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Öğe Acil servise başvuran adli olguların ve düzenlenen adli raporların değerlendirilmesi(2012) Korkmaz, Tanzer; Kahramansoy, Nurettin; Erkol, Zerrin; Sarıçil, Füsun; Kılıç, AyselAmaç: Çalışmamızda adli olguların ilimizdeki profilinin belirlenmesini ve adli olayın niteliği ile olgulara düzenlenen geçici veya kesin raporların ilişkisinin irdelenmesini amaçladık. Yöntemler: Abant İzzet Baysal Üniversitesi Araştırma ve Uygulama Merkezi Acil Servisi’ne 01.01.2008-31.12.2009 tarihleri arasında başvuran adli olgulara ait hasta dosyaları ve adli raporlar retrospektif olarak incelendi. Bulgular: Acil servise başvuran tüm olguların %7,01’ini adli olgular oluşturmaktaydı. Bu olguların %66,4’ü erkek olup yaş ortalaması 32,41±17,83 bulundu. En sık trafik kazası (%53,7) nedeni ile başvuru yapıldığı, olayların çoğunlukla gündüz saatlerinde meydana geldiği (12:00-18:00), olguların ortalama 82,63 dakikada hastaneye ulaştıkları ve acil serviste en sık 1-4 saat kaldıkları tespit edildi. Olguların %30,6’sına hiçbir konsültasyon istenmediği, tedavi sonucu açısından acil servisten taburcu edilen olguların (%68,5) fazla bulunduğu belirlendi. Olguların %69,8’sına geçici adli rapor düzenlendiği ve taburcu edilen olgulara düzenlenen geçici raporların, kesin raporlara göre anlamlı olarak fazla olduğu saptandı. Sonuç: Adli olgulara düzenlenen kesin rapor sayılarının arttırılması, acil serviste çalışan hekimler için mezuniyet öncesi ve sonrası eğitim programlarının yaygınlaştırılması ile hız kazanabilir. (Ha se ki T›p Bül te ni 2012; 50: 14-20)Öğe Acil servise gelen pediatrik adli olguların değerlendirilmesi: Retrospektif bir çalışma(2014) Korkmaz, Tanzer; Erkol, Zerrin; Kahramansoy, NurettinAmaç: Bu çalışmada pediatrik adli olguların analizinin yapılmasını ve bu tür olayların meydana gelmesini önlemek amacıyla alınabilecek tedbirlerin tartışılmasını amaçladık.Yöntemler: Hastanemiz acil servisine 01.01.2009-31.12.2011 tarihleri arasında başvuran pediatrik (0-18 yaş) adli olguların hasta dosyaları ve adli raporları retrospektif olarak incelendi. Bulgular: Çalışmaya alınan 421 pediatrik adli olguların yaş ortalaması 9,9±5,5 idi. Olguların %61'i (n=257) erkek ve %47,3'ü de 5-14 yaş grubunda idi. Olay nitelikleri; trafik kazası (%50,4), düşme (%18,3), kesici-delici alet yaralanması (%10,9), entoksikasyon (%5,9), darp (%5,0) ve diğer (%9,5) olaylardan oluşmakta idi. Dokuz öz kıyım girişimi (tümü on dört yaşın üzerinde) ve dört fiziksel istismar olgusu (üçü 15 yaşın altında) vardı. Gözlem süreci sonunda %20,2 olgunun bir servise yatırılmasına karşın %79,8 olgu acil servisten taburcu edildi.Sonuç: Olguların çoğunluğunun araç dışı trafik kazası sonucu meydana geldiğinin tespit edilmesi, bu yaralanmaların önlenebilir olduğunu göstermektedir. Çocuklar için güvenli bir çevre oluşturulması amacıyla koruyucu ve müdahale edici eğitim politikaları geliştirilmelidir.Öğe Akut ekstremite travmalı olgularda analjezi uygulaması ve eğitimin etkisi(2012) Akarca, Funda Tarbek; Karcıoğlu, Özgür; Korkmaz, Tanzer; Erbil, Bülent; Demir, Ömer FarukGiriş ve amaç: Çeşitli çalışmalarda acil hekimlerinin genellikle hastaların ağrısına olması gerekenden daha az önem verip daha az müdahale ettikleri belirtilmiştir. Bu çalışmada amaç acil servise akut ağrı ile başvuran yetişkin ekstremite travmalı hastalarda acil tıp asistanlarının analjezi uygulama davranışlarının eğitimle kısa dönemde nasıl ve ne boyutta etkilendiğini araştırmaktır. Yöntem: : İki ay içinde acil servise akut ağrı ile başvuran 18 yaş üstü, ekstremite travmalı tüm olgular çalışmaya alındı. Başvuru sırasında triajda olgunun ağrı düzeyi sorulup Numeric Rating Scale (NRS) ile işaretlendi. Hastaların gelişinden itibaren 30. ve 60. dakikalarda NRSler'i belirlendi. Son olarak hastanın çıkış NRS’si, son tanısı kaydedildi. Bir ay süresince veriler toplandıktan sonra toplam 4 saat olmak üzere ilişkili konularda eğitim verildi. Eğitim sonrası 30 gün süresince aynı veriler tekrar toplandı. Dönemler