Vagal Nerve Schwannoma Clinically Mimicking Gastrointestinal Stromal Tumor: Report of a Case

Introduction: Mesenchymal tumors of the gastrointestinal (GI) tract are mainly comprised of a spectrum of spindle cell tumors which include gastrointestinal stromal tumors (GISTs), leiomyomas or leiomyosarcomas, and schwannomas. As all of these tumors of the GI are located in the submucosal layer of the bowell wall, differential diagnosis is very difficult. Histopathological evaluation using immunohistochemical staining is required for the definitive diagnosis.Presentation of case: A 20-year-old female patient was presented with an upper abdominal pain and dyspepsia since 2 months duration.This case  is initially thought as GIST but finally diagnosed as vagal nerve schwannoma by histopathological evaluation after resection of the mass.Conclusion: Schwannomas should be considered in the differential diagnosis of other mesenchimal tumors, such as gastrointestinal stromal tumors and leiomyomas or leiomyosarcomas, indeed it can grow in any part of the peripheral nerves along the gastrointestinal tract. Histopathological evaluation including immunohistochemical staining is required for the definitive diagnosis

Isolated Small Bowel Transplantation in Turkey: A Single Center Experience Running Title: Isolated Small Bowel Transplantation in Turkey

Background SBTx has become a feasible therapeutic option for patients with irreversible intestinal failure. Increase in the number and in the improvement of the patient and graft survival in SBTx has a slow course when compared to other solid organ transplantation. Aim The aim of this study is to analyze 25 isolated SBTx performed since 2003 at a single center. It also aims to compare the patient and graft survivals rate during the early (before 2010) and late (after 2010) period. Materials and Methods Medical charts of 24 patients were analyzed retrospectively. To compare the center’s experience during a twelve year period, the results were divided into two groups (before (n:7) and after 2010 (n:18)). At the appropriate time, data were reported as mean± standard deviation, median, and range. Kaplan Meier method was used for the survival analysis of the graft and the patients. Results Median age of the patients was 39 (min 6 months, max: 56 yr). Six of them were in the pediatric age group. Compared to before 2010, graft survival rates increased from 28.1% to 53.8% in 3 months, from 28.6% to 35.9% in 6 months, and from 14.3% to 29.9% in one year after 2010. At the same period, patient survival rate increased from 57.1% to 72.2% in 3 months, from 28.6% to 38.9% in 6 months, and from 14.3% to 33.3% in one year. In the pediatric age group, patient and graft survival rates were 85.7% in 3 months, 71.4% in 6 months, and 71.4 % in 1 year. Conclusion SBTx is an effective treatment choice for selected patients with intestinal failure. Although patient and graft survival rates were improved after 2010 in our center, it was inferior. Patient and graft survival rates in pediatric SBTx are favourable and promising

