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61.
Engin Dursun Salim Dogru Atila Gungor Hakan Cincik Ethem Poyrazoglu Taner Ozdemir 《Otolaryngology--head and neck surgery》2008,138(3):353-356
OBJECTIVE: To compare the effectiveness of paper-patch, fat, and perichondrium myringoplasty in the treatment of chronic tympanic membrane perforations smaller than 3 mm. SUBJECTS AND METHODS: This investigation included 45 patients with chronic tympanic membrane perforations smaller than 3 mm. The patients were equally divided into 3 main groups according to surgical procedures. Each group consisted of 3 subgroups, which had 1-mm, 2-mm, and 3-mm perforations. The patients underwent paper-patch, fat, or perichondrium myringoplasty via transcanal approach under local anesthesia. Healing of perforation, hearing improvement, and complications were investigated. RESULTS: Closure rates of the perforations in the paper-patch, fat, and perichondrium myringoplasty groups were 66.7%, 86.7%, and 86.7%, respectively. There were no statistically significant differences in tympanic membrane closure rates between techniques with regard to size. CONCLUSION: Three techniques were found to be feasible for tympanic membrane perforations smaller than 3 mm. 相似文献
62.
Kurukahvecioglu O Sare M Karamercan A Gunaydin B Anadol Z Tezel E 《Surgical endoscopy》2008,22(4):907-911
Background Pneumoperitoneum causes intracranial pressure elevation and blood stasis at lower extremities. This study investigates cerebral
oxygen saturation changes during laparoscopy and the effects of intermittent sequential compression (ISC) of the lower extremities
in patients during elective laparoscopic cholecystectomy.
Patients and method Sixty patients were randomly divided into two groups according to the application of ISC to the lower extremities. Group I
served as control group whereas ISC was applied to group II. Cerebral oxygen saturation, peripheral blood oxygen saturation,
heart rate, mean blood pressure, and associated changes have been recorded during the operation.
Results Peripheral blood oxygen saturation and mean blood pressure values did not change significantly after pneumoperitoneum. Cerebral
oxygen saturation levels of the group II patients were higher in than the group I patients and the difference between the
groups was statistically significant (p = 0.0001). The difference became more prominent following the 35th minute of the operation. Mean heart rate of the patients in group II was lower than the patients in group I and the difference
was also statistically significant (p = 0.0001).
Conclusion In this study, it was found that the decrease in cerebral oxygen saturation was recovered with ISC application. This simple
and reliable technique helps to restore cerebral oxygen saturation levels while increasing blood return from the lower extremities. 相似文献
63.
Osman Faruk enyüz Ebru Yeildag Haluk Emir Gonca Tekant Yüksel Yeker Pervin Bozkurt 《Journal of Hepato-Biliary-Pancreatic Surgery》2001,8(3):245-249
Bleeding from esophageal varices is an important cause of morbidity and mortality in children with portal hypertension. The
treatment protocol is planned according to the etiologic factors underlying the portal hypertension, which may be either intrahepatic
or extrahepatic. Although portasystemic venous shunt operations were common previously, they are now regarded as nonphysiologic
and are rarely used because of their unexpected results and complications. Today, in many centers, endoscopic procedures have
become the first-step treatment modality in bleeding esophageal varices. More complicated surgical procedures, such as devascularization
procedures in extrahepatic portal hypertension, and liver transplantation in patients with failing liver, should be performed
when conservative measures fail. We followed up 69 patients with portal hypertension with endoscopic sclerotherapy in our
department. Here we present a retrospective evaluation of the effect of the Sugiura operation on the prognosis of 12 children
(6 with extrahepatic and 6 with intrahepatic portal hypertension) who were not responsive to the sclerotherapy program. No
rebleeding was seen in 9 of the 12 (75%) patients after the procedure, and the mortality rate in this series was 1 of 12 (8.3%);
this patient died of hepatic failure.
Received: November 7, 2000 / Accepted: January 25, 2001 相似文献
64.
