Congenital absence of the pericardium: A rare cause of right ventricular dilatation and levoposition of the heart

Congenital absence of the pericardium is a rare cardiac defect with variable clinical presentations and is usually discovered incidentally. The pathology may lead to serious complications such as incarceration of cardiac tissue, myocardial ischemia, aortic dissection or valvular insufficiency. Diagnosis is not difficult so long as some tips are remembered. We present the cases of two patients with congenital absence of left pericardium

Unusual Presentation of Duplex Kidneys: Ureteropelvic Junction Obstruction

Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11–48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy in six moieties, dismembered pyeloplasty in eight moieties, heminephrectomy in four cases, and simultaneous upper heminephrectomy and lower pole ureteropyelostomy in one patient. Conclusion. There is no standard approach for these patients and treatment should be individualized according to physical presentation, detailed anatomy, and severity of obstruction

Post Endolaryngeal Laser Surgery Carbon Granuloma

Aim: This study was performed to highlight the phenomenon of carbon granulation formation after laser vocal cord surgery. Emphasis was put on the fact that these granulomas closely resemble tumor recurrence and due to the similarity of appearance, histological evaluation is necessary for diagnosis. Methods: This study included 35 male patients presenting to the Acıbadem University Hospital with early-stage laryngeal cancer between 2009 and 2013. All patients underwent laser-assisted interventions on the vocal cords. Patient follow-up was continued for two years and granuloma formation or tumor recurrence was noted. Results: During the two-year follow-up period, a total of five patients presented with new vocal cord lesions. One of the cases was determined to be a tumor recurrence. The remaining four were carbon granulomas that regressed during the follow-up period. Conclusion: Although carbon granuloma formation is not very common, it is still frequent enough to be thoroughly discussed in the literature. With laser surgery for early-stage laryngeal cancer becoming more popular every day, the incidence of carbon granulomas is likely to increase. An algorithm for this type of lesion without putting patients’ health at risk will be a valuable tool in the near future

Study for the Diagnostic Screening of Paroxysmal Nocturnal Hemoglobinuria in Older Patients with Unexplained Anemia and/or Cytopenia

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disease that may lead to weakness and death of patients, if unrecognized and untreated. Although consensus guidelines were reviewed recently for the diagnostic screening of PNH with multi-parameter flow cytometry (FCM), until now, no study has investigated the efficiency of such clinical indications in older patients