24 research outputs found
Our results in treatment of acut hand burns
1986-1991 yılları arasında GATA Haydarpaşa Eğitim Hastanesi Plastik Cerrahi Kliniği ve Yanık Merkezinde yatırılarak tedavi edilen 64 olgudaki 90 el yanığı retrospektif olarak incelenmiştir. Akut el yanıklarının tedavisinde; hastanın yaşı, mesleği, genel durumu, yanığın genişliği, lokalizasyon, derinliği, eşlik eden yaralanmalar göz önüne alınmış kişiye uygun tedavi seçilerek uygulanmıştır. Elde ettiğimiz sonuçlar literatür verilerinin ışığında gözden geçirilmiştir.We reviewed 90 hand bums in 64 patients who admitted GATA Haydarpaşa Training Hospital Plastic Surgery Dept. and Bum Centre between 1986-1991. In the treatment of the acute hand bums; age, occupation, general health, depth and extent of the bum, localization and accompanying travma are all considered and best therapeutique choices were performed. Results were reviewed under the light of literature
The Ki-67 proliferation index predicts recurrence-free survival in patients with dermatofibrosarcoma protuberans
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue sarcoma that originates from the dermis or subcutaneous tissue in the skin. While its prognosis is generally favorable, disease recurrence is relatively frequent. Because morbidity after repeated surgery may be significant, an optimized prediction of recurrence-free survival (RFS) has the potential to improve current management strategies. The purpose of this study was to investigate the prognostic value of the Ki-67 proliferation index with respect to RFS in patients with DFSP. We retrospectively analyzed data from 45 patients with DFSP. We calculated the Ki-67 proliferation index as the percentage of immunostained nuclei among the total number of tumor cell nuclei regardless of the intensity of immunostaining. We constructed univariate and multivariate Cox proportional hazards regression models to identify predictors of RFS. Among the 45 patients included in the study, 8 developed local recurrences and 2 had lung metastases (median follow-up: 95.0 months; range: 5.2−412.4 months). The RFS rates at 60, 120, and 240 months of follow-up were 83.8%, 76.2%, and 65.3%, respectively. The median Ki-67 proliferation index was 14%. Notably, we identified the Ki-67 proliferation index as the only independent predictor for RFS in multivariate Cox proportional hazards regression analysis (hazard ratio = 1.106, 95% confidence interval = 1.019−1.200, p = 0.016). In summary, our results highlight the potential usefulness of the Ki-67 proliferation index for facilitating the identification of patients with DFSP at higher risk of developing disease recurrences
Autogenous free muscle graft reconstruction in sequel facial paralysis
Sekel facial paralizi rekonstrüksiyonunda, yüzde istirahat halinde kabul edilebilir bir görüntü ve istemli hareketlerde simetri sağlanmaya çalışılır. Kas balansı, mimik hareketler sırasında kontrolü sağlamak, orbital, nazal, oral ve bukkofarenjial sfinkterlerin rekonstrüksiyonu önemli diğer hedeflerdendir. Bütün bu hedefler göz önünde tutularak sekel facial paralizili dokuz olguya 24 otojen serbest kas transplantasyonu uygulanmıştır. Palmaris longus veya ayak 2., 3., 4. parmak ekstansor digitorum kasları denerve edildikten iki hafta sonra orbikularis oris ve orbikularis okuli rekonstrüksiyonu için serbest otojen kas grefti olarak kullanılmışlardır. Ayrıca paralizili taraf ağız köşesi orbita kenarına yada zigomatik arkusa asılarak tespit edilmiştir. Olgulardaki yakınmalar girişim sonrası büyük ölçüde giderilebilmiş ve klinik olarak da belirgin düzelmeler görülmüştür. Yapılan süspansiyonla ağız köşesinin statiği kısmen de olsa sağlanabilmiştir. Bu sonuçlar ve yöntemi uygulayan diğer otörlerin sunduğu veriler, tek taraflı sekel facial paralizide otojen serbest kas transplantasyonunun oldukça yararlı bir girişim olduğu görüşünü doğurmuştur. Yöntemin; basit, her plastik cerrah tarafından uygulanabilecek bir yöntem olması, morbidite ve mortalitesinin düşüklüğü ve başarı oranının yüksekliği bu görüşü güçlendirmektedir
Miliary brain metastases from occult lung adenocarcinoma: Radiologic and histopathologic confirmation
