SURGICAL MANAGEMENT OF TEMPOROMANDIBULAR JOINT ANKYLOSIS: INITIAL EXPERIENCES

Objective: The aim of this study is to introduce our initial clinical experience in the operative management of temporomandibular joint (TMJ) ankylosis. Study design: This retrospective study assessed 8 patients with TMJ ankylosis who underwent different surgical procedures. Gap arthroplasty with temporalis muscle and fascia flap repositioning was performed in 6 patients, transport distraction osteogenesis was performed to form a neocondyle in one patient and TMJ prosthesis was replaced in one patient. Patients were followed weekly at first month and at months 3rd, 6th, 12th, and 24th postoperatively. Patients were evaluated in terms of maximum interincisal opening and occlusal stability in each appointment. Results: Mean preoperative Maximum interincisal opening (MIO) of 11 mm (2-14 mm) was improved to 31mm (26-35 mm). All patients had satisfactory mandibular motions 2 years after the operation and reankylosis was not observed in patients. Conclusion: Radiological and clinical evaluation should be carefully performed to avoid possible intraoperative and postoperative complications in the management of TMJ ankylosis. Consistent with the literature, it was observed that temporalis musculofascial flap repositioning is successful to avoid reankylosi

EFFECTS OF ERYTHROPOIETIN ON THE SERUM AND LIVER TISSUE LEVELS OF COPPER AND ZINC IN RATS WITH OBSTRUCTIVE JAUNDICE EFEKTI ERITROPOETINA NA NIVOE BAKRA I CINKA U SERUMU I TKIVIMA JETRE KOD PACOVA SA OPSTRUKTIVNOM @UTICOM

Summary Background: Erythropoietin is an anti-apoptotic, anti-inflammatory, angiogenetic cytokine and has protective properties against oxidative stress. In this study we investigated the effects of erythropoietin on the le vels (serum and liver tissue) of copper and zinc in cholestatic rats. Methods: Thirty-two Wistar albino rats used in the study were divided into four groups -Group I: Sham; Group II: Erythropoietin; Group III: Obstruc tive Jaundice; Group IV: Obstructive Jaundice+Erythro poietin. After the first operation, rats were followed up for seven days and then operated for the second time. Rats were sacrificed by intracardiac blood taking, and the liver tissue samples were obtained immediately. Results: Erythropoietin reduces copper, and increases zinc levels in serum and liver tissues after obstructive jaundice (p<0.05). Furthermore, it has been shown that the levels of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, alkaline phosphatase and total bilirubin/direct bilirubin were significantly lower in Obstructive Jaundice+Erythropoietin group than Obstructive Jaundice group. Conclusions: Erythropoietin affects the changes in copper and zinc levels, thus decrea sing the liver damage biochemically in rats with obstructive jaundice. However, further investigations are needed to discover how erythropoietin therapy might reduce target organ damage in cholestatic liver cases by affecting copper and zinc levels

Endoscopic pilonidal sinus treatment (EPSIT) versus sinus laser therapy (SiLaT) for sacrococcygeal pilonidal sinus

