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Uslukaya Ö, Bozdag Z, Gumus M, Turkoglu A, Böyük A, Yılmaz EE, Gunduz E, Aldemir M. Factors affecting mortality in patients with splenic injuries. Ann Ital Chir 2018; 89:51-55. [PMID: 29629883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED there are not a sufficient number investigating the factors in splenic injuries influencing mortality. In this study, we aimed to investigate the factors affecting mortality in splenic injuries. MATERIALS AND METHODS All 237 patients with splenic injury between 2005 to 2014 were retrospectively analyzed. The patients were divided into two groups, survivors and non-survivors. Age, gender, mechanism of injury, grade of splenic injury, pulse, respiratory rate, systolic blood pressure, hemoglobin levels, number of transfusions, surgical procedure, ISS, RTS and hospitalization period were recorded. Univariate and multivariate analysis were used to compare survivors and non-survivors. RESULTS The average age of the patients was 32 and most (82.7%) were male. Mortality was observed in 18 patients (7.6%). Mortality was found significantly lower in patients who had isolated splenic injury (p=0.048). In univariate analyses, decreased RTS (p<0.001), increased number of blood transfusion (p<0.001), decreased hemoglobin level (p=0, 025) and increased ISS (p<0.001) were found significant in non-survivors. In multivariate analysis; number of transfusions, ISS and RTS were found as independent risk factors for mortality. CONCLUSIONS We found high number of transfusions, high ISS and low RTS as independent risk factors for mortality in patients with splenic injury. KEY WORDS Mortality, ISS, RTS, Splenic trauma.
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Uslukaya Ö, Öner E, Girgin S, Bozdağ Z, Gümüş H, Urakçı Z, Gümüş M. A survey on the factors causing delayed diagnosis and treatment of breast cancer in southeastern Anatolia. J Clin Exp Invest 2016. [DOI: 10.5799/ahinjs.01.2015.04.0552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Uslukaya Ö, Gümüş M, Gümüş H, Bozdağ Z, Türkoğlu A. The Management and Outcomes of Male Breast Cancer. J Breast Health 2016; 12:165-170. [PMID: 28331756 DOI: 10.5152/tjbh.2016.3073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 05/23/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. MATERIALS AND METHODS The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. RESULTS The mean age of the patients was 63.03±12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twenty-nine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. CONCLUSION Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.
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Affiliation(s)
- Ömer Uslukaya
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Metehan Gümüş
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Hatice Gümüş
- Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Zübeyir Bozdağ
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Ahmet Türkoğlu
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
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Uslukaya Ö, Türkoğlu A, Gümüş M, Bozdağ Z, Yılmaz A, Gümüş H, Kaya Ş, Gül M. Factors that Affect Drain Indwelling Time after Breast Cancer Surgery. J Breast Health 2016; 12:102-106. [PMID: 28331744 DOI: 10.5152/tjbh.2016.3070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). MATERIALS AND METHODS From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. RESULTS The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. CONCLUSION DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.
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Affiliation(s)
- Ömer Uslukaya
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Ahmet Türkoğlu
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Metehan Gümüş
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Zübeyir Bozdağ
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Ahmet Yılmaz
- Department of Family Medicine,, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Hatice Gümüş
- Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Şeyhmus Kaya
- Department of Pathology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Mesut Gül
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
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Ülger BV, Gül M, Uslukaya Ö, Oğuz A, Bozdağ Z, Yüksel H, Böyük A. New hormones to predict the severity of gallstone-induced acute pancreatitis. Turk J Gastroenterol 2015; 25:714-7. [PMID: 25599787 DOI: 10.5152/tjg.2014.6201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS Levels of the hormones ghrelin and leptin in rat models of acute pancreatitis (AP) have been investigated in several experimental studies. However, there are very few clinical studies addressing the connection between hormone levels and AP. A few recent studies investigating the changes in ghrelin and leptin levels in patients with AP have been reported; however, our study is the first clinical study to investigate the change of nesfatin-1 levels in patients with gallstone-induced AP. MATERIALS AND METHODS Forty patients were enrolled in this study, eight of which presented with severe AP. Two blood samples were obtained from each study patient. The first blood samples were obtained at patient admission to the hospital and the second was obtained at patient discharge. All samples were collected after at least 6 h of fasting. Plasma nesfatin-1, leptin, and ghrelin levels were measured. RESULTS In all 40 patients, nesfatin-1 and leptin levels were higher at admission and had decreased at discharge. In contrast, the ghrelin levels at discharge were significantly higher than those at admission. Only the changes in these hormones in the mild AP group were significant. CONCLUSION Levels of these hormones were altered during the course of gallstone-induced AP. These changes might be associated with the clinical outcomes of the disease. To clarify whether the magnitude of the change in hormone levels at AP onset can be used as a biomarkers to predict the severity of the disease requires further investigation.
