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31.
Craniofacial surgery concepts developed originally for reconstruction may also be applied to aesthetic surgery. The facial
skeleton is an important component of appearance and may be modified using common craniofacial surgery techniques. Three representative
male patients are presented, who each desired an improvement in his appearance. The techniques used were different and combined
orthognathic and remodeling procedures. Aesthetic male facial skeletal surgery was beneficial in these selected cases. The
results were well received and without complications. Surprisingly, we have found that male skeletal aesthetic patients did
not have unrealistic expectations and were pleasant to manage pre- and postoperatively. 相似文献
32.
Stinner B Nies C Celik I Berghöfer P Rothmund M 《Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))》1999,61(2):78-81
Because of the changing legal basis for hospital reimbursement German hospitals have to classify their cases by ICD-9- and an adapted ICPM code (OPS-301) and have to give an advance calculation of the Diagnosis Related Groups (DRG) starting from January 1996. From January 1st 1996 to the 31st of December 1996 all diagnoses and therapies in a general surgery hospital were classified according to ICD-9- and ICPM (OPS-301). This coding was not computer-assisted but was controlled in a multiple step process. As a consequence 4.6% incorrect codes were found which were irrelevant for reimbursement. 7.2% misclassifications relevant for funding were detected with an obvious learning curve within the first 6 months. The calculation of the distribution of diagnoses and therapies reveals that 80 to 85% of the total spectrum in a general surgery hospital (including vascular and thoracic surgery) were covered by 200 diagnostic and therapeutic codes, respectively. This investigation confirms the need for a physician-based control system of diagnostic and therapeutic coding to minimise economic risks. 相似文献
33.
Kazancioğlu R Sever MS Yüksel-Onel D Eraksoy H Yildiz A Celik AV Kayacan SM Badur S 《Clinical transplantation》2000,14(1):61-65
BACKGROUND: Streptococcus pneumoniae, a common pathogen leading to pneumonia, is a cause of morbidity and mortality in immunosuppressed patients. Vaccination against this agent can be recommended for immunosuppressed patients, including those with chronic renal failure, nephrotic syndrome and renal transplant recipients; however, a diminished immune response and loss of protective antibodies have been observed. PATIENTS AND METHODS: In our prospective study, the efficacy and side effects of polyvalent pneumococcal vaccination were investigated in renal transplant recipients. A total of 21 patients (6 female, 15 male) with well-functioning renal allografts, who had transplant surgery at least 2 months before, were included in the study. The patients were stratified according to the immunosuppressive protocol and 8 received double, while 13 received triple, immunosuppressive agents. After obtaining basal serum samples, all cases were vaccinated with the 0.5 mL intramuscular administration of polyvalent polysaccharide pneumococcal vaccine (Pneumo 23 Pasteur Merieux, lot No: K 1131). RESULTS: Following a mean of 6 wk in all patients and also a mean of 12 wk in 12 patients, serum samples were again obtained to measure pneumococcal antibodies. Antibody titers following 6 and 12 wk of vaccination were significantly higher, as compared with basal values in all patients, except one. These titers did not show any statistically significant difference between double and triple therapies. There was no significant difference between the 12th and 6th wk postvaccination antibody titers. No systemic or local adverse effects were observed. CONCLUSION: Pneumococcal vaccination is safe and effective in patients with well-functioning renal allografts, at least in the short term. This vaccination policy may be useful for preventing invasive pneumococcal disease in immunosuppressed patients. 相似文献
34.
Bari? Mülayim Sema Mülayim Nilüfer Yigit Celik 《The European journal of contraception & reproductive health care》2006,11(1):47-49
Perforation of the uterus by an intrauterine device (IUD) is a serious complication occurring at or following 1/350 to 1/2,500 insertions. It is more common among women with 'lost' IUDs. If a woman presents with pelvic pain and a history of a 'lost' IUD, X-rays of the abdomen and of the pelvis should be ordered. We report on a 'lost' IUD that had been inserted 12 years previously. It was found in the lower anterior abdominal wall. Most probably uterine perforation had happened during a dilatation and curettage (D & C) attempted for removal of the device. Thereafter the IUD must have migrated to the abdominal wall. This case illustrates that unless it can be recovered by simple traction on the threads, a trained medical professional should be called upon for removal of the IUD. 相似文献
35.
