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Öğe Abdominal compartment syndrome due to distended rectal stump(Turk J Gastroenterol 2007; 18 (3): 192-194, 2007) Yılmaz, Sezai; Işık, Burak; Uğraş, Murat Yahya; Söğütlü, Gökhan; Ara, Cengiz; Yılmaz, SezaiAbdominal compartment syndrome is a serious and life-threatening condition that requires early recognition and urgent decompressive laparotomy. This case report describes an abdominal compartment syndrome due to a distended rectal stump. The patient had a previous sigmoid resection with colostomy performed for sigmoid volvulus. As far as we know, this is the first report of abdominal compartment syndrome due to rectal stump. In such cases, high index of suspicion and early intervention affect the clinical course.Öğe Acute uremia and intestinal obstruction due to a retroperitoneal hydatid cyst(Turkish Journal of Gastroenterology, 2007) Yılmaz, Sezai; Uğraş, Murat Yahya; Işık, Burak; Yılmaz, Sezai; Kırımlıoğlu, VedatHydatid disease should be considered in the differential diagnosis of any cystic mass in endemic areas. The symptoms due to bulk effect, usually occurring over a certain period of time, depend on the site and size of the cyst. We report an unusual presentation of retroperitoneal hydatid cyst with rapidly developing uremia and acute intestinal obstruction.Öğe Atnalı Böbrekte Bilateral Simultane Perkütan Nefrolitotomi Sonrası İnatçı Postoperatif Bulantı ve Kusma: İlginç Bir Nedenin Vaka Sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Uğraş, Murat Yahya; Güneş, Ali; Baydinç, Yaşar Can; Söğütlü, GökhanPerkütan nefrolitotomi (PNL), kompleks böbrek taşları da dahil, taş hastalığı için minimal invaziv bir tedavi yöntemidir. İki böbrekte eşzamanlı taş hastalığı ve atnalı böbrekteki taşlar ayrı ayrı kompleks taş tanımı kapsamında olup, ikisinin birlikte varlığı cerrahi açıdan en karışık durumlardan biridir. PNL, her iki durum için de güvenli ve etkin bir tedavi yöntemidir. Bu yazıda, iki taraflı eş zamanlı PNL yapılan bir atnalı böbrek olgusunda ameliyat sonrası gelişen şiddetli bulantı kusma sendromu (PONV) vakası sunduk. İlk tanısal çalışmalarla bu durumu açıklayacak mekanik veya biyokimyasal bir komplikasyon saptanmadı. PONV nin fizyopatolojik oluşumunu irdeleyen bir çalışma sonucunda, daha önce yayımlanmamış olan benzersiz bir etiyoloji saptandı.Öğe Case report of a traumatic abdominal wall hernia resulting from falling onto a flat surface(Ulusal Travma ve Acil Cerrahi Dergisi-Turkish Journal of Trauma & Emergency Surgery, 2010) Yücel, Neslihan; Uğraş, Murat Yahya; Işık, Burak; Turtay, GökhanThis article reports a case of high-energy type traumatic abdominal wall hernia (TAWH) associated with multiple organ injuries including pelvic fractures, liver laceration and ascending colon perforation. The cause of the trauma was falling to the ground from a height of approximately 8 meters. Since the forces affecting the abdomen are unique when falling on a flat surface, the mechanism of defect may be different between a low-energy type handlebar hernia and high-energy type TAWH. Only a few cases of highenergy type TAWH exist in the literature, all reporting falling on or hitting an angled or curved material. To our knowledge, this is the only report of TAWH resulting from falling onto a flat surface. The diagnosis and management are summarized, the literature data are reviewed, and the mechanism of action is discussed.Öğe Case report of a traumatic abdominal wall hernia resulting from fallingonto a flat surface(Ulusal travma ve acil cerrahi dergisi- Turkısh journal of trauma & emergency surgery, 2010) Yücel, Neslihan; Uğraş, Murat Yahya; Işık, Burak; Turtay, GökhanThis article reports a case of high-energy type traumatic abdominal wall hernia (TAWH) associated with multiple organ injuries including pelvic fractures, liver laceration and ascending colon perforation. The cause of the trauma was falling to the ground from a height of approximately 8 meters. Since the forces affecting the abdomen are unique when falling on a flat surface, the mechanism of defect may be different between a low-energy type handlebar hernia and high-energy type TAWH. Only a few cases of highenergy type TAWH exist in the literature, all reporting falling on or hitting an angled or curved material. To our knowledge, this is the only report of TAWH resulting from falling onto a flat surface. The diagnosis and management are summarized, the literature data are reviewed, and the mechanism of action is discussed.