Increased Mean Platelet Volume in Patients with Crimean Congo Hemorrhagic Fever
Artvin Devlet Hastanesi Enfeksiyon Hastalıları ve Klinik Mikrobiyoloji, Artvin, Türkiye
DOI: 10.4328/JCAM.2271 Received: 01.01.2014 Accepted: 27.02.2014 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 1-3
Corresponding Author: Ayşe İnci, Artvin Devlet Hastanesi Enfeksiyon Hastalıları ve Klinik Mikrobiyoloji, Artvin, Türkiye. T.: +90 4662121040 E-Mail: email@example.com
Aim: The Crimean–Congo hemorrhagic fever virüs( CCHFV) is classified within the Nairovirus genus in the Bunyaviridae family. Mean platelet volume (MPV) is a biomarker of platelet function and activity. Platelet activity and aggregation capacity can be determined by measuring mean platelet volume (MPV). MPV is a parameter that has been associated with the diseases in many publications. The aim of this study is to investigate the change in the MPV values in patients with CCHF.
Material and Method: The study was designed in the Artvin State Hospital. We recruited 74 patients with CCHF Thirty healthy individuals were included as a control group whom were age and gender matched with CCHF patients. We compared the levels of MPV, platelet counts, age, gender, hemoglobin, white blood cell between CCHF patients with (and) healthy individuals. Data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) version 15. The t-test or Mann-Whitney U test was used. Level of statistical significance was considered p < 0.05 and the results were presented as mean ± standard deviation.
Results: There was no significant difference between the patients and controls in terms of age and gender. The mean platelet volume was 8.98±1.13 in CCHF group and 8.15±0.53 in the control group. There was a statiscically significant difference between the groups(p<0.001). Platelet counts and leucocyte were significantly lower in the CCHF group. Five patients died, thus the fatality rate was 6.8 %.
Discussion: In conclusion, the present study demonstrated that MPV is increased in CCHF. MPV may be a low-cost indicator for CCHF when together with other parameters. We think that further studies with higher number of patients are required in the future.
Keywords: Crimean Congo Hemo Rrhagic Fever; Mean Platelet Volume; Thrombocytopeni
The Evaluation of Prick Test Results in Malatya
Hasan Kahraman 1, Talat Kılıç 2, Mustafa Haki Sucaklı 3
1 Göğüs Hastalıkları Anabilim Dalı, Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Kahramanmaraş, 2 Göğüs Hastalıkları Anabilim Dalı, Malatya İnönü Üniversitesi, Tıp Fakültesi, Malatya, 3 Aile Hekimliği Anabilim Dalı, Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Kahramanmaraş, Türkiye
DOI: 10.4328/JCAM.1606 Received: 24.01.2013 Accepted: 28.02.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 4-7
Corresponding Author: Kahraman Hasan, Kahramanmaraş Sütçü İmam Üniversitesi, Tıp Fakültesi, Göğüs hastalıkları AD, Kahramanmaraş, Türkiye. GSM: +905338164036 F.: +90 3442212371 E-Mail: firstname.lastname@example.org
Aim: Skin prick test used for determination of allergic diseases is an easy, cheap, safe, fast, and frequently utilized test. There are factors such as genetic tendency, climate, humidity, vegetation, and altitude affecting the development of allergy. Our goal is to determine the allergic susceptibility of allergic patient in Malatya province. Material and Method: The 403 patients who referred to our chest clinic in Malatya between January 2008 and June 2010 with complaint of respiratory allergic diseases including asthma and allergic rhinitis were retrospectively investigated. Skin prick test results were evaluated according to age and gender. Results: Of the 403 patients incorporated to the study, 177 (43.9%) were male, 226 (56.1%) were female. Most common reaction was against to grasses, in 78 patients (19.4%). The other common reactions were found against to grains, in 70 patients (17.4%); to D. Farinea in 51 patients (12.7%); to D Pteronyssinus in 44 patients (10.9%); to grass mix in 41 patients (10.2%). Although reactions were higher in men than in women, only against to D. Pteronyssinus was statistical significant (p=0.032). Reactions were observed most commonly in 10-19 age group and secondly in 20-29 age group. Discussion: Atopic patients in Malatya province should be careful especially against to grasses, grains, and house dust mites.
Keywords: Allergy; Atopy; Skin Prick Test
Evaluation of Species Distribution and Antifungal Resistance of Candida Isolates From Hospitalized Patients
Yeşim Çekin 1, Nilüfer Pekintürk 1, Ayhan Hilmi Cekin 2
1 Tıbbi Mikrobiyoloji, 2 İç Hastalıkları, Antalya Eğitim ve Araştırma Hastanesi, Antalya, Türkiye
DOI: 10.4328/JCAM.1638 Received: 03.02.2013 Accepted: 28.02.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 8-11
Corresponding Author: Yeşim Çekin, Antalya Egitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji, Antalya, Türkiye. GSM: +905057958298 E-Mail: email@example.com
Aim: In this study, we aimed to determine species and antifungal sensitivity of Candida strains.
Material and Method: Candida spp. strains isolated from the clinical specimens of 221 patients who were hospitalized in Antalya Research and Training Hospital between May 2010 and May 2011 were included in the study and investigated retrospectively. Identification and antifungal sensitivities of the candida species were determined by VITEC 2 Compact System (BioMeriéux, France) beside conventional assays.
Results: Respective ratio of Candida spp. growth to total growth was found as 7.6% (211/2915) and 10.3% (155/1499) in the ward and intensive care patients during the study period of 1 year. Of the isolates, 122 were identified as C. albicans, 28 C. parapsilosis, 27 C. tropicalis, 22 C. glabrata, 11 C. lusitaniae, four C. krusei, three C. kefyr, two C. guilliermondii and one as C. haemulonii. C. albicans was the most common isolated strain in all the specimen groups. Resistance rates against amphotericin B, fluconazole, flucytosine, and voriconazole were found as 5.8%, 4.5%, 3.2% and 1.4%, respectively.
Discussion: Infections due to candida species are increasingly gaining importance. Increasing incidence of fungi infections resulting in high rates of morbidity and mortality, and widespread use of empirical antifungals lead resistant fungal strains to rise. Considering highly variable resistance rates reported in our country; we believe it would be appropriate that both the hospitals to monitor Candida resistance and revize their empirical treatment and diagnosis approaches, and national data to be generated through multi-center studies.
Keywords: Candida SPP; Antifungal Susceptibility; Hospital Infections
Evaluation of School Children’s Voiding Problems in Sakarya Region
Adil Emrah Sonbahar 1, Salih Budak 2, Hasan Salih Sağlam 2, Osman Köse 2, Şükrü Kumsar 2, Öztuğ Adsan 2
1 Geyve Devlet Hastanesi, Uroloji Kliniği, 2 S.B. Sakarya Üniversitesi Eğitim ve Arastirma Hastanesi Üroloji Kliniği, Sakarya, Türkiye
DOI: 10.4328/JCAM.1673 Received: 16.02.2013 Accepted: 10.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 12-4
Corresponding Author: Adil Emrah Sonbahar, Sakarya Geyve Devlet Hastanesi, Üroloji Kliniği, Sakarya, Türkiye. GSM: +905357993299 E-Mail: firstname.lastname@example.org
Aim: Our goal was to determine the types of voiding problems of children’s between 6 and 15 years old in Sakarya region.
Material and Method: Totally 3246, 5-16 years old student randomly selected from 8 schools inside province. Students are evaluated in an appropriate room at school with a form pre-prepared in our clinic.
Results: The survey shows that 486 of 3246 students (15%) have voiding problems. The prevalance of dysfunctional voiding problems in all children, was 11.2%(365), nocturia prevalence was 8.7% (279), diurnal enuresis was 1% (32). In boys (totally 1573) the prevalance of dysfunctional voiding problems was 9% (145), nocturia prevalence was 11.7%(184), enuresis nocturia prevalence 11.2% (176), diurnal enuresis was 0.5% (8). In girls (totally 1673) the prevalance of dysfunctional voiding problems was 13.4 (223), nocturia prevalence was 6.7% (111), enuresis nocturia prevalence was 6.2% (103), diurnal enuresis prevalance was 1.4% (24). There was no meaningful statistical difference from the perspective of height and body mass index (BMI) between the chıldren with voiding problems and without any problem (p>0.05).
Discussion: The results for enuresis nocturna, nocturia and diurnal enuresis we have got from our study, are similar to ones that have been done in our country before. There is no data for prevalence od dysfunctional voiding study so far. Dysfunctional voiding problems in girls and in children who are in first years of school are more frequent.
Keywords: Childhood; Voiding Dysfunction; Prevalence
Comparison of Different Suture Techniques
Cemil Kavalci 1, Yunsur Cevik 2, Polat Durukan 3, Mustafa Burak Sayhan 4
1 Baskent University Faculty of Medicine, Emergency Department, Ankara, 2 Keciören Training and Research Hospital, Emergency Department, Ankara, 3 Erciyes University Faculty of Medicine, Emergency Department, Kayseri, 4 Trakya University Faculty of Medicine, Emergency Department, Edirne, Turkey
DOI: 10.4328/JCAM.1690 Received: 22.02.2013 Accepted: 10.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 15-7
Corresponding Author: Cemil Kavalcı, Baskent University, Faculty of Medicine, Emergency Department, Ankara, Turkey. T.: +90 3122126868 GSM: +905055762819 E-Mail: email@example.com
Aim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration.
Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. Chi-Square and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant.
Results: Two-thirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05).
Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.
Keywords: Emergency; Staples; Tissue Adhesives
Knowledge Level of Healthcare Workers About Hepatits B in a State Hospital
Artvin Devlet Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji, Artvin, Türkiye
DOI: 10.4328/JCAM.1678 Received: 15.02.2013 Accepted: 14.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 18-20
Corresponding Author: Ayşe İnci, Artvin Devlet Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji, Artvin, Türkiye. E-Mail: firstname.lastname@example.org
Aim: This study was carried out with 108 healty care workers who were working at Artvin State Hospital to determine their knowledge level about hepatitis B.
Material and Method: Data on knowledge and attitude of health care workers about hepatitis B was collected with a questionnaire.
Results:The mean age of participants were 30.7±5.4. It was determined that 98(%90.8) healthcare workers vaccined against to HBV.All of the participants thought that hepatitis B might be transmitted by blood.
Discussion: Educatiton about hepatits B is necessary for Health Care Workers
Keywords: Hepatitis B; Healthcare Workers; Knowledge Level
Comparison of TOT and TVT in Treatment of Female Stress Urinary Incontinence
Taylan Mit 1, Ahmet Uysal 1, 2, Hakan Camuzcuoglu 1, 3, Sivekar Tınar 1, Tibet Koyuncu 1, Seyhan Sonmez 1
1 MH Aegean Maternity and Teaching Hospital, Department of Obstetrics and Gynecology, Izmir, 2 Çanakkale Onsekiz Mart University, Department of Obstetrics and Gynecology, Çanakkale, 3 Harran University, Department of Obstetrics and Gynecology, Urfa, Turkey
DOI: 10.4328/JCAM.1707 Received: 01.03.2013 Accepted: 15.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 21-4
Corresponding Author: Ahmet Uysal, Çanakkale Onsekiz Mart University, Department of Obstetrics and Gynecology, Çanakkale, Turkey. GSM: +905332635540 E-Mail:email@example.com
Aim: To compare the continence results and complications of the tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures.