arası karşılaştırmalar yapıldı. Bulgular: Eğitim öncesi dönemde alınan 143 hastanın %56.6’sını (n=81), eğitim sonrası dönemde ise 130 hastanın %44.6’sını (n=58) kadınlar oluşturdu. Kadınların başvuru NRS ortalamaları erkeklere göre anlamlı olarak yüksek bulundu (sırasıyla 7.4±2.3 ve 6.7±2.5) (p=0.020). Eğitim sonrası dönemde çalışmaya alınan hastalara (n=91; %70.0) eğitim öncesine (n=61; %42.7) göre anlamlı olarak daha fazla analjezi uygulandığı (p<0.001) ve uygulama sürelerinin de eğitim sonrası dönemde (ortalama 19.3±8.3 dk) eğitim öncesine göre (ortalama 41.3±27.6 dk) anlamlı olarak azaldığı saptandı (p<0.001). Hastalara ikinci dönemde 30 dk içinde analjezi uygulamasında artma görüldü ve yine ikinci dönemde tüm hastalara analjezi uygulamaları bir saat içinde yapılmıştı. Sonuç: Dört saatlik eğitim programı sonucunda acil tıp asistanlarının ağrı yönetimindeki davranışlarında belirgin fark oluşmuştur. Eğitim sonrasında analjezi uygulama oranları artarken uygulama süreleri kısalmıştır.Öğe Analgesic Treatment in Patients With Acute Extremity Trauma and Effect of Training(Elsevier Science Bv, 2012) Akarca, Funda Karbek; Karcioglu, Ozgur; Korkmaz, Tanzer; Erbil, Bulent; Demir, Omer FarukObjectives Studies indicate that emergency physicians (EP) under-evaluate and undertreat the pain experienced by their patients. The objective of this study was to investigate how EPs treat pain in adult patients with limb trauma and to determine if their behavior could be affected by training in the short-term. Methods All consecutive adult patients admitted to the university-based emergency department (ED) within two months were enrolled in the study. The patients were asked to rate their level of pain on the NRS in triage. NRS scores were noted again after 30 minutes and 60 minutes, and on discharge. Patient prescriptions were also tracked to identify any analgesics. After completion of the pre-education phase, four hours of training on pain evaluation and treatment were undertaken under the leadership of experienced staff faculty. The aforementioned outcomes were gathered again in a 30-day period after training and we compared the pre and post training periods. Results A hundred and forty-three patients (81 female) were enrolled in the pre-education phase, and 130 patients (58 female) were eligible for the post-education phase. The mean NRS scores of the females noted on admission were significantly higher than those of the males (7.4 +/- 2.3 vs. 6.7 +/- 2.5, respectively; p=0.020). Patients included in the first phase received analgesia less frequently (42.7% vs. 70.0%, respectively; p<0.001). The mean period of time between admission and initial analgesic administration was shorter in the second phase (41.3 vs. 19.3 minutes, respectively; p<0.001). The ratio of patients receiving analgesia within thirty minutes was greater after training. All patients in the second phase received analgesia within 60 minutes. The residents prescribed analgesics more frequently after training. Conclusions A four- hour training program resulted in apparent changes in the residents' management of pain in patients with extremity trauma. In addition to a more timely administration, the rates of analgesic treatment increased.Öğe Atropa Belladonna (Güzel Avrat Otu) meyvesi ile ilişkili antikolinerjik toksik sendrom: Bir olgu sunumu(2013) Demirhan, Abdullah; Tekelioğlu, Ümit Yaşar; Yıldız, İsa; Korkmaz, Tanzer; Bilgi, Murat; Akkaya, Akcan; Koçakoğlu, HasanAtropa Belladonna (güzel avrat otu) ile gelişen zehirlenmeler antikolinerjik sendroma yol açabilmektedir. Bitkinin yüksek miktarda alınması letarji, koma ve hatta ölümle sonuçlanabilen ciddi klinik tabloya neden olabiir. Bu olgu sunumunda ülkemizde güzel avrat otu olarak bilinen bitkinin meyvesinin bol miktarda yenmesi sonucu gelişen ciddi antikolinerjik sendromu literatür eşliğinde paylaşmayı amaçladık.