Laparoscopic Cholecystectomy Results In Patients With Different Age Groups
İbrahim Yetim 1, Adem Dervişoğlu 2, Oktay Karaköse 2, Yalçın Büyükkarabacak 2, Yüksel Bek 3, Kenan Erzurumlu 2
1 Genel Cerrahi A.B.D., Mustafa Kemal Üniversitesi, Tayfur Atasökmen Tıp Fakültesi, Hatay, 2 Genel Cerrahi A.B.D. , Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, 3 Biyoistatistik A.B.D., Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Samsun, Türkiye
DOI: 10.4328/JCAM.403 Received: 18.09.2010 Accepted: 22.10.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):75-78
Corresponding Author: İbrahim yetim, Mustafa Kemal University, Medical Faculty, Department of Surgery, 31300, Serinyol Hatay, Turkey. Phone: +903262291100 / 2015 Fax: 0090 326 2291188, E-mail: yetim54mail.com
Aim: Laparoscopic cholecystectomy (LC) has been most preferable method for benign gallbladder disease. Advanced age may be increased morbidity and mortality. The aim of this study was to compare the results of LC in patients according to different ages (age ≤ 30, 31 – 64 years, and age ≥ 65).
Material and Methods: A retrospective analysis was performed including overall 511 patients who underwent LC for benign disease of gallbladder at Ondokuzmayis University Medical Faculty and Mustafa Kemal University, Medical Faculty between November 2001 and November 2009. The patients are divided into three groups according to ages: Group A (age ≤ 30 years, n = 47), Group B (age = 31 – 64 years, n = 368), Group C (age ≥ 65, n = 96).
Results: Symptomatic cholelithiasis was the most common indication for LC in all the groups (p > 0.05). Co-morbid diseases were significantly higher in the Group C (≥ 65 years) than in the Group A and B (≤ 30 years, 31 – 64 years) (p=0.001). Co-incidental biliary pathologies, and history of abdominal operation were similar in all the groups. However biliary duct and cystic artery anomalies were significantly more common in the Group A than in the Group B and C (p=0.001). Conversion to OC was required in 26 (5.08 %) patients in this study. The major reason for the (21 cases, 80.76 %) was difficult dissection of the Calot’s triangle. There was no difference in morbidity among the groups (p>0.05).
Conclusions: As a conclusion, it’s thought that biliary anomalies in young patients and co-morbid diseases disorders in elderly patients are more common. These factors do not affect the results of patient that preoperatively well evalu-ated. However surgeon should be aware of this condition and be careful for intraoperative and postoperative complication.
Keywords: Laparoscopic Cholecystectomy, Elderly And Young, Complication.
Surgical Anatomy of the Cerebellum, Dentate Nucleus, The 4th Ventricle and The Clinical Importance of Dentate Nucleus
Yılmaz İlhan 1, Halil Toplamaoğlu 2
1 Şırnak Asker Hastanesi, Şırnak, 2 İstanbul Üniversitesi Cerrahpaşa Tıp Fakltesi Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye
DOI: 10.4328/JCAM.398 Received: 21.09.2010 Accepted: 04.10.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):59-62
Corresponding Author: İlhan Yilmaz, Şirnak Asker Hastanesi Beyin ve sinir cerrahisi, Şırnak, Türkiye. Phone: +905052325844 Fax: +902125545813 E-mail: email@example.com
Being thoroughly familiar with surgical neuroanatomy of the cerebellum gives a chance to the surgeon to know the three dimensional anatomy of the brain and the skull base as a road map regardless of the approach technique to pathological lesion. The surgical anatomy of cerebellum and the fourth ventricle was studied by microsurgical methods on twelve human cadaver brains. The primary aim of this three-partite article series is to summarize the microsurgical anatomy of the cerebellum, fourth ventricle and the den-tate nucleus according to clinical point of view considering the surgical ap-proach techniques.
Keywords: Fourth Ventricle, Cerebellum, The Dentate Nucleus.
The Relation between Inflammatory Markers and Pulmonary Infiltration in Chlamydia Pneumonia
Dilaver Taş 1, Erdoğan Kunter 1, Haldun Şevketbeyoğlu 2, Ahmet Fakih Aydın 3, Oğuzhan Okutan 1, Ersin Demirer 1, Kamil Çelik 4, Zafer Kartaloğlu 1
1 GATA Haydarpaşa Eğitim Hastanesi Göğüs Hastalıkları Servisi, İstanbul, 2 İzmir Asker Hastanesi Göğüs Hastalıkları Servisi, İzmir, 3 İzmir Asker Hastanesi Enfeksiyon Hastalıkları Servisi, 4 İzmir Asker Hastanesi Radyoloji Servisi, İzmir, Türkiye
DOI: 10.4328/JCAM.416 Received: 21.09.2010 Accepted: 05.10.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):67-9
Corresponding Author: Dilaver Taş, GATA Haydarpaşa Eğitim Hastanesi Göğüs Hastalıkları Servisi Selimiye Mah. Tıbbiye Cad. 34668 Üsküdar, İstanbul, Türkiye. Phone: +902165424855 Faks: +902163487880 E-mail: firstname.lastname@example.org
Aim: We aimed to describe the levels of leucocyte count, erythrocyte sedimen-tation rate (ESR) and high sensitive C-Reactive Protein (hsCRP), and to in-vestigate the relation of these biomarkers with the ratio of parenchymal infiltration (RPI) in patients with Chlamydia pneumoniae pneumonia (CPP).
Material and Methods: The diagnosis of CPP was based on serologic testing. Patients with CPP were analyzed the blood leucocyte counts, ESR and hsCRP levels. The parenchymal infiltration ratio, given as percent, was calculated from the high resolution computerized tomography (HRCT) images using the following formula: Pulmonary infiltration ratio = number of images showing infiltration in HRCT x 100 / number of all images x 2. The relation of the extent of the infiltrated lung parenchyma, shown by HRCT, with the leucocyte count, ESR and sCRP was investigated.
Results: Thirty two patients with CPP were included this study. Increasing levels of blood leucocyte counts in 14 (43.7 %), ESR in 27 (84.3 %) and hsCRP in 26 (81.2 %) patients were observed. High sensitive CRP was moderately but significantly correlated with RPI (r = 0.476, p = 0.006). However, RPI was not significantly correlated with blood leucocyte count and ESR (r = 0,011, p = 0,952 ve r = 0,102, p = 0,580, respectively).
Conclusions: Although both ESR and hsCRP were useful to detect infection, only hsCRP was correlated with the extent of parenchymal infiltration. Therefore, as a parameter sCRP can be used to evaluate the severity of CPP but larger series are needed to confirm this finding.
Keywords: Chlamydia Pneumoniae, Pneumonia, C-Reactive Protein, Erythrocyte Sedimentation Rate, Leucocyte.
Demographic Characteristics of Our Patients with Carpal Tunnel Syndrome
Ebru Umay, Sevgi Polat, Ece Ünlü, Özlem Çelik, Aytül Çakcı
Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp Ve Rehabilitasyon Kliniği, Ankara, Türkiye
DOI: 10.4328/JCAM.407 Received: 19.09.2010 Accepted: 03.10.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):63-5
Corresponding Author: Ebru Umay, Sağlık Bakanlığı Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Ankara, Türkiye. GSM: 0505 6433082 Fax: 0312 3340825 E-mail: email@example.com
Aim: Carpal tunnel (CTS) is the most common trap neuropathy but, still fully un-derstood the cause of this and effective factors. In this study was aimed to the evaluation demographic features of the cases with CTS admitted to our electroneuromyography (ENMG) laboratory.
Material and Methods: In the study, 119 patients with CTS to evaluate our ENMG laboratory were received. All patients age, sex, dominant and affected hand, duration of education, marital status, height, weight, additional diseases, occupational, hand and wrist repetitive motion made, use of computer and smoking status was assessed. Patients’ body mass index (BMI) was calculated.
Results: 102 cases (85.7%) females, mean age was 46.32 years ± 12: 18. While in 115 (96.6%) cases using the right hand is dominant, in 85 cases (76.6%) with bilateral involvement were at hand. While the rate of patient who between five to eight year duration of education had was 47.1%, 84% patients were married. Also, BMI were determined as 29.33± 3.01. According to the state in 22 patients with additional diseases, diabetes mellitus in 22, hypothyroidism in 4, also 1 patient had arthritis. The majority of our patients (70.6%) housewives formed. The 67.2% rate of repetetive activities as making crafts, the computer usage at a rate of 11.8% had history. The rate of smoking was 19.3%.
Conclusions: As a result, CTS, especially in middle-aged housewives and obese is a com-mon syndrome. Despite many reasons to be reported in the etiology of idio-pathic 85%. At a rate of 25.4% of women in our society is considered paid work, especially in terms of determining the etiology of the more detailed studies are needed to housewives.
Keywords: Carpal Tunnel Syndrome, Demographic Characteristic, Etiology.
A Review of our Clinical Experience: 107 Spontaneus Pneumothorax Cases
Ufuk Çobanoğlu 1, Fuat Sayır 1, Mehmet Melek 2, Duygu Mergan 1, Fatih Selvi 3
1 Göğüs Cerrahisi Ana Bilim dalı, 2 Çocuk Cerrahisi Ana Bilim dalı, 3 Acil Tıp Ana Bilim dalı, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Van, Türkiye
DOI: 10.4328/JCAM.359 Received: 27.08.2010 Accepted:17.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):54-8
Corresponding Author: Ufuk Çobanoğlu, YYÜ Tıp Fakültesi Araştırma Hastanesi, Göğüs Cerahisi AD. Van, Türkiye.Phone: +904232150473 Fax:+904322168352 GSM: +905362199397 E-mail: firstname.lastname@example.org
Aim: Pneumothorax is the common and life threatening problem of thoracic sur-gery, needs urgent intervention. In this study, spontaneous pneumothorax (SP) cases were divided into two groups and evaluated retrospectively ac-cording to age, sex, diagnostic methods, treatments, and results.
Material and Methods: Between June 2003 and May 2006, 107 patients with SP were enrolled into our study. There were 44 (41.13%) primary spontaneous pneumothorax (PSP) and 74 (58.87%) secondary spontaneous pneumothorax (SSP) patients. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, and hospital stay of the patients were reviewed.
