Efficacy of epidural steroid injection of patients with back pain dependant to lombar disc hernia; prospective, clinical study

It is aimed to evaluate of the effectiveness of the application of epidural steroid injection(ESE) in patients with lumbar disc herniation (LDH) in this study. Between November 2010- December 2011 patients applied Yahyalı State Hospital Algology Clinic withlow back pain for at least 3 months was evaluated in a prospective study. Application of the lumbar epidural steroid injection was planned for 150 patients. visual analogue scale (VAS) were used for scoring pain of patients. Besides, patients with hand-finger floor distance and the degree of straight leg raising were evaluated before and after ESE injection. Ages of patients were between 27- 65 years old, of all patients 67 were men (44,7%), 83 were women (%55,3). Before and after treatment in VAS, direct leg increase, hand- finger ground distance of patients were found to be significantly different between measurements one by one (p=0,0037, p=0,0053, p=0,0062). Epidural steroid administration can provide earlier symptomatic treatment for the patients suffering from low back pain with lumbar disc herniation who did not respond to conservative treatment

The effects of volatile anesthesia (Sevoflurane, and Desflurane), tiva of application blood cell of cytology and oxidant/antioxidant the system

YÖK Tez No: 282062Biz bu çalışmada, rutinde kullanılan volatil anestezi (desfluran, sevofluran) vepropofol kullanılarak yapılan total intravenöz anestezi yöntemlerinin kan hücresitolojisi ve oksidan/antioksidan sistem üzerine etkilerini incelemeyi amaçladık.Çalışmaya 18-50 yaş grubu, genel anestezi ile opere olacak, operasyon süresiyaklaşık olarak 1-3 saat süren ve major cerrahi operasyon geçirmeyecek, ASA I-IIolarak değerlendirilen 45 hasta dahil edildi. Hastalar üç gruba ayrıldı. İndüksiyondanhemen önce ve operasyondan sonra hastalardan venöz kan alınarak hastaların Totaloksidan ve antioksidan status, glutatyon peroksidaz düzeyleri ve kan hücre sayılarıdeğerlendirildi. Çalışmaya dahil edilen tüm hastalardan preoperatif ve postoperatifdönemde periferik kan yayması yapıldı. Histolojik olarak Giemsa yöntemi ileboyanan preperatlar ışık mikroskobunda incelenerek kan hücrelerinin morfolojilerideğerlendirildi.Sonuçta desfluran grubunda total oksidan kapasitesinin, sevofluran ve TİVAgrubunda ise total antioksidan kapasite düzeyinin postoperatif dönemde preoperatifdöneme göre anlamlı düzeyde arttığı görüldü. Tüm gruplarda glutatyon peroksidazdüzeyinde preoperatif dönem ile postoperatif dönem arasında anlamlı düzeyde birfarklılık görülmedi. Tüm gruplarda postoperatif dönemde preoperatif döneme görelökosit sayısının anlamlı düzeyde arttığı, lenfosit sayısının ise anlamlı düzeydeazaldığı görüldü. TİVA grubunda postoperatif dönemde preoperatif döneme görenötrofil, eozinofil ve bazofil sayısının anlamlı düzeyde arttığı görüldü. Periferik kanyaymalarının ışık mikroskobunda incelenmesi sonucunda preoperatif ve postoperatifdönemde anormal morfolojik yapıda kan hücresine rastlanmadı.In this study we aimed to investigate the effects of routinely used volatile anesthetics(desflurane, sevoflurane) and propofol for total intravenous anesthesia on blood cellcytology and oxidant / antioxidant system.Forty-five patients, ASA physical status I-II, ranging in age from 18 to 50 years, andscheduled to have general anesthesia for their surgical procedures (not major surgicaloperations) with approximate operation duration of 1-3 hours, were selected for thisstudy. The patients were divided into three groups. Venous blood was obtainedbefore induction and after surgery and total oxidant and antioxidant status,glutathione peroxidase, and blood cell counts were evaluated. Preoperative andpostoperative peripheral blood smear was examined in all cases. Histologicalpreparations were stained by Giemsa method and morphologies were evaluated bylight microscopy.As a result, in the postoperative period, the total oxidant capacity of desflurane groupand total antioxidant capacity of sevoflurane and TIVA group, were found to besignificantly increased when compared with preoperative period. There was nosignificant difference between preoperative period and postoperative period inrespect to Glutathione peroxidase levels in all groups. In the postoperative period,leukocyte count was significantly increased while lymphocytes were significantlydecreased in comparison with preoperative period. In TIVA group, postoperativecounts of neutrophils, eosinophils and basophils were found to be significantlyincreased than those in preoperative period. The examination of peripheral bloodsmears under a light microscope in preoperative and postoperative period revealedno abnormal blood cell morphological structure