“Miliary brain metastases”, also termed as “Carcinomatous encephalitis”, are an extremely rare form of cerebral metastasis. Here in this article, we report a 52 year-old male patient with miliary brain metastases originating from occult lung adenocarcinoma. There were no significant findings on his initial physical and neurological examinations except limited cooperation. Brain computed tomography revealed edematous regions at the inferior sections of both parietal lobes. Then after, the contrast-enhanced magnetic resonance imaging revealed innumerable multi-dimensional lesions associated with surrounding edema on T2-weighted images. The proton magnetic resonance spectroscopy revealed increases in the choline and lipid peaks with decreased N-acetylaspartate in a similar manner with metastatic brain tumors. Histopathological findings pointed out that malignant epithelial tumor metastasis were originating in primary lung adenocarcinoma. Despite the advances in technical equipments and medical knowledge, miliary metastatic brain tumors are quite rare and the differential diagnosis is difficult. Our aim in this article was to present this rare case in which the lung was thought to be the primary focus; and outline the radiological characteristics. Also, we believe that the findings presented by proton magnetic resonance spectroscopy may contribute to making a differential diagnosis
Isolated Sensorineural Hearing Loss due to Enlargement of Pontine Neuroglial Cyst
Sanli, Ahmet/0000-0003-4072-7522WOS: 000361529400012Isolated sensorineural hearing loss due to posterior fossa benign cystic lesions is extremely rare. Although they are benign in the natural course, rarely they may cause progressive neurological symptoms. Radiologic and audiometric examinations are useful methods for initial diagnosis and follow-up evaluations. A 48 year old man suffered from left-sided progressive hearing loss for six months. Cranial magnetic resonance imaging showed that intrapontine cystic mass measuring 9 mm, enlarged 3 mm during the seven years period. In addition, auditory brainstem response revealed that prolonged 1-5 interpeak latency on the right side and wave 5th was absent on the left. In this report, we described a patient, who has progressive unilateral neural sensorineural hearing loss without any neurological symptoms, because of the enlarging intrapontine cystic mass, which compress to the lower auditory pathways. Although, isolated sensorineural hearing loss has been reported in intraaxial cystic lesions in consequence of cerebellopontine angle compression, but we do not encountered in the English literature that isolated sensorineural hearing loss due to compression of lower auditory pathways by intrapontine cystic mass
Alkaptonuric patient presenting with "black" disc: a case report
WOS: 000319232100012PubMed: 23619548Although intervertebral disc degeneration usually occurs in the natural course of alkaptonuria, detection of the disease by black disc material in a patient without any other sign of alkaptonuria is an extremely rare condition. The authors report a 45-year-old previously healthy female patient who was operated on for prolapsed lumbar disc herniation, and in whom the nucleus pulposus was discovered to be black intraoperatively. The alkaptonuria was diagnosed after histopathological examination of the black disc material. Elevated urinary concentration of homogentisic acid confirmed the diagnosis
Neuroprotective effects of thymoquinone against spinal cord ischemia-reperfusion injury by attenuation of inflammation, oxidative stress, and apoptosis
KISA, Ucler/0000-0002-8131-6810WOS: 000376476100013PubMed: 26871652OBJECTIVE lschemia-reperfusion (I/R) injury of the spinal cord following thoracoabdominal aortic surgery remains the most devastating complication, with a life-changing impact on the patient. Thymoquinone (TQ), the main constituent of the volatile oil from Nigella sativa seeds, is reported to possess strong antioxidant, antiinflammatory, and antiapoptotic properties. This study investigated the effects of TQ administration following I/R injury to the spinal cord. METHODS Thirty-two rats were randomly allocated into 4 groups. Group 1 underwent only laparotomy. For Group 2, aortic clip occlusion was introduced to produce I/R injury. Group 3 was given 30 mg/kg of methylprednisolone intraperitoneally immediately after the I/R injury. Group 4 was given 10 mg/kg of TQ intraperitoneally for 7 days before induction of spinal cord I/R injury, and administration was continued until the animal was euthanized. Locomotor function (Basso, Beattie, and Bresnahan scale and inclined plane test) was assessed at 24 hours postischemia. Spinal cord tissue samples were harvested to analyze tissue concentrations of malondialdehyde, nitric oxide, tumor necrosis