A rare cause of dysphagia: Non aneurysmatıc dysphagia aortica

Dysphagia aortica is a rare etiological factor of dysphagia resulting from extrinsic compression of the esophagus by thoracic aorta. There is no gold standard diagnostic procedure for dysphagia aortica. Dysphagia aortica is usually escaped to attention in the differential diagnosis of dysphagia. Here, we reported compression of the esophagus by thoracic aorta in a 54 years-old male patient who complained from dysphagia

Evaluation of Anterior Segment Parameters and Retinal Nerve Fiber Layer Thickness According to Pregnancy Trimester

WOS: 000441304600015Objective: To analyze the effects of pregnancy on anterior segment parameters and retinal nerve fiber layer (RNFL) thickness. Methods: The study designed prospectively conducted among 122 singleton pregnant women and 49 non-pregnant women. Intraocular pressure (IOP) was measured via the Goldman applanation tonometry. Central corneal thickness (CCT), axial lenght (AxL) and anterior chamber depth (ACD) measurement were performed with Echoscan US 500. For investigating the thickness of RNFL in detail, the optical coherence tomography was used. One Way ANOVA test was used to make a comparison between normal distribution groups. Results: There was no statistically significant difference regarding age. The IOP were 16.0 mmHg in the 1st trimester, 14.6 mmHg in the 2nd trimester, 13.6 mmHg in the 3rd trimester and 15.56 mmHg in the non-pregnant. Statistically, the findings of the 2nd and the 3rd trimester were significantly different from that of the 1st trimester (p = 0.033, p = 0.001, respectively). CCT averages were 554 mu m, 564 mu m and 552 mu m, respectively, according to the trimester, while it was 542 mu m in non-pregnant women. The difference between CCT averages between pregnancies in the 2nd and 3rd trimesters and non-pregnant women was statistically significant (p = 0.022, p = 0.041, respectively). The comparison of average thickness of four RNFL showed no difference between the pregnant and non-pregnant. Conclusions: During gestation, there was an increase in CCT with a decrease in IOP. We also determined that the ACD, AxL, and RNFL thickness measurements do not change with pregnancy

A randomized comparison of a single-incision needleless (Contasure-needlelessA (R)) mini-sling versus an inside-out transobturator (Contasure-KIMA (R)) mid-urethral sling in women with stress urinary incontinence: 24-month follow-up results

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000443429400022PubMed: 29549394There is a shortage of reliable data on the efficiency of the under-investigated mini-slings to treat stress urinary incontinence (SUI). We aimed to compare the effectiveness of the single-incision needleless mini-sling (SIMS) with the transobturator inside-out mid-urethral sling (TOT). Two hundred one women with clinically proven SUI were included in this single-center prospective randomized trial. The patients were randomly allocated to the groups. All surgeries were done by the same single surgeon. Examinations were done by one other blinded surgeon. The patients were followed up for 24 months. Objective cure was defined as the absence of SUI and negative cough-stress test. Subjective cure was defined as no stress leakage of urine after surgery in a validated questionnaire. Failure of the surgery was defined as the need for reoperation. Every complaint was categorized by the IUGA/ICS Classification of Prosthesis-related Complications. The objective (85.4% versus 89.9%, p = 0.362) and subjective (87.6% versus 89.9%, p = 0.636) cure rates were similar with the TOT and SIMS at the postoperative month 24, respectively. The mesh exposure 1 cm rate was 3.4% for both groups, and the mesh exposure > 1 cm rate was 2.2% for both groups. Overall failure rates were 3.4% and 2.2% for the TOT and SIMS group, respectively. No viscus organ perforation was noted. Complications with the SIMS procedure were less painful compared with TOT (p = 0.024). Single-incision needleless mini-slings exhibited similar cure rates as the trans-obturator mid-urethral slings from both the patient and clinician points of view in 24 months of follow-up. Mini-slings resulted in significantly less postoperative pain than trans-obturator mid-urethral slings

Serum ceruloplasmin-ferroxidase activity in bipolar disorder is elevated compared to major depressive disorder and schizophrenia: a controlled study