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Affiliation(s)
- Burak Veli Ülger
- Department of General Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
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Teke M, Göya C, Teke F, Uslukaya Ö, Hamidi C, Çetinçakmak MG, Hattapoğlu S, Alan B, Tekbaş G. Combination of Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification for Differential Diagnosis of Breast Lesions. J Ultrasound Med 2015; 34:1201-1208. [PMID: 26112622 DOI: 10.7863/ultra.34.7.1201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Breast cancer is the second leading cause of death from cancer in women, and early detection is the key to successful treatment. Unfortunately, even with technological advances, the specificity of imaging modalities is still low. Therefore, we evaluated the value of a newly developed noninvasive technique, acoustic radiation force impulse imaging, for differentiating benign versus malignant breast lesions. METHODS We prospectively examined 141 breast lesions in 122 patients. All lesions were classified according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) for mammography, BI-RADS for sonography, and Virtual Touch tissue imaging (VTI; Siemens Medical Solutions, Mountain View, CA) pattern. Internal and marginal shear wave velocity (SWV) values for the lesions were noted. The sensitivity, specificity, accuracy, and positive and negative predictive values for VTI and Virtual Touch tissue quantification (VTQ; Siemens Medical Solutions) were calculated. RESULTS The marginal SWV values were statistically higher in malignant lesions (mean ± SD, 5.41 ± 1.37 m/s) than benign lesions (2.91 ± 0.88 m/s; P < .001). When the SWV cutoff level was set at 4.07 m/s, and the higher of the internal and marginal values was adopted, the combination of VTI and VTQ showed 95.1% sensitivity, 99.0% specificity, and 97.8% accuracy. CONCLUSIONS Breast Imaging Reporting and Data System category 4 lesions are the main focus of research for early detection of breast cancer. Unfortunately, BI-RADS category 4 assessment covers a wide range of likelihood of malignancy (2%-95%). This wide range reflects the necessity for a more specific imaging modality. The combination of VTI and VTQ could increase the diagnostic performance of conventional sonography.
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Affiliation(s)
- Memik Teke
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey.