Selahattin Özmen Reha Yavuzer Osman Latifoğlu Sühan Ayhan Serhan Tuncer İlker Yazıcı Kenan Atabay 《Aesthetic plastic surgery》2001,25(6):432-435
Although, one out of every eight women has a risk of developing breast cancer, the reported incidence of breast carcinoma
detection in reduction mammaplasty materials is rather low. To our knowledge, specimen radiography, which is used for breast
biopsies has not been used for the assessment of breast reduction materials. We investigated the applicability of specimen
radiography and its potential benefits in detection of the breast pathologies, especially malignancies in reduction mammaplasty
materials. Forty patients scheduled for reduction mammaplasty operation were included. In all cases an inferior pedicle reduction
technique was preferred and the radiographs of the resected breast tissues were taken immediately. The radiographs were evaluated
for any possible pathologic appearance and all abnormal findings were marked. For the histopathologic evaluation, in addition
to the random sampling of the pathologist, any marked areas were also microscopically examined. In two cases fibrocystic changes
were found in radiographs and the same results were obtained in the histological examination. No false negative mammogram
was seen. Specimen radiography, which is applicable for breast reduction materials is an easy and cheap method and does not
cause any patient discomfort. It seems that the radiographs of reduction mammaplasty materials are useful to provide guidance
to the pathologist during tissue sampling for microscopic examination especially when large amounts of breast tissue is excised. 相似文献
65.
Goldin SB Wahi MM Farooq OS Borgman HA Carpenter HL Wiegand LR Nixon LL Paidas C Rosemurgy AS Karl RC 《The Journal of surgical research》2007,143(1):151-157
INTRODUCTION: Choosing surgery as a career is declining among U.S. medical students. The 8-wk third year surgery clerkship at our institution can be an intense learning experience, and we hypothesized that during this clerkship medical student quality-of-life would drop significantly from baseline, and that this drop would be greater among certain subgroups, such as women students not interested in pursuing a surgical career, and those who place a high value on a controllable lifestyle. METHODS: At clerkship orientation (baseline), students were asked to complete a survey that measured quality-of-life on an 84-point scale, and depression on a 40-point scale. The quality-of-life scale was composed of select questions from the Medical Outcomes Study, and the Harvard Department of Psychiatry/NDSD brief screening instrument was used to measure depression. Students were also asked the typical number of hours they slept per night. Demographics, attitude toward a controllable lifestyle, and top three specialties of interest were also gathered at baseline. On week 6 of the clerkship, students were surveyed on the same quality-of -life and depression scales, and asked average hours of sleep per night for the previous week. RESULTS: From June 2005 through December 2006, 143 of 177 (81%) students agreed to participate, and after exclusions for missing data, 137 students were included in the analysis. Sixty-nine students were women (51%), and the average age was 25.8 (sd 2.6). Mean quality-of-life at baseline was 57.0 (sd 11.3) and at week 6 was 50.4 (sd 10.1) representing a statistically significant average decline of 6.6 points (P < 0.0001). Mean depression at baseline was 14.4 (sd 3.8) and at week 6 was 15.1 (sd 3.6), representing a small but significant average decline of 0.7 points (P = 0.0155). Mean sleep at baseline was 6.3 h/night (sd 0.9) and at week 6 was 5.7 h/night (sd 1.2), representing a statistically significant average decline of 0.6 h/night (P < 0.0001). Declines were similar on all outcomes between men versus women, those who ranked surgery in their top three career choices versus those who did not, and those who ranked controllable lifestyle as "very important" versus all other categories. CONCLUSION: Quality-of-life and sleep declines and depression increases significantly in third-year medical students from orientation to week 6 of their surgery clerkship at our institution. We look forward to studying quality-of-life on other clerkships for comparison, assessing whether the magnitude of this decline in quality-of-life predicts students avoiding a future career in surgery, and testing interventions to prevent this decline in quality-of-life during the clerkship. 相似文献
66.