Öğe Atropa bellodonna fruit (Deadly Nightshade) related anticholinergic toxic syndrome: A case report(2013) Demirhan, Abdullah; Tekelio?lu, Ümit Yaşar; Yildiz, Isa; Korkmaz, Tanzer; Bilgi, Murat; Akkaya, Akcan; Koço?lu, HasanAtropa Belladonna related poisoning may lead to anticholinergic syndrome. Ingestion of high amounts of the plant may cause lethargy, coma, and even a serious clinical picture that could lead to death. In this case report, we aim to share a case of anticholinergic syndrome that developed after ingestion of the fruit called "Deadly Nightshade" in our country. © 2013 by Turkish Anaesthesiology and Intensive Care Society.Öğe Consistency Assessment for the Causes of Death as Indicated in the Death Certificates and in ICD Codes(Galenos Yayincilik, 2014) Korkmaz, Tanzer; Balaban, BurcinAim: In this study, we evaluated the consistency between the records made in the hospital automation system as well as the causes of death in the death certificates. Methods: Death certificates for the cases occurred in the hospital and data of the hospital automation system were retrospectively analyzed. Results: Out of 351 cases within a two-year period, 218 (62.1%) were male and the mean age of the cases was 67.1 +/- 0.7 years. Our findings showed that 87.5% (n=307) of the deaths in the hospital were among people 60 years of age and older and took place in the intensive care unit and the mean time to death was found to be 15.4 +/- 25.4 hours. It was recorded that 23.9% (n=84) of diseases or conditions directly leading to death were heart failure and 19.9% (n=70) of cases were cardiopulmonary arrest. The maximum consistency was found between the first recorded international classification of disease codes and myocardial infarction. Conclusion: Since the accuracy and consistency of death statistics are largely dependent on the nature of the physician-provided data, good knowledge of physicians regarding details on patient records and the causes of death is of great importance.Öğe Effect of Ankaferd Blood Stopper on air leakage in the lung and prevention of bleeding: an experimental study(Biomed Central Ltd, 2011) Kılıçgün, Ali; Sarıkaş, Necla G.; Korkmaz, Tanzer; Saydam, Özkan; Boran, Çetin; Boztaş, GüledalBackground: Air leakage and hemorrhage are important causes of morbidity and mortality in operations and traumas of the lung. Ankaferd Blood Stopper is a herbal product used for stopping hemorrhage. In our study, we investigated the efficacy of Ankaferd Blood Stopper in the prevention of air leakage in the lung and bleeding. Methods: A total of twenty-one Wistar-Albino rats weighing 240 +/- 20 grams were used in our study. An equal amount of injury was created in all groups by performing left thoracotomies. No interventions were made on tissue injury in the first group, and suturing was performed in the second group, and Ankaferd was applied in the third group. Air leakage and duration of bleeding were recorded in all groups. Results: A statistically significant difference was found between the three groups in terms of air leakage time (p = 0,0001) and bleeding time (p = 0,0001). While a significant effect of Ankaferd was detected in terms of air leakage compared to standard surgery (p = 0,017), no difference was found in terms of bleeding time. Conclusions: Ankaferd Blood Stopper ceases the air leakage in the lung parenchyma significantly and effectively. No significant difference is seen compared to the standard surgery group, although it ceases bleeding significantly.Öğe The effects of Ankaferd Blood Stopper on the recovery process in an experimental oesophageal perforation model(Aves, 2015) Sarıkaş, Necla Gürbüz; Korkmaz, Tanzer; Kahramansoy, Nurettin; Kılıçgün, Ali; Boran, ÇetinBackground: Oesophageal perforation is a life-threatening pathology that is generally treated conservatively; however, surgical procedures are frequently performed. A topical haemostatic agent, Ankaferd Blood Stopper (ABS), also has beneficial wound-healing effects. Aims: This study aimed to determine the effects of ABS following experimental oesophageal perforations. Study Design: Animal