New method alternative to surgery for ingrown nail: Angle correction technique

PubMedID: 19397656[No abstract available

Hydatid disease involvement of primary subcutaneous tissue in the posterior proximal thigh - An unusual localization [1]

PubMedID: 18377614[No abstract available

Jejunal diverticulosis complicated with perforation: A rare acute abdomen etiology

Introduction: Jejunal diverticulosis is a rare intestinal pathology with an incidence of 0.5–1%. While most cases are asymptomatic, 30–40% of the cases may become symptomatic with chronic abdominal pain, malabsorption, hemorrhage, diverticulitis, obstruction, abscess formation and, rarely, diverticula perforation. It is generally localized on the mesenteric side and it develops from the entry points of the vessels into the jejunum. Case presentation: Case 1 – A 36-year Case 2 a 75 old female patient patient was admitted to the emergency department with the complaint of widespread abdominal pain, Case 1 8 diverticules, one with diverticule perforation, was observed in the jejunum segment between the 50th and 90th centimeters after the Treitz Ligament. Case 2 – In the diverticulum 100 cm distal from the Treitz ligament, mesenteric perforation area of 4–5 mm were observed. Results: Segmentary small bowel resection and side-by-side anastomosis were performed in these cases. In the histopathological examination, the Diverticula were seen to be pseudodiverticullar lesions including herniation of the mucosa and submucosa. Conclusion: Jejunoileal diverticulosis is a rare disease with life-threatening complications such as perforation, obstruction and bleeding, it is usually asymptomatic or presents with nonspecific symptoms. It should be considered in the differential diagnosis of acute abdomen. © 201

Parameters predicting follicular carcinoma in thyroid nodules with indeterminate cytology

PubMedID: 26344173AIM: To determine the parameters supporting the malignancy by comparing demographic features of patients and nodule features in malign and benign nodules according to the pathology results after thyroidectomy in patients with the suspicious fine needle aspiration biopsy (FNAB) results for follicular neoplasia. MATERIAL AND METHOD: Thyroidectomy performed 152 cases with the suspicion of follicular carcinoma owing to the FNAB results were included in the study. Age, radiation exposure history, and serum TSH levels of patients were recorded as well as the ultrasound findings of nodules as nodule count, diameter, internal structure, echogenicity, border features, presence of peripheral halo, and presence of internal micro calcifications. Scintigram findings of nodules were also recorded. RESULTS: The mean age of the patients was 48,14 years (range: 20-71 years). Twenty five (16,5%) of the patients were male while 127 (83,5%) were female. Among patients with higher than normal TSH levels, malignancy was more common compared with the patients with normal or lower TSH levels. Presence of intranodular calcifications [Odd's Ratio: 3,1; 95 % Confidence Interval: 1,3-7,4], increase in intranodular vascularization [Odd's Ratio: 14,7; 95% Confidence Interval: 1,4-147,7], absence of halo sign [Odd's Ratio: 0,1; 95% Confidence Interval: 0,04-0,8], and ill-defined margins [Odd's Ratio: 0,1; 95% Confidence Interval: 0,49-0,3] were statistically significantly more common in malignant cases. CONCLUSION: The ability of clinical features, and sonographic parameters to predict malignancy in indeterminate thyroid nodules should be kept in mind since ultrasound is a simple, easy and inexpensive tool in the diagnosis of thyroid nodules

Esophageal schwannoma: Report of a case and review of the literature

Background: Esophageal schwannomas are very rarely seen neurogenic tumors and constitute less than 2% of all esophageal tumors. The current study reports a case of benign esophageal schwannoma and re-evaluates esophageal schwannomas including our case with the other 42 cases in the literature. Methods: A 61-year-old female patient was referred to our clinic with the complaints of dysphagia and a weight loss. In her upper gastrointestinal system endoscopy, a 20-25-cm submucosal lesion was seen, which compressed the esophagus from outside. On computerized tomography and magnetic resonance imaging of the thorax, a mass lesion was detected at the posterior mediastinum. After a preoperative detailed evaluation, a right posterolateral thoracotomy was performed. The mass was excised with the enucleation technique. The diagnosis of benign esophageal schwannoma was made with immunohistochemical examination. Results: Postoperative period was uneventful. Conclusions Generally, the prognosis of esophageal schwannomas is excellent. Complete removal of the mass producing a negative surgical margin, and in malignant cases, excision of the regional lymph nodes, should be essential for long-term disease-free survival. © Springer-Verlag 2014