Discriminating performance of macular ganglion cell-inner plexiform layer thicknesses at different stages of glaucoma 下载免费PDF全文
AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer (GC-IPL) parameters between all the consecutive stages of glaucoma (from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer (RNFL) parameters and optic nerve head (ONH) parameters.
METHODS: Totally 147 eyes (40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography (OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve (AUC) of the receiver operating characteristics.
RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients (P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio (AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the best GC-IPL parameters being minimum and inferotemporal (AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area (AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.
CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other (from glaucoma suspect to moderate-to-severe glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that. 相似文献
36.
Neonatal perforated appendicitis in incarcerated inguinal hernia in the differential diagnosis of testis torsion 下载免费PDF全文
Basak Erginel Feryal Gun Soysal Alaaddin Celik Tansu Salman 《Pediatrics international》2017,59(7):831-832
Appendicitis in newborns is uncommon and difficult to diagnose. Reports on neonatal appendicitis subsequent to inguinal hernia incarceration are exceptionally rare. We present the case of a 26‐day‐old infant with perforated appendicitis due to incarceration of a right inguinal hernia, mimicking right testicular torsion. 相似文献
37.
Ozlem Dural Funda Gungor Ugurlucan Cenk Yasa Ercan Bastu Hulya Eren Bahar Yuksel Serdal Celik Suleyman Engin Akhan 《Journal of pediatric and adolescent gynecology》2017,30(1):e7-e10
Background
Isolated distal vaginal agenesis is a rare anomaly and mostly becomes symptomatic after menarche. We describe an unusual presentation of this anomaly in a prepubertal girl.Case
An 11-year-old prepubertal girl presented with recurrent urinary tract infection, pyuria, and right-sided renal agenesis. The findings of perineal inspection, ultrasonography, and magnetic resonance imaging were consistent with a distal vaginal agenesis with pyometrocolpos. Discharging pyometrocolpos with dissection of the atretic portion and a pull-through vaginoplasty were performed. A cystoscopy showed no sign of a vesicovaginal or uterine fistula.Summary and Conclusion
This rare presentation of distal vaginal agenesis reminds us that congenital malformations of the female genital tract should be considered in patients with congenital anomalies of the urinary system and/or recurrent urinary tract infection, even during the prepubertal period. 相似文献38.
39.
Selim Kurtoglu Mehmet Emre Atabek Ceyhun Dizdarer Ozgur Pirgon Pinar Isguven Sevil Emek 《Pediatric diabetes》2009,10(6):401-407
Background: Insulin detemir is a basal insulin analog designed to produce a superior pharmacokinetic profile to basal formulations of human insulin. It has shown consistently improved tolerability in comparison to neutral protamine Hagedorn (NPH) insulin in adult cohorts, but there are relatively few publications involving pediatric cohorts. Methods: The efficacy and safety of insulin detemir in children with type 1 diabetes was assessed using data from the Turkish cohort of PREDICTIVE? (a large, multinational, observational) study. The children investigated were using basal–bolus therapy involving NPH insulin or insulin glargine at baseline but were switched to insulin detemir as part of routine clinical care by their physicians. Results: Twelve weeks of treatment with insulin detemir significantly reduced mean hemoglobin A1c (9.7–8.9%, p < 0.001) and mean fasting glucose [185–162 mg/dL (10.3–9 mmol/L), p < 0.01]. Fasting glucose variability was also lower after treatment with insulin detemir than previously (on either NPH or glargine, p < 0.05). The frequencies of total, major and nocturnal hypoglycemic events were significantly reduced with insulin detemir relative to baseline, with an estimated mean of 6.89 fewer events/patient/yr overall (p < 0.001) and 2.6 fewer nocturnal events/patient/yr (p < 0.01). Weight and insulin dose remained relatively unchanged. Conclusions: Twelve weeks of treatment with insulin detemir improved glycemic control and reduced hypoglycemia in children with type 1 diabetes. This improved tolerability might allow further dose titration and therefore additional improvements in glucose control. 相似文献
40.
Novel noninvasive detection method for endometriosis: research and development of scintigraphic survey on endometrial implants in rats 总被引:1,自引:0,他引:1
Hascalik S Celik O Kekilli E Elter K Karakas HM Aydin NE 《Fertility and sterility》2008,90(1):209-213
In this experimental study on endometriosis, the majority of the implants were successfully detected with technetium-(99mTc) labeled red blood cell scintigraphy. 相似文献