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

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

14 yaşında bir adölesanda unilateral ovaryen leiomyom: Nadir bir olgu sunumu

Leiomyomlar sıklıkla uterusta rastlanan benin mezenkimal tümörlerdir. Uterin leiomyomlar kadınlarda görülen pelvik kitlelerin en sık nedenlerinden olsa da, over kaynaklı leiomyomlar oldukça nadir görülmekle birlikte bütün over kaynaklı benin tümörlerin yalnızca %0,5 ila %1'ini oluşturmaktadır. Genellikle 20-65 yaş grubunda görülmekte olup, %85'ini premenopozal dönemdeki kadınlar oluşturmaktadır. Bu olguda kliniğimize 6 aydır devam eden bilateral alt kadran karın ağrısı nedeniyle başvuran 14 yaşındaki bir kız çocuğunu sunduk. Ultrasonografik görüntülemede uterus arka duvar komşuluğundan sağ adneksiyal bölgeye uzanım gösteren, uterin ekojenitesi olan solid görünümde 6x5,5 cm boyutlarında bir kitle izlendi. Kitlenin kaynağının ultrason ve magnetik rezonans görüntüleme ile net belirlenememesi üzerine tanısal laparoskopi uygulandı. Sol over kaynaklı kitle laparotomi ile çıkarılıp patolojiye gönderildiğinde patoloji sonucu ovaryen leiomyom ile uyumlu çıktı. Bildirilen vakalar içinde 14 yaşında olarak en genç vakalardan biri olma özelliği yanı sıra 20 yaş altı olup, genelde rastlanandan farklı olarak unilateral karakter taşıması ile farklılık göstermektedir.Leiomyomas are benign mesenchymal tumors mostly seen in the uterus. Uterine leiomyomas are one of the most common reasons of pelvic masses seen in women whereas ovarian leiomyomas are so rare that among all benign ovarian tumors, it accounts only 0.51%. It is mostly seen between ages of 20 to 65 years which premenopausal women consist almost 85% of them. In this case, we aimed to present a 14-year-old girl who was admitted to our clinic with a six months history of bilateral lower quadrant abdominal pain. In ultrasonographic evaluation, there was a solid mass with uterine echogenity extending from the posterior side of the uterus towards to the right adnexial area with diameters of 6 cm x 5.5 cm. The origin of the tumor could not be evaluated with ultrasonography and magnetic resonance imaging. Therefore, diagnostic laparoscopy with an intention to excise was performed. The tumor arising from the left ovary was removed with laparotomy and the final pathology was compatible with ovarian leiomyoma. When we checked the literature our case is one of the youngest of all reported cases that was 14 years old and with unilateral feature differently from the most of the other published cases under age of 20

Unilateral Ovarian Leiomyoma in a 14-year-old Adolescent: A rare case report

Leiomyomas are benign mesenchymal tumors mostly seen in uterus. Uterin leiomyomas are one of the most common reasons of pelvic masses seen in women whereas ovarian leiomyomas are so rare that among all benign ovarian tumours it accounts only 0,5-1 %. It’s mostly seen between ages of 20-65 which premenopausal women consist %85 of them. In this case we wanted to present a 14 years old girl who was admitted to our clinic with a 6 months history of lower quadrant abdominal pain. In the ultrasonographic evaluation, there was a solid mass with uterin echogenity extending from posterior of uterus towards left adnexia with diameters of 6 cm x 5,5 cm. The origin of the tumor was unknown and could not be revealed with ultrasonography nor MRI until diagnostic laparoscopy was performed. Ovarian tumor was removed and the final pathology was compatible with leiomyoma. When we checked the literature there were only 5 cases of ovarian leiomyoma reported under age of 20 and mostly they had bilateral character. The youngest age reported was 13. Our case is the second youngest of all reported cases and it shows a unilateral character. The other important aspect of our case is that sometimes the imaging techniques can’t be adequate for detecting the origin of tumor

Different concentrations of mesna application have an effect on the internal ear?

WOS: 000432766000007PubMed ID: 29728180Objective: The use of Mesna as a chemical dissector in higher concentrations may reduce the length of time of operation by providing more effective dissection as well as being used in otologic pathologies such as tympanosclerosis. In this study, it was aimed to assess the effect of Mesna on the internal ear, which was applied intra-tympanically in higher concentrations than the conventional use. Methods: Twenty-four female rats were included in our study. The rats were randomly divided into three groups (Group 1: Mesna 50%, Group 2: Mesna 100%, Group 3: Saline). At the beginning of the study, DPOAE and ABR measurements were carried out on every rat on days 7 and 14. At the end of the study, cochleas of the rats were excised and histopathological assessments were carried out. Results: Basal values and DPOAE and ABR values on day 7 and 14 of Group 1, Group 2, and Group 3 were similar to each other. No significant difference was detected among the three groups in the histopathological assessment carried out at the end of the study. Conclusion: It was revealed by audiological and histopathological parameters that the use of Mesna at 50% and 100% concentrations did not create toxicity effects on the internal ear. Mesna would be more effective by being used in higher concentrations in audiological surgeries, that its duration of operation world reduce and could being used in different indications including tympanosclerosis

Evaluation of ototoxicity of intratympanic administration of Methotrexate in rats

13th International Congress of the European-Society-of-Pediatric-Otorhinolaryngology (ESPO) -- JUN 18-21, 2016 -- Lisbon, PORTUGALWOS: 000409153800024PubMed ID: 28802357Objective: Methotrexate is a dihydrofolate reductase enzyme inhibitor with very high selectivity, and it is an antiproliferative folic acid antagonist used for the treatment of autoimmune diseases. In this study, our objective was to evaluate the effect of intratympanic Methotrexate application in the inner ear. Methods: This study was planned as an animal study. This study performed in a tertiary referral center. 24 healthy female rats were used in our study. They were separated into three groups. 0.2 cc intratympanic saline was applied to both ears of Group 1. Paracentesis was applied to the tympanic membrane in both ears of Group 2. 0.2 cc intratympanic Methotrexate was applied to both ears of Group 3. At the beginning of the study, Distortion-product otoacoustic emissions (DPOAE) and Auditory brainstem response (ABR) of all rats were measured and then again on the 5th, 10th and 15th day. Histologic examinations of all groups were compared. Results: There was not any significant difference between basal DPOAE and ABR measurement values of the groups and the results were measured again on the 5th, 10th and 15th day (p > 0.05). There was no difference between the groups in terms of histology. Conclusion: The intratympanic Methotrexate injection does not have any ototoxic effect on inner ear. We assume that intratympanic Methotrexate could be used safely on inner ear diseases in which steroid treatment is contraindicated or not effective.European Society of Pediatric Otorhinolaryngolog