Do We Know How to Use Oxygen Properly in Emergeny Department?
Orhan Çınar 1, Hülya Türkan 2, Ethem Duzok 3, Serkan Sener 4, Ahmet Uzun 1, Murat Durusu 1, Murat Eroğlu 5
1 Department of Emergency Medicine GATA, 06013, Etlik, Ankara, Turkey, 2 Department of Anesthesiology and Reanimation, Kasımpasa Military Hospital, Kasımpaşa, Istanbul, 3 Department of Emergency Medicine, Etimesgut Military Hospital, Etimesgut/Ankara, 4 Department of Emergency Medicine, Acıbadem Hospital, Bursa, 5 Department of Emergency Medicine, Erzurum Military Hospital, Erzurum Türkiye
DOI: 10.4328/JCAM.261 Received: 21.04.2010 Accepted: 07.05.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):1-3
Corresponding Author: Orhan Cinar, GATA Acil Tıp AD., 06013, Etlik, Ankara, Türkiye. Phone: +903123043031 E-mail: firstname.lastname@example.org
Aim: The aim of this study was to determine emergency department doctors’ and nurses’ knowledge regarding oxygen therapy.
Material and Methods: A 7-item questionnaire survey was developed and applied to assess knowledge of oxygen therapy. The questionnaire was administered to a total of 100 (20 nurses, 30 resident physicians and 50 intern doctors (last-year medical students) staff from two university teaching hospital in Ankara, Turkey.
Results: A response rate of 100 % was achieved from participants in the study. Only 9 % of the participants answered all the questions correctly on oxygen therapy.
Conclusions: Our study shows that emergency medical staffs have significant gaps in their knowledge on appropriate oxygen therapy. Since deficiencies in emergency medicine staffs knowledge on treatment with oxygen deficits influence patient’s outcome, we recommend that emergency medicine staff should be trained regarding oxygen therapy and medical schools should pay much more attention to this issue in their curricula.
Keywords: Oxygen, Treatment, Emergency, Knowledge, Mask.
The Effects of Hypericum Perforatum Extract on Topical Burn Injury: A Comparative Study with Iodine
Alper Çelik 1, Ömer Faik Ersoy 1, H. Ayhan Kayaoğlu 1, Namık Özkan 1, Neşe Lortlar 2, Suna Ömeroğlu 2, Ebru Arabacı Çakır 3
1 Department of General Surgery, Gaziosmanpasa University Faculty of Medicine, Tokat, 2 Department of Histology and Embryology, Gazi University Faculty of Medicine, Tokat, 3 Department of Pathology Ankara Ataturk Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/JCAM.249 Received: 10.04.2010 Accepted: 05.05.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):4-7
Corresponding Author: Alper Çelik, Gaziosmanpaşa University Faculty of Medicine Department of General Surgery, 60100 Tokat, Turkey. Phone: +905327059540 Fax: +903562133179 E-mail: email@example.com
Aim: We aimed to assess the efficacy of topical Hypericum perforatum (HP) extract and compare with topical iodine in a rat model of thermal skin injury.
Material and Methods: Wistar-Albino rats were subjected to two separate heat-induced third degree burn injuries on dorsal skin. Control group was left untreated, and treatment groups received either topical iodine or HP. Seven days later injured areas were macroscopically examined, and ulcerations were calculated. Histological indices of wound healing and expression of Transforming Growth Factor-β (TGF-β) were analyzed in each animal.
Results: Treatment groups had significantly smaller areas of ulceration. We observed 23.94% reduction in iodine (p=0.008) and 42.89% reduction in HP treated rats (p<0.0001). Transforming Growth Factor-β levels were slightly reduced in HP group. Collagenisation and reepithelization were improved in both treatment groups with significant superiority in HP group. Fibroblast proliferation was better in the same group. It was observed that iodine treatment led to higher rates of necrosis.
Conclusions: We state that HP extract might be beneficial for the treatment of topical burn injury.
Keywords: Topical Burn, Iodine, Hypericum Perforatum Extract, Wound Healing, TGF-β.