Introduction: New surgical treatment methods are being investigated in sacrococcygeal pilonidal sinus disease. Minimal invasive methods such as endoscopic pilonidal sinus treatment (EPSIT) and sinus laser therapy (SiLaT) have promising results and advantages of laparoscopic surgery. Aim: To compare the efficiency and safety of EPSIT with SiLaT. Material and methods: Seventy-three patients with pilonidal sinus who had undergone EPSIT or SiLaT within 2 years were evaluated retrospectively. Data of patients’ demographics, complications and postoperative course were collected and compared between the two groups. Results: We analyzed seventy-three patients who underwent EPSIT or SiLaT, with a mean age of 23.4 ±8.4 (12–46) years and body mass index (BMI) of 25.5 ±4.5 (18–38) kg/m2. Among them, 36 patients (26 males, ten females) underwent EPSIT and 37 patients (27 males, ten females) underwent SiLaT. Mean operative time was similar for both groups (32.3 ±14.8 vs. 31.0 ±14.8; p = 0.757). Early complications (minimal bleeding) were recorded in 2 patients in the SiLaT group. The duration of analgesic use was significantly lower in the EPSIT group compared to the SiLaT group (1.3 ±0.5 (1–3) vs. 1.9 ±1.1 (1–5); p = 0.005). The mean postoperative time of total wound healing was similar for both groups: 23.6 ±14.7 (12–90) vs. 25.2 ±14.5 (14–90) days (p = 0.385). There was no significant difference in the average time of return to total daily activity (3.4 ±0.9 (2–5) vs. 3.6 ±1.2 (2–7) days, p = 0.679). There were no significant differences between the groups regarding late postoperative complications (recurrence: 7). Conclusions: Both methods have similar early and late complications. The duration of need for analgesic usage was shorter in EPSIT patients

Prevalence and characteristics of supernumerary teeth in east-northern Turkish population

<p><strong>Objectives:</strong> The aim of the present study was to determine the frequency and the distribution of supernumerary teeth (ST) in patients from east-northern Turkey.</p> <p><strong>Materials and Methods:</strong> A retrospective study was performed using panoramic radiographs of 1876 patients [673 females (mean age: 13.05±2.79 years) and 1203 males (mean age: 13.63±3.18 years)] ranging in age from 7 to 34 years (mean age: 13.39±3.05 years). Demographic variables including age and sex, the type, number, eruption status of the ST were recorded. In addition, associated pathologies or complications (displacement, eruption failure, resorption of adjacent tooth, and cyst formation) caused by ST were also recorded. The Pearson chi-squared test was used to determine potential differences between genders.</p> <p><strong>Results:</strong> ST were detected in 15 patients (0.75 %). The frequency of males and females with ST was 1.16 % and 0.49 %, respectively (P= 0.944). The most commonly observed ST was premolar (33.33%) followed by mesiodens (26.67%), distomolar (20.0%), lateral (13.33%), paramolar (6.67%), respectively. Most of the ST were found to be unilateral, impacted, and in the maxilla. Complications associated with ST were observed in 20.0% of the patients with ST.</p> <strong>Conclusions: </strong>The frequency of ST in east-northern Turkish general population was found to be 0.75% with no gender difference (p>0.05). The most commonly observed ST was premolar followed by mesiodens

Anatomical variations of donor portal vein in right lobe living donor liver transplantation: the safe use of variant portal veins

WOS: 000330176700007PubMed ID: 24252057In right lobe (RL) living donor liver transplantation (LDLT), portal vein (PV) variations are of immense clinical significance. In this study, we describe in detail our PV reconstruction techniques in RL grafts with variant PV anatomy and evaluate the impact of accompanying biliary variations on the recipient outcomes. In a total of 386 RL LDLTs performed between July 2004 and July 2012, the clinical data on 52 (13%) transplants using RL grafts with variant PV anatomy were retrospectively analyzed. Portal vein anatomy was classified as type 2 in 20 patients, type 3 in 24 patients, and type 4 in eight patients. The PV reconstruction techniques utilized included back-wall plasty (n = 21), back-wall plasty with saphenous vein graft interposition (n = 6), saphenous vein graft interposition (n = 5), cryopreserved iliac vein Y-graft interposition (n = 6), and quiltplasty (n = 3). There was no donor mortality. In a median follow-up of 29 months, none of the recipients had vascular complications. Anomalous PV anatomy was associated with a high (54%) incidence of biliary variations; however, these variations did not result in increased biliary complication rate. Overall, the 1- and 3-year patient survival rates of recipients were 91% and 81%, respectively. Vascular and biliary variations in RL grafts render LDLT technically more challenging. By employing appropriate reconstruction techniques, it is possible to successfully use RL grafts with PV variations without endangering recipient and donor safety