Results: 77 patients (71.96 %) were male and 30 patients (28.04 %) were female and their mean age was 45.7±19.1 years. Chronic obstructive lung disease (COLD) was the most common (39.68%) cause detected in the cases with secondary spontaneous pneumothorax. In twenty (18.695%) patients recurrence was observed and sixteen (14.95 %) of these patients underwent surgery. Whereas 49 (%45.79) patients were managed by tube thoracostomy, 21(19.62%) patients were managed by tube thoracostomy+surgery and 19 (17.75%) patients were managed by tube thoracostomy+ pleurodesis. Operative indications were prolonged air leak and bullae + recurrence. Hospital mortality was 1.86%. The mean postoperative hospitalization time of the patients was 9.1±3.5 days.
Conclusions: Spontaneous pneumothorax is a pathology with low mortality and curable disease when diagnosed and treated in time. The primary treatment mo-dality for spontaneus pneumothorax is conservative treatment or the tho-racotomy depending on the degree of pneumothorax. Surgical procedures can be applied safely, with low recurrence rate, when the tube thoracostomy remains unsuccessful.
Keywords: Spontaneous Pneumothorax, Etiology, Treatment, Prognosis.
Shoulder Subluxation and Shoulder-Hand Syndrome After Stroke; Effect of Brain Lesion Location And Side
Levent Ediz 1, Ozcan Hız 1, Mehmet Fethı Ceylan 2 , Murat Toprak 1
1 Department of Physical Medicine and Rehabilitation, 2 Department of Orthopaedics, Yuzuncu Yil University, Medical Faculty, Van, Turkey
DOI: 10.4328/JCAM.358 Received:27.08.2010 Accepted: 08.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):49-53
Corresponding Author: Levent Ediz, Yuzuncu Yil University, Medical Faculty, Department of Physical Medicine and Rehabilitation, 65100 Van, Turkey. Phone.:+90 432 2150182; Fax:+90 432 2168352. E-mail address: email@example.com
Aim: The effect of brain lesion location and involved brain side in the development of shoulder subluxation (SS) and shoulder hand syndrome (SHS) is still unclear. The aim of the cur-rent study was to evaluate the relationships of SS and SHS with brain lesion location and stroke side.
Material and Methods: The inpatient files of the hemiplegic patients, who were hospitalized for rehabilitation, were evaluated resrospectively. Brain lesion location and involved hemisphere side were assessed by brain CT at the insult time. Brain lesion location groups were comprised as following 4 groups which included 35 patients in each group. Group I: Small superficial infarct. This type infarcts involve small area infarct (no more than 20 mm in diameter) on a cerebral lobe, such as a small right or left frontal lobe infarct. Group II: Large superficial infarct. Infarcts more than 20 mm in diameter on a cerebral lobe or two or more lobes of one cerebral hemisphere, such as a frontoparietal infarct in the left cerebral hemisphere or frontotemporo- parietal infarct in right or left cerebral hemisphere. Group III: Deep infarct. Infarcts of the internal capsule, basal ganglia or thalamus. Group IV: Combination of deep and large superficial infarcts (combined group II+III). Internal capsule or basal ganglia or thalamic infarct combined with fronto-temporal or fronto-parietal or temporo-parieto-occipital infarct on one cerebral hemisphere. A total of 140 hemiplegic patients then devided into 2 groups according to the development of SS and/or SHS.
Results: A significant correlation was found between brain lesion locations and SS and/or SHS development. The groups with combined deep and large superficial, and large superficial infarcts showed more frequent SS and/or SHS development. Patients with SS and/or SHS had got low stages at baseline in the upper extremity according to upper extremity Brunnstroma level, upper extremity Ashworth stage and low stages of functional independence measure (FIM) scores. There wasn’t significant difference in shoulder problem development in terms of involved hemisphere side.
Conclusions: In our study, brain lesion location especially combined deep and large superficial, and large superficial infarcts seem to be a predictor factor for development of SS and/or SHS. But involved hemisphere side is not a predictor factor. Prospective trials are needed to make definite conclusions.
Keywords: Shoulder Hand Syndrome, Shoulder Subluxation, Brain Lesion Location, Brain CT
Our Tyroid Surgery Clinic Experience
İbrahim Yetim 1, Kenan Kardeş 2, Selami Karaca 2, Adnan Saçın 2
1 Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Genel Cerrahi A.B.D. Serinyol, Hatay, 2 Samun Bafra Nafız Kurt Devlet Hastanesi, Genel Cerrahi Kliniği, Bafra, Samsun, Turkey
DOI: 10.4328/JCAM.350 Received: 19.08.2010 Accepted: 04.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):43-5
Corresponding Author: İbrahim Yetim, Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Genel Cerrahi A.B.D. Serinyol, Hatay, Turkey. Phone: +90 326 2111900,+90 532 5060009 E-mail:firstname.lastname@example.org
Aim: Surgical treatment of thyroid gland diseases is performed by many centers. In this study, we obtained from patients who underwent thyroid surgery re-sults were compared with literature data.
Material and Methods: Between April 2005-March 2008 Nafiz Kurt Bafra Samsun State Hospital, General Surgery, thyroidectomy, and complication rates were analyzed retrospectively 146 patients were identified.
Results: Mortality, wound infection, recurrence, and permanent recurrent laryngeal nerve injury was observed. Temporary laryngeal nerve injury in eight patients, three patients hipoparatroidi temporary, one permanent hipoparatroidi patients, 20 patients with hypothyroidism and the hematoma was observed in six patients. Among these patients, 126 patients with benign and malignant thyroid masses were detected in 20 patients. 110 patients with benign nodular colloidal goiter, in 18 cases of adenoma, thyroiditis in 14 cases, four cases were detected in the diffuse colloidal goiter. In 12 patients with malignant patients and eight patients with papillary carcinoma and follicular carcinoma showed trioid.
Conclusions: Our results compared with the studies currently being implemented and high-ly reliable technique troidektominin were found to be adequate.
Keywords:Tyhroid Surgery, Complications, Multinodular Goiter.
The Effects of 0.3 mA and 0.5 mA Threshold Currents on Axillary Brachial Plexus Block
Halit Demir 1, Ayse Mizrak 1, Gunhan Karakurum 2, Unsal Oner 1
1 Department of Anesthesiology and Reanimation, 2 Orthopedic Sugery, Gaziantep University Medical Faculty, Gaziantep, Turkey
DOI: 10.4328/JCAM.342 Received: 13.08.2010 Accepted: 04.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):39-42
Corresponding Author: Ayse Mizrak, Gaziantep University Medical Faculty, Department of Anesthesiology and Reanimation, 27310 Sahinbey, Gaziantep, Turkey. E- mail: email@example.com Fax: 00903423602244 Phone: +0905337181025
Aim: The nerve block success by peripheral nerve stimulator may be increased by optimal nerve localization. However, it is not clear which current threshold is more suitable for this.
Material and Methods: Forty patients between 18-60 years of age were included in this randomized, double blind study. In group 1 (n=20) and group 2 (n=20), the thresholds of current were 0.3 mA and 0.5 mA respectively. The mixture of 150 mg of levobupivacaine (0.5%) and 200 mg of lidocaine (2%) in a total volume of 40 ml was injected around the radial nerve. The duration of postoperative sensory and motor block and the first analgesic requirement were measured.
Results: The onset of sensory and motor block of the musculocutaneus (p=0.01 and p=0.004 respectively) and the onset of motor block of the median and ulnar nerve (p=0.009 and p=0.02 respectively) were significantly shorter in group 1 than in group 2. The duration of postoperative sensory and motor block and the time to first analgesic requirement were significantly longer in group 1 than in group 2 (p=0.0001).
Conclusions: The 0.3 mA current is more beneficial than 0.5 mA current in shortening the onset of sensory and motor block, lengthening the postoperative sensory and motor block and the duration of first analgesic requirement.
Keywords: Axillary-Brachial Plexus Block, Levobupivacaine, Lidocaine, Peripheral Nerve Stimulator, Current Threshold (mA).
The Effective Usage Time of the Humidifier/Bactriel Filters in the Mechanical Ventilator Circuits
Güldem Turan 1, Asuman Şengöz İnan 2, Nur Akgün 3, Jale Taşçıoğlu 4, Paşa Göktaş 2
1 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, 2 Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, 3 Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, 4 Jale Taşçıoğlu: Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Mikrobiyoloji Kliniği, İstanbul, Türkiye
DOI: 10.4328/JCAM.353 Received: 20.08.2010 Accepted: 23.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):46-8
Corresponding Author: Güldem Turan, Barbaros Mah. Ihlamur Sok. Uphill Court B 5 Dai: 2 Batı Ataşehir-İstanbul, Türkiye. GSM: +905332161576 Fax: +902163360565 E-posta: firstname.lastname@example.org
Aim: Ventilator circuits consist of inspiratory and expiratory tubing and disposable humidifier / bacterial filtre. Today’s disposable humidifiers are both dispos-able and has bacterial filtre. In this study, we aimed to determine the time of the efficiency of these humidifier / bacterial filtre in avoiding the ventilator circuit bacterial contamination.
Material and Methods: 32 patients who were mechanically ventilated at least 48 hours were included in this study. Sterile inspiratory and expiratory tubing with humidifier/bacteriel filtre used in ventilator circuit and specimens were obtained from the endotracheal tube side and ventilator side of the humidifier/bacterial filters, water-traps and expiratory tubing side of the ventilator filter at 48th, 72 hours.
Results: At 48th and 72 hour, bacterial colonizations were noted at the endotracheal tube side of the filtres and tracheal aspirate materials and no bacterial colonization were seen at the ventilator side of the humidifier/bacteriel filtres, water traps and at the expiratory tubing side of the ventilator filtres.
Conclusions: Humidifier/bacteriel filtres those efficiency has been shown 72 hours in avoiding the ventilator circuit bacterial contamination. We think that; with additional study results, routine humidifier/bacteriel filtres changes can be done 72 hours.
Keywords: Humidifier, bacteriel filters, ventilatory circuit, mechanical ventilation, nosocomial infection.