Praziquantel-Dymethylsuifoxide Solution: The Side Effect on Hepato-biliary System (An Experimental Study)
İbrahim Yetim 1, Yalçın Büyükkarabacak 2, Kenan Erzurumlu 2, Adem Dervişoğlu 2, Murat Hökelek 3,Sancar Barış 4, Yüksel Bek 5
1 Genel Cerrahi A.B.D., Mustafa Kemal Üniversitesi, Tayfur Atasökme Fakültesi, Hatay, 2 Genel Cerrahi A.B.D. , Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, 3 Mikrobiyoloji A.B.D. , Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, 4 Patoloji A.B.D., Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, 5 Biyoistatistik A.B.D., Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, Türkiye
DOI: 10.4328/JCAM.10.3.15 Received: 03.02.2010 Accepted: 19.02.2010 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3):39 -43
Corresponding Author: İbrahim Yetim, Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Genel Cerrahi A.B.D Serinyol, Hatay, Turkey. Phone: +90 326 211 19 00,+90 532 506 00 09 Email: firstname.lastname@example.org
Aim: In this experimental study, the side effects of praziquantel and dymethylsulfoxide on the hepatobiliary system has been investigated comparing with alcohol , hypertonic and normal saline.
Material and Methods: This study contains five groups of ten rats each. In all groups, transduodenal choledochal cannulation was done and either dymethylsulfoxide, praziquantel in dymethylsulfoxide solution ,0.9 % NaCI, 20 % NaCI or 98 % alcohol were injected. Before surgery, blood samples were taken for measuring AST, ALT, ALP, GGT levels, and repeated every months for three months period. At the end of study, all rats were sacrificed; hepatobiliary excision was done.
Results: Biochemical content and blood samples have not statistically significant difference at the beginning of the study. After protoscolocidals injection into common bile duct, ALT, AST and ALP levels were siginificantly found higher at hypertonic saline group than control’s (p<0.05). GGT level in hypertonic saline group was similar to control’s. Also allthe biochemical results were siginificantly higher at dymethylsulfoxide, praziquantel in dymethylsulfoxide solution and alcohol groups than hypertonic saline and control groups (p<0.05). Although ALT, AST and ALP levels were found highest in hypertonic saline group; GGT level were was highest in dymethylsulfoxide group, (p<0.05) (Figure 1, 2, 3, 4). Histopathological research has shown that hepatoceluler changes were siginificantly higher in hypertonic saline group than control group, (p<0.05) Also it was higher in alcohol , dymethylsulfoxide and praziquantel in dymethylsulfoxide solution groups than the others, (p<0.05) Although dymethylsulfoxide and hypertonic saline have similar side effects on biliary tract; praziquantel in dymethylsulfoxide solution solution has stronger side effect then them, (p<0.05) alcohol has strongest side effect on biliary tract, (p<0.05).
Conclusions: As a conclusion, it is thought that praziquantel in dymethylsulfoxide solution solution has similar risk to alcohol and more than hypertonic saline on hepatobiliary tract in intraoperative use for hepatic hydatidosis.
Keywords: Hydatid Cyst, Alcohol, Hypertonic Saline, Praziquantel, Dymethylsulfoxide.
Variations in Patterns of Bronchial Tree
Cenk Kılıç, Yalçın Kirici, Hasan Ozan
Department of Anatomy, Gulhane Military Medical Academy, Faculty of Medicine, Ankara, Turkey
DOI: 10.4328/JCAM.10.3.16 Received: 24.01.2010 Accepted: 19.02.2010 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3):34-38
Corresponding Author: Cenk Kılıç, Department of Anatomy, Faculty of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, 06018, Turkey. Phone: +90 312 304 35 09 Fax: +90 312 381 06 02 E-mail: email@example.com
Aim: Knowledge of variations in patterns of bronchial tree is useful for diagnosis and surgery of chest diseases. In our study we aimed to expose the variations in patterns of bronchial tree.
Material and Methods: In this study 15 right and 15 left lungs from 15 cadavers were used. All branches of each lobe were dissected from the surrounding parenchyma. Ramification of bronchial tree was displayed. The patterns of segmental and some subsegmental bronchi were determinated and whether accessory bronchus present or not was examined.
