Bir köpekte gerçek hermafrodismus: Olgu sunumu

True hermaphroditism in a dog is described in this case report. An eight month old cross-breed dog with enlarged structure protruding from the vulva was brought for an ovariohysterectomie operation. Physical examinations exposed the presence of an os clitoris and urethral orifice at the base of the os clitoris. Exploratory laparotomy was performed as a diagnostic and therapeutic procedure. Both gonadal tissues and the genital tract were removed during surgery and brought to the laboratory for pathological examinations. Microscopic examinations showed that the right gonad had both seminiferous tubules like testis and primer follicles like ovarium. The concentrations of serum progesterone, testosterone and 17β-estradiol were 0,188 ng/ml, 1,008 ng/ml and 23,61 pg/ml respectively. We concluded that this is a true hermaphrodismus case due to the simultaneous presence of two sex gonads.Bu çalışmada, gerçek hermafrodit bir köpek anlatılmıştır. Vulvasından dışarıya doğru çıkan büyük bir kitle olan 8 aylık melez bir köpek kısırlaştırma operasyonu için araştırma merkezimize getirildi. Fiziksel muayenelerde os klitorisin varlığı ve bunun bazalinde uretral deliğin olduğu saptandı. Teşhis ve tedavi amacıyla hayvana ovariohysterectomie operasyonu uygulandı. Her iki gonadal doku ve uterus patolojik incelemeler için laboratuvara gönderildi. Mikroskobik incelemeler, sağ gonadın hem testis gibi seminifer tubuller hem de ovaryum gibi primer foliküller içerdiğini gösterdi. Serum progesteron, 17β-östradiol ve testosteron düzeyleri sırasıyla 0,188 ng/ml, 23,61 pg/ml, 1,008 ng/ml olarak ölçüldü. Köpekte her iki gonadal dokunun aynı anda bulunması nedeniyle olgunun bir gerçek hermafrodismus olgusu olduğu kanısına varıldı

Relationship Between Atopy Patch Test with Foods and SCORAD

Background and Design: The relationship between food and atopic dermatitis (AD) is controversial. Atopy patch test (APT) gained prominence due to low specificity of “fresh prick tests” (FPT) with foods, commonly late occurrence of lesions in AD and, thus, the inconsistencies in anamneses, and being the provocative tests time consuming and risky, as well as due to the role of T lymphocytes in the pathophysiology of the disease. In this study, we investigated the relationship of APT and FPT made with food with SCORAD index assessing the disease severity.Materials and Methods: Forty-five children (21 males and 24 females) aged between 2-15 years who were diagnosed with AD in our outpatient clinic between May 2006 and May 2007 were included in the study. FPT and APT with eggs, milk and wheat flour were performed in all patients. The severity of illness was assessed using the SCORAD index. Statistical analysis was performed using SPSS version 11.0 for Windows. A p value of less than 0.05 was considered statistically significant

Effects of Different Applications on Postoperative Seroma Formation and Wound Healing Following Mastectomy and Axillary Dissection in Rats

The most frequent postoperative complication after breast surgery is seroma formation. Seroma occurs due to lymphatic and vascular fluid leakage into the dead space created by surgical dissection. The objective of the research was to evaluate the effects of local fibrin glue, tetracycline, talc applications, and flap fixation technique on reducing seroma formation after mastectomy and axillary dissection. In addition, we aimed to determine the level of efficacy for these applications, as well as to identify the most appropriate method to be used in operations with high risk of seroma formation. Materials and Methods. This experimental study was conducted using a total of 60 female Wistar albino rats. They were allocated into six groups and each comprised ten rats. Unilateral mastectomy and axillary dissection were performed on all the rats. Local applications of fibrin glue, tetracycline, talc, and alcoholic iodine were performed in four separate groups. Flap fixation technique was applied in one group and those rats that did not receive any intervention constituted the control group. On the 10th postoperative day, seroma was aspirated under anesthesia, and the amount of seroma fluid was recorded. Seroma fluid was analyzed for interleukin 1-β, vascular endothelial growth factor, and C-reactive protein levels. Tissue samples were obtained from the skin overlaying the dissection area, the axilla, and the thoracic wall. Wound healing was evaluated with histopathological examination. Results. Seroma volume was lower and the wound healing scores were the highest in the flap fixation group and the tetracycline group as compared to the control group. However, the alcoholic iodine group and the talc group had a greater amount of seroma (p < 0.05). There was no difference between the fibrin glue group and the control group. Conclusions. In our mastectomy model, local application of alcoholic iodine and talc substances caused more wound site problems and postoperative seroma formation. While fibrin glue did not cause wound site problems, it did increase seroma formation. These three substances were determined to be inefficacious in postoperative seroma formation. Local tetracycline application and flap fixation technique were found to reduce postoperative seroma and benefit wound healing

Factors affecting mortality in Pediatric Severe Head Injury

Aim: It is aimed to determine the factors affecting mortality in pediatric patients followed up with severe traumatic brain injury in the pediatric intensive care unit. Material and method: All patients followed up in the Pediatric Intensive Care Unit between April 2019 and April 2021 due to severe traumatic brain injury were included. Demographic characteristics, pre-intensive care interventions and imaging findings, treatments applied in intensive care and intervention information of all patients were collected. Results were evaluated as survival rate, presence of tracheostomy requirement, brain death, and Pediatric Cerebral Performance Scale at discharge. The patients divided into two groups as survivors and non-survivors. All obtained data were compared between the two groups. Results: During the study period, 47 patients with a diagnosis of severe traumatic brain injury were followed up. It was observed that the requirement of cardiopulmonary resuscitation, the need for inotrope-vasopressor and the need for erythrocyte transfusion were statistically significantly higher in the non-survivor group. (p value, respectively: 0.001, 0.001, 0.001) The survival rate in all patients in the study group was 70.2%. In non-survivor group most common pupil response at admission was fixed-dilated (71.4%). In non-survivor group 60% of the patients were lost in the first 24 hours of intensive care. Conclusion: Mortality increases in patients who need resuscitation, erythrocyte transfusion and inotrope before intensive care. Patients who died showed pathologic pupillary response and low GCS. Severe TBH patients died mostly in first 24 hours of admission

Comparison of Efficacy and Complications of Holmium Laser and Pneumatic Lithotripters Used in the Ureterorenoscopic Treatment of Proximal Ureter Stones, a Multi-Center Study of Society of Urological Surgery Aegean Study Group

Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones.Materials and Methods:Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared.Results:The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2.Conclusion:If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases

Effect of the Anesthetic Method on the Outcomes of Ureteroscopy for Proximal Ureteral Stones: A Multi-center Study of the Society of Urological Surgery Aegean Study Group

Objective:To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones.Materials and Methods:Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients’ demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner.Results:There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041).Conclusion:URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient’s comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes