstrüktif akciğer hastalığı", "akut myokard infarktüsü" ve "akciğer kanseri" sonucu öldüğü, son olgunun ise "nüks mide Ca" tanısıyla hastanede tedavi altında bulunduğu sırada kaybedildiği belirlendi. Üç olgudan ikisinin tuvalette şalvar uçkuru ile birinin koğuşun kapısına yırttığı çarşaf parçasını geçirerek "ası" yöntemini kullanmak suretiyle intihar ettiği görüldü. Son olgunun ise küçük yaşta çocuğun fiili livata yöntemi ile ırzına geçmek suçundan hükümlü olup, iki mahkum tarafından kesici alet ile öldürüldüğü saptandı. Tutuklu ve hükümlülerin ölüm nedenlerine yönelik olarak alınacak tedbirlerin, bu grupta görülen ölümlerin sayısını azaltacağı düşünüldü.Öğe Kolesistektomi sonrası insidental safra kesesi kanseri saptanan hastaların değerlendirilmesi(2019) Çatal, Oğuz; Özer, Bahri; Şit, Mustafa; Bolat, Ferdi; Erkol, Mehmet HayriAmaç: Biz bu çalışmamızda kliniğimizde kolesistektomi yapılan hastalarda saptanan insidental safra kesesi kanseri olgularını etiyolojik faktörler yönünden inceledik. Yöntemler: Ocak 2010-Aralık 2017 tarihleri arasında Bolu Abant İzzet Baysal Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde kolesistektomi yapılan 3691 hastalar retrospektif olarak değerlendirilmiştir. Hastaların ameliyat öncesi batın ultrasonografi, biokimya ve patoloji spesimenleri, yaş, cinsiyet, histopatolojik sonuçlarına göre gruplandırılmışlardır. Spesimenlerin incelenmesinde kanser evrelemesinde uluslararası kanser savaş örgütünün tümör, nod, metastas evrelemesi kullanılmıştır. Bulgular: Üç bin altı yüz doksan bir hasta içerisinden 16 hastanın patoloji spesimenlerinin değerlendirmesinde insidental safra kesesi kanseri saptandı (%0,50). Hastaların tamamının patoloji spesimenleri incelendiğinde patoloji sonuçlarının adenokarsinom olduğu görülmüştür. Yine patoloji spesimenlerinde iki hastanın karsinoma insitu, iki hastanın T1, beş hastanın T2, yedi hastanın ise T3 olduğu görülmüştür. Sonuç: Bu çalışmada kliniğimizde yaptığımız kolesistektomiler neticesinde ileri yaş kadın, çoklu safra kesesi taşı 3 cm ve 3 cm’den daha büyük safra kesesi taşı olanlarda insidental safra kesesi oranının daha yüksek olduğu görülmektedir. Bunun yanında önem arz eden bir diğer durum benign safra kesesi hastalıkları nedeni ile preoperatif olarak hazırlanan ve opere edilen hastaların patoloji spesimenlerinin ve raporlarının klinikte takibinin ihmal edilmemesi gerekliliğidir.Öğe Mean platelet volume: An overlooked herald of malignant thyroid nodules(Sestre Milosrdnice Univ Hospital, 2019) Şit, Mustafa; Aktaş, Gülali; Özer, Bahri; Koçak, Mehmet Zahid; Erkuş, Edip; Erkol, Mehmet Hayri; Yaman, SemihPhysicians and surgeons pay much attention to evaluating thyroid nodules due to the malignant potential of these growths. Inflammation has a crucial role in the development of cancer. Increase in the mean platelet volume (MPV) has been described in various inflammatory conditions. Since some of thyroid nodules are malignant, we aimed to compare MPV values between patients with malignant and benign thyroid nodules after precise pathologic diagnosis. We retrospectively analyzed hemograms of patients having undergone thyroid surgery for thyroid nodule between January 2013 and January 2015, and compared them to those recorded in healthy subjects. MPV was higher in the malignant thyroid nodule group than in the benign nodule group (9.1 +/- 1 fL vs. 7.8 +/- 0.8 fL). The difference was statistically significant (p<0.001). Increased MPV should be considered as an assistive diagnostic tool in differentiating malignant and benign thyroid nodules. However, further prospective studies are required to confirm its usefulness in this population.Öğe Neutrophil to lymphocyte ratio is useful in differentiation of malign and benign thyroid nodules(Univ Puerto Rico Medical Sciences Campus, 2019) Şit, Mustafa; Aktaş, Gülali; Erkol, Mehmet Hayri; Yaman, Semih; Keyif, Fatih; Şavlı, HalukObjective: Significant amount of thyroid nodules are malignant. Inflammation plays crucial role in the pathogenesis of many disorders, including cancer. Neutrophil to lymphocyte ratio (NLR), has been suggested as an index of inflammatory response and association between increased NLR and cancer has also been reported. In this retrospective analysis, we aimed to study NLR levels in patients with malign and benign thyroid nodules and healthy control subjects. Methods: The patients who underwent surgery for nodular goiter in general surgery clinics of our university hospital between June 2012 and June 2015 and 68 healthy volunteers were included. Patients with thyroid nodules divided into malign or benign nodule groups according to the pathology report. Thyroid carcinomas other than micropapillary tumor were excluded. Preoperative hemogram parameters of these groups were compared. Results: Mean NLR of malign nodule group (2.1 +/- 0.9%) was significantly higher than both those in benign nodule (1.7 +/- 0.9%) and control groups (1.7 +/- 0.6%). Conclusion: We suggest that elevated NLR in patients with thyroid nodules in preoperative period may be an indicator of underlying malign nodular disease. Increased NLR in such patients should encourage physician to perform cancer screening in thyroid gland.