Öğe Case report of a traumatic abdominal wall hernia resulting from fallingonto a flat surface(Turkish Journal of Trauma & Emergency Surgery, 2010) Yücel, Neslihan; Uğraş, Murat Yahya; Işık, Burak; Turtay, GökhanThis article reports a case of high-energy type traumatic abdominal wall hernia (TAWH) associated with multiple organ injuries including pelvic fractures, liver laceration and ascending colon perforation. The cause of the trauma was falling to the ground from a height of approximately 8 meters. Since the forces affecting the abdomen are unique when falling on a flat surface, the mechanism of defect may be different between a low-energy type handlebar hernia and high-energy type TAWH. Only a few cases of highenergy type TAWH exist in the literature, all reporting falling on or hitting an angled or curved material. To our knowledge, this is the only report of TAWH resulting from falling onto a flat surface. The diagnosis and management are summarized, the literature data are reviewed, and the mechanism of action is discussed.Öğe İntractable postoperative nausea and vomiting (PONV) after bilateral simultaneous percutaneous nephrolithotomy on a horses kidney: Case report of aunique cause(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2008) Uğraş, Murat Yahya; Güneş, Ali; Baydinç, Yaşar Kemal; Söğütlü, GökhanÖz: Perkütan nefrolitotomi (PNL), kompleks böbrek taşları da dahil, taş hastalığı için minimal invaziv bir tedavi yöntemidir. İki böbrekte eşzamanlı taş hastalığı ve atnalı böbrekteki taşlar ayrı ayrı kompleks taş tanımı kapsamında olup, ikisinin birlikte varlığı cerrahi açıdan en karışık durumlardan biridir. PNL, her iki durum için de güvenli ve etkin bir tedavi yöntemidir. Bu yazıda, iki taraflı eş zamanlı PNL yapılan bir atnalı böbrek olgusunda ameliyat sonrası gelişen şiddetli bulantı kusma sendromu (PONV) vakası sunduk. İlk tanısal çalışmalarla bu durumu açıklayacak mekanik veya biyokimyasal bir komplikasyon saptanmadı. PONV nin fizyopatolojik oluşumunu irdeleyen bir çalışma sonucunda, daha önce yayımlanmamış olan benzersiz bir etiyoloji saptandı. Başlık (İngilizce): Atnalı böbrekte bilateral simultane perkütan nefrolitotomi sonrası inatçı postoperatif bulantı ve kusma: İlginç bir nedenin vaka sunumu Öz (İngilizce): Percutaneous nephrolithotomy (PNL) has proven to be a minimally invasive surgical technique for stone disease, including complex kidney stones. Bilateral stone disease and stones in horseshoe kidneys are considered as complex stones, and their coexistence is a significant challenging situation for surgery. Yet, PNL is a safe and effective treatment modality for both situations.1'2 We introduce a case of bjlateral simultaneous PNL in a horseshoe kidney, who had intractable postoperative nausea and vomiting (PONV). The cause seems to be unique, since no literature on such condition exists.Öğe Orta ve aşağı penil hipospadiyas cerrahisinde başarıyı etkileyen etkenler: Mathieu ve TIPU teknikleri için karşılaştırmalı bir çalışma(Türk Üroloji Dergisi/Turkish Journal of Urology, 2006) Uğraş, Murat Yahya; Ergin, Hüseyin; Kılıç, Sülayman; Güneş, Ali; Baydinç, AliÖz: Kliniğimizde orta ve aşağı penil hipospadiyas için yapılan Mathieu ve TIPU ameliyatlarında başarı ve istenmeyen yan etki oranlarımızı etkileyen etkenleri tespit etmeyi amaçladık. 1999-2004 yılları arasında orta ve aşağı penil hipospadiyas için yapılan ameliyatların kayıtlarını inceledik. Gerekli durumlarda hastalara ulaşarak verileri güncelledik. Mathieu ve TIPU yapılmış olgularda yaş, geçirilmiş cerrahi öyküsü, meatusun yeri, kordi varlığı, anestezi tekniği, üriner diversiyon şekli ve süresi, ameliyat öncesi ve sonrası kullanılmış olan ilaçlar ve kullanım süreleri, hastanede kalış süresi ile istenmeyen yan etkileri kaydettik. Bu verilerle başarı arasında istatistiksel ilişki varlığını araştırdık. Toplam 34 (%63,0) hastada Mathieu, 20 (%37,0) hastada ise TIPU teknikleri kullanılmış olup, ilk ameliyatın başarı oranları sırasıyla 28/34 (%82,4) ve 