Results: We identified that most common variations in the patterns of bronchial tree are B6c, B6a+6b; B7, B8, B9+10 in right side and B1+2, B3; B7+8, B9+10 in left side. The most common accessory bronchi were bronchus subsuperior arising from B10 in right side, and bronchus subsuperior and bronchus subsuperior arising from B10 in left side. Many researchers used different terminologies for identification of branches of bronchial tree. We commonly found patterns of B1+2 (60%) and B7+8 (79,99%) in left lungs.
Conclusion: It is identified that there are 8 segmental bronchi on the left. This study will be helpful for many radiological and anatomical studies.
Keywords: Bronchi, Lung, Thoracic Surgery, Bronchoscopy, Bronchial Diseases, Terminology.
The Quantity and Course Of Paraumbilical Veins in Adults, and Their Topographic Relation with the Umbilical Vein (Ligamentum Teres Hepatis)
Nurcan İmre 1, Cüneyt Bozer 2, Cenk Kılıç 1, Esra Erdoğan 3, Hasan Ozan 1
1 Anatomi AD, Gülhane Askeri Tıp Akademisi, Askeri Tıp Fakültesi, Ankara, 2 Anatomi AD, Trakya Üniversitesi Tıp Fakültesi, Edirne, 3 Tıbbi Histoloji ve Embriyoloji AD, Gülhane Askeri Tıp Akademisi, Askeri Tıp Fakültesi, Ankara, Türkiye
DOI: 10.4328/JCAM.11.1.17 Received: 12.01.2009 Accepted: 09.02.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):31-33
Corresponding Author: Nurcan İmre, GATA Anatomi AD, Keçiören, Ankara, Türkiye. Phone: +903123043503 E-mail: firstname.lastname@example.org
Aim: The paraumbilical veins surrounding umbilical vein and running within falciform ligament is of the following three types: Burows veins, Sappeys superior and inferior group veins. Sappey’s veins are referred to as accessory portal veins. They form the connection between portal vein and systemic veins. Burows veins terminate in the middle third of umbilical veins and do not enter the intrahepatic portal system directly.
Material and Methods: In this study, the falciform ligament specimens from 20 adult cadavers were used to determine the number and course of paraumbilical veins and to expose its topographic relationship with umbilical vein. The falciform ligament separated into four quadrants and examined.
Results: Mean numbers of paraumbilical veins were found 6.65 ± 2.1 in microscopical examination.
Conclusion: In the relevant literature, there is a lack in studies about the quantity of paraumbilical veins and their topographic relation with the umbilical vein. Detailed information on quantitative parameters of paraumbilical veins may prove helpful in determining pathologies of paraumbilical veins and portal- systemic circulation.
Keywords: Paraumbilikal Vein, The Falciform Ligament, The Teres Hepatis Ligament.
Should Colonoscopy be Administrated to the Patients with Incidental Colorectal FDG PET Absorbtion?
Muammer Kara¹, Aslı Ayan², Murat Kantarcıoğlu¹, Güldem Kilciler¹, Teoman Doğru¹, İlker Turan¹, Özdeş Emer², Melih Akıncı³
¹Gülhane Askeri Tıp Akademisi, Gastroenteroloji BD, ²Gülhane Askeri Tıp Akademisi, Nükleer Tıp AD, ³Sağlık Bakanlığı Dışkapı Hastanesi, Genel Cerrahi Servisi, Ankara, Türkiye
DOI: 10.4328/JCAM.11.1.16 Received: 04.11.2010 Accepted: 19.02.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):28-30
Corresponding Author: Muammer Kara, Gülhane Askeri Tıp Akademisi, Gastroenteroloji BD, 06018, Etlik, Ankara, Türkiye. Phone: +90 312 304 40 52 Fax: +90312 304 40 00 E-mail: email@example.com
Aim: In this study, we aimed to compare the results colonoscopy and if performed, these of histopathologic examinations in patients which are administered 18- fluoro-2-deoxyglucose positron emission tomography (FDG PET) for different reasons and diagnosed incidental colorectal metastasis.
Material and Methods: 26 cases with established focally increased colorectal activity metastasis and who have been performed FDG PET for various clinical indications are included in the study. Cases are performed colonoscopy for differential diagnosis.