Nalbantoglu U Kocaoglu B Gereli A Aktas S Guven O 《The Journal of hand surgery》2007,32(10):1560-1568
PURPOSE: The purpose of this study was to evaluate the treatment of patients with Mason type III radial head fracture with and without elbow dislocation by open reduction with internal fixation, collateral ligament repair, and early mobilization. An additional purpose was to investigate whether there is any effect of elbow dislocation on the severity and functional outcome. METHODS: Twenty-five patients were treated with open reduction with internal fixation using low-profile miniplate and screws for comminuted fracture of the radial head. Eighteen fractures were Mason type III, and 7 fractures were Mason type III with elbow dislocation. There were 5 women and 20 men with a mean age of 34 years. The mean follow-up time was 27 months. Patients were reviewed for functional ability, physical examination, and radiographic assessment. RESULTS: The mean functional index in Mason type III fracture and Mason type III fracture with elbow dislocation was 87 for both groups. The mean range of motion at the elbow joint was calculated as 5 degrees extension to 136 degrees flexion for Mason type III and 7 degrees extension to 133 degrees flexion for Mason type III with elbow dislocation. The mean pronation and supination for all patients were 74 degrees and 67 degrees , respectively. CONCLUSIONS: Selected Mason III radial head fractures and fracture dislocations could be stabilized satisfactorily with internal fixation. Meticulous surgical technique, combined with rigid internal fixation, can allow early motion of the forearm and elbow after fixation of Mason type III radial head fractures with and without elbow dislocation and ligamentous injury. We believe there is still a role for prosthetic replacement in comminuted Mason III radial head fractures that cannot reliably be treated with open reduction and internal fixation. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II. 相似文献
67.
Sahin DA Haliloglu B Sahin FK Akbulut G Fidan H Koken G Buyukbas S Aktepe F Arikan Y Dilek ON 《Journal of laparoendoscopic & advanced surgical techniques. Part A》2007,17(6):723-729
BACKGROUND: The pneumoperitoneum (Pp) is associated with ischemia and reperfusion (I/R) injury and oxidative stress. Various ischemic-preconditioning (IP) methods were used to reduce ischemic injury in intra-abdominal organs. In this experimental, randomized, controlled trial with a blind assessment of the outcome, we evaluated the effects of a new IP method, stepwise rising CO(2) insufflation, on oxidative stress and inflammatory cytokine response. METHODS: Twenty-one rats were divided into three groups. Rats in the control group were subjected to general anesthesia for only 60 minutes. The stepwise group was subjected to 5 mm Hg for 10 minutes, 10 mm Hg for 10 minutes, and 15 mm Hg of CO(2) insufflation for 60 minutes without deflation. In the Pp15 group, the pressure of CO(2) insufflation was fixed at 15 mm Hg for 60 minutes without deflation. Liver and blood samples were examined to determine malondialdehyde (MDA), the antioxidant, superoxide dismutase (SOD), and inflammatory cytokine (tumor necrosis factor-alpha [TNF-alpha], interleukin-6 [IL-6]) levels. Histopathologic scores of liver tissue were examined in all groups. RESULTS: The highest plasma and liver MDA, TNF-alpha, and IL-6 values were in the Pp15 group, followed by the stepwise and control groups. However, plasma and liver SOD levels determined in the control group were significantly higher, compared to stepwise and Pp15 groups. The lowest plasma and liver levels of SOD were in the Pp15 group, followed by the stepwise and control groups. Significantly higher histopathologic scores were found in the Pp15 group, followed by the stepwise and control groups, as well as MDA and inflammatory cytokine (TNF-alpha, IL-6) levels. CONCLUSIONS: We concluded that the stepwise rising CO(2) insufflation method may be an alternative IP method that may lead to a reduction in I/R injury. 相似文献
68.
A. Altunoglu D. Yavuz M. Batur Canoz R. Yavuz Latife A. Karakaş N. Bayraktar T. Colak S. Sezer F. Nurhan Ozdemir M. Haberal 《Transplantation proceedings》2014
Background
Patients with end-stage renal disease (ESRD) experience female sexual dysfunction (FSD). The purpose of this study was to compare FSD in different types of renal replacement therapy and control patients.Methods
The study was consisted of 47 renal transplantation (RT), 46 hemodialysis (HD), and 28 continuous ambulatory peritoneal dialysis (CAPD) patients and 36 healthy control subjects. All groups were evaluated with the following scales: Female Sexual Function Index (FSFI) questionnaire, Short Form (SF)–36 questionnaires, and Beck Depression Inventory (BDI). Demographic data, laboratory values, and hormone levels were obtained. The patients with FSFI score <26.55 were accepted as experiencing sexual dysfunction.Results
Overall, total FSFI scores in RT, HD, CAPD, and control were 22 (range, 2–35), 22.4 (4–34), 18.35 (2–34), and 29.6 (2–35), respectively. The mean total FSFI score was not different in patients receiving different kinds of renal replacement therapy (P > .05) although they were significantly worse then the control group (P < .001). On regression analysis, age was significantly associated with FSD (β = −0.14; P = .001). In addition, the physiologic health domain of SF-36 was significantly better in control groups (P < .001). The difference in terms of mean of BDI score did not reach statistical significance among patient groups (P > .05). Female sexual dysfunction score was negatively correlated with BDI (r = −0.371; P < .001) and positively correlated with the mental-physical components score of SF-36 (r = 0.423 [P < .001] and r = 0.494 [P < .001], respectively) in all patients groups. Regarding the hormones of the patients, there was a significant difference between RT and the HD and CAPD groups in dihydroepiandrosterone sulfate (DHEAS; P < .001), RT and HD in prolactin (P < .001), and RT and CAPD in free testesterone (P < .001).Conclusions
Renal transplantation, hemodialysis, and peritoneal dialysis patients were at more risk of developing sexual dysfunction and lower quality of life scores than healthy subjects. Notably, the mode of renal replacement therapy had no impact on female sexual function. 相似文献69.
