Duane's retraction syndrome: its sensory features

Purpose: To investigate binocularity in Duane’s retraction syndrome (DRS) and to evaluate whether or not there is a relationship between the sensory and clinical features of the syndrome. Methods: Clinical and sensory findings of 29 patients with DRS were recorded. Binocularity was tested with the Bagolini glasses (BG), Worth four‐dot (W4D), TNO and the stereo‐fly plate of the Titmus test. Results: Twenty‐four (83%) patients showed fusion with the BG at near and 23 (79%) had fusion at distance. With the W4D, 23 (79%) patients had fusion at near and 19 (65%) had fusion at distance. Seven (24%) patients demonstrated normal stereoacuity, 15 (52%) had reduced stereoacuity and the remaining seven (24%) patients had no measurable stereoacuity. In patients without stereoacuity, amblyopia (p < 0.001), type 2 and 3 DRS (p = 0.031) and exotropia (p = 0.003) in primary position were more common than in those with reduced or with normal stereoacuity. Restriction of ocular ductions was also more severe in patients without stereoacuity than in those with reduced or normal stereoacuity (p = 0.019, p = 0.016). Patients with type 2 and 3 DRS were significantly more likely to have amblyopia (p = 0.037), large‐angle heterotropia (p = 0.005) in primary position, upshoot or downshoot (p = 0.010) than those with type 1 DRS. Conclusions: Although approximately 75% of DRS patients had fusion and measurable stereoacuity, only 25% demonstrated normal binocularity. This report provides new data on the relationship of sensory features to most of the clinical findings of this syndrome. Sensory features, as well as most clinical features of the syndrome, are better in patients with type 1 DRS.     

Tissue response to N-butyl-2-cyanoacrylate after percutaneous injection into cutaneous vascular lesions

Despite the fact that cyanoacrylates, a group of rapidly polymerizing adhesives, are used widely in general surgery, neuroradiology, otolaryngology, and plastic surgery, scientific data on histopathological changes resulting from the deposition of -butyl-2-cyanoacrylate (NBCA), a new-generation cyanoacrylate derivative, in human tissues is based largely on experimental observations in animals and sporadic postmortem studies in humans. The authors report the consecutive pathological findings of a patient who underwent surgery for facial hemangioma after percutaneous injection of NBCA for devascularization of a lesion, and underwent additional surgery 1 and 6 months after the initial operation for the removal of the residual NBCA cast from the injection site. Acute inflammatory findings after injection of NBCA and the development of a chronic granulomatous foreign body reaction support the histological findings of experimental animal studies and postmortem examinations on humans. Additionally, their findings support the proposed hypothetical sequence of events for the recanalization of cyanoacrylate-embolized vascular structures.     

Postauricular cartilage storage in rhinoplasty

In the past decade, the number of patients demanding rhinoplasty has increased, and this has increased the use of grafts. Although different materials are used as grafts, cartilage is the most popular one. In secondary rhinoplasties the need for cartilage is very frequent. The most suitable cartilage grafts are the ones extracted during primary rhinoplasty. These grafts are disposed of after the operation and in a secondary operation, grafts are obtained from a new donor site. In our department, the surplus cartilages obtained during primary rhinoplasties of the patients who are thought to be probable secondary rhinoplasty candidates are stored in a postauricular pocket after their volumes are measured and marked down. In the secondary operations the volume of the grafts are measured again and the grafts are used. We have found out that there is no significant difference between the initial and secondary volumes of lower lateral cartilages (3.6% of initial volume is lost), but the difference between the initial and secondary volumes of septal cartilages is significant (6.9% of initial volume is lost), and the stored cartilages are sufficient qualitatively and quantitatively for the secondary rhinoplasties.     

Contribution of vitamin C administration for increasing lipolysis

This experiment was designed to investigate whether addition of vitamin C to the solution used in tumescent technique of liposuction might increase lipolysis and whether increased fibrosis might improve skin retraction where liposuction did not work properly and the skin had poor retraction ability. Eighteen Sprague-Dawley rats were used in two groups. Both inguinal fat pads of rats with their vascular structures were elevated and the right inguinal fat pad was injected with 1 cc tumescent solution as a control and the left fat pad with a 1 cc vitamin C-tumescent solution. Histopathological examination showed that all fat pads injected with tumescent solution had normal adipocytes. Those injected with vitamin C-tumescent were shown to have extreme fibrosis and occasional adipocytes.     

Gluteal region morphology: the effect of the weight gain and aging

The gluteal region is an important secondary sexual character itself and it has its place in the concept of the beauty in all communities. Interestingly, as far as we know, there is not any previous study addressing gluteal region morphology in an objective way in the aesthetic surgery literature. The aim of this study was to define the changes of the gluteal region morphology with aging and weight gain. Beside body weight, a total of five distances between predetermined anatomic points in gluteal region were measured on randomly selected 115 female volunteers, with their age ranging from 17 to 48 years (mean 22.7). All the records were analyzed by a correlation matrix using computer-based SPSS 7.5 program. As women grow older, the width of the gluteal region decreases and the gluteal sulcus elongates laterally and inferiorly. Contrary to aging, with weight gain the gluteal region becomes wider as the gluteal sulcus gets shorter. Although the subject does not sound new, our study is the first, documenting the changes in morphology of the gluteal region in relation to weight gain and aging in an objective way.     

Giant cell glioblastoma manifesting as traumatic intracerebral hemorrhage--case report

A 33-year-old male presented with intracerebral hemorrhage in the left temporoparietal region after a traffic accident. Ten months later, the traumatic hemorrhage was found to originate in an underlying giant cell glioblastoma. Our case indicates that non-traumatic underlying pathologies, such as vasculopathies, coagulopathies, or tumors, should be considered in the differential diagnoses of intracerebral hemorrhage occurring in unusual locations after traumatic accidents.     

Brucellosis: a retrospective evaluation

One hundred and sixty-six presumed brucellosis patients were included in the study. These patients were classified as primary (91), relapse (18) and suspected (57) cases according to their clinical presentations, and serologic and microbiologic test results. Primary and relapse cases were evaluated retrospectively according to age, sex, residence, routes of transmission, clinical and laboratory findings, treatment regimens, duration of treatment, and relapse rates. Of the 109 primary and relapse patients, 57 were male and 52 female. The ages of the patients ranged between 16-75 (mean age 40.2). The percentages of the urban and rural residence of the patients were 41.3% and 58.7%, respectively. The most common mode of transmission was consumption of unpasteurized milk and milk products (67.9%). Malaise, fever and sweating were the most frequently observed symptoms (96.3%, 95.4%, 91.7%, respectively). The most common signs were fever (97.2%), splenomegaly (59.6%), and hepatomegaly (37.6%). The liver was the most frequently involved organ (21.1%). Almost all (99.1%) patients were serologically positive. However, the positivity rate of culture was low (15.6%). The most frequently preferred antimicrobial regimen was rifampin and doxycycline combination. The relapse rate was 8.3%. Brucellosis is still prevalent in Turkey as in many other countries in the Mediterranean basin. The clinical presentation of the disease may show regional variations. Patients with a history of occupational or nutritional contact with the bacterium and with a compatible clinical picture should be examined using appropriate diagnostic techniques before any attempt to prescribe an antimicrobial.