Results: Age average of the 26 cases included in the study (9 females, 17 males) was 61.9 (38-87). Colonoscopic lesion have been established in 10 cases (38.5 %), while there was none in 16 cases (61.5 % false positive). Number of the cases which endoscopic lesions have been indicated at the localization coherent with activity metastasis in FDG PET was 9 ( 34.6 % ). However in one of the cases, colonoscopic lesion was at a different localization from the one defined in FDG PET examination.
Conclusion: We have a high false positive ratio in our study. This can be due to FDG shadowing after a poor bowel lavage. For this reason, an adequate bowel lavage administration to the patients before FDG PET examination can reduce the false positive ratio. Thus we can prevent unnecessary invasive attempts. In medical practice, resection of the colonic adenomas found acceptance in protecting from colon cancer. This study showed us that incidental FDG metastasis can indicate premalign or malign lesions. Therefore, colonoscopoic examination is recommended for the cases who have been performed FDG and found increased radioactive metastasis, whether they have been administered bowel lavage or not.
Keywords: FDG PET, Colorectal Administrated, Colonoscopy.
The Effects of Ga-As (904nm) Laser Irradiation on Injured Sciatic Nerves of Rats
Arzu Erbilici 1, Ece Ünlu 1, Yusuf Sinan Şirin 2, Ömer Besalti 3, Aytul Cakci 1
1 Department of Physical Therapy and Rehabilitation, Ministry of Health Ankara Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, 2 Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Surgery, Burdur, 3 Ankara University, Faculty of Veterinary Medicine, Department of Surgery, Ankara, Turkey
DOI: 10.4328/JCAM.10.3.11 Received: 29.09.2009 Accepted: 02.01.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):23-27
Corresponding Author: Ece Ünlü, Department of Physical Therapy and Rehabilitation, Ministry of Health Ankara Dışkapı Yıldırım Beyazit Education and Research Hospital, 06110, Ankara, Turkey. GSM:+905065595122 E-mail: firstname.lastname@example.org
Aim: The purpose of this study was to investigate the effects of Ga-As (904 nm) laser on the crushed nerve region compared with laser of the corresponding spinal cord segments.
Material and Materials and Methods: Thirty Albino Wistar male rats weighing 180-240 g were used in this study. The sciatic nerve was crushed at the middle level with an aneurysm clip (Aesculap FE 751; Tuttingen, Germany) for 4 minutes. The rats were allocated into three groups. In group 1, laser irradiation was applied at the four points along the corresponding spinal cord segments (L3-L6) in contact with the shaved skin. In group 2, the crushed area in contact with the shaved skin was irradiated. In group 3, the same procedure was performed without emission. The first laser treatment was performed on the second day of surgery and was repeated once daily for 21 consecutive days. The measured electrophysiological parameters included compound muscle action potential (CMAP), distal motor latency (DML), and motor nerve conduction velocity (NCV). Measurements were taken just before crushing and were repeated on the 21st day of the treatment and the 42nd day of the follow-up period. Sciatic Functional Index (SFI) and Toe Spread Analysis (TSA) were carried out on postoperative days 2, 7, 14, 21 and 42.
Results: There was no significant difference between groups regarding DML and amplitude of CMAP. The NCV was significantly faster in group 1 on the 21st and 42nd days than in the other groups. The differences between groups regarding SFI and TSA on the 1st, 7th, 14th, 21st, and 42nd days were insignificant (p>0.05).
Conclusion: In conclusion, the use of Ga-As laser did not provide significant benefit on nerve regeneration or functional improvement except for its positive effect on nerve conduction in the crushed area irradiated group.
Keywords: Spread Electrophysiological Parameters, Laser, Nerve Regeneration, Sciatic Functional Index, Toe Analysis.
Dermatologic Analysis in Elderly Patients During Balneotherapy
Selçuk Özdogan 1, Erkan Kaya 1, Ali Hikmet Kayar 1, Mehmet Zeki Kiralp 1, Muhammed Erdal 2
1 Cildiye Kliniği, Estetik İnternational Estetik ve Cerrahi merkezi, Bursa Asker Hastanesi, Bursa, 2 Etimesgut Asker Hastanesi, Ankara, Türkiye
DOI: 10.4328/JCAM.10.3.14 Received: 24.12.2009 Accepted: 18.01.2010 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3):18-22
Corresponding Author: Muhammed Erdal, Etimesgut Asker Hastanesi Serpmeevler bulvarı 06790 Etimesgut, Ankara, Türkiye. GSM: 0505 785 58 87 E-mail: email@example.com
Aim: The aim of this study was to determine skin changes due to balneotherapy in elderly patients who were treated with termal therapy for rheumatismal pain.