Effects of Intravesical Mitomycin and Distilled Water on Recurrence After TUR-TM in Ta, T1 Tumors
Can Ali Tatar 1, Nasır Yılmaz 2, Ömer Gökhan Doluoğlu 3, Öztuğ Adsan 3
1 Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara, 2 Tatvan Devlet Hastanesi, Bitlis, 3 Numune Eğitim ve Araştırma Hastanesi Üroloji Kliniği, Ankara, Turkiye
DOI: 10.4328/JCAM.330 Received: 04.08.2010 Accepted: 23.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):27-9
Corresponding Author: Can Ali Tatar, Türkiye Yüksek İhtisas Hastanesi Kızılay sok No:4 Sıhhiye, Altındağ/Ankara, Türkiye. E-posta: email@example.com, Phone: +90312 306 15 48-312 306 15 34 Faks: 312 311 63 51
Aim: The elimination of floating tumor cells inside bladder during and after tran-surethral resection of tumor (TUR-Tm) due to the cytolytic effects of distilled water has been demonstrated. In this study, our aim is to compare the effects of diluted mitomycin-C (MMC) with distilled water and/or saline with distilled water alone on early recurrence risk.
Material and Methods: 43 patients with Ta-T1 stage transitional cell carcinoma (TCC) have been investigated in 4 groups. MMC 40mg diluted with distilled water and/or saline was applied to the first two groups. Distilled water and saline alone were administered to the other two groups. All instillations were done intravesically within 2-4 hours after resection and kept inside for 2 hours. Patients were controlled in 3, 6, 9 and 12th months by cystoscopic evaluation.
Results: No differences were obtained among patients in the study groups in terms of tumor characteristics. Recurrence was observed only in 5 patients (11.6%) during 12 month follow-up period. Although, there was no recurrence in group I (MMC+ saline) and III (distilled water), recurrence was detected in group IV (saline) (3 patients, 27.3%) at 3th month and in group II (MMC+ distilled water) (2 patients, 20%) at 6th month (p=0.102).
Conclusions: According to our preliminary results there were no significant differences in terms of development of recurrence among treatment groups. Clinical clues have been obtained about non-chemotherapeutic agents, such as distilled water, might be effective in preventing recurrence of the tumor. Supporting our data with more number of patients and longer follow-up was concluded for further researches.
Keywords: Distilled Water, Mitomycin C, Saline, Non-muscle Invasive Bladder Cancer.
Chest Traumas due to Bicycle accident in Childhood
Ufuk Çobanoğlu 1, Mehmet Melek 2, Fuat Sayır 1, Duygu Mergan 1
1 Göğüs Cerrahisi AD, 2 Çocuk Cerrahisi AD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi Van, Türkiye
DOI: 10.4328/JCAM.332 Received: 05.08.2010 Accepted: 18.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):34-8
Corresponding Author: Ufuk Çobanoğlu, Yüzüncü Yıl Üniversitesi Tıp Fakültesi Araştırma Hastanesi Göğüs Cerrahisi AD. Van, Türkiye. Phone:+904322150473 GSM: +905362199397 Fax:+904322168352
Aim: Childhood injuries are the leading cause of death in children and result in significant healthcare utilization. Trauma is the second most common cause of mortality in children aged 1-4 years and leading cause of death in children older than 4 years. Thoracic injury is the second most leading cause of death in traumatized children. Multisystemic injury is found in more than 50% of children with thoracic injuries most of which are secondary to blunt traumas. We planned this study to evaluate thorax trauma cases secondary to bicycle driving in childhood and to draw attention to the importance of the regulation of traffic rules, the education of bicycle drivers.
Material and Methods: A retrospective evaluation was performed in 17 pediatric patients admitted to the Department of Thoracic Surgery during 2006-2010 with a diagnosis of chest trauma due to bicycle driving. For every patient, a pediatric trauma score (PTS) was calculated. Descriptive statistics were performed for PTS.
Results: Eleven (64.70%) cases were injured due to the tricycle accidents and six cases 6 (35.29%) were injured due to the two-wheeled bicycle accidents. The most frequent thoracic pathologies included pulmonary contusion (41.2%) and chest wall contusion (29.41%). Extrathoracic injuries were seen in 35.29%, the extremities (17.64%) and abdomino pelvic (11.76%) being the most commonly involved. Treatment consisted of symptomatic treatment in 12 patients (70.58%), tube thoracostomy in 2 patients (11.76%), and thoracotomy in 1 patient (5.9%). The morbidity was seen in 3 patients (17.64%). The mortality rate was 5.9% (n:1). The mean PTS of the cases who had additional system injuries were signifıcantly worse than the cases who had isolated chest traumas.
Conclusions: The pediatric thorax has a greater cartilage content and incomplete ossification of the ribs. Due to the pliability of the pediatric rib cage and mediastinal mobility, significant intrathoracic injury may exist in the absence of external signs of trauma. Pulmonary con-tusion and pneumothorax are frequently present without rib fractures. Pulmonary contu-sion, pneumothorax, and rib fractures are the most common injuries. In order to prevent bicycle accidents; bicycle drivers should have specific education, helmet use must become widespread and special traffic regulations have to be settled. Increasing the education level if family will contribute to the prevention of childhood trauma.
Keywords: Bicycle Accident; Thoracic Trauma, Child.
The Effect of Nicotine Dependence Level and Educational Level on Occurrence of Lower Respiratory Tract Infection
Dilaver Taş 1, Haldun Şevketbeyoğlu 2, Ahmet Fakih Aydın 3, Selim Kılıç 4, Tümer Özben 5, Ersin Demirer 1, Oğuzhan Okutan 1, Zafer Kartaloğlu 1
1 GATA Haydarpaşa Eğitim Hastanesi Göğüs Hastalıkları Servisi,İstanbul, 2 İzmir Asker Hastanesi Göğüs Hastalıkları Servisi, İzmir, 3 İzmir Asker Hastanesi Enfeksiyon Hastalıkları Servisi, İzmir, 4 GATA Halk Sağlığı Anabilim Dalı, İstanbul, 5 Manisa Komando Jandarma Alay Reviri, Manisa, Türkiye
DOI: 10.4328/JCAM.331 Received: 05.08.2010 Accepted: 20.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):30-3
Corresponding Author: Dilaver Taş, GATA Haydarpaşa Eğitim Hastanesi Göğüs Hastalıkları Servisi, İstanbul, Türkiye. Phone: +902165422362 E-posta: firstname.lastname@example.org
Aim: There are a lot of risk factors which effect occurence of lower respiratory tract infection (LRTI). We aimed to research through case-control study the effect of nicotine dependence level (NDL) and educational level on the oc-curence of lower respiratory tract infections in raw recruits.
Material and Methods: This study was performed in a military unit in the six-month period. The patients with LRTI were the case group while those who didn’t have it were the control group. Both case group and control group were asked to complete the questionnaire which investigated their educational level and smoking status. The smoking group was additionally applied the Fagerstrom Test for Nicotine Dependence (FTND).
Results: The risk of LRTIs development was lower in primary school, high school and university group than uneducated group (OR=0.55 %95 CI 0.32-0.96, OR=0.48 %95 CI 0.29-0.78, OR=0.61 %95 CI 0.38-0.98, respectively). When LRTIs development risks were compared in terms of nicotine dependence status, LRTIs development risk was significantly higher in low nicotine dependent and in high nicotine dependent smokers than the nonsmokers (OR=1.47, 95% CI 1.22-1.77, OR=1.69, 95% CI 1.34-2.13, respectively).
Conclusions: Educational level and NDL effects occurence of LRTI. Probability of LRTI occurrence is lower in individuals with high school and university education than uneducated and primary school education. Likewise, NDL is an inde-pendent risk factor associated with smoking for LRTI. In the individuals with high NDL, the risk of LRTI increases. According to this knowledge, increasing educational level up to high school education in addition to carrying out anti-smoking campaigns reduces incidence of LRTI in young individuals.
Keywords: Lower Respiratory Tract Infection, Nicotine Dependency, Education.
Prediction of Mortality and Causes of Death in a Burn Centre: A Retrospective Clinical Study
Celalettin Sever, Yalçın Külahçı, Haluk Duman
Department of Plastic and Reconstructive Surgery and Burn Unit, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
DOI: 10.4328/JCAM.326 Received: 28.07.2010 Accepted: 12.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):24-6
Corresponding Author: Celalettin Sever, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery, 34668 Kadıköy, İstanbul, Turkey. Fax: + 902163487880 · Phone:+ 90 2165422020 · E-mail: email@example.com
Aim: Mortality rates are important outcome parameters after burn. The causes of mortality have been reported differently in the literature. The aim of the study was to identify parameters that are predictive of major morbidity fac-tors and risk of mortality in patients with burn injury.
Material and Methods: This study was performed among the patients who admitted to the burn center period between December 2001 and June 2010. Within this period, demographic data, treatment, and outcomes of treatment were reviewed and analyzed.
Results: The burn patients were analysed retrospectively during 9-years period between December 2001 and January 2010. Burns caused by scalding were the most frequent (69.7 %) followed by flames (24.4 %). 4.30 % of the patients died because of multisystem organ failure, septicaemia and cardiac respiratory failure.
Conclusions: The most common cause of mortality was multiorgan failure according to our study. The mortality rates and causes of burn centers should be investi-gated retrospectively between different burn centres to determine the most common cause of mortality in burn centers.
Keywords: Burn, Mortality, Morbidity.
Pen Lid Aspirations of School Aged Children: Educators and Parents should pay Attention to an İssue
Ufuk Çobanoğlu, Duygu Mergan
Göğüs Cerrahisi AD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Van, Türkiye
DOI: 10.4328/JCAM.315 Received: 15.07.2010 Accepted:24.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):21-3
Corresponding Author: Ufuk Çobanoğlu, Yüzüncü Yıl Üniversitesi Tıp Fakültesi Araştırma Hastanesi Göğüs Cerrahisi AD. Van, Türkiye. Phone:+904322150473 · GSM: +905362199397 · Fax:+904322168352 · E-mail: firstname.lastname@example.org
Aim: Foreign body aspiration is an important cause of morbidity and mortality in childhood. Determining and removing aspirated foreign bodies from the airways is important in preventing complications. This research aims to in-vestigate the features of tracheobronchial aspiration pen lid cases admitted to Van 100. Yil University Medical Faculty Chest Surgery Clinic, and to find out whether these data are consistent with the literature.