| | - Cemil Göya
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Fatma Teke
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Ömer Uslukaya
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Cihad Hamidi
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Mehmet Guli Çetinçakmak
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Salih Hattapoğlu
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Bircan Alan
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
| | - Güven Tekbaş
- Departments of Radiology (M.T., G.G., C.H., M.G.Ç., S.H., B.A., G.T.), Radiation Oncology (F.T.), and General Surgery (Ö.U.), Dicle University, Medical School, Diyarbakır, Turkey
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Oğuz A, Uslukaya Ö, Ülger BV, Türkoğlu A, Bozdağ Z. İleusun nadir bir nedeni: Gezici dalak. Dicle Med J 2015. [DOI: 10.5798/diclemedj.0921.2015.01.0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Uslukaya Ö, Yılmaz E, Türkoğlu A, Gümüş H, Gümüş M. A rare case of idiopathic granulomatous mastitis associated with erythema nodosum. Journal of Clinical and Experimental Investigations 2015. [DOI: 10.5799/jcei.122641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Ülger BV, Uslukaya Ö, Oğuz A, Gündüz E, Teke M, Baç B. Gallstone obstruction in anastomotic stricture: A very rare case. J Clin Exp Invest 2015. [DOI: 10.5799/ahinjs.01.2015.01.0490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Uslukaya Ö, Yılmaz EE, Türkoğlu A, Gümüş H, Gümüş M. A rare case of idiopathic granulomatous mastitis associated with erythema nodosum. J Clin Exp Invest 2015. [DOI: 10.5799/ahinjs.01.2015.01.0494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gündüz E, Ülger BV, İbiloğlu İ, Ekinci A, Dursun R, Zengin Y, İçer M, Uslukaya Ö, Ekinci C, Güloğlu C. Glutamine provides effective protection against deltamethrin-induced acute hepatotoxicity in rats but not against nephrotoxicity. Med Sci Monit 2015; 21:1107-14. [PMID: 25890620 PMCID: PMC4413811 DOI: 10.12659/msm.893180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to investigate the protective effects of L-glutamine (GLN) against liver and kidney injury caused by acute toxicity of deltamethrin (DLM). Material/Methods Thirty-two rats were indiscriminately separated into 4 groups with 8 rats each: control group (distilled water; 10 ml/kg, perorally [p.o.]), DLM group (35 mg/kg p.o. one dose.), GLN group (1.5 gr/kg, p.o. single dose.) and DLM (35 mg/kg p.o. one dose.) + GLN group (1.5 gr/kg, p.o. one dose after 4 hours.). Testing for total antioxidant status (TAS), total oxidant status (TOS), interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) analyses were performed on tissue samples, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), urea, and creatinine were analyzed on serum samples. Liver and kidney samples were histopathologically analyzed. Results The TOS level in liver was significantly higher in the DLM group than in the control group, and the level in DLM+GLN group was considerably lower than in the DLM group. The TAS level in the DLM+GLN group was considerably higher than in the control and DLM groups. The TAS level in kidney tissues was considerably lower in the DLM group than in controls, but was similar to other groups. Histopathological analyses of liver tissues established a significant difference between DLM and DLM+GLN groups in terms of grade 2 hepatic injury. However, no significant difference was found between DLM and DLM+GLN groups in terms of kidney injury. Conclusions Glutamine leads to significant improvement in deltamethrin-induced acute hepatotoxicity in terms of histopathologic results, tissue oxidative stress parameters, and serum liver function marker enzymes.
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Affiliation(s)
- Ercan Gündüz
- Department of Emergency Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Burak Veli Ülger
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - İbrahim İbiloğlu
- Department of Pathology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Aysun Ekinci
- Department of Biochemistry, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Recep Dursun
- Department of Emergency Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Yılmaz Zengin
- Department of Emergency Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mustafa İçer
- Department of Emergency Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömer Uslukaya
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Cenap Ekinci
- Department of Histology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Cahfer Güloğlu
- Department of Emergency Medicine, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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Abstract
As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.
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Affiliation(s)
- Akın Önder
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Murat Kapan
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Burak Veli Ülger
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Abdullah Oğuz
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ahmet Türkoğlu
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömer Uslukaya
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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Hamidi C, Göya C, Hattapoğlu S, Uslukaya Ö, Teke M, Durmaz MS, Yavuz MS, Hamidi A, Tekbaş G. Acoustic Radiation Force Impulse (ARFI) imaging for the distinction between benign and malignant thyroid nodules. Radiol Med 2015; 120:579-83. [DOI: 10.1007/s11547-014-0495-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
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Aliosmanoğlu İ, Gül M, Tekeş F, Türkoğlu A, Ülger BV, Uslukaya Ö, Oğuz A. Surgical treatment results of acute necrotising pancreatitis and affecting factors on mortality. J Clin Exp Invest 2012. [DOI: 10.5799/ahinjs.01.2012.04.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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