The effect of high volume adrenalin solution infiltration on blood loss in reduction mammaplasty

Aim: One of the important complications during and after the reduction mammoplasty operation is blood loss. The most implemented method to decrease the amount of bleeding is adrenaline infiltration, but adrenalin is mostly infiltrated with the fluid in the volume less than 250cc in the clinic. It is expected that adrenaline will accumulate more in the tissue and thus, exhibit more bleeding-reducing effect by increasing the fluid volume used in the infiltration. In this study, it is aimed to indicate the effect of the infiltration of adrenaline with the high volume fluid, on the amount of blood loss occurring due to the reduction mammoplasty operation. Material and Method: Patients who had undergone bilateral reduction mammoplasty between July 2013 and August 2017 were retrospectively examined. Patients not subjected to infiltration were described as Group 1, patients infiltrated with adrenalin 100cc were described as Group 2, and patients infiltrated with adrenalin 500cc were described as Group 3. Results: The average decrease in the hemoglobin level (bleeding) after the operation was calculated to be 3.4 +/- 0.97 in Group 1, 2.8 +/- 0.83 in Group 2, 1.0 +/- 0.46 in Group 3 and the average amount of bleeding in Group 2 and Group 3 in comparison with Group 1 and the average amount of bleeding in Group 3 in comparison with Group 2 were statistically significantly lower (p<0.001). Discussion: The infiltration of adrenaline in the same concentration with a fluid of a higher volume decreases blood loss after the reduction mammoplasty operation

Yüksek enerjili travma nedeni ile oluşmuş ekstremite defektlerinin tedavisinde negatif basınçlı terapi kullanılması]

Aim: Defects of the extremities due to high-energy trauma are common and it is necessary to repair these defects. Reconstruction is possible with simple surgeries using skin grafts and negative pressure therapy (NPT). In this study, we present our results of the reconstruction of extremity defects caused by high-energy trauma with a simple surgical procedure using NPT. Methods: Patients with soft tissue defects of the upper and lower extremities caused by high energy trauma, who were treated with NPT between November 2009 and June 2015, were included in the study. Results: NPT was performed in 63 patients. The average defect size was 60 cm(2). The patients underwent an average of nine sessions. The average length of hospital stay was 26 days. The defects were reconstructed using skin grafts and local flaps in 58 and two patients, respectively. None of the patients required free flaps. Conclusion: Extremity defects occurring due to high energy trauma can be closed by simple surgical techniques using NPT, patients can be protected from the complications of free tissue transfer, and also treatment is possible at much lower costs

Using negative pressure therapy for improving skin graft taking on genital area defects following Fournier gangrene

Objective: Fournier's gangrene is an infective necrotizing fasciitis of the perineal, genital and perianal regions. Treatment includes aggressive surgical debridement that often results in extensive loss of genital skin. Skin grafts may be used for reconstruction but skin grafting of the male genitalia is diffucult because the penis and scrotum are mobile and deformable. A variety of methods are used to secure skin graft to recipient beds. We used negative pressure therapy (NPT) to secure skin grafts and improve skin graft taking. Material and methods: We used negative pressure therapy for graft fixation in 13 male patients who underwent debridements with the indication of Fournier gangrene, and whose defects formed were reconstructed with grafts between January 2009, and January 2014. Information about age of the patients, sessions of negative pressure therapy applied before, and after reconstruction, duration of hospital stay, and graft losses during postoperative period were recorded. Results: Median age of the patients was 56.15 (46-72) years. NPT was applied to patients for an average of 6.64 sessions (4-12) before and 1 sessions after graft reconstruction. Patients were hospitalized for an average of 26.7 (20-39) days. Any graft loss was not seen after NPT. Conclusion: Because of the peculiar anatomy of the genital region, anchoring of grafts is difficult so graft losses are often encountered. Use of NPT for ensuring graft fixation on the genital region prevents skin graft shearing

3-Diethyl­amino-6-[(Z)-(4-hy­droxy­anilino)methyl­idene]cyclo­hexa-2,4-dienone

In the mol­ecule of the title compound, C17H20N2O2, the aromatic rings are oriented at a dihedral angle of 6.23 (22)°. Intra­molecular N—H⋯O hydrogen bonding involving the amine H atom and the carbonyl O atom affects the conformation of the mol­ecule. One of the ethyl arms is disordered over two conformations, with occupancies of 0.59 (2) and 0.41 (2). The crystal packing is stabilized by inter­molecular C—H⋯O and O—H⋯O hydrogen bonds, and weak C—H⋯π inter­actions