Material and Method: Sixty two urinary incontinence patients; (37 were stress urinary incontinence and 25 were mixed incontinence) underwent TVT or TOT. The clinic-pathologic parameters of the patients, perioperative and postoperative complications and outcome in terms of continence and quality of life were compared.
Results: TOT and TVT were performed on % 50 of the patients respectively. An objective cure rate in patients who underwent TOT was observed in 74% of cases, an objective improvement in 26% of cases. 11 of the patients had dysuria, 10 of them had suprapubic pain. An objective cure rate in patients who underwent TVT was observed in 90% of cases, an objective improvement in 8% of cases. A de novo urge incontinence presented in 2 patients. The quality of life improved in 93,5% of cases. In terms of continence results and quality of life, there was no significant difference between the procedures. The complication rate was higher with the TVT procedure when compared to that of the TOT procedure.
Discussion: TOT procedure in short terms, performs similar operational success with the TVT procedure. Operational time; in consideration of the cystoscopy time, can be an advantage compared to the TVT procedure. If the operation includes anterior colporrhaphy, the success of both procedures reduces.
Keywords: Stress Urinary Incontinence; Transobturator Slings; Retropubic Slings; TOT; TVT; Complications; Quality of Life
The Success Rate of Endocanalicular Laser Dacryocystorhinostomy with Two Different Mitomycin-C Application
Yeşim Altay, Hüseyin Bıçakçı
Etimesgut Devlet Hastanesi, Göz Hastalıkları, Ankara, Türkiye
DOI: 10.4328/JCAM.1684 Received: 18.02.2013 Accepted: 15.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 25-8
Corresponding Author: Yeşim Altay, 48. Cadde Yonca Apt. No.: 33/31 Çukurambar 06520 Ankara, Türkiye. GSM: +905324902298 E-Mail: firstname.lastname@example.org
Aim: To determine the success rate of different application of mitomycin-c (mmc) in endocanalicular multidiode laser dacryocystorhinostomy (ECL-DCR).
Material and Method: A prospective comparative study was conducted on 89 patients with primary acquired nasolacrimal duct obstruction, undergoing ECL-DCR procedures. Group 1 was composed of 44 patients undergoing ECL-DCR with intraoperative 0.4 mg/ml mmc application for 2 minutes and group 2 was composed of 45 patients undergoing ECL-DCR with intraoperative 0.4 mg/ml mmc application for 5 minutes. Patients were followed up for at least 12 months.The main outcome measure for success was resolution or improvement of epiphora and patency of nasolacrimal duct with irrigation.
Results: Final success was 26/44(%59.1) for group 1, and 36/45 (%80) for group 2.The difference was statistically significant (Chi-siquare, p=0.03).
Discussion: Diode laser ECL-DCR with 0.4 mg /ml intraoperative mmc application for 5 minutes appears to be an effective treatment modality for primary nasolacrimal duct obstruction.
Keywords: Endocanalicular Multidiode Laser Dacryocystorhinostomy; Mitomycin-C; Nasolacrimal Duct Obstruction
Evaluation of a CHROMagar Salmonella Medium for the Isolation of Salmonella Species
Yeşim Çekin 1, Özlem Koyuncu Özyurt 2, Duygu Dağlar 3, Hafize Kılınçkaya Doğan 2, Betil Özhak Baysan 2, Aylin Erman Daloğlu 2, Gözde Öngüt 2, Dilara Öğünç 2, Dilek Çolak 2, Belkıs Levent 4
1 Antalya Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji, Antalya, 2 Akdeniz Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji A.D., Antalya, 3 Serik Devlet Hastanesi, Antalya, 4 Türkiye Halk Sağlığı Kurumu, Ankara, Türkiye
DOI: 10.4328/JCAM.1708 Received: 02.03.2013 Accepted: 18.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 29-31
Corresponding Author: Betil Ozhak Baysan, Akdeniz Üniversitesi Merkez Laboratuarı, Tıbbi Mikrobiyoloji A.D., Antalya, Türkiye. GSM: +905057406887 E-Mail: email@example.com
Aim: Salmonella infections are the leading cause of food-borne infections and can cause gastroenteritis outbreaks worldwide. Salmonella species is defined as inability to lactose fermentation, using citrate as a carbon source, using lysine as nitrate source and forming Hydrogen sulfide (H2S) in TSI agar. However, confirmation of false positive results is time consuming and lead to increased costs. The aim of this study is to evaluate the performance of CHROMagar Salmonella (CHROMagar Microbiology, France) which is developed for isolation and detection of Salmonella species.
Material and Method: For this purpose, among a total of 148 isolates which were isolated from various clinical specimens and stocked at the Central Laboratory of Akdeniz University Hospital, 65 were Salmonella spp., 10 were Pseudomonas aeruginosa, 10 were E. coli, 10 were Acinetobacter baumannii, 10 were Klebsiella pneumoniae, 18 were Morganella morganii, 11 were Citrobacter spp., 5 were Providencia spp., 4 were Aeromonas spp., 5 were Proteus spp. were included in this study. All of the 65 Salmonella spp. isolates apperared with mauve colonies at the CHROMagar Salmonella.
Results: E. coli and Klebsiella pnemoniae species were seen as blue, Providencia species were seen as pale-blue; Morganella morganii species were seen as pale-pink, mauve; and Pseudomonas aeruginosa species were seen as pale. Acinebacter baumannii and Aeromonas spp. species were also seen as mauve colonies.
Dicussion: CHROMagar Salmonella medium can detect Salmonella species with %100 sensitivity, however there is a need to biochemical or serological confirmation.
Keywords: Salmonella Spp; CHROMagar; Identification
The Impact of Endoscopy Training During Residency on the Diagnostic
M.Ali Eryılmaz, Nergis Aksoy, Serden Ay, Ahmet Okuş, Ömer Karahan
Konya Training and Research Hospital, General Surgery, Konya, Turkey
DOI: 10.4328/JCAM.1681 Received: 19.02.2013 Accepted: 23.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 32-6
Corresponding Author: Serden Ay, Konya Eğitim ve Araştırma Hastanesi, Necip Fazıl Mah. Ateşbazı Sok. Meram Yeniyol PK:42040 Konya, Türkiye. T.: +90 3323236709 E-Mail: firstname.lastname@example.org
Aim: The aim of the study is to evaluate the impact of endoscopy training during residency on endoscopic diagnosis.
Material and Method: the patients files who had undergone endoscopy between 2009 and 2011 in surgical endoscopy unit, retrospectively evaluated. Endoscopists were divided into 2 groups as endoscopy training during residency (group 1) or than after (group 2). Histopathological evaluation was accepted as the method to confirm the diagnosis. Endoscopic and pathological diagnoses were compared and the consistencies of the Endoscopists were calculated.
Results: There were 9055 endoscopic evaluation and 1285 biopsies were taken in 3 years period. The mean age of the patients were 54 (15-94). There were 15 surgeons, 8 in group 1, 7 in group 2. In upper gastrointestinal system endoscopy the consistency rates were 79% in group 1 and 72% in group 2 (p=0,035). In lower gastrointestinal system endoscopy, the consistency rates were 79% in group 1 and 80% in group 2 (p=0,709).
Discussion: Endoscopy training during residency has positive impact on identification of upper gastrointestinal system lesions.
Keywords: Endoscopy; Residency; Diagnosis
Comparison of Oral Terbinafine with Itraconazole in the Treatment of Tinea Pedis
Memet Erşan Bilgili 1, Zeynep Nurhan Saraçoğlu 1, Hamza Yıldız 2, Abdurrahman Aslan 1, İlham Sabuncu 1
1 Osmangazi Üniversitesi Tıp Fakültesi, 2 Eskişehir Asker Hastanesi, Deri ve Zührevi Hastalıkları Kliniği, Eskişehir, Türkiye
DOI: 10.4328/JCAM.1746 Received: 20.03.2013 Accepted: 28.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 37-40
Corresponding Author: Hamza Yıldız, Deri ve Zührevi Hastalıkları Kliniği, Eskişehir Asker Hastanesi, 26020, Eskişehir, Türkiye. T.: +90 2222204530/4220 F.: +90 2222303433 E-Mail: email@example.com
Aim: The aim of this study was to evaluate the efficacy and safety of oral terbinafine and itraconazole in the treatment of the patients with interdigital tinea pedis.
Material and Method: A total 60 patients with clinically and mycologically diagnosed as interdigital tinea pedis were enrolled to the study. Patients were divided into two groups. The first group received oral terbinafine 250 mg/day for two weeks (n:30). The second group received itraconazole 200 mg daily for 7 days (n:30). At the first visit and 15, 30, 60 days after the start of the study, signs and symptoms were assessed clinically and scales were taken for mycological assessments.
Results: Six patients who did not return after the first visit were excluded from the study (2 on terbinafine, 4 on itraconazole). The effectiveness of therapy was evaluated at day 15, 30, 60. Symptoms were absent in 57.1% of terbinafine group and 46.1% of the itraconazole group in the first control. The effectiveness of the terbinafine group was 82.1% and 73.1% of the itraconazole group in second control. At day 60, the cure rates were similar (89.3% for terbinafine, 84.6% for itraconazole). No statistical significant differences between the two groups was observed (p>0.05).
Discussion: Oral terbinafine and itraconazole have the same effectiveness and tolerability in the treatment of interdigital tinea pedis.
Keywords: Tinea Pedis; Terbinafine; Itraconazole
Comparison of Sugammadex and Neostigmine in Short Term Surgery
Fatih Koç, Güldem Turan, Dilek Subaşı, Osman Ekinci
Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
DOI: 10.4328/JCAM.1694 Received: 24.02.2013 Accepted: 28.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 41-
Corresponding Author: Güldem Turan, Barbaros M. Uphill S. B 5 Dai: 2 B. Post Code: 34746 Atasehir, Istanbul, Turkey. T.: +90 2166883642 F.: +90 2163460582 E-Mail: firstname.lastname@example.org
Aim: This study compared the efficacy and cost effectivines of sugammadex and neostigmine for reversal of neuromuscular blockade induced by rocuronium for short term elective surgery.
