Coronary-Subclavian Steal Syndrome Presenting with Ventricular Tachycardia

Coronary-subclavian steal through the left internal mammary graft is a rare cause of myocardial ischemia in patients who have had a coronary bypass surgery. We report a 70-year-old man who presented with sustained monomorphic ventricular tachycardia 5 years after the surgical creation of a left internal mammary to the left anterior descending artery. Cardiac catheterization illustrated that the left subclavian artery was occluded proximally and that the distal course was visualized by retrograde filling through the left internal mammary graft. Clinical ventricular tachycardia was reproducibly induced with a single ventricular extrastimulus, and antitachycardia pacing terminated the tachycardia. Restoration of blood flow by way of a Dacron graft placed between the descending aorta and the subclavian artery resulted in the total relief of symptoms. Ventricular tachycardia could not be induced during the control electrophysiologic study after surgical revascularization

The success of extracorporeal shock wave lithotripsy at stones up to 10 mm in horseshoe kidneys

Aim of this study is to research retrospectively the effectiveness of extracorporeal shock wave lithotripsy (SWL) for horseshoe kidney according to the size of stones. SWL treatment applied on 27 kidney stones in 21 patients at a single center were examined retrospectively. Stones were classified according to their size, the number of shock waves applied and average session number. The mean age of the patients was 44 (18-70). Stone sizes were 16mm (7-40) X 10mm (5-30). Average of sessions was 2.55 (1-3) and shock number was 1643 (977- 2300). The success rate of SWL treatment at horseshoe kidney stones which were under 10 mm was 90% and for over 10 mm it was 30% (p=0.001). Success rates were detected 63%, 52% and 48%; respectively up to 0-15 mm, 0-20mm and for all stones. The SWL success rate with horseshoe kidney is similar to that in normal kidney. The success rate decreases as stone size increases. SWL is a safe and effective treatment option for horseshoe kidney stones. Especially for stones up to 10 mm, the rate of SWL's success rate is pretty high. [Med-Science 2016; 5(3.000): 767-70

Ocular Toxoplasmosis Developed After Liver Transplantation

Ocular toxoplasmosis after solid organ transplantation occurs usually within the first three months of primary infection or reactivation of latent infection. There are a few reports of ocular toxoplasmosis following liver transplantation in the literature, however, no reports were detected in the national data. In this report a 35-year-old female patient diagnosed as ocular toxoplasmosis following reactivation in the second year after liver transplantation, was presented. The case was successfully treated with trimet-hoprim/sulfamethoxazole and clindamycin. This case was presented to emphasize late presentation of toxoplasmosis in transplantation patients and to withdraw attention to the importance of serological investigations done before transplantation

The impact role of childhood traumas and life events in patients with alopecia aerate and psoriasis

© 2014, Ismail Volkan Şahiner et al.Background: Alopecia areata (AA) and psoriasis are common dermatological diseases which may be associated with psychosomatic origin. Close relationship with stressful life events has been shown both AA and psoriasis in previous studies. Dermatologic diseases which are thought to be psychosomatic origin are not examined about childhood traumas except AA. In the literature there is no study that investigates both stressful life events with childhood trauma in healthy indiviudals and dermatological diseases with psychosomatic origin such as AA and psoriasis. Objective: To determine whether stressful life events and childhood traumas play a role in AA is the first aim of this study. If it is, will this role specific for AA as a second aim? The patients with psoriasis and healthy individuals were also investigated too. Methods: Patients (range: 18-70 years of age) with a diagnosis of AA and psoriasis who admitted to Dermatology Outpatient Department of Baskent University Medical Faculty between August 2009 and July 2010 were recorded and analyzed for our study. Healthy individuals without past or present psychiatric symptoms proven by the Composite International Diagnostic Interview (CIDI) as control group were selected randomize. Forty patients with AA, 30 patients with psoriasis, and 50 healthy subjects as controls were stratified as three individual groups. The Childhood Trauma Questionnaire, the Life Events Checklist, The Beck Depression Inventory, and the Beck Anxiety Inventory and socio demographic data questionnaire were administered to the participants. Informed consent was obtained from all participants. Results: The rate of childhood traumatic events, the stressful life events, anxiety and depression scores were significantly higher in both AA and psoriasis group than healthy controls. Significant difference was not found between AA and psoriasis patients. Conclusion: Childhood traumas and stressful life events may play a role in the pathogenesis of AA. In addition, this role may also apply to other psychosomatic diseases as psoriasis. This result may let us understand the role of past and present psychological stressors in the etiology of dermatologic psychosomatic diseases. Psycho dermatologic new approaches are needed to evaluate stressful life events and childhood traumas