experiment. Methods: The experimental rats were classified into 6 groups (with 7 rats in each group). Pairs of groups (primary repair alone and primary repair + ABS) were terminated in the 1st, 2nd, and 3rd weeks following injury. The oesophageal perforations, which were 8-10 mm in length, were created using a nasogastric tube. The perforation sites were repaired with a 6-0 polyglactine thread in the primary repair groups. Additionally, ABS was sprayed over the perforation site in the treatment groups. Each oesophagus was evaluated histopathologically. Results: There were fewer microabscesses and areas of necrosis in the ABS groups compared with the primary repair groups. The histopathological evaluation revealed that the ABS groups had less inflammation and more re-epithelisation compared to the primary repair groups (p=0.002 and p=0.003, respectively). Fibrosis in the ABS groups was moderate in the 2nd week and mild in the 3rd week. Comparing the groups with respect to the time intervals, only the 1st week groups showed a significant difference in terms of re-epithelialisation (p=0.044). Conclusion: Topical ABS application on the repaired experimental oesophageal perforation regions led to positive wound-healing effects compared with the rats that were administered the primary repair alone.Öğe Emergent treatment of epidural pneumatosis and pneumomediastinum developed due to tracheal injury: A case report(2010) Kılıçgün, Ali; Gezer, Suat; Korkmaz, Tanzer; Kahramansoy, NurettinThe presence of air in epidural space is called epidural pneumatosis. Epidural pneumatosis is a rarely encountered phenomenon in emergency medicine practice. A 10-year-old patient was admitted with cervical trauma due to a bicycle accident. Subcutaneous emphysema, pneumothorax, pneumomediastinum and epidural pneumatosis were detected. Pretracheal fasciotomy after tube thoracostomy and closed underwater drainage were performed. Since sufficient clinical improvement could not be observed, tracheal exploration and primary repairment were performed. Only after these interventions, epidural pneumatosis and pneumomediastinum completely regressed. The case is presented due to its rarity and with the purpose to remind clinicians of epidural pneumatosis in tracheal injuries.Öğe Emergent Treatment of Epidural Pneumatosis and Pneumomediastinum Developed Due to Tracheal Injury: A Case Report(Elsevier Science Bv, 2010) Kilicgun, Ali; Gezer, Suat; Korkmaz, Tanzer; Kahramansoy, NurettinThe presence of air in epidural space is called epidural pneumatosis. Epidural pneumatosis is a rarely encountered phenomenon in emergency medicine practice. A 10-year-old patient was admitted with cervical trauma due to a bicycle accident. Subcutaneous emphysema, pneumothorax, pneumomediastinum and epidural pneumatosis were detected. Pretracheal fasciotomy after tube thoracostomy and closed underwater drainage were performed. Since sufficient clinical improvement could not be observed, tracheal exploration and primary repairment were performed. Only after these interventions, epidural pneumatosis and pneumomediastinum completely regressed. The case is presented due to its rarity and with the purpose to remind clinicians of epidural pneumatosis in tracheal injuries.Öğe Evaluation of Pediatric Forensic Cases in Emergency Department: A Retrospective Study(Galenos Yayincilik, 2014) Korkmaz, Tanzer; Erkol, Zerrin; Kahramansoy, NurettinAim: Our aim was to evaluate the properties of pediatric forensic cases and to discuss the precautions in order to prevent the occurrence of these forensic events. Methods: The patient files and forensic reports of pediatric (age 0-18 years) forensic cases, who were referred to the emergency department in our hospital between January 01, 2009 and December 31, 2011 were retrospectively investigated. Results: A total of 421 forensic pediatric cases with a median age of 9.9 +/- 5.5 years were included in the study. Off the cases, 61% (n=257) were male and 47.3% were in 5-14 age group. The