Material and Method: After written informed consent, 33 patients aged 18–65, ASA I-III, who were undergoing short term surgery (<90 min) were randomly selected and divided into two groups (Group Sugamadex, n=16; group Neostigmine, n=17). All patients were given 1,5 µg kg-1 fentanyl, 5-7 mgkg-1 thiopental, 0,6 mg kg-1 rocuronium for anaesthesia induction. Anaesthetic maintenance was ensured through 50% O2-N2O and 1% sevoflurane. Neuromuscular blockade was monitored using acceleromyography and a train-of-four (TOF) mode of stimulation. During surgery maintenance doses of 0.1-0.2 mgkg-1 rocuronium were administered according to reappearance of the third response of the TOF. Patients were given sugammadex 2 mg kg_1(group S) or neostigmine 50 µg kg_1 (with atropine 20 µg kg_1) (group N) at reappearance of the second response of the TOF after the last dose of rocuronium in the end of the surgery.
Results: Demographic properties were similar in the two groups. Time to recovery of the TOF ratio of 0.9 and extubation time after sugammadex compared with neostigmine were significantly shorter, being 2.3 ± 0.9 versus 9.4 ± 2.7 min and 6.6 ± 1.6 versus 12.9 ± 2 (P<0.001). The costs were higher in group S (71.2 ± 9.8 $ ) than group N (1.7 ± 0.2 $) per patient (p<0.001).
Discussion: Recovery of neuromuscular function after rocuronium to a TOF ratio of 0.9 was faster with 2mg kg_1 sugammadex when compared with 50 µg kg_1 neostigmine, while sugammadex was the more expensive then neostigmine.
Keywords: Sugammadex; Neostigmine; Neuromuscular Blockade
The Relationship in Hypertensive Patients Endothelin Levels, Echocardiographic Findings and Valsartan
Hüseyin Cakiroglu 2, Kenan Saglam 1, Muhammed Erdal 2, Coşkun Meric 1
1 Gulhane Military Academy of Medicine, Departments of Internal Diseases, Ankara, 2 Isparta Military Hospital, Department of Internal Diseases, Isparta, 3 Etimesgut Military Hospital, Department of Family Medicine, Ankara, Turkey
DOI: 10.4328/JCAM.1518 Received: 05.01.2013 Accepted: 28.03.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 46-9
Corresponding Author: Hüseyin Çakiroğlu, Isparta Military Hospital, Department of İnternal Medicine, Isparta, Turkey. T.: +90 2462241418 F.: +90 2462241314 E-Mail: email@example.com
Aim: It is estimated that treatment options which lower endothelin (ET) levels may be a new treatment approach for hypertensive patients. For this purpose in this study, we investigated whether the antihypertensive effect of valsartan is due to its effect on serum ET levels or not. In addition to this, the relationship between serum ET evels and left ventricular hypertrophy (LVH) was also determined.
Material and Method: Twenty-three patients (14 men, 9 women) with an age range of 33-70 years having Stage 1 (n=3) or Stage II (n=20) hypertension according to the criteria defined by the Joint National Committee Report VII (JNC VII) were included.
Results: Compatible to previous studies, serum ET evels of the hypertensive patients were higher than of the healthy controls (p<0.05). In the hypertensive group, there were significant reductions in both ET levels and LVH after three months of valsartan and/or hydrochlorothiazide treatment (p<0.05). Serum ET levels of patients with LVH or hypertensive retinopathy were higher than patients without LVH or hypertensive retinopathy, however this finding was not statistically significant (p>0.05).
Discussion: Valsartan was found to be effective in decreasing serum ET levels in addition to its beneficial effect on hypertension. In addition to this, serum ET levels were observed to be elevated in hypertensive patients. However, valsartan did not seem to be effective in the development of complications related to hypertension.
Keywords: Hypertension; Endothelin; Valsartan
Role of Breast Ultrasound in Patients with Negative Mammogram Presenting with Breast Pain Without a Palpable Lump
Ebru Özan 1, Mert Köroğlu 1, Eda Parlak 1, Mehtap Ergün 1, Arsenal Sezgin Alikanoğlu 2
1 Radyoloji Bölümü, 2 Patoloji Bölümü, Antalya Eğitim Araştırma Hastanesi, Antalya, Türkiye
DOI: 10.4328/JCAM.1739 Received: 18.03.2013 Accepted: 01.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 50-2
Corresponding Author: Ebru Özan, Antalya Eğitim Araştırma Hastanesi Radyoloji Bölümü, Varlık Mah. Kazım Karabekir Cad. Soğuksu 07050 Antalya, Türkiye. GSM: +905056100765 F.: +90 2422494402 E-Mail: firstname.lastname@example.org
Aim: To determine if addition of an ultrasound examination to mammography has an impact on detecting breast cancer in the patients who present with breast pain without a palpable lump.
Material and Method: The mammography data from January 2008 to April 2011 was retrospectively reviewed for patients who presented with focal breast pain without a palpable lump. A total of 135 patients in which an ultrasound examination was performed in addition to mammography were retrospectively analyzed for their imaging findings and eventual outcome based on biopsy results, imaging follow-up, or clinical follow-up. For the purpose of test analysis, categories 1-3 were considered negative on mammography and ultrasound and categories 0, 4, and 5 were considered positive on mammography while categories 4 and 5 were considered positive on ultrasound.
Results: The addition of an ultrasound examination in the presence of a normal or benign mammogram in the whole group upgraded the examination category in 14 (%10.3) of 135 cases without increasing the sensitivity for detection of breast cancer. In patients presenting with breast pain without a palpable lump, addition of an ultrasound examination to a negative or benign mammogram does not increase the sensitivity for detecting breast cancer.
Discussion: Breast pain also known as mastalgia or mastodinia, is a common symptom affecting up to 70% of women at some time or the other in their lives. There is limited data about the value of ultrasound in addition to mammography, for detection of breast cancer in patients presenting with breast pain without a palpable lump. To the best of our knowledge, our study is one of first studies revealing this issue in the literature. Further studies including more participants of patients with mastalgia, will provide additional data.
Keywords: Mastalgia; Mammography; Ultrasound; Breast Cancer
Comparison of Three Methods for Laryngeal Mask Airway Insertion in Adults: Standard, Lateral and Rotational
Ata Mahmoodpoor 1, Samad EJ Golzari 2, 3, Masoud Hamidi1, Masoumeh Hamidi 1, Masoud Parish 1, Hassan Soleimanpour 1, Mirmousa Mirinezhad 1
1 Department of Anesthesiology, Tabriz University of Medical Sciences, 2 Cardiovascular Research Center, Tabriz University of Medical Sciences, 3 Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
DOI: 10.4328/JCAM.1752 Received: 22.03.2013 Accepted: 12.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 53-6
Corresponding Author: Samad EJ Golzari, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. T.: +989141151894 E-Mail: email@example.com
Determination of an optimal Laryngeal Mask Airway (LMA) insertion technique is of great importance as unsuccessful prolonged insertion and multiple attempts are associated with adverse respiratory effects and trauma. The purpose of this study was to compare the ease of insertion of LMA using the standard approach with lateral and rotational techniques. 150 adult patients undergoing general anesthesia using LMA were randomized into one of the three mentioned techniques: standard, rotational and lateral. The time for LMA insertion, number of LMA insertion attempts and LMA insertion success rate were noted for all patients. Demographic characteristic of patients between three groups did not have significant difference. Patient movement and time for LMA insertion and time for LMA insertion was significantly less in lateral technique (P<0.001). The overall success rate for LMA insertion between three groups was not of significant difference (P= 0.06); however, there was a positive trend toward the lateral insertion group. Lateral technique is practically easy, does not require pushing toward the back of the mouth and consequently is associated with the least complications. Therefore, it seems that the 90 degrees rotational or lateral techniques might be considered as the best ways for LMA insertion.
Keywords: Laryngeal Mask Airway; Insertion Technique; Complications
The Association Between Febrile Seizures and Iron Deficiency Anemia in Childhood
Olcay Ünver 1, Rabia Gönül Sezer 2, Ayşe Esin Kibar 3, Afşin Ünver 4, İlke Özahi İpek 5, Abdülkadir Bozaykut 2
1 Mersin Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Çocuk Nöroloji, Mersin, 2 Zeynep Kamil Kadın Doğum ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları, İstanbul, 3 Mersin Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Çocuk Kardiyoloji, Mersin, 4 Özel Göztepe Hastanesi, Çocuk Sağlığı ve Hastalıkları, İstanbul, 5 Medipol Üniversitesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, İstanbul, Türkiye
DOI: 10.4328/JCAM.1716 Received: 13.03.2013 Accepted: 25.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 57-60
Corresponding Author: Olcay Ünver, Mersin Kadın Doğum ve Çocuk Hastalıkları Hastanesi, Halkkent Mah. Fatih Sultan Mehmet Bul. No: 23, 33240, Mersin, Türkiye. T.: +90 3242230701/5430 E-Mail: firstname.lastname@example.org, email@example.com
Aim: Febrile seizures are the most common seizure type in childhood. In recent years febrile seizures are linked with iron deficiency anemia. The aim of this study is to evaluate the association between febrile seizures and iron deficiency and iron deficiency anemia.
Material and Method: 139 children, aged 6 months to 5 years, admitted to our pediatric outpatient and emergency clinic between November 2003 and August 2004 were enrolled in the study. The diagnosis of iron deficiency anemia and febrile seizures were made according to the criteria of American Academy of Pediatrics. The study group consisted of 93 children with one or more febrile convulsions. None of them was on antiepileptic therapy. The control groups consisted of children with a febrile illness in the absence of convulsions (n=21) and healthy children (n=25).
Results: There was no statistically significant difference in Hb, MCV and ferritin levels between the study and control groups (p>0,05). The serum iron levels were lower in the children with febrile seizures compared to the children with a febrile illness in the absence of febrile seizures and healthy children. The result is statistically significant (p<0,05).
Discussion: The present study showed that the percentage of iron deficiency is higher in the children with febrile seizures compared to the control groups even before the anemia develops. The results of this study suggest that iron deficiency may play a role in the etiopathogenesis of febrile seizures. However, further standardized and controlled studies are required to evaluate this finding.
Keywords: Febrile Seizures; Iron Deficency; Child
The Cardioplegia Having N-Acetylcysteine Effects on Myocardial Protection
İlker İnce 1, Erdal Şimşek 2, Kasım Karapınar 3, Gökhan Özerdem 4
1 Tokat Gaziosmanpaşa Üniversitesi Kalp ve Damar Cerrahisi Anabilim dalı Tokat, 2 Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Bölümü Ankara, 3 Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahisi Bölümü, Ankara, 4 Özel Çağ Hastanesi Kalp ve Damar Cerrahisi Bölümü Ankara, Türkiye
DOI: 10.4328/JCAM.1730 Received: 18.03.2013 Accepted: 24.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 61-4
Corresponding Author: Erdal Şimşek, Ceyhun Atıf Kansu Caddesi 166/4, 06510, Balgat, Ankara, Türkiye. GSM: +905323280217 E-Mail: firstname.lastname@example.org
Aim: In open heart surgery, oxidants and free radicals consisting of after ischemia and reperfusion are responsible for myocardial injury in the first place. N-acetylcysteine is a powerful antiinflammatory and antioxidant agents, therefore we investigated the effect of the prevention of N-acetylcysteine in ischemia-reperfusion injury.
