Laser Photocoagulation of Tongue Hemangioma: Case Report

This report describes two cases of tongue hemangioma and shows the effectiveness of photocoagulation with diode laser. A thirty-five year-old female patient with a tongue hemangioma measuring 20x30 mm was referred. The lesion had been present for 15 months and the patient reported a gradual enlargement with dental trauma. A forty-three year-old female patient had a tongue hemangioma measuring 21x25 mm. The lesion was located on the right lateral side of her tongue and had caused minor discomfort with dental trauma for the previous 8 months. Lesions were surgically photocoagulated with a diode laser applied through a glass microscope slide. The procedures lasted 15 minutes and the patients were discharged on the first postoperative day. Minimal swelling and crusty scarring occured during the first postoperative week. After one month, the operative sites healed without any residual scarring. Patient satisfaction was achieved with minimal morbidity. Lower morbidity, minimal patient discomfort and satisfactory aesthetic results are favorable for the patients. Laser photocoagulation is promising as the treatment of choice for such lesions

İNMEDE BEYİN ÖDEMİ VE KAFA İÇİ BASINÇ ARTIŞI: TÜRK BEYİN DAMAR HASTALIKLARI DERNEĞİ UZMAN GÖRÜŞÜ

Beyin ödemi inmeden sonra sık karşılaşılan bir sorundur. İntrakranial basınç artışı serebral perfüzyonu bozarak veserebral herniasyona yol açarak mortalite ve morbiditeyi artırır. İnme hastası takip eden nörologların, hangi inmedensonra beyin ödemi gelişeceğini kestirebilmesi, beyin ödemi gelişmemesi için önlemler alabilmesi, gelişirse intrakranialbasınç artışı ve serebral herniasyonu klinik ve radyolojik olarak tanıyabilmesi, ve önlenemezse beyin ödemi veintrakranial basınç artışını hızlı ve etkin şekilde tedavi edebilmesi gerekir. Bu uzman görüşü Türk Beyin DamarHastalıkları Derneği bünyesinde aktif olarak çalışan 60 uzmanın ortak görüşü ile hazırlanmış bir klinik rehberniteliğindedir

Acil Serviste Kardiyopulmoner Resüsitasyonda Perfüzyon İndeksinin Değeri

DOGAN B, Value of Perfusion Index in Cardiopulmonary Resuscitation in Emergency Department, Hacettepe University Faculty of Medicine, Emergency Medicine Thesis. Ankara, 2020. Perfusion index (PI) is an effective parameter used in critical patient monitoring to show cardiac output and tissue perfusion. In our study, it was planned to investigate the relationship between End Tidal Carbon Dioxide (EtCO2) and PI values in cardiopulmonary resuscitation and its effectiveness in predicting survival. Out of hospital cardiopulmonary arrest adult patients who were brought to Hacettepe University Emergency Department and cardiopulmonary arrest adult patients while being treated within the hospital between November 2018 and April 2019, were included in this prospective and observational study. 100 patients were included in the study. Data were obtained using Utstein parameters. In addition, a one-month survival and cerebral performance scale score was analyzed, along with EtCO2 and PI values at baseline, fifth, tenth, fifteenth, twentieth, twentyfifth, thirtieth, thirtyfifth, fortieth and end of cardiopulmonary resuscitation (CPR), EtCO2 and PI values. It was observed that gender, presence of comorbidity, etiology, arrival rhythm, witness status, pre-hospital CPR or defibrillation did not affect the PI value of the patients (p=0,803), (p=0,764), (p=0,69), (p=0,244), (p=0,769). The cut-off value could not be determined in predicting mortality and neurological outcome. When the patients who were returned to spontaneous circulation (ROSC) were examined, PI values were found to be insufficient to predict one month survival (p=0,15). There is no relation between hemoglobin, mean arterial pressures after ROSC and PI value (p=1). PI was not effective in predicting prognosis and survival in cardiopulmonary resuscitation (p = 0.270). There is not enough study on the prognostic value of PI in cardiopulmonary arrest patients, there is a need for extensive studies on this subject.DOĞAN B, Acil Serviste Kardiyopulmoner Resüsitasyonda Perfüzyon İndeksinin Değeri, Hacettepe Üniveristesi Tıp Fakültesi, Acil Tıp Uzmanlık Tezi. Ankara, 2020. Perfüzyon indeksi (PI) kritik hasta monitörizasyonunda kardiyak debiyi ve doku perfüzyonunu göstermede etkin olarak kullanılan bir parametredir. Çalışmamızda End Tidal Karbondioksit (EtCO2) ile PI değerleri arasındaki ilişkinin kardiyopulmoner resüsitasyondaki yeri ve sağkalımı öngörmedeki etkinliğinin araştırılması planlanmıştır. Prospektif ve gözlemsel olarak planlanan bu çalışmaya Kasım 2018 ile Nisan 2019 arasında Hacettepe Üniversitesi Acil Servis’e hastane dışından getirilen ve hastane içinde tedavisi devam ederken arrest olan erişkin kardiyopulmoner arrest hastaları alınmıştır. Çalışmaya 100 hasta dahil edildi. Utstein parametreleri kullanılarak veriler elde edildi. Ek olarak başlangıç, beşinci, onuncu, onbeşinci, yirminci, yirmibeşinci, otuzuncu, otuzbeşinci, kırkıncı ve kardiyopulmoner resüsitasyon (KPR) sonu EtCO2 ve PI değerleriyle birlikte bir aylık sağkalım ve serebral performans skala skoru analiz edildi. Hastaların cinsiyeti, komorbidite varlığı, etiyolojisi, geliş ritmi, tanık durumu, hastane öncesi KPR veya defibrilasyon uygulanmasının PI değerini etkilemediği görüldü (p=0,803), (p=0,764), (p=0,69), (p=0,244), (p=0,769). Mortaliteyi ve nörolojik sonlanımı öngörmede cut-off değeri belirlenememiştir. Spontan dolaşıma geri dönüş (SDGD) sağlanan hastalar incelendiğinde PI değerleri bir aylık sağkalımı öngörmede yetersiz olduğu bulunmuştur (p=0,15). Hemoglobin, SDGD sonrası ortalama arter basınçları ile PI değeri arasında da ilişki yoktur (p=1). Kardiyopulmoner resüsitasyonda PI’nın prognoz ve sağkalımı öngörmede etkin olmadığı görülmüştür (p=0.270). Kardiyopulmoner arrest hastalarında PI’nın prognostik değeri ile ilgili yeterli çalışma yoktur, bu konuyla ilgili geniş çapta çalışmalara ihtiyaç vardır