Material and Methods: Thirteen pediatric patients who were admitted to our clinics between 1995 and 2007 with the diagnosis of pen lid aspiration, were retrospectively reviewed in terms of gender, age, complaints, timing of consultation, physical examination findings, radiologic findings and, localization of the foreign body, types of treatment given, complications and mortality.
Results: Of the patients 6 (46.2%) were male and 7 (53.8%) were female. The range of age was 7-14 years, and mean age was 9.2± 5.6. The most common complaint was unexpected coughing in symptomatic patients. Other frequent symptoms were respiratory distress and wheezing. It has also been revealed that of all the cases, 6 (46.2%) admitted to the hospital in the first 6 hours, 5 (38.4%) in 24 hours, and 2 patients (15.4%) consulted in the hospital after more than 72 hours elapsed. Nine (69.2%) of the foreign bodies were located in the right bronchial tree, 4 (30.8%) were in the left. The foreign bodies were taken out by rigid bronchoscopy in all cases. There were no complications and mortality in this group.
Conclusions: Pen lids aspiration for school-age childern is a significant danger, they are mainly accidentally among the school-age children. This series has been compiled to underline the fact that these events can be prevented by simple precautions by parents and teachers.
Keywords: Pen Lid, Tracheobronchial Aspiration, Treatment.
Pleural Effusion Resultant after Upper Abdominal Surgery: Analysis of 47 Cases
Ufuk Çobanoğlu 1, Mehmet Kadir Bartın 2, Duygu Mergan 1, Özkan Yılmaz 2, Ali Demir 2, Osman Toktaş 2
1 Göğüs Cerrahisi AD, 2 Genel Cerrahi AD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Van, Türkiye
DOI: 10.4328/JCAM. 305 Received: 02.07.2010 Accepted: 24.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):16-20
Corresponding Author:Ufuk Çobanoğlu, Adres: Yüzüncü Yıl Üniversitesi Tıp Fakültesi Araştırma Hastanesi Göğüs Cerrahisi AD. Van. Phone: +904322150473 GSM: +905362199397 Fax:+904322168352
Aim: Postoperative pulmonary complications, following upper abdominal surgery, occur at a rate which is higher, than lower abdominal surgery. One of these complications is pleural effusion. In this study, the frequency and causes of pleural effusions and the changes of the blood gas values and pulmonary functions of the patients with pleural effusions, occured after upper abdominal surgery are discussed in the accompaniment of the literature.
Material and Methods: 148 patients to whom upper adominal surgery is performed and in 47 of these patients pleural effusion is developed (31.75%) , were examined restrospectivitely. Preoperative and postoperative pulmonary function tests (PFT) and arterial blood gas (ABG) results and the blood proteins, albumin values were recorded. The anesthesia type, the surgery properties, involving type of surgery and the surgical incision were determined.
Results: Pleural effusion is detected bilaterally in 8 patients (17:02), at the right side in 21 patients (44.69%) ,and at the left side in 18 patients (38.29%). The 40.42% (19 cases) of the patients who has pleural effusion in the postoperative period, had liver and gallbladder surgery, the %23.41 (11 cases) had spleen and pancreas surgery and the %36.17 (17 cases) had the other surgical procedures.
Conclusions: While the upper abdominal surgery, impairment of the integrity of the dia-phragm‘s peritoneum that covers the abdominal cavity where there is a high-liquid pressure, may cause the liquid transition to the pleural space that has a negative pressure. Hypoalbuminemia and hipoproteinemia, that will occur due to the changes of oral intake and diet regulation in the postoperative period, may cause a reason for the pleural effusion. For this reason, doctors who performed these surgery procedures, should not ignore this complica-tion, in the period of postoperative follow-ups of the patients.
Keywords: Abdomen, Surgery, Pleural Effusion.
Chest Traumas due to Fall in Childhood
Ufuk Çobanoğlu 1, Mehmet Melek 2
1 Göğüs Cerrahisi AD, 2 Çocuk Cerrahisi AD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, Van, Türkiye
DOI: 10.4328/JCAM.304 Received: 02.07.2010 Accepted: 13.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):11-5
Corresponding Author: Ufuk Çobanoğlu, Yüzüncü Yıl Üniversitesi Tıp Fakültesi Araştırma Hastanesi Göğüs Cerrahisi AD. Van, Türkiye. Phone: +904322150473 · GSM: +905362199397 · Fax:04322168352 · E-mail: email@example.com
Aim: Falls are the most common reason for childhood traumas. The aim of this study is to investigate the causes, types, monthly frequencies and results of injuries due to fall of children in our region and to recommend some precautions for preventing these injuries.
Material and Methods: A retrospective evaluation was performed in 47 pediatric patients admitted to the Department of Thoracic Surgery during 2006-2009 with a diagnosis of chest trauma due to fall. For every patient, a pediatric trauma score (PTS) was calculated. Descriptive statistics were performed for PTS and the duration of hospital stay.
Results: The mean PTS of the cases who had additional system injuries were signifıcantly worse than the cases who had isolated chest traumas. Similarly, the length of hospital stay was also much longer in the cases with associated system injuries.
Conclusions: Injuries occur mostly in summer season. It may be due to the fact that the children do not go to the school and usually spend their times outside in this period. The children and their parents should be educated about the prevention of these accidents. Additionally, the accident and injury rates may also be reduced by constructing safer games and sports grounds with robust infrastructure.
Keywords: Fall, Childhood, Trauma.
Results of Mini Axillary Thoracotomy for Primary Spontaneous Pneumothorax
Fazlı Yanık, Yekta Altemur Karamustafaoğlu, Mustafa Kuzucuoğlu, Rüstem Mammedov, Yener Yörük
Trakya Üniversitesi Tıp Fakültesi Göğüs Cerrahi Ad, Edirne, Türkiye
DOI: 10.4328/JCAM. 288 Received: 08.06.2010 Accepted: 05.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):4-6
Corresponding Author: Yekta Altemur Karamustafaoğlu, Trakya Üniversitesi Tıp Fakültesi, Göğüs Cerrahi AD, Kat:4, Balkan Yerleşkesi 22030, Edirne, Türkiye. Tel/Faks: 0 284 2355936 · E mail: firstname.lastname@example.org
Aim: Pneumothorax knows a common clinical problem. Mini axillary thoracotomy major indication is pneumothorax surgery, allowing easily apical resection and pleurectomy with excellent longterm results. Herein, we describe our ex-perience with the axillary thoracotomy for the treatment of pneumothorax.
Material and Methods: A total of 56 cases underwent mini axillary thoracotomy with the diagnosis of primary spontaneous pneumothorax in our department between 1996-2008. Fifty four of the cases were males (96.5%) and two (3.5%) were females with a mean age of 28.2 (17-43). Twenty-nine cases (51.7%) had right pneumothorax and 27 (48.3%) left pneumothorax.
Results: We performed apical wedge resection and apical pleurectomy in 33 cases (59%), bullae ligation and apical pleurectomy in 23 cases (41%). Four patients developped morbidity. There was no mortality. Median hospital stay was 4.5 day (3-8). During 13 years follow up recurrens was not detected.
Conclusions: A mini axillary thoracotomy was short hospital stay, cosmetically accept-able was not recurrence. A mini axillary thoracotomy is a good choice when a spontaneous pneumothorax requires surgery due to excellent results for the patient.
Keywords: Pneumothorax, Thoracotomy, Minimal Invasive.
Single Stage Transthoracic Approach to the Right Lung and Liver Dome Hydatid Cysts
Rasih Yazkan¹, İbrahim Ethem Özsoy¹, Gökhan Ergene¹, Mehmet Avcılar²
¹Göğüs Cerrahisi Kliniği, ²Genel Cerrahi Kliniği, Şanlıurfa Eğitim ve Araştırma Hastanesi, Şanlıurfa, Türkiye
DOI: 10.4328/JCAM.292 Received: 16.06.2010 Accepted: 29.06.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):7-10
Corresponding Author: Rasih Yazkan, Şanlıurfa Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, Şanlıurfa, Türkiye. GSM: +905054835961, Fax: +904143131928 · E-mail: email@example.com
Aim: Both lungs and liver hydatid cysts is still an important health problem in our country. In this study we aimed to present the superiority of transthoracic approach to 24 adults right lung and liver dome hydatid cyst.
Material and Methods: Between September 2008 – June 2010 in our clinic was performed by transthoracic approach to 24 adult patients with simultaneous right lung and liver dome hydatid cyst in a single stage. Cases diagnosed by clinical evaluation, chest radiograph, chest computed tomography, abdominal ultrasonography and abdominal computed tomography. 19 cases (79.17%) were male and 5 cases (20.83%) were women, age range was 17-35 and average was 22±2,8.
Results: The most common findings with 19 patients (79.17%) were chest pain. 6 (%25) patients have bilateral lung hydatid cysts. 17 (70.83%) patients in the right lower lobe, 7 (29.17%) patients in the right middle lobe, 5 (20.83%) patients in the left lower lobe in 1 (4.16%) patient in the left upper lobe in lung, the hepatic lesions were all of the dome located.
Conclusions: Single stage transthoracic approach is prevent the second surgical proce-dures on simultaneous right lung and liver dome hydatid cyst and it is safe and effective method.
Keywords: Lung Hydatid Cyst, Liver Hydatid Cyst, Transthoracic Approach.
Physical Medicine and Rehabilitation Consultations in Patients Hospitalized in a University Hospital
Özcan Hız, Levent Ediz, Murat Toprak, İbrahim Tekeoğlu
Yüzüncü Yıl Üniversitesi Tıp Fakültesi Fiziksel Tıp Ve Rehabilitasyon Anabilim Dalı, Van, Türkiye
DOI: 10.4328/JCAM.275 Received: 05.05.2010 Accepted: 21.05.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):1-3
Corresponding Author: Özcan Hız, Yüzüncü Yıl Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Van, Türkiye. GSM: 905053696340 · E-mail: firstname.lastname@example.org
Aim: This study was designed to overview our limitations, the point of view of other clinical disciplines about our department, and to outline the sphere of our interests by analysing the consultation data requested from the Depart-ment of Physical Medicine and Rehabilitation (PM&R) for patients hospital-ized in other departments.