type of the events were traffic accident (50.4%), fall (18.3%), stab injuries (10.9%), intoxication (5.9%), pounding (5.0%) and other incidents (9.5%). There were nine cases of suicide attempt (all of them were above 14 years of age) and four cases of physical abuse (three of them were under 15 years of age). After the observation period, 79.8% of the cases were discharged from the emergency department, whilst 20.2% of cases were hospitalized in one of the clinics. Conclusion: Because most of the cases were traffic accident, this situation show us that these injuries are preventable. Prevention and intervention strategies should be developed for providing a safe environment for children.Öğe An evaluation of pre-admission factors affecting the admission time of patients with stroke symptoms(2010) Korkmaz, Tanzer; Ersoy, Gürhan; Kutluk, Kürşad; Erbil, Bülent; Akarca, Funda KarbekObjective: New drugs to be optimally curative in stroke therapy should be given quickly after the appearence of the symptoms. In this study, we studied the factors regarding the delay of the patients' admissions to the emergency departments and the knowledge level of the people about the stroke. Methods: A prospective study was designed in a third referral hospital. The adult patients admitting to hospital with neurologic symptoms were recruited in the study. The patients who admit to the hospital in more than 3 hours after the symptoms appear were asked about the reasons of the delay with open ended questions. Results: The mean age of 117 patients that included in the study were 66.7±13.2. Of these patients, 44% (n=52) were admitted in the first three hours. For patients arriving at hospital in the first three hours the demographic analysis were statistically significant for those living with family members (p=0,008) and for those with speech impairment (p=0,002). Of the patients who arrived at the hospital in more than three hours (n=61, 45.9%), most had either waited for the symptoms to disappear or were hesitant about coming to the hospital. Conclusions: The general knowledge level of the people about the symptoms and risk factors of stroke is thought to be the most important parameter concerning the early admittance. However in this study we found that even the knowledge level is insufficient stroke patients have been reported to admit to the emergency department in the first six hours.Öğe Evaluation of the Forensic Patients Presenting to the Emergency Department and Legal Reports(Galenos Yayincilik, 2012) Korkmaz, Tanzer; Kahramansoy, Nurettin; Erkol, Zerrin; Saricil, Fusun; Kilic, AyselAim: In this study, the aim was determining the profile of the forensic cases in our city and investigating the relationship between the type of forensic events and the temporary or definite reports that were prepared in these cases. Methods: Medical documents and forensic reports of the patients, who had presented to the emergency department at Abant Izzet Baysal University Research and Application Center, between 01.01.2008-31.12.2009, were analyzed retrospectively. Results: Forensic patients constituted 7.01% of all cases in the emergency department. Majority of patients were male ( 66.4%), the mean age was 32.41 +/- 17.83. The most common type of forensic event was motor vehicle accident ( 53,7%). Forensic events were reported to occur mostly during daytime, in the 12.00-18.00 hour period. Hospital arrival time was 82.63 minutes in average, length of stay in emergency department was 1-4 hours and, 30.6% of the patients were discharged without any consultations. Discharge rate from the emergency department was 68.5%. The rate of temporary reports prepared for patients who were discharged from emergency service were as high as 69.8% and was significantly higher than that of definite reports. Conclusion: Generalization of the pre-and post-graduate training programs for the physicians working in emergency department can increase the number of definite reports in forensic cases.