Surgical treatment of diffuse polyposis of the large intestine

A technique of the operation developed by the authors for patients with diffuse polyposis of the colon is described. A new method of total colectomy is proposed including removal of the rectum mucosa and the endorectal loop ileoanal anastomosis and simultaneous creation of the small intestine reservoir (operations on 2 patients) and a new method of creation of the small intestine reservoir (operations on 7 patients). Good functional results were obtained. Six-eight months after operation the patients had stools 1-6 times a day. In none of 5 men operated upon impotence has developed.     

Hypoechoic space formation with periprostatic nerve block: myth or reality?

INTRODUCTION: The most efficacious and commonly applied anesthetic technique for prostate biopsy is periprostatic block. In a previous publication, the creation of a 'hypoechoic space' at the injection site was described. This was reported to be a routine and essential part of the technique in various subsequent series. We were interested in assessing the incidence of the formation of such a hypoechoic area, and more importantly, whether it had any impact on pain management. MATERIALS AND METHODS: One hundred and eleven consecutive patients were prospectively evaluated. Local anesthetic consisted of 2.5 ml of 2% lidocaine for each side of the prostate. Infiltration was done within the neurovascular space at the base of the prostate just lateral to the junction between the prostate and the seminal vesicle. The creation of a hypoechoic nodule was recorded in three categories: no formation, unilateral or bilateral formation. Three groups were compared regarding the intensity of pain using a numeric analog scale. RESULTS: No hypoechoic area was formed in 30 (27%) patients. A unilateral nodule was created in 40 (36%), and a bilateral nodule was seen in 41 (37%) patients. The median pain scores were 3.3, 2.5 and 1.3 for the no hypoechoic wheal, unilateral and bilateral wheal groups, respectively (p<0.0001). CONCLUSION: Our results suggest that the creation of a hypoechoic space with anesthetic infiltration for prostate biopsy is indeed an important aspect of the technique with regard to pain control; however, it may not be accomplished in every case.     

A rare foreign body into the male penile urethra

A wide variety of urethral foreign bodies have been described in the literature. In adults, this is commonly caused by the insertion of objects used for masturbation, and is often associated with a mental disorder as in our case described herein. We report a 28-year-old man, hospitalized for self-insertion of a pen into the urethra. The pen was removed successfully by surgery.     

Factors affecting adult knowledge of diabetes in Narlidere Health District, Turkey

Abstract The objective was to determine the level of knowledge on diabetes in an adult population in Turkey. In this cross-sectional study, 524 people aged over 30 were selected from the population of Narlıdere Health District, Izmir, Turkey. A questionnaire was performed to determine sociodemographic characteristics and knowledge of diabetes. Each item on the questionnaire was given a score with a possible final total of 100 points. Knowledge level was evaluated in the whole group, DM-positive and -negative groups. “DM-positive” group refers to respondents who either have diabetes themselves or whose relatives have it. “DM-negative” group refers to respondents who do not have diabetes themselves and whose relatives do not. In total, 479 people were included in the study (response rate=87.6%). The mean age of the study group was 50.2±12.8 and 61% of them were women. Mean diabetes knowledge scores were 62.9±17.9 for the study group, 68.3±16.1 for the “DM-positive” group and 60.6±18.2 for the “DM-negative” group. The “DM-negative” group had a significantly lower mean score than the other two groups. Overall, diabetes knowledge was higher in participants with diabetes or who had a relative with diabetes, who were educated for more than 5 years and who had health insurance. The diabetes knowledge of the study group was not satisfactory. Diabetics and people who have relatives with diabetes had a higher knowledge level than the population without diabetes. Detailed information regarding diabetes should be provided to not only diabetics, but also the population as a whole.     

Repeated paracentesis for treatment renal failure after heart transplantation in patient with ascites

We report a case of orthotopic heart transplantation in a 42-year-old man who had cardiomyopathy with severe biventricular heart failure, ascites, and large umbilical hernia. He successfully received an orthotopic heart transplantation. After heart transplantation, renal failure was noted. Ascites and renal failure were successfully managed with repeated paracentesis. His cardiac and abdominal symptoms subsided gradually following transplantation. His umbilical hernia was repaired 55 days after the heart transplantation because of strangulation. In this case study, we report a patient with ascites who was treated for postoperative renal failure with repeated paracentesis.