Öğe A new model of reversible obstructive jaundice using rapidly absorbable suture materials(Canadian Soc Clinical Investigation, 2012) Kahramansoy, Nurettin; Erkol, Mehmet Hayri; Yılmaz, Edip E.; Şit, Mustafa; Yılmaz, Fahri; Tosun, Mehmet; Çöl, CavitPurpose: Reversible obstructive jaundice models have some limiting features, including the need for a second anaesthesia, re-laparotomy and surgical intervention after common bile duct ligation. The present study investigates the feasibility of a new application that can eliminate these limitations. Rapidly absorbable suture materials were used for ligation; therefore, spontaneous biliary decompression was anticipated by the self release of these rapidly degrading materials. Methods: Common bile ducts in Wistar Albino rats were ligated with silk, polyglytone 6211, or irradiated polyglactine 910 (n=7 for each group). Rats were grouped according to both the suture materials and the experiments termination date: 5 days (sham, silk5, polyglytone5, polyglactine5) and 21 days (silk21, polyglytone21, polyglactine21) after the ligation. Biochemical and morphologic changes of liver were assessed. Results: The group polyglactine21 showed significantly lower mean ALT, AST, GGT, total and direct bilirubin values when compared with the group polyglactine5 (p=0.004-0.037). Morphologic changes did not correlate with the biochemical amelioration. In the group polyglytone21, not only the biochemical but also the morphologic changes significantly ameliorated when compared with the group polyglytone5 (p=0.003-0.043). No procedure associated mortality was observed. Conclusion: Common bile duct ligation with polyglytone offers a new reversible model for prolonged obstructive jaundice which abolishes the need for re-laparotomy and a second surgical intervention and significantly reduces mortality.Öğe Ölümle sonuçlanan iki fiziksel çocuk istismarı olgusu(2014) Erkol, Zerrin; Albek, Emre; Cantürk, Nergis; Erkol, Mehmet HayriÇalışmada biri babası ve üvey annesi, diğeri ise üvey annesi tarafından istismara maruz bırakılan ve ölümle sonuçlanan iki çocuk istismarı olgusunun sunulması ve benzeri olguların meydana gelmesinin önlenmesi amacıyla alınması gerekli tedbirlere dikkat çekilmesi amaçlanmıştır. Her iki olgunun dış muayenesinde değişik yaşlarda travmatik bulgular ile sigara yanıkları, ikinci olguda ayrıca sol omuzdan kaburga kavsi altına uzanan geniş bir alanda yanık skarı saptanmıştır. Birinci olgunun zaman zaman babası tarafından evin bahçesindeki ağaca kollarından kalın ip ile bağlandığı iddia edilmiş olup dış muayenesinde bağlanma ile uyumlu şekilde her iki kol üst kısımda nedbe dokuları gözlenmiş, ikinci olgunun ise ileri düzeyde kaşektik bir tablo içerisinde bulunduğu izlenmiştir. İç muayenede birinci olguda sağ fronto-temporal bölgede kronik, sol temporal bölgede taze subdural hematom ile pürülan menenjit; ikinci olguda ise sağ parietal bölgede kronik subdural hematom ile her iki parietal ve kısmen temporal bölgede subaraknoidal kanama tespit edilmiştir. Adli Tıp Kurumunun raporlarında; her iki olgunun ölümünün beyin kanaması ve gelişen komplikasyonlardan meydana geldiğinin belirtildiği görülmüştür. Nedenleri çok boyutlu olan ve sonuçları çocuklarımızı, dolayısıyla tüm toplumumuzu trajik şekilde etkileyen çocuk istismarının önlenmesi konusunda multidisipliner çalışmaların yaygınlaştırılmasının, toplumsal duyarlılığın arttırılması için sivil toplum kuruluşları ile resmi kuruluşların işbirliğinin artırılmasının önemi büyüktürÖğe Retrospective analysis of thyroidectomy cases that became subjects due to unintended consequences(Ortadogu Ad Pres & Publ Co, 2012) Erkol, Zehra Zerrin; Ertan, Ayşegül; Gökdoğan, Can; Kadıoğlu, Pınar; Yavuz, Nihat; Erkol, Mehmet HayriObjective: The aim of to this study was determine the risk area of surgical interventions of the thyroid that became subjects, and to provide feedback about