Ozan Ozkaya Hulya Nalcacioglu Demet Tekcan Gurkan Genc Bilge Can Meydan B. Handan Ozdemir M. Kemal Baysal Hasan Tahsin Keceligil 《Pediatric nephrology (Berlin, Germany)》2014,29(7):1283-1287
Background
Dense deposit disease (DDD) (also known as membranoproliferative glomerulonephritis type II) in childhood is a rare glomerulonephritis with frequent progression to end-stage renal disease (ESRD) and a high recurrence after kidney transplantation. The pathophysiologic basis of DDD is associated with the uncontrolled systemic activation of the alternative pathway (AP) of the complement cascade.Case-diagnosis/treatment
A 14-year-old girl presented with edema and nephrotic range proteinuria. Blood tests showed hypoalbuminemia, nephrotic range proteinuria, normal renal function, and a low C3 level. Renal biopsy confirmed the diagnosis of crescentic DDD. Complement analysis revealed strong AP activation (low C3), positive C3 nephritic factor (C3NeF), and a decreased complement factor H (CFH) levels with CFH polymorphisms. Therapy with eculizumab was considered after the failure of corticosteroid and plasmapheresis to modulate the ongoing massive proteinuria and persistence of low serum C3 levels. There was a marked clinical and biochemical response following the administration of eculizumab.Conclusions
Our case emphasizes the efficacy of eculizumab in the management of crescentic DDD in a patient with a normal renal function, in a short follow-up period. Considering previously reported cases, it appears that eculizumab represents a promising new approach which may prevent progression to ESRD in a subset of patients with DDD. 相似文献70.
Huseyin Bozbas Ilyas Atar Aylin Yildirir Aliseydi Ozgul Murathan Uyar Nurhan Ozdemir 《Renal failure》2013,35(3):331-339
Background. Sudden death is common in end-stage renal disease (ESRD). Cardiac arrhythmia is observed frequently in patients with ESRD and is thought to be responsible for this high rate of sudden death. This study investigated the prevalence and the predictors of arrhythmia in patients on maintenance dialysis. Methods. Ninety-four patients on hemodialysis program were enrolled in the study. Routine laboratory results were noted. Arrhythmia, periods of silent ischemia, and heart-rate variability analyses were obtained from 24-hour Holter monitor recordings. Corrected QT (QTc) dispersion was calculated from 12-lead surface EKG. Echocardiographic and tissue Doppler examinations were performed on interdialytic days as well. Ventricular arrhythmia was classified according to Lown classification; classes 3 and above were accepted as complex ventricular arrhythmia (CVA). Results. The mean age was 52.5±13.2 years; 44 (46.8%) were women. Ventricular premature contractions were detected in 80 (85.1%) patients, of whom 35 (37.2%) were classified as complex ventricular arrhythmia (CVA). Coronary artery disease, hypertension, and QTc dispersion appeared as independent factors predictive of CVA development. Atrial premature contractions (APC) were detected in 53 patients (56.4%) and supraventricular arrhythmia in 15 (16%) patients; all were identified as atrial fibrillation. Duration of dialysis therapy was found as an independent predictor of APC. Conclusion. Arrhythmia is frequently observed in ESRD patients receiving hemodialysis and may be responsible for the high rate of sudden mortality. Hypertension, CAD, and QTc dispersion are independent predictors of CVA, and duration of dialysis therapy is an independent factor affecting APC development in these patients. 相似文献