Nonlinear robust control of tendon–driven robot manipulators

This work addresses the position tracking control problem for tendon–driven robotic mechanisms in the presence of parametric uncertainty and additive external disturbances. Specifically, a full state feedback nonlinear robust controller is proposed to tackle the link position tracking problem for tendon–driven robot manipulators with uncertain dynamical system parameters. A robust backstepping approach has been utilized to achieve uniformly ultimately bounded tracking performance despite the lack of exact knowledge of the dynamical parameters and presence of additive but bounded disturbance terms. Stability of the overall system is proven via Lyapunov based arguments. Simulation studies performed on a two link planar robot manipulator driven by a six tendon mechanism are presented to illustrate the effectiveness and viability of the proposed approach.Scientific and Technological Research Council of Turkey (112E561

Parotis bezinden kaynaklı sialolipom]

Sialolipoma which is composed of adipocyte cells and glandular tissue is a rare salivary gland tumor. Sialolipomas can be found in the major and minor salivary glands but most commonly in the parotid gland. Sixty year old male presented with a painless, buccal mass, which had been growing slowly over two year. On physical examination a soft mass was detected on parotid gland. On ultrasonography examination 4×3×2 cm sized hypoechoic mass with limited lobulated contours was detected in the right parotid gland. Lesion had been excised totally. According to microscopic examination; the diagnosis was sialolipoma. Sialolipoma is a rare variant of salivary gland tumors and it should be kept in mind for differential diagnosis of buccal masses. © 2017 by Türkiye Klinikleri

Analysis of Benign Soft Tissue Mass of Upper Extremity in Young Adult Men

Amaç: Bu çalışmada, üst ekstremitede cilt altı kitle tanısı ile askeri birliklerinden kliniğimize sevk edilen genç erişkin erkek hastalar sunulmaktadır. Gereç ve Yöntem: Aralık 2013 - Aralık 2014 arasında askeri birliklerinden üst ekstremitede kitle ön tanısı ile kliniğimize sevk edilen ve cerrahi müdahale yapılan 20-30 yaş arası erkek hastaların lezyonları histopatolojik tanı, kitle büyüklüğü ve lokalizasyon açısından incelendi. Bulgular: 77 genç erişkin erkek hastadaki toplam 77 lezyon incelendi. Lezyonların %28.6'si epidermal kist, %27.3'ü ganglion kisti, %18.2'si hemajiom, %14.3'ü lipom, %5.2'si tenosinovial dev hücreli tendon kılıfı tümörü, %3.9'u schwannom ve %2.6'sı ekstraskeletal osteokondrom olarak raporlandı. Tümörler lokalizasyonları açısından incelendiğinde lezyonların %13'ü kolda, %13'ü ön kolda, %38.9'u el ayasında ve %35.1'i parmaklarda olduğu tespit edildi. Lezyonlar boyutları bakımından incelendiğinde %49.3'ü 0-1 cm arasında, %22.1'i 1-2 cm arasında, %20.8'i 2-3 cm arasında, %7.8'i 3 cm'nin üzerinde olduğu tespit edildi. Sonuç: Üst ekstremitedeki yumuşak doku kitleleri özellikle askerlik gibi bedensel faaliyetlerin yoğun olarak yapıldığı dönemlerde semptomatik olmakta ve askerlerin hastanelere sevklerinin başlıca nedenleri arasında sayılmaktadırlar. Bu lezyonlar ekstremite distaline doğru daha fazla semptom verdileri için daha küçük boyutlarda bile semptomatik olup eksize edilmektedirler. Bu çalışmada üst ekstremitede cilt altı kitle tanısı ile askeri birliklerinden kliniğimize sevk edilen genç erişkin erkek hastalar sunulmaktadır. Gereç ve Yöntem Bu çalışmada kliniğimize 2013 Aralık- 2014 Aralık arasında askeri birliklerinden üst ekstremitede kitle ön tanısı ile sevk edilen ve cerrahi müdahale yapılan 20-30 yaş arası.Objective: Aim of this study is presenting of young adults which were referred to our clinic from their military units because of their upper extremity soft tissue masses. Materials and Methods: In this study upper extremity soft tissue masses of 20-30 years old young adults who were referred to our clinic between November 2014 and November 2015 from their military units were examined according to histopathological diagnosis, size and localization. Results: 77 lesion from 77 young adults were examined. According to histopathological determination it was reported that 28.6% of lesions were epidermoid cysts, 27.3% of lesions were ganglion cysts, 18.2% of lesions were hemangioma, 14.3% of lesions were lipoma, 5.2% of lesions were tenosynovial giant cell tumor of tendon sheath,3.9% of lesions were schwannomas and 2.6% of lesions were extraskeletal chondroma. According to location of lesions it was seen that 13% of the lesions were located in arm, 13% in forearm, 38.9% in the palmar part of the hand and 35.1% of lesions were on fingers. According to size of the lesions it was measured that 49.3% of the lesions were 0-1 cm, 22.1%; 1-2 cm, 20.8%; 2-3 cm and 7.8% were under 3 cm. Conclusions: Benign soft tissue masses of upper extremity can be symptomatic in intensive physical activity period as military service and these are common reason of referring soldiers to hospitals. These lesions are more symptomatic even in smaller sizes when they appear at the distal part of extremity and may be excised from distal part of extremity