Material and Method: The study group composed of two groups of 15 patients underwent coroner artery bypass surgery. Group I consisted of patients treated with N-acetylcysteine (NAC) (n:15), and Group II (control group) (n:15) consisted of patients without any additional medication. Blood samples were collected preoperative, after cross-clamp, postoperative 1th and 5 th days. Serum phospho creatine kinase (CPK), creatine kinase myocardial band (CKMB), troponin I, interleukin-6 (IL-6) and interleukin-10 (IL-10) levels were measured. The development of postoperative infection, length of stay in intensive care unit and hospital were compared between two groups.
Results: Proinflammatory cytokine levels (IL-6) were significantly lower (p <0.05) and anti-inflammatory cytokine levels (IL-10) were significantly higher (p <0.05) in Group I after cross clamp, postoperative 1th and 5th days. There was no significant difference in other parameters between two groups.
Discussion: When the levels of IL-6 and IL-10 are examined, NAS are marked to decrease systemic immunologic response and mortality and morbidity because of positive antiinflammatory feature for the patients that can progress excess immunologic response. However, between the groups, there is no any significant difference in terms of clinical parameters; so it gives an impression of that anti-inflammatory feature of the NAS is not enough alone to decrease mortality and morbidity.
Keywords: N-Acetyl Cysteine; Reperfusion Injury; Systemic Inflammatory Response Syndrome
The Effect of the Ovarian Endometrioma Surgery on Ovarian Reserve and Ovarian Blood Flow
Manolya Yılmaz 1, Ahmet Uysal 1, 2, Ahmet Seçkin Önoğlu 1, Fatma Uysal 3, Cüneyt Eftal Taner 1
1 SB Ege Doğumevi ve Kadın Hastalıkları Eğitim Hastanesi, Kadın Hastalıkları ve Doğum, İzmir, 2 Çanakkale Onsekiz Mart Üniversitesi, Kadın Hastalıkları ve Doğum ABD, Çanakkale, 3 SB Ege Doğumevi ve Kadın Hastalıkları Eğitim Hastanesi, Radyoloji, İzmir, Türkiye
DOI: 10.4328/JCAM.1751 Received: 21.03.2013 Accepted: 24.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 65-8
Corresponding Author: Ahmet Uysal, Çanakkale Onsekiz Mart Üniversitesi, Kadın Hastalıkları ve Doğum ABD, Çanakkale, Türkiye. GSM: +905332635540 E-Mail: email@example.com
Aim: To investigate the effectiveness of laparoscopic endometriosis surgery on ovarian reserve and ovarian blood flow index.
Material and Method: Twenty-six patients were evaluated prospectively whom had laparoscopic surgery due to endometrioma in third care education and research hospital. Before and after surgical procedure all patients FSH, LH and E2 levels were measured in their 3rd menstrual period day. Periodically cysts and ovarian volume as well as ovarian artery resistive index measured by using transvaginal Doppler sonography.
Results: Twenty-six patients’ mean age was 25, 6 ± 4, 5 (20-36 years). When the compared to changes of preoperative and postoperative values of hormonal parameters FSH (p: 0,455) and LH (p: 0,672) were insignificant and E2 (p: 0,024) was significant respectively. While ovarian volume was decreasing significantly (p: 0,001), Ovarian Artery RI parameter was not changed (p: 0,587).
Discussion: Our study was showed that while laparoscopic surgical treatment of ovarian endometriomas significantly decrease ovarian volume, but hormonal parameters and ovarian blood flow were not affected.
Keywords: Endometriosis; Ovarian Reserve; Doppler Ultrasonograpfi
Seroprevalence of Rubella and Cytomegalovirus Among Childbearing Aged Women
Mikrobiyoloji ve Klinik Mikrobiyoloji, Manisa Devlet Hastanesi, Manisa, Türkiye
DOI: 10.4328/JCAM.1766 Received: 28.03.2013 Accepted: 24.04.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 69-71
Corresponding Author: Nilüfer Pekintürk, Mikrobiyoloji ve Klinik Mikrobiyoloji, Manisa Devlet Hastanesi, Manisa, Türkiye. GSM: +905058114455 E-Mail: firstname.lastname@example.org
Aim: Rubella and cytomegalovirus (CMV) infection during pregnancy, can lead congenital infections causing serious abnormalities of fetus. Seronegative women’s babies are under risk of congenital infections, for both of virus. In this study, determination of rubella and CMV seroprevalence among childbearing aged women who presented to our hospital’s clinics is aimed.
Material and Method: Rubella IgG antibodies were investigated in 5415 sera and CMV IgG in 576 sera of women between 15-49 ages, in our hospital central laboratory, between 1 November 2008 and 31 August 2010.
Results: 5085 (93.9%) of seras tested detected positive for Rubella IgG antibodies and 562 (97.6%) seras were positive for CMV IgG.
Discussion: It has been determined that, 6.1% of childbearing aged women whose test results are evaluated, are susceptible to rubella, 2.4% are susceptible to CMV and their babies are at risk group for congenital infections. Childbearing aged women must be screened for rubella and CMV antibodies, and seronegative ones must be instructed about congenital infections and precautions decreasing risk and vaccined for rubella.
Keywords: Rubella; Cytomegalovirus; Childbearing Age
Recurrence and Progression Rate of High Grade Ta Bladder Cancer: 5-Year Follow up Results
Muhammet Fatih Kılınç 1, Nurettin Cem Sönmez 2, Osman Murat İpek 2, Ayhan Dalkılıç 2, Serdar Arısan 2, Soner Güney 2
1 Ankara Eğitim ve Araştırma Hastanesi Üroloji Kliniği, Ankara, 2 Şişli Etfal Eğitim ve Araştırma Hastanesi Üroloji Kliniği, İstanbul, Türkiye
DOI: 10.4328/JCAM.1815 Received: 15.04.2013 Accepted: 03.05.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 72-4
Corresponding Author: Muhammet Fatih Kılınç, Ankara Eğitim ve Araştırma Hastanesi Üroloji Kliniği, Ankara, Türkiye. GSM: +905317941525 E-Mail: email@example.com
Aim: The aim of the present study to evaluate recurrence and progression rates and success of BCG therapy, in a population with high grade Ta bladder cancer.
Material and Method: Of the 45 patients treated and follow up at our institution from 1997 to 2005 for the histopathological diagnosis of primary bladder cancer with high grade Ta bladder cancer were treated with BCG weekly for 6 weeks. At a follow up of mean 55,6 months patients were evaluated with urinary cytology, cystoscopy, transurethral resection and random mucosal biopsies. Recurrence, grade and stage progression were analyzed.
Results: Of the 48 patients 8 (16,6%) responded positively to BCG without recurrence, while disease recurred as stage Ta in 14 (29,1%) and progressed as stage T1 in 11 (22,9% ) at a five- year follow up, and progressed to muscle layer infiltration in 15 (31,25%). Three (6%) patients died of bladder cancer. The number of tumors, gender, age and size of tumors did not appear to be predictive factors of progression to muscle invasion but an association with carcinoma in situ appeared to correlate highly with progression (p <0.001).
Discussion: Our study demonstrates the high progression potential of high grade Ta bladder cancer, since nearly 50% recurred and 30 % progressed to invasive disease. These results may be closely compared with the results of previous trials of high grade T1 bladder cancer. We suggest that recurrence should be detected at an early stage using long-term follow up with strict observance of the surveillance protocols during a minimum 5-year tumor-free period.
Keywords: Urinary Bladder Neoplasm; Disease Progression; Recurrence; High Grade Ta
The Effects of Hysteroscopic Submucosal Myoma Resection on Number of Sanitary Pads
Semih Mun 1, Ahmet Uysal 1, 2, Ahmet Seçkin Önoğlu 1, Fatma Uysal 3, Cüneyt Eftal Taner 1
1 SB Aegean Maternity and Teaching Hospital, Obstetrics and Gynecology, Izmir, 2 Çanakkale Onsekiz Mart University, Obstetrics and Gynecology, Çanakkale, 3 SB Aegean Maternity and Teaching Hospital, Department of Radiology, Izmir, Turkey
DOI: 10.4328/JCAM.1820 Received: 16.04.2013 Accepted: 02.05.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 75-8
Corresponding Author: Ahmet Uysal, Çanakkale Onsekiz Mart University, Obstetrics and Gynecology, Çanakkale, Turkey. GSM: +905332635540 E-Mail: firstname.lastname@example.org
Aim: To research the effect of hysteroscopic resection of submucosal myoma (HRSM) on the amount of pads used during the menstrual period in a premenopausal patient with menometrorrhagia caused by submucosal fibroids.
Material and Method: A total of 27 women with submucosal fibroids were included in this prospective study using the Pictorial Blood Assessment Chart (PBAC) to evaluate quantity of menorrhagia. Bleeding evaluation and number of pads used by patients in the 6th month after HRSM were recorded.
Results: The average age of patients included in the study was 41±5.1. Of 27 patients 20 (74%) had one. 4 (14%) had two and 3 (12%) had three or more submucosal myomas. The diameter of removed fibroids were 17 (63%) less than 3 cm, 6 (22%) between 3 and 5 cm and 4 (15%) were above 5 cm. In the postoperative 6th month on the day of heaviest menstrual bleeding average number of pads used dropped to 3.8 compared to 9.1 in the preoperative period (p<0.05).
Discussion: HRSM performed due to menometrorrhagia in the premenopausal period significantly reduces the number of pads used and the number of days of bleeding.
Keywords: Submucosal Myoma; Menorrhagia; Hysteroscopy; Sanitary Pad
Helicobacter Pylori Seropostivity of Colon Cancer
F. Tuğba Köş 1, Sevilay Sezer 2, Ozan Yazıcı 3, Burak Civelek 3, Ayla Yıldız 4, Sercan Aksoy 3, Nuriye Özdemir 3, Doğan Uncu 3, Bülent Akıncı 3, Nurullah Zengin 3
1 Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Bilim Dalı, Kahramanmaraş, 2 Ankara Numune Eğitim ve Araştırma Hastanesi, Biyokimya Kliniği, Ankara, 3 Ankara Numune Eğitim ve Araştırma Hastanesi, Tıbbi Onkoloji Kliniği, Ankara, 4 Ankara Numune Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye
DOI: 10.4328/JCAM.1826 Received: 19.04.2013 Accepted: 07.05.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 79-82
Corresponding Author: F. Tugba Kos, Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, Tıbbi Onkoloji Bilim Dalı, 46000, Merkez, Kahramanmaraş, Türkiye. GSM.: +905323064615 F.: +90 3442212371 E-Mail: email@example.com
Aim: Until now many researches have showed that Helicobacter pylori infection may be etiological factor of colorectal cancer. The aim of current study was to investigate the frequency of H.pylori infection seropositivity of colorectal cancer patients and compare the clinicopathological features of H.pylori positive patients with negative ones.
Material and Method: Seventy four colorectal patients were included in study. Retrospectively, patients clinical features, surgery history and pathological characteristics were screened. Patients group serum samples were collected. H.pylori Ig G level were quantitatively measured with ELISA method and levels above 5 arbU/ml were accepted as seropositive.
Results: Patients median age was 60.5 ( range 26-83) and 56.8% (n=42) were male. H.pylori Ig G was positive in 37.8% (n=28) and negative in 62.2% (n=46) of patient group. H.pylori serpositive and negative patients median age of diagnosis were 56 and 64 respectively (p=0.01). There were no significant difference between H.pylori seropositive group when compared with negative group according to age, level of CEA and Ca 19-9, stage, lymph node involvement, perineural and vascular invasion, presence of polyps, differantion, localisation of tumours.
Discussion: H.pylori seropositive patients were diagnosed at younger age. Association of this finding with etiology was confusing. Further studies with healthy controls may provide detailed information about whether H.pylori seropositivity is associated with colorectal cancer etiology.
Keywords: Colorectal Cancer; Helicobacter Pylori; Seropositivity
Comparison of Serum IL-23 and IL-17 Levels in Patients with Systemic Sclerosis and Healthy Subjects
Demir Celal 1, Sahin Ali 2, Kucuksahin Orhan 3, Turgay Murat 3, Turkcapar Nuran 3, Erten Sükran 4, Kınıklı Gülay 3
1 Division of Internal Medicine, Cide Government Hospital, Kastamonu, 2 Division of Rheumatology, Sanliurfa Education and Research Hospital, Sanliurfa, 3 Department of Internal Medicine – Rheumatology, Ankara University School of Medicine, Ibni Sina Hospital, Ankara, 4 Division of Rheumatology, Atatürk Education and Researh Hospital, Ankara, Turkey
DOI: 10.4328/JCAM.1709 Received: 05.03.2013 Accepted: 07.05.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 83-7
Corresponding Author: Celal Demir, Cide Devlet Hastanesi, İç Hastalıkları, Kastamonu, Turkey. E-Mail: firstname.lastname@example.org
Aim: Systemic Sclerosis (SSc) is a chronic autoimmune-multisystemic disease with unknown aetiology. Fibrosis, vasculopathy and immune system activation are responsible for SSc pathogenesis. Cytokines such as interleukin (IL)-17 and IL-23 may play a role in disease development, disease severity, involvement and characteristics rather than one. For this reason, we aimed to compare the serum levels of serum IL-17 and IL-23 in SSc patients and healthy controls.
Material and Method: Fourty patients with SSc and fourty healthy control were included in the study. Autoantibody profiles, organ involvement of the patients were determined. Modified Rodnan skin scores (MRSS) of the patients were calculated. Serum IL-17 and IL-23 levels were measured by ELISA.
Results: The patients had a mean MRSS of 13.15. Any statistically significant difference between MRSS and IL-17/IL-23 levels were not detected. (p=0.142 and p=0.668, respectively). Twenty-one (52.5%) patients had lung involvement and 16 (40%) patients had gastrointestinal involvement. Thirty-six (90%) patients were ANA positive, 21 (52.5%) patients were anti-Scl-70 positive, 6 (15%) of the patients were anti-centromere positive. The mean IL-17 levels of the patients and control group were 0.67±0.55 pg/ml and 0.52±0.10 pg/ml (Mann-Whitney U, p=0.007), respectively. The mean of IL-23 levels of healthy control group and patients were found to be 30.27±12.68 pg/ml and 29.32±10.52 pg/ml, respectively (p=0.60). There were no statistically significant relation between serum levels of IL-17/IL-23 and age, pulmonary and gastrointestinal involvement, disease severity, autoantibody profiles. The levels of IL-17 differed significantly in SSc patients and control group but not so in IL-23.
Discussion: In our study we concluded that SSc is associated with IL-17, but not with IL-23. IL-17 might contribute to SSc pathogenesis, but no correlation was found between the serum levels of IL-17/IL-23 and clinical symptoms, laboratory findings or disease activity. Anti-IL-17 can be a potential therapeutic agent in SSc patients.
Keywords: Interleukin-17; Interleukin-23; Systemic Sclerosis
Molar Pregnancy with a Co-Existing Viable Fetus
Ruya Deveer 1, Yaprak Engin-Ustun 1, Ozlem Gun-Eryilmaz 1, Eren Akbaba 1, Mehmet Deveer 2
1 Zekai Tahir Burak Women Health Research and Education Hospital, Perinathology, 2 Dr Nafiz Körez Public Hospital, Radiology, Ankara, Turkey
DOI: 10.4328/JCAM.830 Received: 12.10.2011 Accepted: 13.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 88-90
Corresponding Author: Rüya Deveer, 30. Cad. 340. Sk. Mutlu Apt. 5/5, Çiğdem Mah., Çankaya, Ankara, Turkey. GSM: +905063801350 E-Mail: email@example.com
The aim of this study was to report the clinical features, management, and outcome of a case of molar pregnancy with a coexisting viable fetus and to review the literature. In this article, we report a case of pregnancy with diffuse placental molar change and a normal fetus which presented with hyperemesis gravidarum and hyperthyroidism. Genetic amniocentesis showed normal fetal karyotype. A healthy full-term live male infant was delivered by cesarean section. In molar pregnancies with a normal karyotype fetus, with intensive maternal follow-up, continuation of pregnancy can be suggested.
Keywords: Molar Pregnancy; Hyperthyroidism; Healthy Infant
New Onset Murmur and Hemodynamic Deterioration in a Patient with Infective Endocarditis
Zekeriya Arslan 1, Murat Tavlaşoğlu 2, Leyla Guler 3, Adem Guler 2, Mehmet Ali Sahin 2
1 Department of Cardiology, 2 Department of Cardiovascular Surgery, Gülhane Military Medical Academy, Etlik, 3 Anesteziyoloji A.D., Gazi Üniversitesi, Ankara, Turkey
DOI: 10.4328/JCAM.783 Received: 22.08.2011 Accepted: 17.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 91-3
Corresponding Author: Mehmet Ali Şahin, GATA Kalp Damar Cerrahisi A.D. 06010 Etlik, Ankara, Türkiye. T.: +90 3123045243 F.: +90 3123045200 E-Mail: firstname.lastname@example.org
Despite the use of new wide spectrum antibiotics, infective endocarditis may lead to a paravalvular abscess or an aorta-cavitary fistula formation. Although the latest developments in surgical techniques give some advantages to perform an appropriate surgery in more complex operations in patients with complicated infective endocarditis, the mortality rates are still high. We hereby report a case of infective endocarditis caused a fatal complication that was aorta-cavitary fistula caused hemodynamic deterioration. The case underwent a successful surgical procedure in which fistula was repaired using a pericardial patch and mechanic valve prosthesis was implanted in aortic position. The case was discharged without any complication after finishing the antibiotic regime on the postoperative 28th day. We would like to discuss the treatment strategy of this case and current literature related management options will be presented.
Keywords: Infective Endocarditis; Aorta-Cavitary Fistula; Murmur
Granulomatous Prostatitis: Report of Two Cases and Review of the Literat
Fikret Erdemir 1, Mete Kilciler 2, Adem Yaşar 1, Doğan Atılgan 1, Doğan Köseoğlu 3
1 Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, 2 Gülhane Numune Askeri Tıp Akademisi, Üroloji Anabilim Dalı, Ankara, 3 Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, Tokat, Türkiye
DOI: 10.4328/JCAM.841 Received: 26.10.2011 Accepted: 21.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 94-6
Corresponding Author: Adem Yaşar, Tokat Devlet Hastanesi, Üroloji Servisi 60100 Merkez, Tokat, Türkiye. T.: 0 356 2289363 Gsm: 0 5055607039 E-mail: email@example.com
Granulomatous prostatitis (GnP) accounts for 0.8–1% of benign inflammatory conditions of the prostate. It mimics prostate cancer clinically, histologically and biochemically. Non-specific granulomatous prostatitis is the most common type of granulomatous prostatitis. As most GnP is of the non-specific type, therapy is mainly supportive and up to 62% of the patients have spontaneous resolution. The present study reviews the transrectal ultrasonography results and serum prostate specific antigen (PSA) levels of 2 patients with biopsy-proven non-specific granulomatous prostatitis.
Keywords: Granulomatous Prostatitis; PSA; Diagnosis; Treatment; Prostate
Delayed Phase Nasal Metastasis of Renal Cell Carcinoma as a Rare Epistaxis Cause
Kerem Öztürk, Mustafa Şahin, Raşit Midilli, Bülent Karcı
Ege Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı, İzmir, Türkiye
DOI: 10.4328/JCAM.848 Received: 07.11.2011 Accepted: 21.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 97-9
Corresponding Author: Mustafa Şahin, Ege Üniversitesi Kulak Burun Boğaz Anabilim Dalı 35100, Bornova, İzmir, Türkiye. T.: 02323902600 F.: 02323902670 E-mail: firstname.lastname@example.org
Malign tumors of sinonasal area composes %1 of malignant tumors in adults and %3 of head and neck malignities. Metastasis to this area is rare but malignities that metastatic to head and neck and below down clavicula, renal cell carcinoma (RCC) is the third after lung and breast cancer . As the most frequent malignancy of kidney, RCC is generally seen in male over 40 year old and forms %3 of malign tumors in adults and in RCC cases %8 of disease arises by the metastasis to head and neck which is accepted as a bad prognostic factor. In this case report, a 81 year old male patient is presented with literature datas who is underwent nephrectomy 8 years ago for RCC and referred with recurrent epistaxis and delayed phase nasal RCC metastasis.
Keywords: Renal Cell Carcinoma; Nasal Metastasis; Epistaxis
An Adult Patient with Pneumonia Due to Aspiration of Dental Prosthesis
Şamil Günay 1, Ahmet Ersin Erbaş 1, Funda Arun 2
1 Göğüs Cerrahisi Kliniği, 2 Anestezi ve Reanimasyon Kliniği, Ordu Devlet Hastanesi, Türkiye
DOI: 10.4328/JCAM.856 Received: 14.11.2011 Accepted: 21.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 100-2
Corresponding Author: Şamil Günay, Osm Ortadoğu Hastanesi, Şanlıurfa, Türkiye. GSM: +905336472915 E-mail: samilgünay@yahoo.com
In patients with a new and suddenly beginning of bronchial asthma and repetitive respiratory infection, one should consider the possibility of obstruction by a foreign body. In this case we present a male patient with pneumonia due to aspiration of dental prosthesis. A 32-year-old man presented with a 4-month history of dyspnea, chest pain and new compliants of diaphoresis and fever persistend despite of antibiotic treatment. Then the patient consultated to our chest surgery department. After the physical examination of patient we made the fiberoptic flexible bronchoscopy according to the uncertain opasity seen in the chest radiography. Later in the operating room, with the patient under general anesthesia, we extracted the aspirated foreign body, dental prosthesis, by rigid bronchoscopy.