Material and Methods: This trial was performed using the data of consultations made by our PM&R department in patients hospitalized in other clinical departments between December 2007 and December 2008. The department which requested the consultation, the reason for the consultation request, the diagnosis made and the treatment recommended by our PM&R Department were all recorded. The results were given in the number of patients and percentages.
Results: A total of 373 consultations were requested by 17 different departments (186 females and 187 males) throughout the study. The most common diagnoses made by our department were neurological and rheumatological diseases.
Conclusions: The results of our study suggest that our department is primarily regarded as a rehabilitation unit, while it is also known as a therapeutic clinic, particularly for rheumatological diseases, which we mainly attribute to the presence of a rheumatology division in our department. In the light of our findings, we concluded that diagnosis and therapy of rheumatological diseases should be particularly included in the educational programs of PM&R residents.
Keywords: Consultation, Physical Medicine and Rehabilitation, Rheumatic Disease.
Necrotizing pancreatitis with hypertriglyceridemia development result:A cese port
İbrahim Yetim 1, Orhan Veli Özkan 1, Güvenç Diner 1, Aydın Yılmaz 1, Cumali Gökçe 2, Hasan Kaya 2
1 Genel Cerrahi A.B.D. 2 İç Hastalıkları A.B.D. Mustafa Kemal Üniversitesi, Tayfur Atasökmen Fakültesi, Hatay, Türkiye
DOI: 10.4328/JCAM.352 Received: 19.08.2010 Accepted: 17.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):124-6
Corresponding Author: İbrahim Yetim, Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Genel Cerrahi A.B.D Serinyol-Hatay ,Turkey. Phone: +90 326 2111900,+90 532 5060009 Email:email@example.com
Acute pancreatitis due to hypertriglyceridemia is a relatively rare clinical en-tity. Acute pancreatic necrosis is a life threatening form of acute pancreatitis in which early recognition and treatment is important. Necrotising pancreatitis should be treated immediately. We presented a case of pancreatic necrosis due to hypert¬riglyceridemia which required surgical intervention. We performed necro-sectomy. After surgery the patient recovered. We presented the case in order to mention necrotising pancreatitis arising from hypertriglyceridemia and requiring surgical exploration.
Keywords: Hypertriglyceridemia, Necrotizing Pancreatitis, Surgery.
Lung Resection in an Elderly Patient with Limited Pulmonary Function; Case Report
Figen Türk, Cansel Atinkaya, Gökhan Yuncu, Gökhan Öztürk
Göğüs Cerrahisi Kliniği, Tıp Fakültesi, Pamukkale Üniversitesi, Denizli, Türkiye
DOI: 10.4328/JCAM.273 Received:01.05.2010 Accepted: 12.05.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):109-11
Corresponding Author: Figen Türk, Erenler Mah. 211 Sk, No: 4/4, Yenişehir, Denizli, Türkiye. Phone: +90-258-373 98 34 · E-mail: firstname.lastname@example.org
Anatomical resection (lobectomy) is the best surgical choice for lung cancer.1 Chronic obstructive pulmonary disease is a common etiological factor for these cancers. Surgical resection is usually avoided in lung cancer patients at an ad-vanced age because of respiratory insufficiency due to chronic obstructive pul-monary disease and resections that are more limited than lobectomy are recom-mended especially when the FEV1 value is below 1 L. We discuss the postopera-tive results of a lung cancer patient who underwent lobectomy despite being of advanced age and having an FEV1 value below 1 L.
Keywords: Lung Cancer, Elderly, FEV1, Cronic Lung Disease.
A Case Report of Tuberculosis Mimicking Metastatic Lung Cancer
Seyfettin Gümüş 1, Ömer Deniz 1, Bülent Karaman 2, Deniz Doğan1, Hayati Bilgiç 1
1 Göğüs Hastalıkları ve Tüberküloz AD, 2 Radyoloji AD, Ankara, Türkiye.
DOI: 10.4328/JCAM.256 Received: 14.04.2010 Accepted: 05.05.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):104-6
Corresponding Author: Seyfettin Gümüş, GATA Göğüs Hastalıkları ve Tüberküloz AD, Etlik, Ankara, Türkiye. Phone: +903123044413 E-mail: email@example.com
Tuberculosis (TB) is an infectious disease caused by M. Tuberculosis Complex that involves both mainly lungs and other organs. Post-primary pulmonary TB is mostly seen in adults. It is usually located in apical region of lungs and makes cavitary lesions. We can see different clinical pictures in the areas of high incidence with TB. In the differential diagnosis of nodular and cavitary lesions in the lungs, meta-static lung cancer, wegener granulomatosis and TB are included. We report a case with different radiological appearance and a clinical sign that has extra-TB dif-ferential diagnosis which most possible cause is metastatic lung cancer.
Keywords: Tuberculosis, Lung Cancer, Cavity, Nodule.
Primary Cyst Hydatidosis of Pelvis with Groin Pain and Limb: a Case Report
Kenan Koca 1, İsmail Hakkı Özerhan 2, Özcan Altınel 2, Yüksel Yurttaş 1, Serkan Bilgiç 1
1 Department of Orthopedic Surgery, 2 General Surgery, Gulhane Military Medicine Academy, Ankara, Turkey
DOI: 10.4328/JCAM.237 Received: 21.03.2010 Accepted: 11.04.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):101-103
Corresponding Author: Kenan Koca, Gülhane Askeri Tıp Akademisi, Ortopedi ve Travmatoloji Anabilim Dalı, 06018, Etlik, Ankara, Türkiye. Phone: +903123045531 Fax: +903123045500 E-mail: firstname.lastname@example.org
Echinococcosis may involve all organs of body; however, primary pelvic cyst hydatid involving bone with groin and anterior hip pain is very rare. We presented a case of extensive pelvic cyst hydatido-sis involving bone without pathological fracture, in a 22-years-old man. First symtoms of patient was groin and anterior hip pain and limb. The diagnosis was made clinico-radiologically and the patient was cured with enbloc resection and filling bone cement. The pa-tient was relieved completely one year after surgery. Cyst hydatid should be included in the differential diagnosis in patients with groin and anterior hip pain, although pelvic cyst hydatoid result in urinary, genital and abdomen problems. Much hydatid disease can be cure by administration of antihelminthic drugs, however, curet-tage and bone cementing is good choice in patient involving bone to eliminate recurrences and bone fracture.
Keywords: Cyst Hydatid, Pelvis, Bone, Hip Pain.
A Case Report Of Chickenpox in Conjunctiva
Deniz Turgut Çoban, Güngör Firidin
Gazi Devlet Hastanesi, Göz Hastalıkları Bölümü, Samsun, Türkiye.
DOI: 10.4328/JCAM.10.04.07.31 Received: 17.03.2010 Accepted:05.04.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):97- 8
Corresponding Author: Deniz Turgut Çoban, Gazi Devlet Hastanesi, Göz Hastalıkları Bölümü, Samsun, Türkiye. Tel: +905066025562E-mail: email@example.com
Chickenpox is a primarily infection of Varicella-zoster virus and is childhood disease. Although varicella virus infections are usu-ally benign skin disease, they can have serious systemic mani-festations and complications. In this study, it is aim the presen-tations of a case report of chickenpox in conjunctiva.
Keywords: Chickenpox, Conjunctiva.
Toxic Epidermal Necrolysis Caused by Amoxicillin
Celalettin Sever, Yalçın Kulahcı, Sinan Oksuz, Haluk Duman
Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydarpasa Training Hospital, Istanbul, Turkey
DOI: 10.4328/JCAM.336 Received: 11.08.2010 Accepted: 09.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):121-3
Corresponding Author: Celalettin Sever, Selimiye Mah. Tıbbiye Cad. 34668 Kadıköy, İstanbul, Turkey. Phone : +902165422656 · E –mail : firstname.lastname@example.org
Toxic epidermal necrolysis (TEN) is a severe skin reaction related to drugs and infections, characterized by fever, stomatitis and conjunctivitis. Many drug related TEN cases have been reported in literature but amoxicillin related TEN cases are rare. In this article, a case of amoxicillin related severe TEN in a female patient during treatment of tonsillitis has been reported. The increased use of amoxicillin, especially for control of infection, may be the reason for the increased incidence TEN due to the same drug. The identification of a drug as the cause for the im-mune related cytotoxic reaction may be difficult if the molecule is not generally known to be a classical cause of this reaction.
Keywords: Toxic Epidermal Necrolysis; Amoxicillin; Drug Reaction.
A Case of Organizing Pneumonia with Migratory Pulmonary Infiltrates
Nurhan Köksal 1, Hasan Kahraman 1, Nurhan Atilla 1, Müge Cinkara 1, Hasan Türüt 2
1 Department of Pulmonary Diseases, 2 Department of Chest Surgery, Kahramanmaraş Sütçü Imam University, Faculty of Medicine, Kahramanmaraş, Turkey
DOI: 10.4328/JCAM.354 Received: 23.08.2010 Accepted: 04.09.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):127-9
Corresponding Author: Nurhan Köksal, Kahramanmaras Sutcu Imam University, Faculty of Medicine, 46050, Kahramanmaraş, Turkey. Phone:+ 90 344 221 1431 Fax:+90 344 221 2371 E-mail: email@example.com, firstname.lastname@example.org
Organizing pneumonia (OP) can mimic several parenchymal lung diseases. A 39 year old man tailor, complaining of fever, cough and dyspnea was admitted to our hospital. Examination of the chest revealed rales at the bilateral lower-middle zone. The posteroanterior chest radiograph showed alveolar opacity at the right lower zone. The patient was hospitalized with the probable diagnosis of bacterial pneumonia, and started cephtriaxon 2gr/day and dirithromycin 500 mg/day em-pirically. Clinical and radiological improvement didn’t appear. PPD and acid fast bacilli in sputum were negative. Two weeks later, the chest radiograph showed that the opacities were migrated to the right middle zone. Open lung biopsy was done. As pathologic findings were consistent with OP, corticosteroid treatment was given. The alveolar opacities disappeared at the control HRCT two months after the start of steroid therapy. Early diagnosis is life-saver and OP must be included in the differential diagnosis when pulmonary infiltrates don’t regress with treatment.
