Sex-change surgery in a type 3 VWD patient

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Kanin dirofilariosis' inin pulmoner arteriotomi ile cerrahi sağaltımı-Olgu sunumu

Dirofilaria immitis köpeklerde gözlenen bir nematod olup, periferik kandan alınan örneklerin ısık mikroskobunda incelenmesiyle mikrofilerlerin gözlenmesiyle tanısı konabilir. Sunulan bu olgu 35 kg agırlıgında erkek kangal köpegiydi ve klinige kilo kaybı ve öksürük sikayetiyle getirildi. Preoperatif biyokimyasal ve idrar analizlerinde organ yetmezligine ilgili bir bulguya rastlanmadı. Hematolojik muayenede lökositozis belirlendi. Olgun parazitlerin uzaklastırılması için cerrahi girisim uygulandı. Cerrahi uygulaması sırasında EKG ve arteriyel kan basıncı monitörizasyonu femoral arter kateteri aracılıgıyla gerçeklestirildi. Genel anestezi altında 4. interkostal aralıktan sol torakotomi gerçeklestirildi. Arteria pulmonaris diseke edildi. Satinsky damar pensiyle tutulan a.pulmonaris’e iki cm uzunlugunda longitudinal ensizyon gerçeklestirildi. Damar grefti ensizyon hattına dikildi. Ortalama arteriyel kan basıncı 60 mm Hg’ya düsürüldü. Uzun Alligatör forsepsi kullanılarak 10 dakika boyunca greft içinden kör atıslar yapıldı ve olgun parazitler uzaklastırıldı. Arteria pulmonaris’e lokalize olan 8 olgun parazit uzaklastırıldı. notropik ilaç kulanılarak arteriyel kan basıncı normal seviyeye çıkarıldı. Postoperatif periyotta komplikasyon gözlenmedi. Postoparetif periyotta ivermektin (50 mcg/kg) derialtı yolla uygulandı. Altı aylık postoperatif gözlem periyodunda periferik kanda mikrofilere rastlanmadı.Dirofilaria immitis is a nematode prevalent in dogs and can be diagnosed by detecting microfilaria in blood smear samples with a light microscope. The present case is a 35 kg male Anatolian shepherd breed dog which was brought to our clinic with the complaints of weight loss and cough. In preoperative biochemical and urine analyses, no evidence of an organ deficiency was observed. Leucocytosis was present in hematological examination. Surgical intervention was used to remove the adult parasites. During the surgery, ECG and arterial blood pressure through a femoral arterial catheter was monitored. Under general anesthesia left thoracotomy was performed through the 4th intercostal space. Pulmonary artery was dissected. A 2 cm longitudinal incision was made to the pulmonary artery and then an arterial graft was inserted into the pulmonary artery through this incision site. The mean arterial blood pressure was intentionally dropped down to 60 mmHg. Using a long Alligator forceps, blind shots were performed through the graft for a period of 10 minutes to clasp and remove parasites. Eight adult parasites located in the pulmonary artery were removed. Using an inotropic drug, blood pressure was elevated up to its normal limits. No complications appeared during the postoperative period. Ivermectin (50 mcg/kg) was administered subcutaneously after surgery. During the six month post-surgery, no microfilaria was encountered in the peripheral blood

Evolution of seismic hazard maps in Turkey

Due to copyright restrictions, the access to the full text of this article is only available via subscription.A review on the historical evolution of seismic hazard maps in Turkey is followed by summarizing the important aspects of the updated national probabilistic seismic hazard maps. Comparisons with the predecessor probabilistic seismic hazard maps as well as the implications on the national design codes conclude the paper