DEEP VEIN THROMBOSIS AFTER SEX REASSIGNMENT SURGERY: A CASE REPORT

Genel popülasyonda derin ven trombozu (DVT) insidansı yaklaşık 100.000'de 67 olarak yer almaktadır. DVT'ye neden olan birçok risk faktörü mevcuttur. Bunlar arasında ileri yaş, malignite varlığı, spontan düşük öyküsü, hamilelik, oral kontraseptif kullanımı, geçirilmiş tromboembolizm hikayesi, kalp yetmezliği, obezite, immobilite veya trombotik aktiviteye sahip hematolojik problemler gibi iyi bilinen birçok faktör bulunmaktadır. Günümüzde daha az dikkat çeken bir diğer yüksek risk grubu da yüksek doz östrojen kullanan ve erkekten kadına cinsiyet değişikliği amaçlanan transseksüellerdir. Biyolojik fonksiyonlar açısından transseksüellerin kendi biyolojik cinslerinden farklı olduğuna dair bir kanıt yoktur. Oral kontraseptif kullanımı ve major cerrahinin trombotik olaylara yol açması iyi bilinmektedir. Fakat oral kontraseptif kullanımı sırasında erkekten kadına cinsiyet değiştirme operasyonu olan ve postoperatif dönemde DVT gelişen bir olguya literatürde rastlanmamıştır. Bu makalede cinsiyet değiştirme operasyonu sonrası DVT gelişen bir olgumuzu sunmaktayız. Deep vein thrombosis (DVT) has an estimated annual incidence of 67 per 100 000. There are many etiologic factors that may cause deep vein thrombosis and these factors are very well known to increase the risk of venous thromboembolism such as increased age, presence of malignancy, history of spontaneous miscarriages, pregnancy, oral contraceptive usage, previous history of venous thromboembolism, heart failure, obesity, paralysis, or the presence of a thrombophilic abnormality. Another less conspicuous group of users of (high-dose) estrogens are male-to-female transsexuals. At present, there is no evidence that transsexuals differ in their biological functions from members of their biological sex. Oral contraceptive usage and surgery have been shown to cause significant number of thrombotic events. In addition, male to female transsexual patients must be considered as a risk group before surgery. To the best of our knowledge, this is the first case that had used oral contraceptives and developed DVT following sex reassignment surgery. We aimed to present a case that developed DVT after sex reassignment surgery

A Successful Neurotization of Two Different Muscles Using a Single Intact Motor Nerve Experimental Study on Rats

The development of microsurgical techniques and better understanding of nerve biology has resulted in significant improvement in the results of nerve repair. Some problems are still present. What would be the method of choice if 2 transected nerves were to be coapted and only one neighboring intact nerve was available? We performed neurotization of 2 different muscles by a single intact nerve, using only one nerve graft by reverse end-to-side coaptation that has already been introduced into the literature. We assessed the results histomorphologically and functionally. Twenty-four adult rats were used in the present study and equally divided into 4 groups

Wearable handmade wound dressing: Letter to the editor

Until the mid 1900s it was firmly believed that wounds healed more quickly if they were kept dry and left uncovered. After much careful research, we now understand that wounds heal faster and better when a moist environment is maintained. We suggested a new idea for dressing wide wounds. Underpants made from 100% cotton were treated with mupirocin and D-panthenol pomade in a steel container and then they were sterilized. In the last step, patients put on second underpants over the handmade dressing. This is time saving, easy to use make dressing easily and very cost effective. Furthermore, it is more comfortable for the patient and mobilization of the patient is easier than traditional dressing. Application areas may be multiple such as gloves, socks, undershirt, even brassiere for burn wounds, chronic ulcer wounds, crush injury, and skin grafted areas

Does Carbon Dioxide Therapy Really Diminish Localized Adiposities? Experimental Study with Rats

The probability of a positive effect of carbon dioxide (CO(2)) gas on the physiologic oxidative lipolytic process led to its use for localized adiposities. The authors considered that existing studies on CO(2) therapy were not sufficient to exhibit the efficiency of CO(2) therapy. The scientific basis for evaluating CO(2) therapy including standard dietary regimen, standard daily physical effort, and standard psychosocial stimuli was not clear. Despite this unclear situation, CO(2) therapy is extremely popular worldwide. The authors designed an experimental study using histomorphologic examination and the laser-Doppler flow meter to monitor treated tissue in rats. They devised a controlled applicator device appropriate for gas injection of rats and compared biochemical effects between CO(2) and breathable air

Popliteal Lymph Node Metastasis After Excision of the Malign Melanoma of the Heel

Generally, melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease may be the popliteal fossa. A 50-year-old woman presented with pigmented macular lesion on the left heel. Pathology report was positive for malign melanoma, 6.63 mm thickness and Clark's level V, following excision. There was no evidence for systemic metastasis; additional surgical intervention was not performed because of the thickness of the lesion and the patient was monitored. After 21 months, we noticed a 3 x 2 cm palpable inguinal lymph node on the same side and popliteal lymphatic metastasis was determined by pre-operative lymphoscintigraphy. Pathologic report was positive for only popliteal sentinel lymph node. We performed both popliteal and grion lymph node dissections simultaneously. We suggest that groin and popliteal lymphatic dissection must be per-formed together for popliteal lymph node positive malign melanoma cases

Our experience on forehead flaps for the reconstruction of face defects and assessment of patient expectations

Objective: Local flaps have been preferred frequently for the reconstruction of face defects because of good color and tissue texture matching. Forehead flap is also a local flap that is used to repair facial defects. Material and Methods: In this study the outcomes of patients who were reconstructed with forehead flap during an 8-year period (1994-2002) were presented and advantages and disadvantages of the forehead flap were discussed. Thirty-two cases (18 women and 14 men) with ages ranging between 24-71 years (mean 53.9 years), were included in this study. Localization of the reconstructed defects were the nose (19 patients), the medial cantus (11 patients), the orbit (1 patient), and the infraorbital region (1 patient). The defect size was between 1 x 1.5-6 x 8 cm. Outcomes were assessed by a questionnaire that was performed both by patients and by two different surgeons. Results: Follow-up duration ranged between 8 to 24 months and there was no complication except marginal necrosis in 1 patient. Donor area appearance was assessed as perfect for %66.7 of surgeons but %66.6 of patients was assessed as acceptable. Conclusion: Reconstruction of facial defects is more critical than other body regions regarding anatomical, functional and aesthetical results. Forehead flap can be used for appropriate facial tissue defects with great safety and patient satisfaction

Total vaginal reconstruction with combined 'Split Labia Minora Flaps' and full-thickness skin grafts

Purpose: Vaginal reconstruction with split-thickness skin grafts is the most common method for total vaginal reconstruction. Although it has disadvantages like contraction of the graft, foreshortening, donor site morbidity and long-lasting periods of vaginal standing; its easy surgical technique makes it popular. A new method using split labia minora (LM) flaps and full-thickness skin graft is discussed in this study