We should think about the possibility of foreign body aspiration for the patients with suddenly beginning of the complaints such as, bronchial asthma, repetitive respiratory infection, diaphoresis, chest pain and fever. Sometimes people hides the true anamnesis because of be ashamed or amnesia.
Keywords: Aspiration Pneumania; Dental Prosthesis
Little Old Lady’s Hernia: Obturator Hernia
Birdal Güllüpınar, Aydın Sarıhan, Neşe Çolak Oray
Dokuz Eylül Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye
DOI: 10.4328/JCAM.875 Received: 13.12.2011 Accepted: 23.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 103-5
Corresponding Author: Birdal Güllüpınar, Vali Hüseyin Öğütçen Bulvarı, Korutürk Mahallesi, Ilıca Apt. 37/3 35220 Balçova, İzmir, Türkiye. T.: +90 2324122701 GSM: +905419400369 E-Mail: email@example.com
Obturator hernia is a rare kind of abdominal hernia and 0,4% of patients with obturator hernia have mechanical intestinal obstruction. It’s a type of pelvic hernia that is seen in advanced age and hard to recognize. Obturator hernia is important because it has a high mortality and morbidity rate when diagnosed lately. The most frequent symptom of Obturator hernia is intestinal obstruction with strangulation. The treatment of obturator hernia is emergent surgery. In our case report we presented a rarely seen obturator hernia case and we revised the diagnostic and treatment methods in the light of literature.
Keywords: Obturator Hernia; Abdominal Hernia; Intestinal Obstruction
Reconstruction of Thoracic Wall Defect with Polytetrafluoroethylene Graft
Şevket Yılmaz Eğitim ve Araştırma Hastanesi Göğüs Cerrahi Kliniği, Bursa, Türkiye
DOI: 10.4328/JCAM.861 Received: 19.11.2011 Accepted: 27.12.2011 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 106-8
Corresponding Author: Erkan Akar, Şevket Yılmaz Eğitim ve Araştırma Hastanesi Göğüs Cerrahi Kliniği Yıldırım 16230 Bursa, Türkiye. F.: +90 2242955000 GSM: +905052596901 E-Mail: firstname.lastname@example.org
The most common causes of major thoracic traumas are stabwounds, traffic accidents and gunshot wounds. Thoracic wall defects developing due to these injuries should be repaired if they lead to paradoxal respiration. We repaired the thoracic wall defect of the 25-year-old male patient who was admitted to our clinic with gunshot wound with Polytetrafluoroethylene graft as expansion dysfunction and paradoxal respiration developed. No complications developed and he was discharged with recovery. In conclusion, Polytetrafluoroethylene graft is a good reconstruction tool at present because it prevents paradoxal respiration successfully, applied easily and cosmetic.
Keywords: Thoracic Wall; Polytetrafluoroethylene; Gunshot
A Rare Clinic Entity: Jejunal Diverticular Perforation and Ileus
Erhan Dedeoglu 1,Temel Bulut 2, Başak Bayram 3, Berrin Dedeoğlu 4
1 Acil Servis, 2 Çanakkale Devlet Hastanesi, Genel Cerrahi, 3 Dokuz Eylül Üniversitesi, Acil Tıp AD, İzmir, 4 Çanakkale Barbaros ASM, Aile Hekimi Uzmanı, Çanakkale, Türkiye
DOI: 10.4328/JCAM.826 Received: 25.11.2011 Accepted: 02.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 109-11
Corresponding Author: Erhan Dedeoglu, Department of Emergency Medicine, Canakkale Public Hospital, Canakkale Devlet Hastanesi, Acil Servis, Canakkale, Türkiye. GSM: +905054423119 E-Mail: email@example.com
Jejunal diverticulum are very rare and they are usually asemptomatic. These asemptomatic diverticles are incidentaly encountered during the laparatomy or various radiologic imaging studies. Because of the fact that the delay in the diagnosis of acute complications causes an apparent increase and is rarely seen in mortality and morbidity, the two cases who admitted to the emergency room with acute abdominal syndrome and were admitted to the laparatomy and established jejunal diverticulasis diagnosis were aimed to be reported.
Keywords: Jejunal Divertikulum; Ileus; Perforation
An Unusual Mass on the Skin of Scrotum: Acrochordon
Ahmet Ali Sancaktutar 1, Yaşar Bozkurt 1, Abdülkadir Tepeler 2, Necmettin Penbegül 1, Murat Atar 1
1 Department of Urology, University of Dicle, Diyarbakır, 2 Department of Urology, University of Bezmi Alem, Turkey
DOI: 10.4328/JCAM.794 Received: 05.09.2011 Accepted: 03.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 112-3
Corresponding Author: Ahmet Ali Sancaktutar, Department of Urology, University of Dicle, Diyarbakır, Turkey. T.: 00 90 412 248 80 01 F.: 00 90 412 248 85 23 M.: 00 90 532 362 05 44 E-Mail: firstname.lastname@example.org
Acrochordons (skin tag or fibroepithelial polyp) are soft, skin-colored, pedunculated lesions that can be present anywhere on the body. Although they are common in other sites of the body, giant acrochordons are reported rarely in the literature. Histologically, the polyp were covered by squamous epithelium, stroma was composed of loose collagen fibers and dilated capillaries. We present the case of one giant skin tag on scrotum.
Keywords: Acrochordon; Skin Tag; Scrotum Skin
Primitive Neuroectodermal Tumour: A Rare Association with Neurofibromatosis Type 1
Hatice Gümüş 1, Metehan Gümüş 2, Uğur Fırat 3, Hakan Önder 4, Fatih İnci 5
1 Department of Radiology, 2 Department of General Surgery, 3 Department of Pathology, 4 Department of Radiology, Medical School, Dicle University, Diyarbakir, 5 Department of Radiology, Elazıg Harput State Hospital, Elazıg, Turkey
DOI: 10.4328/JCAM.867 Received: 05.12.2011 Accepted:19.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 114-6
Corresponding Author: Hatice Gümüş, Department of Radiology, Medical School, Dicle University, Yenişehir 21280 Diyarbakır, Turkey. T.: +90 4122488 58 F.: +90 4122488115 E-Mail :email@example.com
Neurofibromatosis type 1 (NF–1), is a common hereditary disease which often take the form of benign tumours. Spinal primitive neuroectodermal tumour (PNET) is very rare. Herein we report US, CT and MRI findings of a female patient with PNET involving the spinal epidural and paravertebral spaces with neurofibromatosis type 1. A 37-year-old woman has NF–1 presented with lower back pain and progressive weakness of the right lower extremities. US revealed a heterogenous well defined solid mass. CT and MRI revealed heterogenously enhanced mass originating from the right neural foramen at the level of L5–S1. Adjacent to the lesion, there was a large hernia sac, including bowel loops and mesentery, in the posterolateral abdominal wall. The definitive diagnosis was made by transabdominal percutaneous tru-cut biopsy. Although it is rare, the possibility of PNET should be kept in mind in assessing the spinal epidural lesions.
Keywords: Spinal Tumour; Primitive Neuroectodermal Tumour; Neurofibromatosis Type 1
Hydrocarbon Pneumonitis; Clinical and Radiological Variability
Bunyamin Sertogullarindan 1, Aydin Bora 2, Fuat Sayır 3, Bulent Ozbay 1
1 Department of Pulmonary Medicine, 2 Department of Radiology, 3 Department of Chest Surgery, Yuzuncu Yil University Medical Faculty, Turkey
DOI: 10.4328/JCAM.869 Received: 17.12.2011 Accepted: 19.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 117-9
Corresponding Author: Bunyamin Sertogullarindan, YYU Arastirma Hastanesi, K.Karabekir Caddesi 65200 Van, Turkey. T.: +90 4322150470-6135 GSM: +905336584452 E-Mail: firstname.lastname@example.org
Aspiration of hydrocarbons causes respiratory pathologies from simply to critical. Our aim is to attract attention to clinical and radiological variability in these cases. We presented a 22-year old young case exposed to diesel fuel by accidental aspiration. Three days after the aspiration, because of clinical deterioration, he was admitted to our emergency clinic. In the chest radiograph on admission showed infiltration in the right middle lobe. But a right lower lobe atelectasis emerged two days later. Bronchoscopy revealed inflamed and hyperemic mucosa and no bronchial obstruction. No secondary bacterial pneumonia was seen. The patient was treated with systemic steroids and antibiotics. After two weeks of treatment there was complete clinical improvement and significant radiologic regression. In the hydrocarbon aspiration cases clinical picture is variable. Radiological picture may develop with a delay. Unless there is a new evidence for an important complication, the steroid treatment should be followed.
Keywords: Hydrocarbons; Aspiration
Coexistence of Familial Mediterranean Fever and Hyperimmunoglobulinemia D Syndrome in a Child
Resul Yılmaz 1, Taner Sezer 2, Haluk Esmeray 3
1 Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Pediatri Ana Bilim Dalı, 2 Başkent Üniversitesi, Tıp Fakültesi, Pediatrik Nöroloji Bilim Dalı, 3 İstanbul Üniversitesi, Tıp Fakültesi, Pediatri Ana Bilim Dalı
DOI: 10.4328/JCAM.874 Received: 13.12.2011 Accepted: 03.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 120-2
Corresponding Author: Resul Yılmaz, Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Pediatri Ana Bilim Dalı, Tokat, Türkiye. T.: +90 3562129500/1298 GSM: +905054850558 E-Mail: email@example.com, firstname.lastname@example.org
Hereditary periodic fever syndromes are Mendelian inherited single gene diseases which are also known as hereditary autoinflammatory syndromes, are characterized by recurrent attacks of fever and inflammation. Familial Mediterranean Fever and Hyperimmunoglobulinemia D syndrome are prototypes and are inherited autosomal recessively. The diagnosis is based on clinical course, family history and is confirmed with genetic mutation analysis. We describe a 5- year-old boy who had recurrent attacks of fever, skin rash, and cervical lymphadenopathy since he was 2 years old. His genetic analysis revealed homozygous M694V and V377I for MEFV and MVK gene respectively. Due to our knowledge, this is the first report of a patient who has both HIDS and FMF clinical and genetic features.
Keywords: Familial Mediterranean Fever; Hyperimmunoglobulinemia D Syndrome; Children
“Typhlitis” A Rare Diagnose For Emergency Room; Case Report
Birdal Gullupinar 1, Aydin Sarihan 1, Hanife Ciftcioglu 1, Hakan Topacoglu 2
1 Department of Emergency Medicine, Dokuz Eylul University School of Medicine, Izmir, 2 Department of Emergency Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/JCAM.878 Received: 13.12.2011 Accepted: 19.01.2012 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 123-5
Corresponding Author: Birdal Güllüpinar, Vali Hüseyin Öğütçen Bulvarı, Korutürk Mahallesi, Ilıca Apt. 37/3 35220 Balçova, İzmir, Türkiye. T.F.: +90 2324122701 GSM: +905419400369 E-Mail: email@example.com
Typhlitis is an acute table that is characterised by the necrosis and perforation of the ascendant colon and cecum. It is often observed to be related to leukemia and lymphoma. If neutropenia, fever, pain in lower right quadrant and sensibility is present in a patient with malignancy, the first thing to think about is typhlitis. Abdominal computed tomography is used in the diagnosis of typhlitis.Typhlitis is related to high mortality and morbidity.The theraphy for typhlitis is medical or, depending on the complications, surgical. Diagnosis should be early and therapy should be started immediately. In our paper, we have presented the “typhlitis” case, which is an oncological emergency that is rarely observed in emergency services, and examined the diagnosis and therapy methods in the light of the relevant literature.