Material and Methods: Older than 50 years old 51 patients with generalize ostoarthritis were treated with balneotherapy enrolled our study in October- November 2009. All patients treated 21 days with balneotherapy. Patient’s skin analyses were done twice, at first day and 19th day of the treatment. Skin analyses were done at face region and fore arm flexor region. Moisturing, elasticity, pigmentation, fat ratio assessed in skin analysis.
Results: 20 male and 31 female, totally 51 patients were enrolled our study. Before balneotherapy, mean moisturing was %67, after balneotherapy mean moisturing decreased %47 at fore arm region. After balneotherapy, mean moisturing at face decreased from %54 to %45. Fat ratio decreased from %28 to %20 Before balneotherapy and after balneotherapy elasticity and pigmentation differences were not significant statistically.
Conclusion: By aging, skin becomes sensitive to environmental factors. Dry skin is a usual problem during balneotherapy. Patients with dry skin have pruritus and discomfort. We suggest patients treated with balneotherapy to use moisturing cream for protecting dry skin problems during balneotherapy.
Keywords: Balneology, Skin Humidification, Geriatrics, Dermatology.
Analyses of Preoperative Presumptive Diagnosis in Lung and Mediastinal Lesions
Ekber Şahin 1, Şule Karadayı 2, Aydın Nadir 1, Burçin Çelik 1, Hafize Sezer 3, Melih Kaptanoğlu 1
1 Göğüs Cerrahisi, 2 Acil Tıp, 3 İstatistik, Cumhuriyet Üniversitesi Tıp Fakültesi, Sivas, Türkiye
DOI: 10.4328/JCAM.10.3.13 Received: 29.11.2009 Accepted: 06.01.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):13-17
Corresponding Author: Şule Karadayı, Cumhuriyet Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı, 58140, Sivas, Türkiye. Phone : +90346 2580528 Fax: +900346 2581305 E-mail: firstname.lastname@example.org
Aim: The aim of this study was to investigate the correlation of preoperative presumptive and final histological diagnosis in patients without previous histological evaluation.
Matherial and Methods: We enrolled sixty-five patients who were operated for lung and mediastinal lesions between December 2005 and December 2008. In all patients, three presumptive diagnosises were established and they were compared to final histological diagnosis. ROC curve was used for analysing data.
Results: Postoperative histological diagnosis were as follows: lung cancer 23.1 % (15/65), hydatid cyst 23.1% ( 15/65 ), sarcoidosis 13.8% (9/65), tuberculosis 9.2% ( 6/65) and other disease 30.8 % ( 20/65). Sensitivity of presumption in the diagnosis of lung cancer, hydatid cyst, tuberculosis and sarcoidosis were 80%, 93.3%, 50% , 66.7% respectively.
Conclusion: We think that the exploratory thoracotomy should be performed when the lung cancer and hydatid cyst are suspected for diagnosis. For accurate diagnosis of tuberculosis and sarcoidosis, more detailed and careful preoperative laboratory studies should be done.
Keywords: Computed Tomography, Lung, Lung Cancer, Hydatid disease, Mediastinum
Value and Implantation Risk of Thin Needle Aspiration Biopsy in The Diagnostic Malign Pulmonary Lesions
Pınar Yaran², Ülkü Yazıcı¹, Erkmen Gülhan¹, Abdullah İrfan Taştepe¹, Funda Demirag¹, Güven Çetin¹, Mehmet Bahadır Berktaş¹
¹Department of Thoracic Surgery, Ataturk Training and Research Hospital for Chest Disease and Chest Surgery, Kecioren, ²Thoracic Surgery Clinic, Akay Hospital, Kavaklidere, Ankara, Turkey
DOI: 10.4328/JCAM.10.3.13 Received: 10.11.2009 Accepted: 22.11.2009 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):8-12
Corresponding Author: Ülkü Yazıcı, Department of Thoracic Surgery, Ataturk Training and Research Hospital for Chest Disease and Chest Surgery, Sanatoryum Caddesi Kecioren, Ankara 06280 Turkey. Fax:+903123552135 Phone : +903123552110 E-mail: email@example.com
Aim: The aim of our study was to investigate the diagnostic value of fine needle aspiration biopsy in malignant lesions, compare the results obtained by a Chiba and an injection needle and determine whether or not malignant cells are implanted on the course of the needle.