the data of the cases mainly to general surgeons and all health care providers. Material and Methods: Legal expert reports written by the Third Specialized Board of Council of Forensic Medicine between 2006-2009 about cases that developed unintended consequences due to thyroid surgery were analyzed retrospectively. Data were assessed with SPSS 13.0 package program. Results: Of a total of 28 cases, 23 (82.2%) were females and 5 (17.8%) were males. Mean age was 41.3 years. Of the cases, 13 (46.5%) were operated on for multinodular goitre (MNG), 3 (10.7%) for toxic multinodular goitre (MNG), 2 (7.1%) for nodular goitre, 2 (7.1%) for Basedow-Graves, 2 (7.1%) for chronic lymphocytic thyroiditis, 2 (7.1%) for recurrent goitre, 1(3.6%) for papillary carcinoma, 1(3.6%) for anaplastic carcinoma, 1 (3.6%) for follicular adenoma and 1 (3.6%) for a reason not stated in the file. Twenty-one (75.0%) cases underwent subtotal thyroidectomy and 7 (25.0%) cases total thyroidectomy. Unintended consequences were hypoparathyroidism in 10 cases, unilateral vocal chord paralysis in 7 cases, bilateral vocal chord paralysis in 5 cases, hematoma in 3 cases, and hematoma + bilateral vocal chord paralysis, bleeding from the margin of tracheostomy cannula, esophagus injury in one case for each. According to legal expert decisions, in 21 cases, tretament was consistent with medical rules, medical practice faults were found in 6 cases and it in one case, no opinion could be given in terms of medical practice. Conclusion: Discussing thyroidectomy cases whom undesired consequences developed in scientific platforms may be useful to decrease the risk.Öğe Surgical approach to extensive hidradenitis suppurativa(Wiley-Blackwell, 2011) Büyükaşık, Oktay; Hasdemir, Ahmet Oğuz; Kahramansoy, Nurettin; Çöl, Cavit; Erkol, Mehmet HayriBACKGROUND Hidradenitis suppurativa (HS) is a chronic suppurative disease of skin with high recurrence. OBJECTIVE To determine factors affecting complications and recurrence of HS in patients who underwent surgery. MATERIALS AND METHODS We operated on 15 patients with HS at 36 sites between 1999 and 2009. The affected areas were classified as groin, axilla, buttocks, nuchae, perianal, and perineal. All patients were treated using wide surgical excision under general anesthesia. The methods of reconstruction varied depending on the size and location of the defect. RESULTS The female:male ratio of patients was 4:11. Mean age was 41.8 +/- 10.6. Twenty-eight (77%) of the lesions were Stage III according to Hurley's staging system. Mean follow-up was 42 months. Radical excision was performed on all lesions; 20 were reconstructed with primary closure, nine with fasciocutaneous flaps, and five with split-thickness skin grafts. The overall complication rate was 25% (9/36) and complications occurred mostly in perineal, perianal, and buttocks sites. Two (5.5%) recurrences were seen only in buttocks site. CONCLUSION To prevent complication, avoid recurrence of HS, and improve patients' quality of life, early and wide surgical excision is important and effective. The recurrence and complications are mostly related to the location of the disease. The authors have indicated no significant interest with commercial supporters.Öğe Volvulus of splenic flexure: An autopsy case(Comenius Univ, 2012) Erkol, Mehmet Hayri; Erkol, Zehra Zerrin; Aybastı, N.; İnal, M.Objective: The definition of volvulus is an axial twist of a portion of the gastrointestinal tract along its mesentery. The involved bowel is obstructed partially or completely with a variable degree of arterial and venous occlusion. The colon is the most common site for volvulus. The splenic flexure is the least common site of colonic volvulus. Splenic flexure volvulus (SFV) is a very rare cause of colonic obstruction, constituting 1-2 % of colonic volvulus. Mortality rate of the SFV cases is low. Case report: We experienced a SFV case who was a 20-year-old male soldier. The case had come to the state hospital with complaints of severe left abdominal and lumbar pain and a medical history of relapsing urinary infection and nephrolithiasis. The doctor had hospitalized him with the diagnosis of paralytic ileus caused by nephrolithiasis. He had died after 14 hours and 35 minutes from hospitalization. Autopsy findings showed out that the death cause was generalized peritonitis due to gangrenous SFV. Conclusion: In this paper, we presented this case and discussed its properties in the light of the literature data (Fig. 2, Ref. 7). Full Text in PDF www.elis.sk.