Keywords: Neutropenia; Abdominal Pain; Fever; Enterocolitis; Malignancy
The Evaluation and Management of Sleep Disordered Breathing During Perioperative Period
Tülay Kıvanç 1, Hüseyin Lakadamyalı 2
1 Başkent Üniversitesi Konya Uygulama ve Araştırma Merkezi, Göğüs Hastalıkları ve Tüberküloz Uzmanı, Konya, 2 Başkent Üniversitesi Alanya Uygulama ve Araştırma Merkezi, Göğüs Hastalıkları ve Tüberküloz Uzmanı, Antalya, Türkiye
DOI: 10.4328/JCAM.1953 Received: 27.06.2013 Accepted: 14.07.2013 Printed: 01.01.2015 J Clin Anal Med 2015;6(1): 126-30
Corresponding Author: Hüseyin Lakadamyalı, Başkent Üniversitesi Alanya Uygulama ve Araştırma Merkezi, Göğüs Hastalıkları ve Tüberküloz Uzmanı, Antalya, Türkiye. T.: +90 2425102525 E-Mail: firstname.lastname@example.org
Obstructive sleep apnea (OSA) is a syndrome defined frequently by decrease in arterial oxygen saturation, repeated upper airway obstruction episodes, increases in sympathetic output and tone, and repetitive arousals during sleep. OSA is the most common form of sleep-disordered breathing. In the United States, it has been estimated that 4% of middle aged males and 2% of middle aged females have OSA. Nevertheless the majority of patients who affect from OSA are undiagnosed and untreated. All these evidences imply that a prominent portion of OSA patients who undergo surgery will not be diagnosed and that the physicians must screen patients suspected of having sleep-disordered breathing to customize the anesthetic care and start necessary evaluations and therapy.
Keywords: Sleep Disordered Breathing; Obstructive Sleep Apnea; Perioperative Evaluation
Angioedema Due to Pear: Medical Image
Kavalci Cemil, Yilmaz Fevzi, Demir Ali
Numune Training and Research Hospital, Emergency Department, Ankara, Turkey
DOI: 10.4328/JCAM.1399 Received: 13.11.2012 Accepted: 06.12.2012 Printed: 01.01.2015
Corresponding Author: Kavalci Cemil, Numune Training and Research Hospital, Emergency Department, Altindag, Ankara, Turkey. GSM: +905055762819 E-Mail: email@example.com
A 60-years-old female patient presented to our emergency department with dispne and edema in her mouth and lips. It was learned from the history that her symptoms were occured 15 minutes after eating a pear.
Left Ventricular Pseudoaneurysm Formation Due to Free Wall Rupture
Ahmet Baris Durukan 1, Hasan Alper Gurbuz 1, Murat Tavlaşoğlu 2
1 Medicana International Ankara Hospital, Department of Cardiovascular Surgery, Ankara, 2 Diyarbakır Military Medical Hospital, Diyarbakır, Turkey
DOI: 10.4328/JCAM.1448 Received: 05.12.2012 Accepted: 18.12.2012 Printed: 01.01.2015
Corresponding Author: Ahmet Baris Durukan, Umit Mahallesi 2463. Sokak 4/18, 06810, Yenimahalle, Ankara, Turkey. GSM: +905322273814 F.: +90 3122203170 E-Mail: firstname.lastname@example.org
A 66 year old male patient admitted with chest pain on exertion. His coronary angiography revealed total occlusion of first obtuse marginal branch. Cardiac CT and MRI were performed and demonstrated left ventricular free wall rupture leading to pseudoaneurysm formation (Figure 1, Video 1). Cardiac CT image (Figure 1B) illustrates left ventricular free wall rupture on posterolateral aspect with pseudoaneurysm formation. Cardiac MRI (Figure 1C) revealed the defect on left ventricular free wall. The size of the defect was 20.4 mm in cranio-caudal direction. The dimensions of the pseudoaneurysm sac were measured as 49.5X42.4X46.7 mm. The patient refused surgical treatment.
Circumflex Coronary Artery to Aberrant Bronchial Artery Fistula
Ahmet Baris Durukan 1, Hasan Alper Gurbuz 1, Murat Tavlasoglu 2
1 Medicana International Ankara Hospital, Department of Cardiovascular Surgery, Ankara, 2 Diyarbakir Military Hospital, Department of Cardiovascular Surgery, Diyarbakir, Turkey
DOI: 10.4328/JCAM.1449 Received: 05.12.2012 Accepted: 18.12.2012 Printed: 01.01.2015
Corresponding Author: Ahmet Baris Durukan, Umit Mahallesi 2463. Sokak 4/18, 06810, Yenimahalle, Ankara, Turkey. GSM: +905322273814 F.: +90 3122203170 E-Mail: email@example.com
A 58 year old male patient was admitted to our clinic with claudication. Leriche syndrome was diagnosed based on physical examination and angiography. Prior to operation coronary angiography was performed during cardiac evaluation due to presence of risk factors and minor ECG findings. Coronary Arterial Fistula (CAF) between Left Circumflex (Cx) coronary artery and bronchial vasculature was observed. Computed tomographic angiography (CTA) was performed for detailed description of the fistula. The fistula originating from the Cx artery origin was travelling medially and inferiorly, deviating to posterior direction at the level of the left atrial appendix and reaching the descending aorta on the anterior aspect. There was an arterial branch originating from the left internal mammary artery (LIMA). It was travelling from the lateral aspect of the innominate vein inferiorly. It was soon deviating to posterior direction on the level of aortic arch, passing medial to the left main bronchus and reaching the descending aorta on the anterior aspect. Both vessels joined on the right anterolateral aspect of the descending aorta 1 cm below the level of carina, then directing to left pulmonary hilus. The joined vessel had a peribronchial distribution pattern. There were no other right or left bronchial arteries. We believe that the vessel originating from LIMA is an aberrant bronchial artery, and there was a fistula between this bronchial artery and Cx coronary artery. The pulmonary anatomy was normal bilaterally (Figure 1).
The patient was asymptomatic, so left untreated and is being followed-up. Aortobifemoral bypass was performed for Leriche Syndrome. Coronary angiography was inconclusive in diagnosing aberrant bronchial artery since it is not routinely visualized. Coronary CTA described the very detailed anatomy.
Unusual Presentation of Hydatid Cyst Patient on Emergency Department
Turkyılmaz Atilla 1, Eryigit Umut 2, Karaca Yunus 2
1 Karadeniz Technical University, Faculty of Medicine, Department of Thoracic Surgery, 2 Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, Trabzon, Turkey
DOI: 10.4328/JCAM.1432 Received: 01.12.2012 Accepted: 21.12.2012 Printed: 01.01.2015
Corresponding Author: Umut Eryigit, Karadeniz Technical University, Faculty of Medicine, Department of Emergency Medicine, 61080 Trabzon, Turkey. T.: +90 4623775202 F.: +90 4623775444 E-Mail: firstname.lastname@example.org
A 30-year-old male patient presented to the emergency department with fever, chest pain and shortness of breath. Multiple cystic lesions in the right hemithorax were identified at pulmonary imaging (Figures 1a, b). We learned that tube thoracostomy for spontaneous pneumothorax had been performed because of prolonged air leak two years previously. During surgery, a hydatid cyst rupturing into the pleura was identified and he received albendazole therapy for two months postoperatively. The patient was hospitalized with a preliminary diagnosis of multiple pleural hydatid cysts. Several cystic lesions localized to pleural areas were determined at right thoracotomy and removed. The patient was recommended six months albendazole therapy and discharged.
Pulmonary hydatid cyst developing in association with Echinococchus granulosus is a parasitosis representing a serious health problem for Turkey. Cysts opening into the pleura may cause pleural effusion, empyema, pneumothorax and pneumonia. Treatment for pulmonary hydatid cyst consists of surgery and postoperative albendazole therapy. Local hypertonic solutions and long-term postoperative albendazole therapy are particularly useful in preventing recurrence of hydatid cysts rupturing into the pleura .
Gigant Malign Germ Cell Tumor Occured in Intraabdominal Undescended Testis
Mehmet Reyhan 1, Sezgin Güvel 2, Ali Fuat Yapar 1
1 Nükleer Tıp Bölümü, 2 Üroloji Bölümü, Başkent Üniversitesi Tıp Fakültesi Adana Uygulama ve Araştırma Merkezi, Ankara, Türkiye
DOI: 10.4328/JCAM.1466 Received: 10.12.2012 Accepted: 03.01.2013 Printed: 01.01.2015
Corresponding Author: Sezgin Güvel: Başkent Üniversitesi Tıp Fakültesi Adana Uygulama ve Araştırma Merkezi Üroloji Bölümü 01250 Yüreğir, Adana, Türkiye. GSM: +905339575282 E-Mail: email@example.com
Otuz altı yaşında erkek hastaya, Diabetes Mellitus nedeniyle başvurduğu Endokrin Hastalıkları polikliniğinde yapılan fizik muayene sırasında palpasyonda abdominal kitle fark edilmesi üzerine bilgisayarlı tomografi (BT) çekilmiş. BT’de mesane duvarına ve seminal veziküllere invaze görünümde yumuşak doku dansiteli kitle saptanmış. Öyküsünde ve muayenesinde bilateral inmemiş testis saptanması üzerine hasta Üroloji bölümüne refere edildi. Kitlenin metabolik karakterini belirleme ve evreleme amaçlı 18F Florodeoksiglukoz (FDG) Pozitron Emission Tomografi (PET)/BT yapıldı. PET/BT’de heterojen tarzda artmış FDG tutulumu gösteren (SUVmax:5), epigastrik bölgeden başlayarak orta abdominal bölgeyi ve pelvik boşluğu dolduran 25x18x28 cm boyutlarında lobüle konturlu hipermetabolik kitlesel lezyon saptandı. Ayrıca sol inguinal kanalda hafif FDG tutulumu gösteren 37×31 mm çaplı inmemiş testis olduğu düşünülen yumuşak doku dansitesi izlendi. Alfa fetoprotein 20916 ng/mL, LDH:389 U/L iken Beta HCG normal sınırlardaydı. Kitleden yapılan iğne biyopsinin patolojik incelemesinde germ hücreli tümör saptandı. Hastaya BEP (bleomisin, etoposid ve cisplatin)’den oluşan 4 kür neoadjuvan kemoterapi verildi. Kemoterapi sonrası kitlede küçülme olmadı. Göbek altı median insizyon yapılarak kitle çıkarıldı. Solda inguinal kanal girişinde hipoplazik yapıda testis bulundu ve orşiektomi uygulandı. Çıkarılan kitlenin patolojik incelemesinde teratom ve fokal yolksak tümörü saptandı. Çıkarılan sol testis atrofik özellikteydi. Postoperatif 15. gün AFP değeri 13.63 ng/mL olarak saptandı. Burada hastanın preoperatif PET/BT görüntüleri sunulmaktadır.