15/20 (%75,0) idi. Mathieu sonrası 5 (%14,7) hastada üretrokutanöz fistül, bir hastada yara enfeksiyonu ve cilt açıklığı; TIPU sonrası 3 (%15,0) hastada üretrokutanöz fistül, bir meatus darlığı ve bir cilt insizyonu açıklığı gelişmişti. Ameliyat başarısı ve istenmeyen yan etkilerin hasta yaşı, hipospadiyasın yeri ve diversiyon süresi ile ilişkisini saptayamazken, Foley sonda kullanılmasının (r: 0,45; p=0,001) ve spinal-kaudal anestezi yapılmasının (r: 0,38; p=0,005) istenmeyen yan etkileri artırdığını saptadık. Bu çalışmada, hipospadiyas cerrahisinde başarıyı etkileyen etkenler yayınlarla uyumlu bulunmuştur. Cerrahi sonrası diversiyon için Foley sonda kullanılması istenmeyen yan etki gelişimini artırmış, cerrahinin genel anestezi ile yapılması ise azaltmıştır.Öğe Percutaneous nephrolithotomy for pediatric stone disease(Scandinavian Journal of Urology and Nephrology, 2003) Güneş, Ali; Uğraş, Murat Yahya; Yılmaz, Uğur; Baydinç, Can; Soylu, AhmetObjective: We evaluated the outcomes and complications of percutaneous nephrolithotomy (PNL) operations performed in pediatric patients using adult-sized surgical equipment at our center. Material and Methods: The medical and surgical records of 23 children who underwent a total of 25 PNL operations using 24 or 26 F rigid nephroscopes were evaluated retrospectively. The following aspects were considered: stone burden; duration of surgery and complications; details concerning recovery, success, residual fragments and auxiliary procedures; and follow-up details. Results: The success rate of a single PNL session was 70.8%; with the use of auxiliary procedures this was increased to 91.6%. Perioperative and early postoperative complications were excessive bleeding and transfusion in two patients, hydropneumothorax in one, perforation of the collecting system in three and urinoma in one. Complications were more common in children aged <7 years or with staghorn stones. The mean time to catheter removal was 3.4 days and the mean hospitalization time was 4.8 days. Idiopathic hypercalciuria, hypocitraturia, cystinuria and hyperoxaluria were diagnosed in two, two, one and three patients, respectively. Conclusion: Performing PNL with adult-sized equipment is associated with significant complications in children aged <7 years or with staghorn stones. This treatment should not be considered in routine clinical practice. As all stone-removal methods are associated with complications, PNL should be used only if other methods fail or are unavailable.Öğe Protective effect of resveratrol against renal oxidative stress in cholestasi(Ren Fail. 2005;27(4):435-40., 2005) Ara, Cengiz; Karabulut, Aysun Bay; Çoban, Sacid; Uğraş, Murat Yahya; Kırımlıoğlu, Vedat; Yılmaz, SezaiBACKGROUND/AIMS: This experimental study was designed to evaluate histological changes of the kidney and renal tissue levels of malondialdehyde (MDA), reduced glutathione (GSH), and nitric oxide (NO) and the effect of resveratrol on these metabolites after bile duct ligation in rats. METHODS: Secondary biliary cirrhosis was induced by bile duct ligation for 28 days. Swiss albino rats were divided into three groups. Group 1: Sham (n=7), Group 2: Bile duct ligation (n=7), Group 3: Bile duct ligation plus resveratrol (n=7). Bile duct ligation (BDL) plus resveratrol group received 10 mgr/kg dose of resveratrol intraperitoneally daily throughout 28 days. Kidney tissues were harvested to determine the tissue levels of MDA, GSH, and NO activity. Liver and kidney tissues were removed for light microscopic evaluation. RESULTS: Cholestasis was determined by biochemical and pathologic examination. In the resveratrol-treated rats, levels of MDA were significantly lower than those of the BDL group (p < 0.04). The levels of GSH in the resveratrol-treated rats were significantly higher than those in the BDL group (p < 0.01). The levels of NO in the resveratrol group were significantly lower than those in the BDL group (p < 0.01). CONCLUSION: The present study demonstrates that intraperitoneal administration of resveratrol in bile duct ligated rats maintains antioxidant defenses and reduces kidney oxidative damage. This effect of resveratrol may be useful in the preservation of renal oxidative stress in cholestasis.