Comparison of Diverting Colostomy and Bowel Management Catheter Applications in Fournier Gangrene Cases Requiring Fecal Diversion

In some patients of Fournier gangrene originated from perianal region, it is important to prevent fecal contamination in order to provide healing without wound infection. For this purposes, diverting colostomy or bowel management catheter methods were performed. In this study, it is aimed to carry out a comparison of prognosis and cost efficiency between diverting colostomy and bowel management catheter methods applied for preventing fecal contamination in Fournier’s gangrene patients. Fourty-eight patients with diagnosis of Fournier’s gangrene, serious perianal infections, and preserved sphincters and without rectum injury after debridement were included in the study. The cases were divided into two groups as patients who were subjected to colostomy for fecal diversion and who were subjected to bowel management catheter without colostomy. Then, the groups were compared in terms of age, predisposing factors, duration of hospital stay, mortality, additional surgery requirements, and cost. Fourty-eight patients were included the study. Sixteen patients were treated without colostomy. Decreased duration of total hospital stay, additional surgery requirements, and hospital expense in bowel management catheter group has determined. It is thought that preferring bowel management catheter method instead of colostomy in patients without rectum injury, who require diverting colostomy and have undamaged anal sphincters, can relieve patients, patients’ relatives, healthcare organizations, and the national economy of a serious burden. In addition, although patients’ satisfaction and workforce loss factors are not taken into consideration in this study, the bowel management catheter method is thought to have positive effects also on these parameters. © 2013, Association of Surgeons of India

Comparison of early surgical alternatives in the management of open abdomen: A randomized controlled study [Open abdomen yönetiminde erken dönem cerrahi alternatiflerin karşılaştırılması: Randomize ileriye yönelik çalışma]

PubMedID: 26033648BACKGROUND: Abdominal compartment syndrome (ACS) is a clinical syndrome characterized by progressive intraabdominal organ dysfunction resulting from an acute increase in intra-abdominal pressure (IAP). In the absence of prompt treatment, ACS can lead to lethal organ failure. Treatment of ACS is achieved by immediate decompression of the abdominal cavity. As to how and when decompression laparotomy should be performed depends on the clinical condition of the patients. There is limited data regarding outcomes of abdominal closure techiques. The present study aimed to investigate two different temporary closure methods, the vacuum assisted closure (VAC) and Bogota bag techniques, in 40 patients who underwent decompressive laparotomy as part of the management of ACS. METHODS: The study included 40 patients who developed ACS during follow-up or following trauma and abdominal surgery. As part of the treatment for ACS, these patients underwent decompressive laparotomy at the Cukurova University Medical Faculty, General Surgery Department and followed up in the Intensive Care Unit of the same hospital. VAC and Bogota bag procedures were performed as temporary closure methods for the treatment of ACS. Patients were randomly assigned to each of the two groups according to the temporary closure method performed. Clinical, laboratory, mortality and morbidity results of the patients in both groups were compared. RESULTS: Demographic features of the patients (age, sex, body mass index, co-morbidities) were similar between the two groups. The most common reason of ACS was gastrointestinal perforation in 12 (30%) patients. Decrease in incision width was significantly faster in the VAC group than in the Bogota group. Primary closure of fascia was considered appropriate in 16.9 days in the VAC group and 20.5 days in the Bogota bag group. The decrease in abdominal pressure was similar between the two groups on days 1, 4 and 7 but appeared to be significantly lower on day 14 in the VAC group. 12 patients (30%) died during the study. Among the deceased patients, 5 (12%) were in the VAC group, whereas, 7 (17.5%) belonged to the Bogota bag group. CONCLUSION: Based on these results, it is suggested that VAC has advantages when compared to the Bogota bag as a temporary closure method in the management of abdominal compartment syndrome. © 2015 TJTES

Early propranolol treatment ameliorates endothelial dysfunction in experimental septic lung