Sacrospinous Ligament Fixation Under Local Anesthesia in Elderly Patients at High Risk of General Anesthesia

Introduction and Hypothesis: Sacrospinous ligament fixation(SSLF) is a commonly used surgical procedure in pelvic organ prolapse due to high treatment success rates. Many intraoperative and postoperative anesthesia-related obstacles may be encountered by the elderly population. Local anesthesia alone or with intravenous sedation may provide simple, cheap, and safe anesthesia. For elderly patients at high risk for general anesthesia according to the American Society of Anesthesiologists(ASA), it is better to operate through the vaginal route under local anesthesia. To perform minimal invasive SSLF surgery, the Pelvic Floor Repair Tissue Fixing Anchor, which is a target-specific system, can be used. In this prospective observational study, evaluation was made of elderly patients who underwent SSLF under local anesthesia. Materials and Methods: The study included 11 patients evaluated as high risk for general and regional anesthesia who underwent SSLF under local anesthesia as pelvic organ prolapse surgery. All operations were performed by a single experienced surgeon using 1% lidocaine infiltration and the Pelvic Floor Repair Tissue Fixing Anchor system. Results: The mean age of the patients was 69.6 years. Stage IV prolapse was determined in 7 (63.6%) patients, 4 (36.3%) had a history of hysterectomy, 5 (45.4%) were classified as ASA 3, and 6 (54.6%) as ASA 4. No complications occurred and patients were followed up for 24 months. In two patients, recurrence of POP was observed at postoperative 8 and 10 months, respectively. Conclusions: The results of this study demonstrated the surgical and anesthetic safety of SSLF under local anesthesia for pelvic organ prolapse in elderly patients

An Interdisciplinary Approach to the Management of Organizations

Understanding the nature of economic potential of nonprofit organizations is an important factor to assess the impact of globalization on the performance of business world. There are sufficient reasons in theory and evidence in practice to investigate areas where the dynamics of market mechanism fail to operate. These areas are important parts of the realms of economic cosmos in which daily instant data and information flow unabated. Economic environment is sensitive to data changes with new inventions and innovations. The definition, content and meaning of data itself also differs and transforms from the view point of time and period

Experimental investigation of heat conduction characteristics of density-layered stone wool materials

This work presents an experimental study to investigate the heat conduction coefficient of the density-layered stone wool plates insulation materials used in heat insulation applications. The stone wools, which have 70, 100, and 150 kg/m3 of densities, have been combined in different thicknesses to 60 mm. The aim of this layer combination is to benefit from lower heat conductivity and lightness of the lower density stone wools and the better strength of higher density stone wools. First, the single-layer stone wools with 60 mm of thickness, which is in the insulation market, have been tested. Then, they have been combined in different thicknesses, with a total thickness of 60 mm. A total of 18 samples have been produced, and the thermal conductivity of samples has been measured experimentally. Consequently, the heat conduction coefficient of density-layered stone wools and their weights have been compared experimentally. At the end of the present study, it is observed that density-layered stone wool plates play a critical role in improving the heat conductivity and lowering the weight of high-density plates. When combining 10 mm thick 150 kg/m3 density stone wool with 50 mm thick 70 kg/m3 density stone wool, the heat conductivity has been improved by 3.52% and the weight of the 1 m2 plate has reduced by 4 kg (44%) according to the stone wool with 150 kg/m3 of density

Experimental Investigation of Heat Conduction Characteristics of Density-Layered Stone Wool Plates (Accepted paper)

This work presents an experimental study toinvestigate the heat conduction coefficient of the density-layered stone woolplate insulation materials used in heat insulation applications. The stonewools, which have 70, 100, and 150 kg/m3 of densities, have beencombined in different thicknesses to 60 mm. The aim of this layer combinationis to benefit from lower heat conductivity and lightness of the lower densitystone wools and the better strength of higher density stone wools. First, thesingle-layer stone wools with 60 mm of thickness, which is in the insulationmarket, have been tested. Then, they have been combined in differentthicknesses, with a total thickness of 60 mm. A total of 18 samples have beenproduced, and the thermal conductivity of samples has been measuredexperimentally. Consequently, the heat conduction coefficient ofdensity-layered stone wools and their weights have been comparedexperimentally. At the end of the present study, it is observed thatdensity-layered stone wool plates play a critical role in improving the heat conductivityand lowering the weight of high-density plates. When combining 10 mm thick 150kg/m3 density stone wool with 50 mm thick 70 kg/m3density stone wool, the heat conductivity has been improved by 3.52% and theweight of the 1m2 plate has reduced by 4 kg (44%) according to the stone woolwith 150 kg/m3 of density.&nbsp;</p