factor-alpha, interleukin-1, superoxide dismutase, glutathione-peroxidase, catalase, and caspase-3. In addition, histological and ultrastructural evaluations were performed. RESULTS Thymoquinone treatment improved neurological outcome, which was supported by decreased levels of oxidative products (malondialdehyde and nitric oxide) and proinflammatory cytokines (tumor necrosis factor-alpha and interleukin-1), increased activities of antioxidant enzymes (superoxide dismutase, glutathione-peroxidase, and catalase), as well as reduction of motor neuron apoptosis. Light microscopy and electron microscopy results also showed preservation of tissue structure in the treatment group. CONCLUSIONS As shown by functional, biochemical, histological, and ultrastructural analysis, TQ exhibits an important protective effect against I/R injury of the spinal cord
Neuroprotective effects of Ganoderma lucidum polysaccharides against traumatic spinal cord injury in rats
Gurer, Bora/0000-0003-1500-6184; Sargon, Mustafa Fevzi/0000-0001-6360-6008WOS: 000363901600010PubMed: 26298021Introduction: Ganoderma lucidum (G. lucidum) is a mushroom belonging to the polyporaceae family of Basidiomycota and has widely been used as a traditional medicine for thousands of years. G. lucidum has never been studied in traumatic spinal cord injury. The aim of this study is to investigate whether G. lucidum polysaccharides (GLPS) can protect the spinal cord after experimental spinal cord injury. Materials and methods: Rats were randomized into five groups of eight animals each: control, sham, trauma, GLPS, and methylprednisolone. In the control group, no surgical intervention was performed. In the sham group, only a laminectomy was performed. In all the other groups, the spinal cord trauma model was created by the occlusion of the spinal cord with an aneurysm clip. In the spinal cord tissue, caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, nitric oxide levels, and superoxide dismutase levels were analysed. Histopathological and ultrastructural evaluations were also performed. Neurological evaluation was performed using the Basso, Beattie, and Bresnahan locomotor scale and the inclined-plane test. Results: After traumatic spinal cord injury, increases in caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels were detected. After the administration of GLPS, decreases were observed in tissue caspase-3 activity, tumour necrosis factor-alpha levels, myeloperoxidase activity, malondialdehyde levels, and nitric oxide levels. Furthermore, GLPS treatment showed improved results in histopathological scores, ultrastructural scores, and functional tests. Conclusions: Biochemical, histopathological, and ultrastructural analyses and functional tests reveal that GLPS exhibits meaningful neuroprotective effects against spinal cord injury. (C) 2015 Elsevier Ltd. All rights reserved
Lomber cerrahi sonrası brown-sequard sendromuna yol açmış gangliyon kisti
Servikal omurganın semptomatik ganglion kistleri sıklıkla ilerleyici nörolojik kötüleşmeye neden olurlar. 67 yaşında erkek hasta lomber cerrahi sonrası C3-4 ganglion kistine bağlı gelişen akut hemiparezi ile sunulmaktadır. Lezyon acil olarak sol taraflı C3-4 kısmi laminektomi ile çıkartıldı ve cerrahi sonrası hastanın nörolojik defisiti hemen hemen tümüyle iyileşti. Üst servikal omurganın asemptomatik ganglion kistleri daha önceki nörolojik bulguların yokluğunda bile laringeal entübasyon süresince vertebral kolonun hafif ektansiyonuna bağlı gelişen spinal kanal daralması nedeniyle akut nörolojik bozukluğa yol açabilirler. Bu tür olgularda, intra- ve/veya postoperatif komplikasyonlardan korunabilmek için cerrahlar tarafından minimal invaziv cerrahi yaklaşımların tercih edilmesi lazımdır.Symptomatic ganglion cysts of the cervical spine usually cause progressive neurological deterioration. A 67 year-old- female patient presented with acute hemiparesia due to C3-4 ganglion cyst after lumbar surgery. The lesion was removed urgently via left sided C3-4 partial hemilaminectomy, and postoperatively the patients neurological deficits improved almost completely. Asymptomatic ganglion cysts of the upper cervical spine may cause acute neurological deterioration due to narrowing of the spinal canal by slight expansion of vertebral column during laryngeal intubation, even in the absence of preceding neurological findings. In such cases, minimally invasive surgical approaches should be chosen by surgeons for the prevention of intra- and/or postoperative complications