Öğe Evaluation of the Patients Applying to the Hospital for a Tick Bite(Aves, 2011) Korkmaz, Tanzer; Sirmatel, Fatma; Boztas, GuledalObjective: Cases of tick bite require careful assessment because Crimean-Congo haemorrhagic fever (CCHF) is an increasingly important tick-borne disease in Turkey. The aim of this study is to analyse the patients who applied to the hospital for a tick bite and to determine the prevalence of tick bites in the Bolu Province according to the records of the Provincial Directorate of Health. Methods: The charts of the patients admitted to the Emergency Department between 1 January 2007 and 31 July 2010 were reviewed. The locations where the tick attached to the patient, site of the tick bite on the body, dates of tick bite and removal of the tick as well as the demographic characteristics were recorded. Moreover, data of the Provincial Directorate of Health on total number of tick bites, confirmed CCHF cases and deaths due to CCHF in the Bolu Province during the study period were evaluated. Results: A total of 451 patients were admitted to the Emergency Department, and 52.5% were female. The mean age was 41.7 years. The cases were predominantly observed in June and July, and were mostly from the city center (n=216) and the majority of them (n=338) were found to take place in the patients' primary living area. For patients in some professional groups such as labourers, officials and retired persons, the difference between male and female patients was statistically significant in terms of incurring a tick bite. According to the records of the whole province during the study period, 10 979 patients had a tick bite, 72 were diagnosed as CCHF, and 6 patients had a fatal outcome. Conclusions: Contact with a tick is a hazardous condition and precautions such as development of public awareness, preventive measures and education of the healthcare staff is crucial.Öğe İlginç bir inhaler cihaz kazası; çivi aspirasyonu olgusu(Turkish Anaesthesiology and Intensive Care Society, 2014) Kılıçgün, Ali; Korkmaz, Tanzer; Bilgi, Murat; Özkök, DilşadYabancı cisim aspirasyonları ciddi ve potansiyel olarak ölümcül bir tıbbi durumdur. Çocuklarda sıvı gıdalar, kuruyemiş, oyuncak parçaları, yetişkinlerde ise gıda artığı, diş protezi ve iğne daha sıklıkla aspire edilen yabancı cisimlerdir [1,2]. Bu bildirimde, kronik obstrüktif akciğer hastalığı (KOAH) tanısıyla bronkodilatör ilaç kullanımı sırasında, inhaler cihazın içerisinde bırakılan çiviyi kazara aspire eden ender bir olgu örneğini sunmayı amaçladık.Öğe Kene tutunmasıyla hastaneye başvuran olguların değerlendirilmesi(2011) Korkmaz, Tanzer; Sırmatel, Fatma; Boztaş, GüledalAmaç: Ülkemizde bazı kene türlerinin Kırım-Kongo kanamalı ateşi (KKKA) virusunun vektörü olması nedeniyle kene tutunmaları dikkatle değerlendirilmelidir. Bu çalışmanın amacı Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi Acil Servisine kene tutunmasıyla başvuran hastaları incelemek ve Bolu İl Sağlık Müdürlüğünün verilerine göre bu durumun il genelindeki sıklığını ortaya koymaktır. Yöntemler: Bu çalışmada 1 Ocak 2007-31 Temmuz 2010 arasında kene tutunmasıyla Acil Servise başvuran tüm hastaların dosyaları değerlendirildi. Hastaların demografik özellikleri, kene tutunmasının gerçekleştiği yer, kenenin tutunduğu vücut bölgesi, kenenin tutunma ve çıkarılma tarihleri kaydedildi. Ayrıca Bolu İl Sağlık Müdürlüğü kayıtlarına göre çalışma döneminde tüm il genelinde kene tutunmasıyla başvuran, kesin KKKA tanısını alan ve KKKA’dan ölen hastaların sayıları değerlendirildi. Bulgular: Kene tutunmasıyla 451 hastanın Acil Servise başvurduğu; olguların %52.5’inin kadın ve yaş ortalamasının 41.7 olduğu saptandı. Olguların en fazla Haziran ve Temmuz aylarında görüldüğü; kenenin hastalara daha çok şehir merkezinde (n=216) ve hastaların yaşadığı bölgede tutunduğu (n=338) saptandı. İşçi, memur ve emekli gibi bazı meslek gruplarında, erkeklerin kene tutunmasına maruz kalmaları, kadınlara göre istatistiksel olarak anlamlı farklar gösterdi (p<0.001). Çalışma döneminde il genelindeki kayıtlara göre toplam 10 979 kene tutunması bildirilmişti. Bu süre içinde 72 olguya KKKA tanısı konulmuştu ve 6 hasta kaybedilmişti. Sonuçlar: Kenelerle temas hâlâ riskli bir durum olduğundan halkın bilgilendirilmesi, gerekli korunma önlemlerinin alınması, sağlık çalışanları için hizmet içi eğitim toplantılarının sürdürülmesi gerektiği sonucuna varıldı.