PubMedID: 29969202Background. Recent reports have indicated an improved prognosis in sepsis with beta blocker agents; however, the underlying action mechanism is still under debate. Objectives. The aim of this study was to investigate the potential effect of propranolol on endothelial dysfunction in septic rats. Material and methods. The cecal ligation and puncture model (CLP) was used to generate sepsis. Adult male Wistar-Albino rats were divided into 4 groups: group 1 was a sham group, group 2 received sterile saline, group 3 received 10 mg/kg of propranolol 3 days before the intervention, and group 4 received 10 mg/kg of propranolol 30 min after CLP. Six rats from each group were sacrificed 24 h postoperatively. The remaining rats were followed for survival. We have also evaluated the effects on systemic inflammation, coagulation and the lung tissue with immunohistochemical and electron microscopic evaluation. Results. Serum tumor necrosis factor alpha (TNF-?) and plasminogen activator inhibitor-1 (PAI-1) levels, as well as tissue TNF-? scores were elevated in septic rats. Electron microscopic examination of the lung tissue showed endothelial dysfunction in the sepsis group. Pretreatment significantly improved survival. Moreover, pre-treatment altered serum vascular endothelial growth factor receptor-1 (VEGFR-1) levels and post-treatment reduced serum PAI-1 and VEGFR-1 levels. In both the pre- and post-treatment groups, electron microscopic examination revealed improvement of the destroyed lung endothelium and showed only mild alterations in the cytoplasmic organelles, especially in the mitochondria of the endothelial cells. Conclusions. These results suggest that the improved outcome with beta blockers in sepsis may be due to the ameliorated endothelial dysfunction. Further studies focusing on the potential effect of beta blockers on the endothelium may lead to a better understanding of sepsis. © 2019 by Wroclaw Medical University

Successful One Stage Surgical Removal of Intravenous Leiomyomatosis with On Pump Beating Heart Technique

PubMedID: 26847505An intravenous leiomyomatoma is a rare benign smooth muscle tumour originating from myometrial veins. Surgical resection is the best treatment for intracardiac extension of intravenous leiomyoma. Here we present a very rare case of intravascular and intracardiac leiomyomatosis. We successfully performed one-stage surgery to remove the leiomyomatosis with beating heart under cardiopulmonary bypass. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

Antiviral Combination Therapy with Low-Dose Hepatitis B Immunoglobulin for the Prevention of Hepatitis B Virus Recurrence in Liver Transplant Recipients: A Single-Center Experience

PubMedID: 26093739Objectives This study presents the overall long-term hepatitis B virus (HBV) recurrence rate with possible associated factors after hepatitis B immunoglobulin (HBIG) was given in combination with 4 different antiviral (lamivudine, adefovir, entecavir, and tenofovir) drugs. Patients and Methods Between September 2000 and October 2013, the medical records of 42 adult patients who underwent liver transplantation at the Cukurova University Medical Hospital for chronic liver failure or hepatocellular carcinoma (HCC) secondary to chronic HBV were reviewed retrospectively. The analyses of risk factors for recurrence were performed based on the efficacy of hepatitis B envelope antigen (HBeAg), hepatitis B core antibody (anti-HBc), HBV DNA, preoperative prophylaxis, and the presence of HCC. Posttransplantation HBV recurrence was defined as persistence of hepatitis B surface antigen (HBsAg) positivity after orthotopic liver transplantation, or the reappearance of HBsAg and HBV DNA after initial HBsAg undetectability despite prophylaxis. Results The mean follow-up of 28 patients having HBIG and lamivudine prophylaxis was 73.25 ± 37.5 months with a recurrence rate of 3.5%. The mean follow-up of 2 patients having HBIG and adefovir prophylaxis was 90 ± 46.6 months with a 50% recurrence rate. The mean follow-up of each 6 patients who received prophylaxis with entecavir and tenofovir groups were 27.5 ± 16.1 and 16.17 ± 5.3 respectively, with no posttransplantation recurrence for both groups. On univariate analysis, preoperative factors such as anti-HBc, HBV DNA, preoperative prophylaxis, and the presence of HCC did not show any correlation with recurrence. However, HBeAg showed statistical significance for recurrence. Conclusions Low-dose HBIG in combination with antiviral agents (lamivudine, entecavir, and tenofovir) is efficacious in preventing recurrence of HBV in posttransplantation patients. © 2015 Elsevier Inc. All rights reserved