Huntington koresi olan bir hastada epidural anestezi

Huntington koresi (HK) nadir görülen otozomal dominant geçiş gösteren sinir sistemi bozukluğudur. Semptomları hayatın 3. ve 4. dekatlarında istemsiz koreiform hareketleri, ataksi ve ilerleyici mental bozulma olarak gösterir. HK tanılı olgularda anestezi yönetimi ile ilgili sadece birkaç olgu sunumu yayınlanmıştır. Hastalar bazı intraoperatif komplikasyonlar (regürjitasyon ve pulmoner aspirasyon gibi), zayıf respiratuar fonksiyon, uzamış suksinilkolin ve tiyopental cevabı, midazolama karşı yükselmiş sensitivite, ve rijit spazmlara yol açan titremeler gibi postoperatif komplikasyonlar açısından yüksek risk altındadırlar.Tüm bunlar güvenli geri dönüş ve anestezi sırasında güvenli havayolu sağlamak için ideal anestezi yönetimi gerektirmektedir. Bildiğimiz kadarıyla, literatürlerde HKli hastalarda epidural anestezi uygulanması bulunmamaktadır. Burada, HK tanılı olgumuzda başarılı epidural anestezi deneyimimizi sunmayı amaçladık.Huntington's chorea (HC) is a rare, autosomal, dominant hereditary disorder of the nervous system. Symptoms occur in the third and fourth decade of life and manifest as involuntary choreiform movements, ataxia, and progressive mental deterioration. Only a few case reports have been published describing the anesthetic management of patients with HC. Patients are at greater risk for some intraoperative complications (e.g., regurgitation and pulmonary aspiration), poor respiratory function, prolonged response to succinylcholine and thiopental, increased sensitivity to midazolam, and postoperative shivering leading to rigid spasms. All these factors make an ideal anesthesiological management necessary for this group of patients to guarantee an absolute airway protection during all the anesthesia and a fast and safe recovery. To the best of our knowledge, epidural anesthesia in HC patients has not been reported in the literature. Herein, we present our successful experience using epidural anesthesia in a HC patient

Is standard cervical mediastinoscopy still a valuable operation?

WOS: 000305914400007Background: Mediastinoscopy is a widely used surgical procedure in the diagnosis of mediastinal disease and the staging of lung cancer. Objective: To question the feasibility of mediastinoscopy procedure at a newly established thoracic surgery center. Methods: Fifty patients who underwent mediastinoscopy at the Thoracic Surgery Clinic of Duzce University School of Medicine, between January 2009 and January 2011 were reviewed retrospectively. Results: In a majority of cases, mediastinoscopy was conducted with diagnostic purposes, and frequently, sarcoidosis and tuberculosis diagnoses were made. Among patients with malignancy who had mediastinoscopy for staging purposes, N2 or N3 were determined in half of them. In mediastinoscopy, which has a 98% success rate, 16% morbidity rate was determined, where hoarseness due to nervus laryngeus recurrens damage and pneumothorax are frequently observed. There was no mortality among patients. Conclusions: Although mediastinoscopy may cause various complications in newly established thoracic surgery centers, it is an essential surgical procedure that should be routinely applied to patients

The histopathological evaluation of mediastinal lymph node stations in sarcoidosis

WOS: 000304300200006Background: Even if the clinical and radiological findings indicate sarcoidosis, diagnosis can be established by showing histopathologically the sarcoid granulomas in the tissue. Mediastinoscopy is a surgical procedure that is commonly used to obtain histological specimens to examine for mediastinal lymph node involvement in sarcoidosis. Objective: To demonstrate which of the mediastinal lymph node stations that the biopsies were taken had the highest diagnostic value for histopathological examination in sarcoidosis. Methods: Operative and histopathology reports of 14 patients who underwent mediastinoscopy and diagnosed with sarcoidosis in the Thoracic Surgery Clinic of Duzce University School of Medicine, between January 2009 and January 2011 were reviewed retrospectively. Results: On thorax tomography images of the patients with sarcoidosis, lymph nodes of the bilateral lower paratracheal and hilar mediastinal lymph node stations were frequently enlarged to pathological dimensions. In the majority of the cases, biopsies were taken by mediastinoscopy from the bilateral lower paratracheal lymph node stations. Histopathological examination of the biopsy material showed severe noncaseating granulomatous inflammation, most commonly in the right lower paratracheal, followed by left lower paratracheal and at least common highest mediastinal lymph node stations. Conclusions: During mediastinoscopy to be performed on patients with suspected sarcoidosis, we recommend that priority be given to taking biopsies from the lower paratracheal lymph nodes and sent for frozen examination for definitive diagnosis to prevent unnecessary mediastinal dissection that might result in serious complications

Traumatic pulmonary pseudocyst: 2 case reports

WOS: 000315072900015PubMed: 23588916Traumatic pulmonary pseudocysts (TPP) are cavitary lesions that are rarely seen after blunt thoracic traumas. Two male patients who were diagnosed with cystic lesions in the left lung after trauma were followed in our clinic with the diagnosis of TPP. Due to increase in cyst dimensions and wall tension, which were seen on the follow-up thorax tomography, surgical intervention was decided for both cases. The first case underwent cystotomy and capitonnage via thoracotomy, and was discharged without any complication. However, the second case was lost due to cardiac arrest during the operative preparations. Thorax tomography is an important method in the diagnosis and radiological follow-up of TPP. The surgery option should always be remembered for patients who show progression during the follow-up

Twin pregnancy with posterior reversible encephalopathy syndrome and anesthesia management [İki?z gebede posteri?or reversi?ble ensefalopati? sendromu ve anestezi? yöneti?mi?]

Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, mental dysfunction, seizures, and visual loss and usually develops due to acutely increasing and uncontrollable arterial blood pressure. It can be diagnosed clinically and radiologically. Recently, although increasing amount of literature reveal that different kinds of patient populations have been repeatedly developing this syndrome, it has been reported to be seen mostly in pregnancy and pospartum period. Herein, we report a multiple pregnant woman with reversible encephalopathy syndrome who did not have a diagnosis of preeclampsia with clinical and neurological findings along with literature review

Primary Hydatid Cyst of the Chest Wall

WOS: 000308968400015PubMed: 22249910