Abdominal and perineal approaches in the surgical treatment of rectal prolapse

Introduction: Rectal prolapse is a disease, which is an important cause of social and functional problems and has a continuing debate about the ideal surgical treatment of itself. In this study, we aimed to investigate the abdominal and perineal approaches with early and late postoperative result in the patients undergoing surgery for rectal prolapse.Materials and methods: Between 2006-2011, the records of 21 patients undergoing surgery with the diagnosis of rectal prolapse were reviewed, retrospectively. The demographic and physical examination findings, surgical procedures, early and late postoperative complications, recurrence and mortality rates were recorded.Results: The median age was 43 years and female/male ratio was 1.63/1. The most common presenting complaint was gas control failure and often wetting with mucus. Stage 1 and stage 3 rectal prolapses was detected in 19% and 81% of the patients, respectively. The most common surgical procedure was Notaras (54%). Early postoperative complications were seen in 14.3% of the patients. There were no postoperative recurrence, mortality and complication requiring re-exploration. Advanced age and shorter duration of hospital stay were determined and often performed under regional anesthesia in the patients undergoing perineal approach. No statistical differences were observed in terms of early postoperative complications and recurrence.Conclusion: Results of abdominal and perineal approaches were similar, when they were applied with taking into account the risk factors for surgical treatment, findings of the patients and the surgeon’s experience

Living donor liver transplantation for obese patients: Challenges and outcomes

Living donor liver transplantation (LDLT) is an accepted option for end-stage liver disease, particularly in countries in which there are organ shortages. However, little is known about LDLT for obese patients. We sought to determine the effects of obesity on pretransplant living donor selection for obese recipients and their outcomes. On the basis of body mass index (BMI) values, 148 patients were classified as normal weight (N), 148 were classified as overweight (OW), and 74 were classified as obese (O). O recipients had significantly greater BMI values (32.1 +/- 1.6 versus 23.2 +/- 1.9 kg/m(2), P Living donor liver transplantation (LDLT) is an accepted option for end-stage liver disease, particularly in countries in which there are organ shortages. However, little is known about LDLT for obese patients. We sought to determine the effects of obesity on pretransplant living donor selection for obese recipients and their outcomes. On the basis of body mass index (BMI) values, 148 patients were classified as normal weight (N), 148 were classified as overweight (OW), and 74 were classified as obese (O). O recipients had significantly greater BMI values (32.1&thinsp;&plusmn;&thinsp;1.6 versus 23.2&thinsp;&plusmn;&thinsp;1.9 kg/m2, P&thinsp;&lt;&thinsp;0.001) and received larger actual grafts (918.9&thinsp;&plusmn;&thinsp;173 versus 839.4&thinsp;&plusmn;&thinsp;162 g, P&thinsp;=&thinsp;0.002) than recipients with normal BMI values. Donors who donated to O recipients had a greater mean BMI (26.3&thinsp;&plusmn;&thinsp;3.8 kg/m2) than those who donated to N recipients (24.4&thinsp;&plusmn;&thinsp;3.2 kg/m2, P&thinsp; =&thinsp;0.001). Although O recipients were more likely to face some challenges in finding a suitable living donor, there were no differences in graft survival [hazard ratio (HR)&thinsp;=&thinsp;0.955, 95% confidence interval (CI)&thinsp;=&thinsp;0.474-1.924, P&thinsp;=&thinsp;0.90] or recipient survival (HR&thinsp;=&thinsp;0.90, 95% CI&thinsp;=&thinsp;0.56-1.5, P&thinsp; =&thinsp;0.67) between the 3 groups according to an adjusted Cox proportional hazards model. There were no significant differences in posttransplant complication rates between the 3 recipient groups or in the morbidity rates for the donors who donated to O recipients versus the donors who donated to OW and N recipients (P&thinsp;=&thinsp;0.26). Therefore, we recommend that obese patients undergo pretransplant evaluations. If they are adequately evaluated and selected, they should be considered for LDLT. Liver Transpl 20:311-322, 2014. &copy; 2013 AASLD.</p