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1.
Increased arterial stiffness in young normotensive patients with Turner syndrome: associations with vascular biomarkers
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Özlem Keskin Ayfer Tuncer Gonul Adalioglu Bulent E. Sekerel Cansn Saçkesen Omer Kalayc 《Pediatric allergy and immunology》2006,17(6):396-407
Allergoid immunotherapy is a new form of allergen immunotherapy allowing safe administration of high allergen doses. There is limited information on the effects of allergoid immunotherapy in children with allergic rhinitis. To investigate the immunological and clinical effects of allergoid immunotherapy in children with allergic rhinitis due to grass pollen allergy. Children with allergic rhinitis were assigned to allergoid immunotherapy (n = 27) or control (n = 26, no immunotherapy) groups. Children in the immunotherapy group received seven injections of grass pollen allergoid immunotherapy before grass pollen season and continued to receive maintenance immunotherapy for 27 months. All patients were offered a pharmacotherapy regimen to be used on demand during the pollen seasons. Clinical and laboratory parameters were compared between the immunotherapy and control groups. The rhinoconjunctivitis symptom-medication score and asthma symptom score were lower in the immunotherapy group after 1 yr of maintenance immunotherapy (p < 0.01 for both). Skin test reactivity and nasal reactivity as determined by nasal provocation testing for grass pollen were significantly decreased after 1 yr of immunotherapy (p < 0.001 for both). The seasonal increase in bronchial reactivity and nasal lavage eosinophil cationic protein levels were prevented after the first year of immunotherapy (p < 0.05 for both). The seasonal increase in immunoglobulin (Ig)E decreased (p < 0.05) and grass-specific IgG, IgG(1) and IgG(4) increased significantly already at the end of the seven-injection build-up therapy (p < 0.001, for all). Interleukin (IL)-4 levels in the culture supernatants showed a steady decline from baseline at first and second year of immunotherapy (p < 0.001) but remained unchanged in the control group. Allergoid immunotherapy is an effective method in the treatment of grass pollen-induced allergic rhinitis in children and prevents the seasonal increase in bronchial hyper-reactivity. Changes in specific IgE and IgG levels and decreased IL-4 production in peripheral blood mononuclear cell culture supernatants may account for the observed clinical effects. 相似文献
5.
Hidir Esme MD Huseyin Fidan MD Ahmet Cekirdekci MD 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):137-140
Background Hydatid disease is the most severe helminthic zoonosis, with an important public health problem especially in rural areas
in Turkey. The aim of this study was to review the problems and advantages encountered in surgical treatment of 43 patients
who were ventilated with one-lung ventilation during last four years.
Methods Patients, operated with one-lung ventilation, constitute the study group. Data related to symptoms, radiographic findings,
performed surgical procedures, perioperative and postoperative morbidity, hospitalization time, and cyst recurrence were collected
from each individual's records.
Results Cystotomy and capitonnage were performed in all cases. Perioperative complications were seen in 5 patients. Four of these
5 patients had double-lumen endotracheal tube malpositioning. In one patient hypoxemia developed. The most common postoperative
complication was atelectasis. One patient had recurrent cysts. There was no perioperative or postoperative death.
Conclusions We prefer cystotomy and capitonnage because it is a fast and effective technique with limited postoperative complications.