Duodenum ülser perforasyonları cerrahi sağıtımı ve değerlendirilmesi

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.sonucu gelişen duodenal darlık nedeni ile kesin ülser ameliyatı uygulanmıştır. Tablo 9 da görüldüğü gibi PS - TV - Drenaj uygulanmış olan olgularda erken dönem mortalitesi % 6 ile diğer serilere oranla oldukça yüksektir. Burada da vakalarımızın genellikle gecikmiş dönemde başvuran, orta yaşın üzerinde ve genellikle yandaş bir hastalıkla birlikte olan olguların çoğunluğu oluşturduğunu belirtmek gerekir. Bizim çalışmamızda 10 vakaya basit kapama ile birlikte drenajsız pari- etal celi vagotomi uygulanmıştır. 1 vaka erken dönemde - duodenal ülser perfo- rasyonu ve sigmoid kolonda gangrenin birlikte bulunduğu - toksemiden ölmüştür. Çalışmamızda erken dönem sonuçlarının diğer serilere göre kötü olmasına karşın izlene döneminde yapılan kontrollarda elde edilen sonuçların diğer seri lerle paralel olması yüz güldürücüdür. Tablo 9 da görüldüğü gibi J.G.Gray ve arkadaşlarının 5 yıl izledikleri 49 vakalık PS - TV - Drenaj gurubunda Visick I ve II % 90 bulunmasına karşılık bizim çalışmamızda 5,5 yıl izlenen 96 vakalık aynı gurupta Visick I ve II % 92,7 olarak bulunmuştur. İzleme süresi 6 ay gibi henüz çok erken olmasına karşın PS - PCV uygu lanmış olan 5 vaka yapılan kontrollarda Visick I olarak değerlendirilmiştir. Yapılan kontrollarda 96 vakalık PS - TV - Drenaj gurubunda % Zk- vakada dumping, % 7 vakada diare görülmüştür. Hastalarda heriki yakınmanmda hafif şid dette oldukları saptanmıştır. P.H.Jordan ve arkadaşlarının çalışmasında % if, 5 vakada dumping, % 11 vakada hafif diare gözlenmiştir. ÖZET Perfore duodenal ülserin sağıtımmda kliniğimizde son 6 yıl içinde uygulanmış olan cerrahi sağıtım yöntemlerini - basit kapama, basit kapama-trun- kuler vagotomi-drenaj, rezeksiyon-BII, basit kapama- drenajsız parietal cell vagotomi - içeren 265 olgunun erken ve 105 olgunun geç dönem sonuçları değer lendirilmiştir. - 25

Effects of subthreshold yellow pattern laser treatment in diabetic macular edema: Optical coherence tomography angiography study

Purpose: The purpose of the study was to assess the effects of subthreshold yellow pattern laser (SYPL) treatment in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Thirty eyes of 30 diabetic patients diagnosed as naïve DME (central subfield thickness [CST] 400 µm) between October 2018 and January 2020 at Ege University Faculty of Medicine, Department of Ophthalmology were prospectively included in the study. Fovea sparing SYPL were performed to the macula. Comprehensive eye examination along with OCTA was performed at baseline, 1st month, and 3rd month of follow-up. Data during the follow-up were compared with the baseline. Results: The mean age of the patients (15 male and 15 female) was 63.7±6.7 (48–74) years. The mean diabetes duration was 17.9±5.4 (13–27) years and mean HbA1c was 6.6±0.5 (5.7–7.7) g/dL. Best-corrected visual acuity (BCVA) did not show significant change during the follow-up (p=0.698). CST measurements were 323.7±40.1 (262–393) µm, 316.8±40.9 (268–377) µm and 318.1±39.9 (226–396) µm at baseline, 1st, and 3rd month, respectively (p=0.591). On OCTA, mean vessel density (VD) in superficial capillary plexus were 44.7±4.6 (37.4–52.3), 45.6±4.7 (38.6–54.9), and 44.6±3.9 (37.5–49.8); while mean VD in deep capillary plexus (DCP) was 43.1±4.8 (36.3–52.7), 45.3±4.8 (38.9–54.2), and 42.7±3.3 (37.4–49.3) at baseline, 1st, and 3rd month, respectively (p=0.383 and p=0.291). Foveal avascular zone area did not change significantly during the follow-up (p=0.998). Conclusion: SYPL treatment in DME appears to be safe with no statistically significant difference in macular capillary perfusion, as well as no change in BCVA and CST during the 3 months of follow-up

Disseminated candidiasis developing during prophylaxis with fluconazole in a small-intestine transplant recipient

A 31-year-old man underwent immunosuppressive treatment and was treated with 150 mg per day of prophylactic oral fluconazole after receiving a small-intestine transplant. The patient had acute rejection by the end of the first week after the transplant. Endoscopic examination showed white plaques. In blood and urine cultures, growth of Candida albieans was detected. Biopsy specimens showed high levels of conidia and hyphae in all regions. Intravenous treatment with caspofungin was started for the patient. Candidal findings had regressed on follow-up endoscopy. However, the patient died 3 months after transplant because of the effects of immunosuppression on his bone marrow and the development of disseminated intravascular coagulation. Candida species are the most common cause of invasive fungal infections that develop after solid-organ transplant. Following transplant, candidemia may develop during systemic antifungal treatment with a high level of mortality. (Progress in Transplantation. 2012;22:110-112) (C) 2012 NATCO, The Organization for Transplant Professionals doi: http://dx.doi.org/10.7182/pit201232