False Positivity of Ultrasonographic Lung Sliding Sign While Verifying Success in Endotracheal Tube Positioning
Ümit Kaldırım, Salim Kemal Tuncer, Yusuf Emrah Eyi
GATA Askeri Tıp Fakültesi, Acil Tıp AD. Ankara, Türkiye
DOI: 10.4328/JCAM.2210 Received: 06.12.2013 Accepted: 12.12.2013 Printed: 01.01.2015
Corresponding Author: Yusuf Emrah Eyi, GATA Askeri Tıp Fakültesi, Acil Tıp AD. Ankara, Türkiye. GSM: +905325822802 E-Mail: firstname.lastname@example.org
Araç içi trafik kazası nedeniyle kardiyak arrest olan 47 yaşındaki hasta acil servise getirildi. Endotrakeal tüp (ETT) ile entübe edilen hastada oskültasyon ile solunum sesleri istenilen kalitede duyulamadı. Balon maske ile havalandırılan hastada akciğer ultrasonunda plevral kayma hareketi gözlenirken (Resim 1) eş zamanlı olarak bakılan kapnografide end-tidal CO2 miktarı entübasyon başarısını teyit etmedi. Bunun üzerine hasta ekstübe edildi ve tekrar entübasyon gerçekleştirildi. Oskültasyon, kapnografi ve plevral kayma hareketinin görülmesi ile ETT lokalizasyonu doğrulandı (Resim 2). Kardiyopulmoner resüsitasyona cevap veren hasta yoğun bakım kliniğine yatırıldı. Hastanın toraks tomografisinde her iki akciğerde pnömotoraksa rastlanmadı.
A Very Rare Cause of Chronic Groin Pain and Small-Bowell Obstruction: Obturator Hernia
Ramazan Aydin 1, Selim Baris Gul 2, Mehmet Selim Nural 3
1 Department of Radiology, Samsun Education and Research Hospital, Samsun, 2 Department of Radiology, Aksaray State Hospital, Aksaray, 3 Department of Radiology, University of Ondokuz Mayis, Faculty of Medicine, Samsun, Turkey
DOI: 10.4328/JCAM.2240 Received: 19.12.2013 Accepted: 03.01.2013 Printed: 01.01.2015
Corresponding Author: Ramazan Aydin, Samsun Education and Research Hospital, Department of Radiology, Ilkadim, Samsun, Turkey. T.: +90 3623121919 F.: +90 3624576041 E-Mail: email@example.com
A 65-year-old woman with presented to the Emergency Department (ED) with a suddenly onset of abdominal pain which was located in the left lower quadrant and left groin. She had recurrent attacks of left groin pain of about three year duration. Her pain was exacerbated by adduction and radiating to the thigh. On physical examination, she had a distended abdomen. No palpable inguinal mass or hernia was found. All biochemical laboratory tests were within the normal range. Abdominal radiography showed a small-bowel obstruction. Abdominal ultrasonography showed multiple dilated small bowel loops. Computed tomography (CT) scan was performed urgently at the emergency radiology room. CT showed a bowel loop between the left obturator externus and pectineus muscles and presence of dilated small-bowel loops, consistent with a diagnosis of small-bowel obstruction secondary to an obturator hernia (Fig. 1A, B). An emergency laparotomy was performed and the hernia was repaired.
Could Recurrent Anxiety Be a New Surgical Indication for Patients with Spontaneous Pneumothorax?
Süleyman Demirel Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Isparta, Türkiye
DOI: 10.4328/JCAM.2074 Received: 30.09.2013 Accepted: 01.10.2013 Printed: 01.01.2015
Corresponding Author: İsa Döngel, Süleyman Demirel Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, Isparta, Türkiye. T.: +902462119251 GSM: +905052228388 F.: +902462112830 E-Mail: firstname.lastname@example.org
Yazkan R. ve ark. tarafından yapılan “Tekrarlama Anksiyetesi Spontan Pnömotorakslı Hastalar için Yeni Bir Cerrahi Endikasyon Olabilir mi?” başlıklı çalışmayı spontan pnömotoraks klinik tablosuna farklı bir bakış açısı ortaya koyması nedeniyle ilgiyle okudum.
Subungual Exotosis of the Toe
Recep Bedir 1, İbrahim Şehitoğlu 1, Rüştü Köse 2
1 Patoloji Anabilim Dalı, 2 Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Rize, Türkiye
DOI: 10.4328/JCAM.2134 Received: 04.11.2013 Accepted: 14.11.2013 Printed: 01.01.2015
Corresponding Author: Recep Bedir, Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Rize, Türkiye. T.: +90 4642130491 F.: +90 4642170364
Subungual ekzositoz çoğunlukla ayak başparmağını tutan osteokondromun bir varyantı olarak bilinen benign osteokartilajenöz bir tümördür. Klinik olarak, ağrı, tırnak deformitesi ve tipik radyolojik bulgularla ile karakterizedir. Çoğunlukla adelösan ve genç erişkinlerde görülür [1, 2].
The Effect of Bone Fractures to the Vital Functions and the Place in Judicial Reports
Yusuf Emrah Eyi, Ümit Kaldırım, Salim Kemal Tuncer
GATA Askeri Tıp Fakültesi, Acil Tıp AD. Ankara, Türkiye
DOI: 10.4328/JCAM.2142 Received: 10.11.2013 Accepted: 20.11.2013 Printed: 01.01.2015
Corresponding Author: Yusuf Emrah Eyi, GATA Askeri Tıp Fakültesi, Acil Tıp AD. Ankara, Türkiye. E-Mail: email@example.com
Derginizde yer alan “Acil Serviste Düzenlenen Adli Raporların Uygunluğunun Değerlendirilmesi ve Tespit Edilen Eksiklikler”  başlıklı Sayın Bozkurt ve arkadaşları tarafından yazılan makaleyi ilgi ile okuduk. Deneyimlerini bizlerle paylaştıkları için teşekkür ederiz. Yazarların çalışmada adli raporlardaki hatalardan bahsederken, raporların sonuç kısmında belirtilmesi gereken kemik kırıklarının hayat fonksiyonlarına etkisinin çalışma genelinde değerlendirilmemesinin çalışma kısıtlılıklarından biri olduğu kanaatindeyiz ve bu noktaya temas etmek istiyoruz.
Our Experiences with Chest Trauma Patients in Syrian Civil War
Department of Thoracic Surgery, Süleyman Demirel University School of Medicine, Isparta, Turkey
DOI: 10.4328/JCAM.2414 Received: 19.03.2014 Accepted: 19.03.2014 Printed: 01.01.2015
Corresponding Author: Rasih Yazkan, Süleyman Demirel University School of Medicine, Department of Thoracic Surgery, Isparta, Turkey. GSM: +905054835961 F.: +90 2462370240 E-Mail: firstname.lastname@example.org
Günay Ş. ve ark. tarafından yazılan “Suriye İç Savaşı Nedeniyle Oluşan Göğüs Travmalı Hastalardaki Deneyimlerimiz“ başlıklı makaleyi ilgiyle okudum.
Bladder Inflammatory Pseudotumour
Betül Ünal 1, Tümay İpekçi 2, Mustafa Burak Hoşcan 2
1 Akdeniz University, Faculty of Medicine, Department of Pathology, Antalya, 2 Başkent University, Faculty of Medicine, Department of Urology, Alanya Practice and Research Center, Alanya, Turkey
DOI: 10.4328/JCAM.2438 Received: 25.03.2014 Accepted: 25.03.2014 Printed: 01.01.2015
Corresponding Author: Mustafa Burak Hoşcan, Baskent University Alanya Research and Practice Center, Department of Urology Alanya-Antalya, Turkey. GSM: +905324364855 F.: +90 242115563 E-Mail: email@example.com
Ayırıcı tanı güçlüğü oluşturan, klinik, radyolojik ve patolojik veriler bir araya getirilerek ve korele edilerek tanı konulması mümkün olan mesanede inflamatuar pseudotümör (IP) olgu sunusunu ilgiyle okuduk . İnflamatuar pseudotümör yerine sıklıkla inflamatuar miyofibroblastik tümör olmak üzere farklı isimler kullanılmaktadır. Nadir görülen iğsi hücreli bir tümör olup malignite potansiyeli net değildir. Benign proliferatif bir lezyon olmasına karşın rekürrens göstermesi ve histopatolojik olarak ayırıcı tanısının güç olması nedeniyle önem arz etmektedir. Günümüze kadar etyolojisinde idrar yolu enfeksionları, travma, cerrahi gibi etkenler suçlanmış, bunun yanında bazı olgular idiopatik kabul edilmiştir. Mincik I ve arkadaşlarının transüretral rezeksiyon uygulanan 406 hasta üzerinde yaptıkları araştırmada 399 hastada üretelyal karsinom izlenirken 2 hastada IP izlenmiştir. IP tanısı alan hastalardan birinde siklofosfamid kullanım öyküsü olup etyolojide suçlanmış, diğerinde ise sebep belirtilmemiştir . Paul S ve arkadaşları olgularında IP ve pseudomemranöz sistit birlikteliğini bildirmişler ve tedavide transüretral rezeksiyon uygulanmıştır . IP ayırıcı tanısında leiyomyom, postoperatif iğsi hücreli nodül, nodüler fasiit, nörofibrom gibi benign lezyonların yanısıra ürotelyal karsinomun iğsi hücreli varyantı, leiyomyosarkom, embriyonal rabdomyosarkom ve sarkomatoid karsinom gibi malign lezyonlar da yer almaktadır . Olgu sunusunda yazarlar ayırıcı tanı içerisine kısıtlı sayıda lezyon almışlardır. Elbette doğru tanı için hasta kliniği, radyolojisi ve patolojisi birlikte korele edilmelidir. Bu noktada immünohistokimya yardımcıdır. İmmünohistokimyasal boyalardan vimentin, desmin, kas spesifik aktin, düz kas aktin ve keratin pozitifliği tanıyı desteklerken ALK-1 olguların yarısında boyanmasına rağmen diğer karışan lezyonlardan ayrımda önemli bir role sahiptir. Ayrıca epitelyal membran antijen, p53, h-kaldesmon, miyogenin negatifliği de yine tanıyı destekleyicidir [5,6]. IP tedavisinde transüretral rezeksiyon ilk sırayı alırken, parsiyel ve radikal sistektomi de literatürde bildirilmiştir [6,7].