Keywords: Organizing Pneumonia, Migratory Pulmonary Infiltrates, Corticosteroid
Thalassemia Minor Presenting with Xiphodynia
Makbule Ergin, Ali Yeğinsu
Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi AD. Tokat, Ankara, Türkiye
DOI: 10.4328/JCAM.308 Received: 09.07.2010 Accepted: 31.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):119-20
Corresponding Author: Makbule Ergin, Gaziosmanpaşa Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi AD. Tokat, Ankara, Türkiye. Phone: +905052933175 E-posta: email@example.com
Xiphodynia describes an uncommon syndrome with group of symptoms ranging from upper abdominal pain, chest pain, throat, head and arm symptoms referred from xiphosternal joint or the xiphoid process. A 37-year-old woman presented with a sharp and persistant pain complaint of chest, mid-dorsal region and arm and anemia. Pain was refractor to medication and xiphoid resection was perfor-med. The patient was diagnosed as thalassemia minor histopathologically. After resection pain was disappeared. At the 6th month follow up patient was asym-ptomatic and no pain was detected. Surgical resection of xyphoid bone may be curable in medically refractor xiphodynia.
Keywords: Xiphodynia, Thalassemia Minor, Xiphoid Bone Resection, Chest Pain.
Pure Motor Aphasia Developed After Cerebral Vasculitis due to Systemic Lupus Erythematosus
Murat Terzi, Osman Demir, Musa Onar
Ondokuz Mayıs Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Samsun, Türkiye
DOI: 10.4328/JCAM. 295 Received: 28.06.2010 Accepted: 19.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):116-8
Corresponding Author: Murat Terzi, Ondokuz Mayıs Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Samsun, Türkiye. Phone: +90 (532) 3156884 Fax: + 90 (Fax: (+90 362) 4576041 · E-mail: firstname.lastname@example.org · email@example.com
Systemic lupus erythematosus (SLE) is a complex multisystem disease that may involve the central and peripheral nervous systems. Common clinical findings inc-lude seizures, depression, psychosis, aseptic meningitis, headache, cranial and peripheral neuropathies. The incidence of stroke as a neurological involvement in patients with SLE is between 3-20%. Possible reasons for the development of stroke are suggested as hypercoagulability and thrombosis due to antiphospho-lipid antibodies, cerebral vasculitis, cerebral embolus due to Libman Sacks en-docarditis and hypertension due to the disease itself or long term corticosteroid use. We present clinical, laboratory and radiological imaging findings that confirm cerebral vasculitis of a SLE case with the clinical presentation of acute stroke in this study.
Keywords: Lupus, Vasculit, Stroke, Aphasia.
Post-Traumatic Retroperitoneal Hematoma in a Patient with Solitary Kidney and Forgotten Ureteral Stent
Mustafa Aldemir, Evren Işık, Önder Kayıgil
Ankara Atatürk Eğitim ve Araştırma Hastanesi, 2. Üroloji Kliniği, Ankara, Türkiye
DOI: 10.4328/JCAM.282 Received: 29.05.2010 Accepted: 07.06.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):114-5
Corresponding Author: Mustafa Aldemir, Aydınlıkevler Mahallesi, Arılık Sokak No: 5/5, 06130, Ankara, Turkiye.Phone.: +905336309102 · Fax.: +903122912705 · E-mail: firstname.lastname@example.org
Ureteral stents are frequently used in urology practice. If forgotten to be removed, they might lead to recurrent urinary tract infections, hematuria, formation of enc-rustations and stones and irreversible deterioration of the kidney function. Herein, we present a patient who was diagnosed with left retroperitoneal hematoma fol-lowing trauma who admitted to emergency department. Radiological evaluations including kidney-ureter-bladder x-ray and abdominal computerized tomography demonstrated a left ureteral stent in the kidney. History of the patient confir-med the presence of the ureteral stent which was inserted five years ago and has been forgotten to be removed. Following insertion of the uretereal stents, patients must be informed regarding the necessity of the removal of the stent after certain duration of time and these patients should be follow-up cautiously. History taking is a very important part of patient evaluation despite the presence of technological diagnostic advances and tools.
Keywords: Solitary Kidney, Forgotten Ureteral Stent, Trauma, Retroperitoneal Hematoma.
Perianal and Gluteal Burn as a Complication of Hemorrhoid Treatment Caused by Bidet
Celalettin Sever, Yalçın Külahçı, Haluk Duman
Plastik Cerrahi Servisi GATA Haydarpaşa Egitim Hastanesi, İstanbul, Türkiye
DOI: 10.4328/JCAM.277 Received: 08.05.2010 Accepted: 07.06.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):112-3
Corresponding Author: Celalettin Sever, Plastik Cerrahi Servisi GATA Haydarpaşa Egitim Hastanesi, İstanbul, Türkiye. GSM: +905327181775 · E-mail: email@example.com
Contact with hot objects and surfaces often causes burns. We present a case of burn injury in the perianal region caused by use of a bidet to relieve the pain caused by hemorrhoid.This case report supports an ultimate need for further development and actual implementation of preventative measures for hot water contact burns in the homes of people who are at greatest risk.
Keywords: Burn, Perianal, Hemorrhoid.
Recurrent Inguinal Hernia and Reservoir Migration after Three-Piece Penile Prosthesis Implantation
Ali Avcı 1, Özcan Altinel 2, Ismail Hakki Ozerhan 2, Nail Ersoz 2, Mustafa Tahir Ozer 2
1 Department of Emergency Medicine, 2 Department of General Surgery, GATA, Etlik, Ankara, Turkey
DOI: 10.4328/JCAM.264 Received: 23.04.2010 Accepted: 28.05.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):107- 8
Corresponding Author: Ozcan Altınel, General Surgeon. Department of Emergency Medicine, Etlik, 06018, Ankara, Turkey. Phone: +903123043076 · GSM: +905354959283 · E-mail: firstname.lastname@example.org
A healthy 60 years-old man was operated for bilateral inguinal hernia a year before implementation of penile prosthesis implantation. Three months after PPI, inguinal hernia recurrence occurred on left side in which reservoir of penile prost-hesis was placed. Reservoir was both herniated and migrated. Although there are lots of complications due to penile prosthesis implantation, recurrent inguinal hernia is a rare complication in reservoir area. Surgeon must examine the inguinal region carefully before PPI operation. If there is a herniation, general surgeons should perform tension-free herniography. As a result of place and pressure of reservoir of penile prosthesis, weakness of wall might increase the likelihood of recurrence.
Keywords: Penile Prosthesis, Recurrent Inguinal Hernia, Reservoir Herniation.
A Rare Dislocation: Isolated Proximal Tibiofibular Joint Dislocation
İbrahim Arziman, Yavuz Katırcı, Serkan Bilgiç, Salim Kemal Tuncer
Department of Emergency Medicine Gülhane Military Medical Academy School of Medicine, Ankara, Turkey
DOI: 10.4328/JCAM.236 Received: 21.03.2010 Accepted:14.04.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):99- 100
Corresponding Author: Serkan Bilgiç, GATA Ortopedi ve Travmatoloji AD, 06018, Ankara, Türkiye. GSM:+905052270148 E-mail: email@example.com
Isolated dislocation of proximal tibiofibular joint is one of the rarely encountered and easily overlooked traumas in ER departments. Injury mechanism can not be elucidated entirely; however it occurs com-monly by sudden inversion of foot, concurrently knee is at flexion and foot is at plantar flexion. Diagnosis can be made by determin-ing swelling and sensitivity increase at proximal tibia with comparing healthy side and radiological imaging techniques. Treatment is still a challenging and controversial issue and most of the cases are ap-proached conservatively; for selected cases, it is possible to carry out surgical stabilization. We have reported the case, an isolated disloca-tion of the proximal tibiofibular joint in a football player.
Keywords: Proximal Tibiofibular Joint, Physical Examination, Radiography, Early Diagnosis.
Multiple Ruptured Epidermal Cysts on the Scalp Mistaken as Hidradenitis Suppurativa: Case Report
Yalçın Külahcı 1, Celalettin Sever 1, Zafer Küçükodacı 2, Fatih Uygur 1, Haluk Duman 1
1 Department of Plastic and Reconstructive Surgery, 2 Department of Pathology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey
DOI: 10.4328/JCAM.216 Received: 26.02.2010 Accepted: 18.03.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):94-6
Corresponding Author: Yalçın Külahcı, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic and Reconstructive Surgery, Selimiye Mah. Tıbbiye Cad., 34668 Kadıköy, İstanbul, Turkey. Phone:+ 902165422020 Fax: + 902163487880 E-mail: firstname.lastname@example.org
Epidermal cyst is one of the most common benign soft tissue tumors, and it may be easily identified and treated by surgical excision. We experienced a patient who had multiple masses on the scalp and the masses had been misdiagnosed as hidradenitis suppurativa (HS) because of persistent pain, sinus tract and fistula formation and purulent discharge. Based on physi-cal examination, early total excision was performed. On the histopathologic examination, it was diagnosed as multiple ruptured epidermal cysts. In the case presented here, we would like to introduce an initial misdiagnosis but ultimately accurate treatment with excellent cosmetic result and highly sat-isfaction of the patient.
Keywords: Epidermal Cyst, Hidradenitis Suppurativa, Skin Graft, Tissue Expansion.
Sjogren Syndrome Presented with Dibrachial Neuropathy Clinic
Murat Terzi, Nilgün Cengiz, Hande Türker, Yakup Türkel, Tuba Yazıcı
Ondokuz Mayıs Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Samsun, Türkiye
DOI: 10.4328/JCAM.207 Received: 15.02.2010 Accepted: 01.04.2009 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):91-3
Corresponding Author: Murat Terzi, Ondokuz Mayıs Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Samsun, Türkiye. Tel: +905323156884 Fax: +90 362457604 E-mail: email@example.com, firstname.lastname@example.org
Sjögren syndrome (SS) can affect either central nervous system (CNS) or peripheral nervous system (PNS). Symmetric sensory-motor peripheral neuropathy and pure sensorial symmetric poly-neuropathy are the most common diseases observed in relation to PNS. Rarely, asymmetrical polyneuropathy such as mononeuritis multiplex and brachial neuropathy may be observed. In this article, we present the clinical and electrophysiological properties of a case which arises with dibrachial neuropathy. Our case is important in terms of evaluation of SS during definitive diagnosis and perform-ing related examinations, especially in patients with a subacute- chronical asymmetric weakness.