The effect of cold ischemia time on delayed graft function and acute rejection in kidney transplantation

The objective of this study is to evaluate the impact of cold ischemia time (CIT) on delayed graft function (DGF) and acute rejection (AR) among deceased donor kidney transplant recipients. The medical records of 111 patients who underwent kidney transplantation from deceased donors between November 1994 and July 2009 were retrospectively analyzed. DGF was observed in 54% of the patients and the prevalence of AR in the first year after transplantation was 9.9%. The incidence of DGF was higher among patients with longer CIT. There was no correlation between CIT and AR episodes. Higher body weight of recipients and donors, history of prior blood transfusion and advanced donor age were related with DGF. Patients with DGF had higher serum creatinine levels at the first, third and fifth years. There was a negative correlation between recipient body weight and creatinine clearance at the first year. CIT has an important role in the development of DGF as a modifiable risk factor. Moreover, donors with advanced age and higher body weight as well as recipients with higher body weight and history of blood transfusions are at risk for the development of DGF. Prevention of DGF may help to improve graft function at the first, third and fifth years and shorten the hospital stay

THE ASSOCIATION BETWEEN INFLAMMATION MARKERS, MALNUTRITION AND QUALITY OF LIFE WITH VOLUME STATUS IN THE PRE-POST TRANSPLANT PERIOD

WOS: 00032823200153

The relation between serum testosterone levels and cardiovascular risk factors in patients with kidney transplantation

The objective of the study is to evaluate the relationship between serum testos-terone levels and cardiovascular risk factors (CVRF) in patients after kidney transplantation and with chronic kidney disease (CKD). Seventy-five male patients, aged between 18 and 68 years, who had kidney transplantation at least six months earlier, were enrolled into the study. Only renal transplant recipients and CKD patients with a creatinine level of 0.05). Serum testosterone levels were independent risk factors affecting IVC collapse index, systolic BP and LA. m-TORi and CNIs drugs might have no negative effect on serum testosterone levels, and improvement of the serum testosterone levels after transplantation might have a positive contribution on cardiac risk factors

Knowledge Attitude and Behavior in the Domain of Organ Transplantation Among Healthcare Professionals Working in a Tertiary Care Hospital and Patients Admitted to the Urology Clinic

Objective: To measure the knowledge level about organ and tissue donation and to determine the attitudes and behaviors of patients admitted to our hospital as well as healthcare professionals working in our hospital. Materials and Methods: A questionnaire designed to document knowledge attitude and behavior in the domain of organ transplantation and donation was prepared by the researchers. This survey was conducted among 298 participants including patients who were admitted to the urology clinic in our hospital between March 2015 and June their relatives as well as healthcare professionals working in our hospital. Results: 90.3% of the participants did not donate any organ previously. Only 50% of respondents knew that brain death and vegetative state were different concepts. 69.1% the participants had knowledge about organ donation. Conclusion: Public education about organ donation and transplantation and a positive attitude on this issue are very important to increase the number of organ donations

Knowledge Attitude and Behavior in the Domain of Organ Transplantation Among Healthcare Professionals Working in a Tertiary Care Hospital and Patients Admitted to the Urology Clinic

Objective: To measure the knowledge level about organ and tissue donation and to determine the attitudes and behaviors of patients admitted to our hospital as well as healthcare professionals working in our hospital. Materials and Methods: A questionnaire designed to document knowledge attitude and behavior in the domain of organ transplantation and donation was prepared by the researchers. This survey was conducted among 298 participants including patients who were admitted to the urology clinic in our hospital between March 2015 and June their relatives as well as healthcare professionals working in our hospital. Results: 90.3% of the participants did not donate any organ previously. Only 50% of respondents knew that brain death and vegetative state were different concepts. 69.1% the participants had knowledge about organ donation. Conclusion: Public education about organ donation and transplantation and a positive attitude on this issue are very important to increase the number of organ donations