Material and Methods: Fine needle aspiration biopsy was done on the resected material from a total of 70 patients (67 male and 3 female) with a mean age of 58.17 years (range: 38-75 years) who underwent surgery for prediagnosed malignancy.For each surgically resected material, the cytological and histopathological findings of the internal aspirates from both the Chiba and injector needles as well as the smears from the external surfaces of these needles were compared.
Results: Of the 70 biopsy materials obtained by the Chiba needle, malignancy was demonstrated in 58, benign lesions in one, while 11 were non-diagnostic. The results obtained with the injector needle revealed 58 malignancies, and 12, without any diagnosis. With both techniques, no false positive results were observed. The diagnostic sensitivity of the techniques was 84% and 82% for the Chiba and injector needles respectively. Examination of the smears obtained from the external surfaces revealed malignant cells in 45 (64.3%) of the 70 smears obtained with a Chiba needle and 42 (60%) of the 70 smears obtained with an injector needle.
Conclusions: Fine needle aspiration is a method with high diagnostic value. It can be easily performed in selected cases with malignant pulmonary lesions. There were no significant differences between the two methods in terms of diagnostic yield. Any intervention targeting the tumor tissue, especially in advanced stage cellular and malignant tumors, carries a significant risk for implantation of malignant tumor cells on the course of the needle.
Keywords: Lung, Needle Biopsy, Malignancy.
Occult Foreign Body; Mimicking Lung Cancer
Koray Aydoğdu 1, Göktürk Fındık 1, Leyla Sağlam 2, Sadi Kaya 1
1 Department of Thoracic Surgery, 2 Department of Chest Disease, Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/JCAM.10.3.21 Received: 24.09.2010 Accepted: 30.01.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):57-59
Corresponding Author: Koray Aydoğdu, Department of Thoracic Surgery Atatürk Chest Disease and Chest Surgery Training and Research Hospital Ankara, Turkey. Phone : +090 312 355 21 10 Fax : +90 312 355 1 35 E-mail: firstname.lastname@example.org
We describe a case of chronical bronchial foreign body present- ing with cough, dyspnea and recurrent hemoptysis mimicking asthma, chronic bronchitis and lung cancer and undergoing sur- gical resection for diagnosis. Occult tracheobronchial foreign body aspirations are infrequently seen in adults. It may be un- detected for months to years as in our case. Sometimes it can mimic a lung cancer with an endobronchial lesion placed in the bronchus.
Keywords: Foreign Body, Aspiration, Lung Cancer.
Thoracic Wall Necrotizing Fascitis in a Neonate: a Case Report
Serdar Onat, Alper Avcı, Refik Ulku, Menduh Oruç, Cemal Özçelik
Dicle University Faculty Of Medicine, Department of Thoracic Surgery, Diyarbakir, Turkey
DOI: 10.4328/JCAM.10.3.24 Received:27.11.2009Accepted: 07.01.2010 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):54-56
Corresponding Author: Alper Avcı, Dicle University School of Medicine, Department of Thoracic Surgery, 21280 Diyarbakır, Turkey. Phone: +90 412 2488001-16-4993 Fax: +90 412 2488520 E-mail: email@example.com
Necrotizing fasciitis (NF) is a rapidly progressive and potentially life-threatening infection of superficial fascia and subcutaneous tissue. Thoracic wall is one of the rarest locations for NF. Broad-spectrum antibiotics receiving, early surgical debridement, and skin grafting are life saving in NF. We report a 7-day-old female neonate who had left sided thoracic wall NF. She had undergone extensive surgical debridement within 4 hours of hospital ad-mission, and reconstruction of skin defect by split-thickness skin grafting later. Early diagnosis is important, as prompt surgical debridement offers the best chance for survival. Early and exten-sive surgical debridement is a widely accepted clinical approach and the mainstay of effective treatment. The goals of surgi-cal intervention are to remove all necrotic tissues, and to help control the progression of NF. Reconstruction of skin defects should be performed by early split-thickness skin grafting like our patient or primary closure. Because early wound resurfacing prevents fluid, electrolyte, and protein loss from the wound site, and decreases secondary infection. Although chest wall NF is rare in neonates, it is a rapidly spreading, highly lethal infection. A high index of suspicion, early diagnosis, and aggressive ap-proach are essential to its successful treatment.