Keywords: Sjögren Syndrome, Dibrachial Neuropathy, Electrophysiology.
Pes Cavus and Charcot Marie Tooth Disease: A Case Report and Brief Review of the Literature
Levent Ediz 1, Özcan Hız 1, Mehmet Fethi Ceylan 2, Murat Toprak 1, Yasemin Özkan 1
1 Department of Physical Medicine And Rehabilitation, 2 Department of Orthopaedics, Yüzüncü Yıl University Medical Faculty, Van, Turkey
DOI: 10.4328/JCAM.293 Received: 22.06.2010 Accepted: 12.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):149-51
Corresponding Author: Özcan Hız, Yüzüncü Yıl University Medical Faculty, Department of Physical Medicine And Rehabilitation, Van, 65100, Turkey. Phone: +905053696340 · E-mail: email@example.com
Charcot-Marie-Tooth (CMT) is a disease that is highly heteroge-neous, both clinically and genetically. Clinical and electrophysiologi-cal data are essential for diagnosis. Children with CMT experience acquired foot weakness, contracture and deformity (pes cavus and hammer toes) from an early age. Early intervention targeting the foot and ankle may prevent long-term disability in CMT. Here we present a CMT patient with acquired pes cavus and hammer toes and review the literature briefly for diagnosis, treatment, and re-habilitation of CMT. As a result we conclude that CMT should also come into mind in the differential diagnosis of acquired pes cavus and hammer toes.
Keywords: Pes Cavus, Hammer Toe, Charcot Marie Tooth Disease.
Theophyllıne: Adverse Effects, Poisoning and Treatment Approaches
Muhammed Charehsaz 1, 2, Aylin Gürbay 1, M. Evvah Karakılıç 3, Gönül Şahin 1
1 Hacettepe Üniversitesi, Eczacılık Fakültesi, Farmasötik Toksikoloji, Ankara, 2 Yeditepe Üniversitesi, Eczacılık Fakültesi, Farmasötik Toksikoloji Anabilim Dalı, İstanbul, 3 Hacettepe Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Ankara, Türkiye
DOI: 10.4328/JCAM.382 Received: 13.09.2010 Accepted: 24.09.2010 Printed:01.09.2011 J Clin Anal Med 2011;2(3):157-63
Corresponding Author: 1). Aylin Gürbay, Hacettepe Üniversitesi, Eczacılık Fakültesi, Farmasötik Toksikoloji Anabilim Dalı, 06100, Ankara, Türkiye. E-Posta: firstname.lastname@example.org 2). Gönül Şahin, Hacettepe Üniversitesi, Eczacılık Fakültesi, Farmasötik Toksikoloji, Ankara, Türkiye, 06100, Ankara, Türkiye. Phone: + 90 312 309 29 58 Faks: + 90 312 311 47 77 E-mail: email@example.com
Theophylline, which is a methylxanthine derivative, has been commonly used in all over the world for many years due to its cheapness and effectiveness in treatment of asthma and chronic obstructive pulmonary disease (COPD). There is a close relationship between its bronchodilator effect and blood lev-els of theophylline. Maintenance of its blood level between 10-20 μg/ml is important to obtain a maximum bronchodilator effect. Besides having a nar-row therapeutic range, its alteration of pharmacokinetic characteristics due to individually factors, drugs, diet, and habits such as smoking and alcohol has led to requirement of more carefully use of theophylline for patients at every age. In the present review article, in addition to pharmacokinetic/dynamic properties of theophylline, its adverse effects, poisoning with over dose of theophylline and approaches of its treatment have been given.
Keywords: Theophylline, Adverse Effects, Poisoning and Treatment.
Asperger Syndrome In Adulthood: A Review
Ali Evren Tufan 1, İbrahim Durukan 2, Umut Işık 3
1 Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi, Çocuk Psikiyatrisi Polikliniği, Elazığ, 2 Gülhane Askeri Tıp Akademisi, Çocuk Psikiyatri AD, Ankara, 3 Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi, Psikiyatri Polikliniği, Elazığ, Türkiye
DOI: 10.4328/JCAM. 357 Received: 26.08.2010 Accepted: 17.09.2010 Pirinted:01.09.2011 J Clin Anal Med 2011;2(3):152-6
Corresponding Author: İbrahim Durukan, Gülhane Askeri Tıp Akademisi, Çocuk Psikiyatrisi AD-Ankara, Türkiye. Phone :+90 (312) 304 4565, E-mail: firstname.lastname@example.org
Asperger’s syndrome (AS) is one of the disorders classi-fied under pervasive developmental disorders. Individuals with AS have problems in social interaction, unusual spe-cial interests, and a tendency to ritualized behavior. AS is a chronic disorder that affects the social, occupational, sexual and psychological functionality of individiuals with AS. This review was prepared on the basis of a selective literature review by Pubmed and information in relevant reference books. As a result, longitudinal studies are deemed to be necessary to be able understand the features of AS in adult-hood.
Keywords: Asperger, Pervasive Developmental Disorder, Adult.
Popliteal Artery Injuries
Mehmet Ali Şahin, Adem Güler, Murat Kadan
Gülhane Askeri Tıp Akademisi Kalp Damar Cerrahisi A.D. Etlik, Ankara, Türkiye
DOI: 10.4328/JCAM.280 Received:25.05.2010 Accepted: 20.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):144-8
Corresponding Author: Mehmet Ali Şahin, GATA Kalp Damar Cerrahisi A.D., 06010, Etlik, Ankara, Türkiye. Phone: +90 312 3045243, Fax: +90 312 3045200 E-mail: email@example.com
Popliteal artery injuries are an important cause of amputation and morbidity. Existence of concomittant bone or other different pa-thologies and prolonged time of transport to the hospital leads to increased mortality. On the other hand, early surgical intervention, prevention of hypovolemic shock, systemic anticoagulation and fasciotomy in proper cases decrease morbidity and mortality. In both artery and vein injuries, vein ligation must be a non desirable choice, and when it is inevitable fasciotomy must be performed to prevent development of compartment syndrome.
Keywords: Popliteal Artery İnjuries, Amputation, Fasciotomy, Hypovolemic Shock.
Serkan Bilgiç, Cemil Yıldız, Ali Şehirlioğlu
GATA Ortopedi ve Travmatoloji AD, Ankara, Türkiye
DOI: 10.4328/JCAM.245 Received: 01.04.2010 Accepted: 12.04.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):135-43
Corresponding Author: Serkan Bilgiç, GATA Ortopedi ve Travmatoloji AD, 06018, Ankara, Türkiye. GSM:+905052270148 Phone:+903123043076 Fax: +903123045500 E-mail: firstname.lastname@example.org
The abnormal sagittal deformity of spine is called kyphosis. Thoracic kyphosis above 50-60 degrees is accepted as abnormal. Kyphosis is the most common deformity in pathologic cases. Firstly we will give informa-tion about anatomy and biomechanics of spine, than about etiopatho-genesis of posttraumatic kyphosis, sign and semptoms. Finally treanment principles and methods will be explained.
Keywords: Posttraumatic, Kyphosis.
Basic Laboratory Safety and General Survey of the Turkish Laboratory Safety Status
Dokuz Eylül Üniversitesi Tıp Fakültesi, Multidisipliner Laboratuvarı, İzmir, Türkiye
DOI: 10.4328/JCAM.225 Received: 10.03.2010 Accepted: 23.03.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):130-34
Corresponding Author: Meral Karaman, Dokuz Eylül Üniversitesi Tıp Fakültesi, Multidisipliner Laboratuvarı, Balcova, 35340, İzmir, Türkiye. Phone: 902324124653 Fax: 902322599723 E-mail: email@example.com
Clinical and research laboratory employees have to face various hazards and biological risk factors in the working environment due to laboratory structures and regulations. In order to protect per-sonnel from these occupational hazards and laboratory acquired infections, basic microbiological practices which are the major fac-tors of biosafety concept should be well known, appropriate and safe laboratory equipments (primary barriers) should be used and functional working areas (secondary barriers) should be designed. We have limited data regarding biosafety profiles of the laborato-ries and laboratory staff in our country. Nevertheless, in the light of the existing studies, it is thought that technical and infrastructural facilities are inadequate and also biosafety levels and related ap-plications are either not well known or not properly carried out by the staff. Implementing theoretically accepted basic microbiologi-cal practices, a certain quality and cosciousness level of the staff, continuous in-service training are important factors of a safe and efficient working environment in the laboratories.
Keywords: Basic Laboratory Safety, Biosafety, Biosafety Cabinets.