Beneficial Effects of Quercetin on the Zone of Stasis in an Experimental Burn Model

Objective: In burn injury, the zone of stasis determines the width and depth of the necrosis. Our aim is to show the effectiveness of quercetin on the viability within the zone of stasis in burns of rats. Materials and Methods: Forty-eight rats were divided into three groups. The rats in Group 1 (control group) were only applied the comb burn model; the rats in Group 2 (post-burn group) were administered 50 mg/kg of quercetin intraperitoneally, every day after the burn procedure until euthanasia; and the rats in Group 3 (pre-burn group) were administered 50 mg/kg of quercetin intraperitoneally, every day for 7 days before and after the burn procedure until euthanasia. Results: The living tissue calculated was 85.41% (+/- 14.06) in Group 3, 40.37% (+/- 9.75) in Group 2, and 16.81% (+/- 9.4) in Group 1. The level of apoptosis was 30.0 (+/- 10.8) in Group 3, 33.8 (+/- 08.7) in Group 2, and 37.4 (+/- 11.5) in Group 1. The level of autophagy was 49.50 (+/- 8.58) in Group 3, 27.17 (+/- 5.53) in Group 2, and 21.00 (+/- 5.66) in Group 1. All the differences between the groups were statistically significant (p< 0.01). Conclusion: Quercetin reduces apoptosis and increases autophagy, thereby increasing tissue viability in the zone of stasis of burn injury.Namik Kemal University Research Center [NKUBAP.00.20.AR.15.01]The article was supported under project NKUBAP.00.20.AR.15.01 by the Namik Kemal University Research Center

Kafa travması sonrası karşı kulakta ileri derecede işitme kaybı: olgu sunumu

Hearing loss is a known outcome following head trauma. The conductive as well as sensorineural hearing loss have been demonstrated both in cases of head injury. The labyrinthine concussion is postulated to be the underlying mechanism, and it is a common finding in head traumas. There is no specific treatment for labyrinthine concussion. The diagnosis mainly relies on audiometric tests. We reported a case of labyrinthine concussion in the opposite ear of a patient who had head trauma. At 2-month of follow-up, we observed that the contralateral hearing loss of our case persisted.Kafa travması sonrasında işitme kaybı görülebildiği bilinmektedir. Kafa yaralanmaları sonrası hem iletim tipi hem de sensörinöral tip işitme kaybı meydana geldiği gösterilmiştir. Altta yatan mekanizmanın kafa travmalarında sıklıkla rastlanan labirentin konküzyon olduğu varsayılmaktadır. Labirentin konküzyonun özel bir tedavisi yoktur. Tanı esasen odyometrik testlere dayanır. Bu yazıda kafa travması sonrası karşı kulakta labirentin konküzyon nedeniyle işitme kaybı oluşmuş bir hasta sunduk. İki aylık takip sonrasında, karşı kulaktaki işitme kaybının düzelmediğini gözlemledik

The effect of intradermal administration of inactive platelet-rich plasma on flap viability in rats

Purpose: To evaluate the effect of inactive form of platelet rich plasma (PRP) on the flap viability. Methods: Thirty six rats were used. Rats were divided into six groups then 9x3 cm random pattern skin flaps were elevated from dorsum of all rats. For precluding vascularization from the base, a silicone layer was placed under the flap in groups 2(only flap+silicone), 4(saline+silicone) and 6(PRP+silicone). In groups 1(only flap), 2(only flap+silicone) nothing was done except flap surgery. In groups 3(saline) and 4(saline+silicone), saline was applied intradermally, in groups 5(PRP) and 6(PRP+silicone), inactive form of PRP which obtained from different 16 rats was applied intradermally, into certain points of flaps immediately after surgery. After 7 days flap necrosis ratio was measured in all groups. Results: Mean necrosis rate in group 5(PRP) (16.05%) was statistically significantly lower than group 1(only flap) (31,93%) and group 3(saline) (30,43%) (p < 0.001). Mean necrosis rate in group 6(PRP+silicone) (36.37%) was statistically significantly lower than group 2(only flap+silicone) (47.93%) and group 4(saline+silicone) (45.65%) (p < 0.001). Conclusion: Intradermal inactive platelet rich plasma administration decreases flap necrosis so for skin application