Giant Cervical Polyp Due to a Foreign Body in a ''Virgin''

A 17-year-old virgin who had a giant cervical polyp which had developed through a foreign body and protruded out of the hymen was evaluated; the aetiological significance of the foreign body in the formation of the cervical polyp is discussed.     

Transplantation for cystic fibrosis: outcome following early liver transplantation

BACKGROUND AND AIM: Life expectancy in patients with cystic fibrosis (CF) has recently improved due to numerous factors, including a multidisciplinary approach to their management. Prolonged survival may have led to an increasing impact of liver disease on the prognosis of CF patients. The aim of this study was to assess the role of liver transplantation in patients with CF. METHODS: The factors influencing outcome in 24 patients (15 adults and nine children) with CF who have received single liver transplantation, triple heart-lung-liver transplantation (tx) or died while being assessed for triple grafting, were analyzed. RESULTS: Median age at tx in single liver recipients (13 years) was lower than in triple graft recipients (21 years) and those who died (23 years). All patients who received single liver tx made an excellent recovery, including significant improvement of their respiratory function (mean forced vital capacity (FVC) increased from 61% before transplantation to 82% of expected, 6-9 months after tx). Four out of five patients who received triple tx died (0-2 months) after operation. On the basis of our retrospective review, we propose modifications to an existing scoring system for liver tx assessment in CF by scoring additional points for elevated white blood count, bilirubin, and impaired pulmonary function. These changes will need to be evaluated prospectively to confirm their predictive value. CONCLUSIONS: Liver transplantation is effective therapy in young patients with cystic fibrosis, portal hypertension and hepatic dysfunction, and is indicated before a critical stage of deteriorating lung function is reached. In patients with both end-stage liver and lung disease, triple tx has a poor prognosis. Pre-emptive liver tx in younger patients with CF not only has a better outcome but improves lung function.     

Rupture of a silicone gel mammary prosthesis and amyloidosis: a case report

There has been a great deal of controversy regarding the safety of silicone breast implants. Silicone gel prostheses older than 10 years have the risk of either leakage or outright rupture. The role of silicone gel in relation to connective tissue disease or amyloidosis has not been proved by current serologic, immunologic, or epidemiologic tests. In this paper, we present a case with renal amyloidosis and a history of untreated silicone implant rupture for five years.     

Leukoaraiosis in stroke patients

Pathogenesis of leukoaraiosis (LA) is not clearly understood and its significance in patients with stroke remains undetermined. In the Neurology Department of Ankara Hospital, computed tomography (CT) examination of brain was performed for various reasons in 288 patients. LA was detected in 178 patients by the use of brain CT. Patients with LA had a higher incidence of hypertension history (70.8%) when compared with the non-LA group (57.3%; p <.05). There was no statistically significant difference in terms of sex, mean age, smoking, diabetes mellitus, history of cerebrovascular disease, cardiac failure, ischemic cardiac disease between patients with and without LA. We showed that LA is related to hypertension but not related to age, diabetes mellitus, or cardiac disease in our patient population.     

Situs inversus and coronary artery disease

Situs inversus is a rare condition and there are few reports of myocardial revascularization in such patients. A 56-year-old woman with situs inversus totalis and coronary artery disease underwent successful anastomosis of the right internal mammary artery to the anterior descending coronary artery, and a saphenous vein graft to the right coronary artery.     

Factors affecting haemorrhagic transformation in middle cerebral artery infarctions.

OBJECTIVE: Haemorrhagic transformation (HT) affects treatment and prognosis in patients with acute ischaemic stroke. The factors affecting haemorrhagic transformation in infarcts due to occlusion of middle cerebral artery (MCA) stem or branch were investigated. MATERIALS AND METHODS: Of 412 patients who were followed in our clinic between January 2001 and December 2001 with acute ischaemic stroke, 86 patients with occlusion in MCA stem or branch were enrolled in this study. These patients were divided into 2 groups, those with HT (n = 35) and without HT (n = 51). Age, sex, systemic arterial hypertension, diabetes mellitus, blood glucose level in the acute period, renal and liver function tests, systolic and diastolic arterial blood pressure in the acute period, previous cerebrovascular disease, leukoaraiosis, modified Rankin Disability Score (mRDS) and stroke subtype were evaluated. RESULTS: High blood glucose level in the acute period and presence of leukoaraiosis on cranial computerized (CCT) tomography were detected as risk factors in development of HT. HT was seen more frequently in MCA stem infarction than branch infarction. mRDS were worse in the group with HT. In multivariate analysis, there were independent relationships between mean blood glucose level on admission, mRDS, presence of diabetes mellitus, and MCA stem infarction and development of haemorrhagic transformation in patients with MCA territorial infarction.     

Chondromyxoid fibroma involving the entire metacarpal: a case report

The occurrence of chondromyxoid fibroma in the hand is rare. We report a case of chondromyxoid fibroma involving the whole fourth metacarpal that was treated by curettage and cancellous bone allograft.     

Are Discrete Coronary Artery Fistulae Different from Coronary Arteriovenous Malformations?

AIM: To delineate whether coronary arteriovenous malformations have different properties than classical discrete coronary artery fistulae. METHODS: Group 1 included 17 patients with discrete coronary fistula that represents a coronary artery fistula draining into any cardiac chamber. Group 2 included six patients with coronary arteriovenous malformations representing extensive coronary artery malformation. Cardiopulmonary bypass was used in 12 of the Group 1 patients and 5 in Group 2. RESULTS: There was no operative mortality in either group. Following a hemodynamically nonsignificant residual fistulous communication, which was detected by repeat coronary angiography in Group 2; we changed our surgical technique of suture ligation on beating heart. Then we preferred pulmonary arteriotomy and sutured the orifice of coronary arteriovenous malformations from within the chamber. CONCLUSIONS: Coronary arteriovenous malformations have different morphology and also complex progression properties when compared with discrete coronary artery fistulae. Surgical repair of coronary arteriovenous malformation should be done by suturing the multiple drainage holes inside the draining chamber. Suture ligation of coronary arteriovenous malformation is difficult due to the fragile vessel.     

Anthrax in eastern Turkey, 1992-2004

We investigated animal and human anthrax cases during a 13-year period in eastern Turkey. From 1992 to 2004, a total of 464 animal and 503 human anthrax cases were detected. Most cases occurred in summer. Anthrax remains a health problem in eastern Turkey, and preventive measures should be taken.