OBJECTIVE: In this study, we aimed to study copper metabolism in schizophrenia, bipolar disorder, major depression compared with healthy control. METHODS: This is a single-centered cross-sectional study. The patients with schizophrenia (n = 36), bipolar disorder (n = 37), major depression (n = 40), and healthy control (n = 32) were included in the study. All participants were initially evaluated by a clinical psychiatrist to confirm the appropriate diagnosis using the Structured Clinical Interview for Diagnostic and Statistical Manuel of Mental Disorders-IV (DSM-IV) Axis I Disorders (SCID-I). Serum copper level, ceruloplasmin mass, and ceruloplasmin-ferroxidase activity were measured. One-way ANOVA and Kruskal–Wallis Tests were performed for statistical analyses. RESULTS: Serum ceruloplasmin-ferroxidase activity (χ2  = 9.11, p = 0.028) demonstrated a significant statistical difference in all groups compared with the control group. Serum ceruloplasmin-ferroxidase activity of the bipolar disorder group was significantly higher than the healthy control group (p = 0.012), major depression group (p = 0.027), and the schizophrenia group (p = 0.019). Erythrocyte sedimentation rate (ESR) (p = 0.028) and waist circumference (p = 0.005) in bipolar disorder group, and the C-reactive protein (CRP) (p < 0.001) and cholesterol (p = 0.043) in the schizophrenia group were found as the determinants of ceruloplasmin-ferroxidase activity. CONCLUSION: In this study, ceruloplasmin-ferroxidase activity is higher in all groups in comparison to the healthy control. The significantly higher ceruloplasmin-ferroxidase activity was shown in bipolar disorder followed by the major depression and schizophrenia. The ceruloplasmin-ferroxidase activity was correlated with erythrocyte sedimentation rate in the bipolar disorder group and with C-reactive protein in the schizophrenia group. Therefore, the ceruloplasmin-ferroxidase activity may be an encouraging candidate in the neuro-immune modulation and become a reliable clinical tool for demonstrating the strong association of inflammation in these disorders

A randomized prospective comparison of the needleless mini-sling "hammock" and "U-shape" configurations for management of stress urinary incontinence: 18 month follow-up results

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000431871800015PubMed: 29556707Objective To compare the efficacy of needleless mini-sling placed either retropubic (U-shape) or trans-obturator (hammock-shape) to treat stress urinary incontinence. Setting One hundred and twenty six women were randomized in a 2:1 ratio to receive hammock-shaped or U-shaped of Contasure-NDL. Methods All surgical procedures were performed by one senior surgeon experienced in anti-incontinence surgery with mesh. Cough-stress test was considered for objective outcome. Subjective outcomes consisted of International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I) and three-item Likert scale to measure satisfaction. Assessments were performed preoperatively and at postoperative 6th, 12th and 18th month. Results The objective cure rates at postoperative 6th and 12th month were significantly lower in U-shape group compared to hammock-shape group (85.4 vs. 96.4%; p = 0.034) and was comparable with hammock-shape group at 18 th month postoperative (90.2 vs. 96.4%, respectively; p = 0.216). The subjective cure rates at postoperative 6th, 12th and 18th month were similar between groups (90.2/90.2/100% vs. 96.4/96.4/96.4%, respectively; p > 0.05). Median of total ICIQ-SF scores was significantly lower in hammock-shaped group (1.62 +/- 2.92) compared to U-shape (3.80 +/- 2.64) at 18th month (p < 0.001). The rate of patients reported as very satisfied or satisfied to the Likert scale was 90.2% in U-shape group and 96.4% in hammock group. Patients' responses to PGI-I were majorly distributed to "much better" and "very much better" with a mean score of 1.93 +/- 2 in U-shape and 1.33 +/- 1 in hammock group at 18th month of follow-up (p < 0.001). Conclusion U-shape placement of needleless single-incision mini-sling mimicking the retropubic route did not satisfy in achieving the patient's goal when compared to hammock-shape placement

A Novel Technique for Mapping the Vascularity of Labia Minora Prior to Labiaplasty: Cold Light Illumination

yassa, murat/0000-0001-8661-1192; dogan, ozan/0000-0002-0016-8749WOS: 000442303900015PubMed: 30140106Objective Aim of the study was to assess the feasibility of a novel technique to determine the vascularity of labia minora prior to labiaplasty. Methods A cold light source employed in laparoscopic procedures was used to illuminate the outer surface of the labia minora as described in this prospective descriptive study. Results Of the patients, 46.1% (n = 41) had upper third prominence, 36% (n = 32) had middle third prominence, and 18% (n = 16) had lower third prominence according to the Banwell classification of morphologies. Right labia minora width was 0-2 cm in 51.7% (n = 46), 2-4 cm in 47.2% (n = 42) and > 4 cm in 1.1% (n = 1) of cases. Left labia minora width was 0-2 cm in 52.8% (n = 47), 2-4 cm in 41.6% (n = 37) and > 4 cmin 5.6% (n = 5) of cases. The incidence of Anterior 2 and Posterior 1 vessels in the differentmorphologies were statistically significantly different (p = 0.007, p = 0.018). The Anterior 2 vessel was higher in the lower morphology group whereas the Posterior 1 vessel was higher in the upper morphology group. A central vessel was observed in 93.3% (n = 83) of patients in the left labium minus and the right labiumminus. The incidence of the Posterior 1 vessel was significantly higher in the left labium minus than in the right labium minus (p = 0.021). Discussion This novel technique to assess labial vascularity using a cold light source could be very useful to reduce dehiscence by avoiding excessive resection of highly vascularized tissue. Most units can easily access a cold light source, which can be used to assess labial vascularity prior to labiaplasty