Öğe Masif intraabdominal kanamaya yol açan metastatik matür teratom: Olgu sunumu(2011) Büyükaşık, Oktay; Hasdemir, A. Oğuz; Kahramansoy, Nurettin; Kılıçgün, H.Ali; Korkmaz, Tanzer; Çöl, Cavit; Erkol, Hayri; Yanık, SerdarTeratomlar nadir karşılaşılan olgulardır. Onyedi yaşında bir erkek hasta akut batın ve hipovolemik şok tablosu nedeniyle acil servise getirildi. Yapılan laparatomide batın içinde masif kanama, karaciğerde multipl metastatik lezyonlar ve retroperitonda aktif kanayan 5x3x3 cm boyutlarında kitle saptandı. Total eksizyon yapıldı. Patolojik tanısı metastatik matür teratom olarak rapor edildi. Skrotal ultrasonografide sağ testiste 2x1 cm boyutunda kitle saptandı. Hasta, tetkikleri henüz devam edilmekte iken, eksploratris laparatomiden sonraki 24. günde oluşan yeni bir kanama nedeniyle kaybedildi. Bu olgu nadir bir olguyu hatırlatmak ve tartışmaya açmak amacıyla sunulmuştur. -Abstract-Öğe The mechanism of activity of ankaferd blood stopper in the control of arterial bleeding and in the process of wound healing(Drunpp-Sarajevo, 2012) Korkmaz, Tanzer; Sarıkaş, Necla Gürbüz; Kılıçgün, Ali; Serin, Erdinç; Boran, ÇetinObjectives: Ankaferd Blood Stopper (ABS) carries a historical role in the Traditional Turkish Medicine as a topical haemostatic agent. We aimed to study the effect of the ABS on the control of arterial bleeding in addition to investigate its impact on cytokine and platelet levels and vascular histopathology Methods: Blood samples were collected from all the rats (21 rats) before and after the study for platelet, interleukin-1, and tumor necrosis factor-alfa measurements. Following the anterior incision of the femoral artery, the rats were divided into 3 groups, the first to be a sterile tomponade applied on the incised artery, the second ABS spray and the third ABS embedded sponge and bleeding time was recorded. After seven days the animals were sacrificed and the previously incised femoral arteries were excised for histopathological evaluations. Results: The bleeding time of the control group was longer (209.28 seconds) than the ABS spray group (53.57 seconds) and ABS sponge group (56.42 seconds). There was no statistical significant difference regarding PLT (platelet) levels. Additionally the analysis of tumor necrosis factor-alfa and interleukin-1, reveald no significant difference both within (p=0.218, p=0,759 respectively) and among the groups day0 and day7 (p=O.441, p=0.846 respectively). Conclusion: The present study suggests that the ABS can be easily used and efficiently control the bleeding. However, the results of the present study showed no major effect of the ABS on PLT values, and pro-inflammatory cytokines. Further studies remain to be done for illuminating the efficient mechanisms that ABS uses for stopping bleeding.Öğe Metastatic mature teratoma presented with massive intraabdominal bleeding: A case report(2011) Büyükaşik, Oktay; O?uz Hasdemir, A.; Kahramansoy, Nurettin; Ali Kiliçgün, H.; Korkmaz, Tanzer; Çöl, Cavit; Erkol, HayriTeratomas are rarely encountered. A 17-year-old male patient presented to the emergency clinic with findings of acute abdomen and hipovolemic shock. Massive hemorrhagic blood collection, multiple metastatic lesions in the liver and a bleeding retroperitoneal mass with dimensions of 5×5×3 cm were detected in abdomen at laparotomy. The bleeding mass was excised totally. The pathologic diagnosis was metastatic teratoma. Scrotal ultrasonography revealed a mass with dimensions of 2×1 cm in the right testis. While the investigations proceeded, he died of a new massive bleeding on the postoperative 24th day.