Keywords: Chest Wall; Infant, Infection; Surgery, Emergency.
Thyroid Nodule Demonstrating Itself as Calcified Lung Lesion
Ediz Yorgancılar, Müzeyyen Yıldırım, Ramazan Gün, Faruk Meriç, İsmail Topçu
Kulak Burun Boğaz Baş ve Boyun Cerrahisi Anabilim Dalı, Dicle Üniversitesi Tıp Fakültesi, Diyarbakır, Türkiye
DOI: 10.4328/JCAM.10.3.25 Received:13.12.2009 Accepted: 22.12.2009 Printed: 01.09.2010 J.Clin.Anal.Med.2010;1(3):51-53
Corresponding Author: Ediz Yorgancılar, Kayapınar Mah. Altın-1 Sitesi, B-Blok, No:6, 21120, Diclekent, Diyarbakır, Türkiye. Phone: +904122488001/4543 E-mail: firstname.lastname@example.org
Multinodular goiter (MNG) is the most prevalent thyroid pathol-ogy. Thyroid gland enlarge as a result of MNG, the initial exten-sion is typically outward. After this cervical enlargement, expan-sion may extend in to the mediastinum. As substernal goiters enlarge within the mediastinum, vascular and visceral structures may slowly became compressed. The most common symptoms of substernal goiter result from compression of the trachea and/or esophagus and include dyspnea, choking sensation, cough, and dysphagia. Progressive hoarseness and superior vena cava syndrome are less common symptoms. Substernal goiters can remain asymptomatic for many years and it may be diagnosed incidentally. For example, routine chest radiography may reveal a mediastinal mass or tracheal deviation. Many authors have advocated surgical removal of all substernal goiters, even when these goiters are asymptomatic. In this article, we report a case of substernal MNG which demonstrating itself as a nodular cal-cification on chest X-Ray radiography.
Keywords: Substernal Goiter, Calcific Lung Nodule.
Bilateral Elastofibroma Dorsi: a Case Report
Burçin Çelik 1, Oğuz Aydın 2, Ömer Serdar Bekdemir 1, Cemgil Diren Öztürk 1
1 Göğüs Cerrahisi Anabilim Dalı, 2 Patoloji Anabilim Dalı, 19 Mayıs Üniversitesi Tıp Fakültesi, Samsun, Türkiye
DOI: 10.4328/JCAM.10.3.23 Received: 24.11.2009 Accepted: 23.12.2009 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3):48-50
Corresponding Author: Burçin Çelik, 19 Mayıs Üniversitesi Tıp Fakültesi Göğüs Cerrahisi AD, Kurupelit, 55139, Samsun, Türkiye. Phone: +90 362 312 19 19/2701 Fax: +90 362 457 60 41 E-mail: email@example.com
Elastofibroma dorsi is a rare, slow-growing soſt tissue tumor of the chest wall. The tumor typically located under the lower pole of the scapula. A 57-year-old woman who had retired as a teacher, presented with a 1-year history of pain on the back and with a 3-month history of swelling located under the leſt scapula. Computed tomography and magnetic resonance imaging showed bilateral, solid soſt tissue tumors under the scapula. She underwent total resection of the tumor on the leſt side. Tumor was diagnosed histopathologically as elastofibroma. Elastofibroma dorsi can be undetermined because of its localization. Radiological examination is important especially on diagnosis of bilateral localization.
Keywords: Elastofibroma, Bilateral, Diagnosis, Chest Wall Tumor.