Rapid Parenchymal Lung İnjury due to Electric Shock: A Rare and an Emergency Case of Thoracic Surgery
Rasih Yazkan, Gökhan Ergene, İbrahim Ethem Özsoy
Şanlıurfa Education and Research Hospital, Department of Thoracic Surgery, Şanlıurfa, Turkey
DOI: 10.4328/JCAM.318 Received:19.07.2010 Accepted: 26.07.2010 Printed: 01.09.2011
Corresponding Author: Rasih Yazkan, Şanlıurfa Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, Şanlıurfa, Türkiye. GSM: +905054835961 · E-mail: firstname.lastname@example.org
A 44 year-old male admitted to our hospital due to a high voltage electric shock, first chest x-ray demonstrated partial left mediastinal shift (Figure 1), an hour later respiratory distress, chough, tachypnea and hemoptysis were developed, at the same time chest x-ray and chest computed t o m o g r a p h y demonstrated left lower lobe a t e l e c t a s i s , minimal left pneumothorax and complete left mediastinal shift (Figure 2, 3a, 3b)…
Bilateral Endobronchial Seeding After Spontaneous Rupture of Pulmonary Hydatid Cyst
Berkant Özpolat 1, Çağrı Şenyücel 2
1 Göğüs Cerrahisi Anabilim Dalı, 2 Radyoloji Anabilim Dalı, Kırıkkale Universitesi Tıp Fakültesi Kırıkkale, Türkiye
DOI: 10.4328/JCAM.301 Received: 30.06.2010 Accepted: 12.07.2010 Printed:01.09.2011
Corresponding Author: Berkant Özpolat, Kırıkkale Universitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, 71100, Kırıkkale, Turkey. Phone: +903182252485, E-mail: email@example.com
A 10-year-old boy presented with sudden unset cough and watery sputum which occured 10 days ago. Chest computed tomography (CT) demonstrat-ed a ruptured left sided pul-monary hydatid cyst with bi-lateral alveolar consolidation areas due to endobronchial spread (Figures 1,2)…
Penetrating Chest Wall and Upper Extremity Trauma Secondary to Falling on an Iron Rod
Berkant Özpolat 1, Cemal Düzgün 2
1 Kırıkkale Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, Kırıkkale, 2 Gazi Mustafa Kemal Devlet Hastanesi, Kalp Damar Cerrahisi Kliniği, Ankara, Türkiye
DOI: 10.4328/JCAM.284 Received: 02.06.2010 Accepted: 17.06.2010 Printed: 01.09.2011
Corresponding Author: Berkant Özpolat, Kırıkkale Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Anabilim Dalı, 71100, Kırıkkale, Turkey. Phone: +903182252485 E-mail: firstname.lastname@example.org
A 55-year-old male admitted to the emergency room after falling down from a height on an iron bar. Physical examination showed the iron rod with entry side at the right parascapular area and exit side at right posterior upper extremity without any visceral injury (Figure 1)…
Pulmonary Sequestration in a Middle Age Man
Akın Yıldızhan, Nurettin Yiyit, Ahmet Rauf Görür
GATA Haydarpaşa Training Hospital, İstanbul, Türkiye
DOI: 10.4328/JCAM.244 Received: 31.03.2010 Accepted: 21.04.2010 Printed: 01.09.2011
Corresponding Author: Akın Yıldızhan, GATA Haydarpaşa Training Hospital, 34100, İstanbul, Türkiye. E-mail : email@example.com
A 40 years old male patient was admitted with recurrent lung infections. Thoracic CT displayed a mass like lesion in lower lobe of the left lung (Figure 1). The lesion was suspected us about to be a sequestration and a CT angiography was performed. An aberrant vessel arising from thoracic aorta and supplying the lesion was detected (Figure 2,3). The lesion was accepted as pulmonary sequestration.
Immense Mass of Thoracic Wall: Primary Osteosarcoma of the Rib
Yetkin Ağaçkıran 1, Suat Gezer 2, Abdullah İrfan Taştepe 3
1 Department of Pathology, Atatürk’s Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, 2 Clinic of Thoracic Surgery, Medical Faculty of Düzce University, Düzce, 3 Clinic of Thoracic Surgery, Atatürk’s Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Türkiye
DOI: 10.4328/JCAM.11.2.31 Received: 11.02.2010 Accepted: 21.02.2010 Printed:01.09.2011
Corresponding Author: Suat Gezer, Göğüs Cerrahisi AD., Düzce Üniversitesi Tıp Fakültesi 81620 Konuralp, Düzce, Türkiye. E-mail: Suatdr@hotmail.com
A 14 years old female patient admitted for a swelling under the left breast. Chest x-ray (Figure 1a) and thoracic computed tomography (Figure 1b) showed a mass on thoracic wall. A tru-cut needle biopsy named the mass as osteosarcoma and the mass was resected. Postoperative histopathological examination confirmed a chondroblastic type osteosarcoma (Figure 2).
A warfarin-induced subconjunctival hemorrhage
Savas Özsu, İsmail Yılmaz, Tevfik Özlü
Department of Chest Diseases, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/JCAM.240 Received: 25.03.2010 Accepted: 13.04.2010 Printed: 01.09.2011
Corresponding Author: Savaş Özsu, Department of Chest Diseases, School of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey. Phone: +904623775402 Fax: +904623257031, +904623250518 E-mail: firstname.lastname@example.org
A 60-year old man hyphema in right eye and pre-sented with hemoptysis to emergency department. The patient’s medical history was remarkable for COPD and pulmonary hypertension (PHT). Detailed history his current medications have been included warfarin treatment for PHT one month ago. His physi-cal examination was found bilateral roncus and sub-conjunctival hemorrhage (Figure 1)…
Minimally Invasive Surgery for Pectus Excavatum: Park Technique
Hyung Joo Park
Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea
DOI: 10.4328/JCAM.518 Received: 03.12.2010 Accepted: 03.12.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):84-90
Corresponding Author: Hyung Joo Park, Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Korea. E-mail: email@example.com
Pectus excavatum (PE) is the most commonly encountered chest wall defor-mity which comprises one out of 1,000 live births. Depression of the anterior chest wall due to posterior angulation of the sternum and costal cartilages results in compression of internal thoracic organs as well as aesthetically unpleasant appearance. Multiple surgical techniques have been developed to correct this condition. Ravitch procedure, the technique including the excision of all deformed costal cartilages, division of intercostals bundles from the sternum, and transverse sternal osteotomy, was proposed in 1949 and most widely applied until recently. The Wada technique, principally sternal turnover, has been an alternative procedure. Those invasive techniques involve tedious and bloody operations resulted in a permanent defect of costal cartilages or contracture of the chest wall. Most importantly, a large, unsightly operative scar at the anterior chest is aesthetically dissatisfying. In this study “Minimally Invasive Surgery for Pectus Excavatum: Park Technique” was explained.
Keyworld: Pectus Excavatum; Minimally Invasive Surgery; Park Technique
Trakeabronşial Cerrahide Tek Akciğer Ventilasyonunda Pezzer Kateter Kullanımı
M. Muharrem Erol 1, Hakan Salcı 2, A. Sami Bayram 3
1 Department of Thoracic Surgery, Faculty of Medicine Karadeniz Technical University, Trabzon, 2 Department of Surgery, Faculty of Veterinary, Medicine, Uludag Universit, Bursa, 3 Department of Thoracic Surgery, Faculty of Medicine Uludag University, Bursa, Türkiye
DOI: 10.4328/JCAM.335 Received:06.08.2010 Accepted: 20.08.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):82-3
Corresponding Author: M. Muharrem Erol, Karadeniz Technical University, Faculty of Medicine, Department of Thoracic Surgery, 61080 Trabzon, Turkey. Phone: +904623775000 E-mail: firstname.lastname@example.org
Aim: One-Lung Ventilation (OLV) is widely used in a variety of cardiac, thoracic, and major vascular procedures to ventilate an isolated lung field in humans and dogs. Endobronchial tubes, endobronchial blockers, and single-lumen tubes are commonly using equipments for OLV.
Material and Methods: Conventional one-lung intermittent positive-pressure ventilation (OL-IPPV) has been a valuable technique during anaesthesia for intrathoracic opera-tions in humans and dogs. Here, our experience resulted in the usage of Pezzer catheter to establish OLV in dogs, while performing tracheobronchial resection. OLV was successfully established with Pezzer catheter in 12 dogs. All application was performed by the same surgeon. An optimal diameter Pezzer catheter was selected to insert into the lumen of the trachea and the main bronchus. The length of the catheter was prepared and middle point of the head of the catheter was cut at the level of holes on it. Following tracheo-bronchial resection, the cut head was inserted into the trachea with a clamp and end of the catheter was instantly inserted the main bronchus (Figure 1). Sutures were prepared interruptedly and passed between the trachea and the main bronchus. Before sutures were started the ligation tightly, Pezzer catheter was removed in the lumen and than ligations were completed.
Results: No accidental episode was encountered during the manipulation. OLV was successfully established, and the mean oxygen saturation range and end tidal carbon dioxide concentration was 95% and 37-41% before and after inser-tion of the Pezzer catheter, respectively. The respiratory modes during the surgery were not need to change.
Discussion: OLV is essential in the tracheaobronchial resections. Here, the Pezzer cath-eter is presented to obtain OLV. It has been concluded that Pezzer catheter is a very practical and reliable method and it can be choice for cases which require OLV.
Keywords: Tracheabronchial Surgery, Pezzer Catheter, Lung Ventilation
Asimetrik Eksizyon Pirimer Kapma TekniğiPilonidal Sinüs Hastalığının Tedavisinde Uygun bir Seçenek midir?
Hakan Bulus, Ali Coskun
Kecioren Training and Research Hospital Department of General Surgery, Ankara, Turkey
DOI: 10.4328/JCAM.279 Received:27.05.2010 Accepted: 29.07.2010 Printed: 01.09.2011 J Clin Anal Med 2011;2(3):79-81
Corresponding Author: Hakan Bulus, Keçiören Training and Research Hospital, Department of General Surgery, Pinarbasi mahallesi Sanatoryum caddesi Ardahan sok.no:1 Kecioren 06310, Ankara, Turkey. Phone: +90 312 356 90 00 · Fax: +90 312 356 90 22 · E-mail: email@example.com
Aim: Pilonidal sinus is a disorder, commonly occurred in sacrococcygeal region, abolished daily activity and quality of life, caused lost work force for long time.This study,is aimed to search the efficiency of technique of asymmet-ric excision primary closure in pylonidal sinus disease, commonly to be seen among young men, surgery treatment.
Material and Methods: September 2006- September 2008, at Keçiören Education And Research Hospital General Surgery Institute , total 186 (F/M 137/49) patient , applied asymmetric excision primary closure with diagnosis of pylonidal sinus dis-ease, is considered .Patients are considered according to age, sex, time of surgery, time of hospitalization, postoperative early period complication and recurrences.
Results: In this study , age mean who operated because of pylonidal sinus disease is 24,3(16-50) in men ; 23,9(16-50) in women.The rates of occured wound place infection and hematoma is respectively % 8,6 (n=16), %1,6 (n=3).Accorrding to following outcomes rate of recurrence is % 4,8.ConclusionAsymmetric excision primary closure is an appropriate treatment choice, because of early period complication and late period recurrence incidence of the pilonidal sinus disease is rarely.
Keywords: Pylonidal Sinus Disease, Treatment.