Thoracic Esophageal Perforation After Blunt Trauma in a Child: A Delayed Diagnosis and Surgical Management
Alper Avcı, Sevval Eren, Bulent Ozturk
Thoracic Surgery Department, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
DOI: 10.4328/JCAM.10.3. 22 Received: 14.11.2009 Accepted: 11.12.2009 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3):44-47
Corresponding Author: Alper Avcı, Dicle University School of Medicine, Department of Thoracic Surgery, 21280, Diyarbakır, Turkey. Phone: +90 412 2488001-16 4993 Fax : +90 412 2488520 E-mail: firstname.lastname@example.org
Esophageal rupture due to external blunt trauma is extremely rare in children. A-13-year old boy was admitted to emergency room with shortness of breath and abdominal pain. His history revealed fall down from 3 metres height, falling of a wooden block over chest, 4 hours before at home. Thoracic esophageal perforation was diagnosed at the 6th day of hospital stay. Surgical management was planned and right-sided thoracotomy was performed at the 7th day after admission. The esophageal layers were closed primarily and separately after muscular and mucosal debridement. Reinforcement of the primary repair was done with pleural and intercostal muscle flaps. The esophagus was tied with absorbable sutures at proximal and distal parts of the perforation to block the esophageal passage. Gastrostomy and jejunostomy were performed for nutrition. We report here a successful management with primary repair of this esophageal perforation of late diagnosis.
Keywords: Esophageal Rupture, Child, Thoracic Injury, Surgery.
Perfusionist Education in Turkey and in the World
Aydın Bilgili, Türker Şahin, Adem Güler, Harun Tatar
GATA Kalp Damar Cerrahi Kliniği, Etlik, Ankara, Türkiye
DOI: 10.4328/JCAM.10.3.41 Received: 04.03.2010 Accepted: 17.03.2010 Printed: 01.09.2010 J.Clin.Anal.Med. 2010;1(3).60-62
Corresponding Author: Adem Güler, GATA Kalp Damar Cerrahi Kliniği, Etlik, Ankara, Türkiye. Phone: +90 312 304 52 71 GSM: +90 506 531 91 11 E-mail: email@example.com
Perfüzyonistler kalp cerrahisi içerisinde aldıkları sorumlulukları nedeniyle önemli bir yere sahiptirler. Açık kalp ameliyatlarında uygulanan kardiyopulmoner baypas desteği ameliyatın başarısını ve hastanın iyileşme sürecine etki eden kriterlerden biridir. Açık kalp ameliyatları günümüzde birçok merkezde uygulanır hale gel-miş ve buna paralel olarak perfüzyonist sayısında önemli derece-de artış olmuştur. Böyle önemli bir görevi üstlenen ve hastanın direkt olarak yaşamsal fonksiyonlarına etki edebilecek perfüz-yonistlerin eğitim düzeyleri çok farklılık göstermektedir. ABD ve Avrupa ülkeleri ile karşılaştırıldığında Türkiye’de perfüzyon eğiti-mi ile ilgili bir standart mesleki bir tanım bulunmamaktadır. Bu ülkelerde perfüzyonistliğin tanımı yapılmış ve belirli standartlar konularak eğitim kalitesinin sürekliliği amaçlanmıştır. Günümüz Türkiye’sinde perfüzyon eğitimi usta çırak ilişkisine dayanmakta-dır. Perfüzyonistler vaka başında bilgi ve becerilerini geliştirmeye çalışmaktadırlar. Kaliteli ve güvenli bir perfüzyon uygulaması için akademik eğitim almış sorumluluklarını bilen perfüzyonistlere ih-tiyaç duyulmaktadır. Anahtar
Keywords: Perfüzyonistlerin Eğitimi; Kardiyopulmoner Bypass; Türkiye.
Tracheobronchially Placed Nasogastric Tube in an Intubated Patient
Suat Gezer, Bekir Sami Karapolat
Medical Faculty of Düzce University, Clinic of Thoracic Surgery, Düzce, Türkiye
DOI: 10.4328/JCAM.10.3.31 Received: 09.03.2010 Accepted: 17.03.2010 Printed: 01.09.2010
Corresponding author: Suat Gezer, Düzce Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi AD. 81620, Konuralp, Düzce, Türkiye. E-mail : Suatdr@hotmail.com
A 27 years old male patient was referred to our hospital with traumatic asphyxia due to a job accident. He had been intubated before the admission. He was hospitalized in the intensive care unit and a nasogastric tube was inserted. However, radiological investigations showed that the tube was passed just near the endotracheal tube and placed in the tracheobronchial system (Figure 1,2).