One-lung ventilation prevents the exposure of lower lung areas from massive aspiration, which may cause acute obstruction
of airways, and contamination by cyst contents from the operative part of the lung that causes recurrent disease. One-lung
ventilation in pulmonary hydatid cyst surgery may be preferred owing to lower mortality and morbidity rates. 相似文献
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Stereological evaluation of liver volume in living donor liver transplantation using MDCT via the Cavalieri method. 总被引:4,自引:0,他引:4
Cihan Duran Bulent Aydinli Yaman Tokat Yildiray Yuzer Mecit Kantarci Metin Akgun Kamil Yalcin Polat Bünyami Unal Refik Killi S Selcuk Atamanalp 《Liver transplantation》2007,13(5):693-698
In living donor liver transplantation (LDLT), obtaining the precise volume of the graft is very important to decrease volume-related postoperative complications, especially in cases with suspected small-for size grafts. We used stereology based on the Cavalieri method (CM), a new method to measure liver graft volume, and compared the results with those obtained through intraoperative measurement (IOM) and through multidetector computed tomography (MDCT) measurement. Liver volumes estimated using the 3 methods were well-correlated with each other (r(2) = 0.94 and P < 0.001 for IOM and CM; r(2) = 0.91 and P < 0.001 for IOM and MDCT, and r(2) = 0.95 and P < 0.001 for CM and MDCT); however, they were different from each other (in descending order, 908 +/- 124 cm(2), 861 +/- 121 cm(2), and 777 +/- 168 cm(2) for MDCT, CM, and IOM, respectively). Although MDCT and CM overestimated the volumes, the results of CM were almost similar to those obtained via IOM. In conclusion, our results suggest that CM measured the liver graft volume more reliably. Thus, its use, particularly in cases with suspected small-for-size graft, may prove useful. 相似文献
8.
Tarik Zafer Nursal Bulent Erdogan Turgut Noyan Melih Cekinmez Betul Atalay Nevzat Bilgin 《Journal of clinical neuroscience》2007,14(4):344-348
OBJECTIVE: Gastric paresis in traumatic brain injury (TBI) hinders the effectiveness of enteral support in this patient group. In this study we have investigated the effect of metoclopramide on gastric emptying in TBI patients. METHOD: In this prospective, randomized, controlled, double-blind study, 19 TBI patients with Glasgow Coma Scale scores of 3-11 were included. In all patients, enteral nutrition was commenced with a nasogastric feeding tube within 48 hours of trauma. Patients were randomized into two groups. In the metoclopramide (M) group, 10 mg metoclopramide was delivered intravenously three times daily for 5 days. In the control (C) group, an equal volume of saline was administered. Besides demographics, gastric emptying according to a paracetamol absorption test at days 0 and 5, time to reach target nutritional requirements, gastric residues, intolerance to feeding, nutritional complications, and clinical outcomes were recorded for each patient. RESULTS: The gastric residue rates were 2.7+/-7.4 mL and 8.1+/-17.7 mL per 100 patient days for groups C and M respectively (p=0.408). Similarly, feeding intolerance and complication rates did not significantly differ between groups C and M, (respectively p=0.543 and 0.930). Gastric emptying parameters also were similar between the study groups. CONCLUSION: We were unable to document any advantage to using metoclopramide in TBI patients. Simple intragastric enteral feeding with close monitoring of the possible complications seems to be sufficient with acceptable morbidity rates. 相似文献
9.
Mehmet Oguz Yenidunya Mustafa Erol Demirseren Serdar Gorkem Bulent Adil Tasbas Candemir Ceran 《European journal of plastic surgery》2007,29(7):327-330
Nonunion in the forearm following a radioulnar fracture is one of the nightmares of the orthopedic surgeon. Fortunately, it
is rare. We treated a large bone defect of the forearm, using a vascularized fibular graft after excision of the unhealed
bone segment in a 10-year-old boy with neurofibromatosis. This situation followed a double fracture that had been operated
on several times using conventional methods. Following the debridement of the unhealthy tissues in the pseudoarthrotic region,
the vascularized fibula was placed on the dorsal surface of the proximal radius fragment. The distal fragment of the radius
was inserted into the fibular cavity and fixation was established with a Kirschner wire distally and with a plate proximally.
Only two screws were used to fix the plate. The peroneal artery was anastomosed with the radial artery; one of its venae comitantes
was anastomosed with the cephalic vein in an end-to-end fashion. After surgery, the elbow was immobilized at 90 degrees of
flexion with a splint for 6 weeks. One year after surgery, forearm stabilization and elbow and hand functions were very satisfactory.
However, because the distal epiphyses of the bones were destroyed following the repeated surgery and the original trauma itself,
a very prominent difference between the two forearms occurred, suggesting the need for bone lengthening in the future. By
presenting this case we would like to conclude that one can expect good bone healing with a vascularized bone transfer in
these cases when there is not enough space to place screws, but support can be provided by an external splint and K wire. 相似文献
10.
Nurzat Elmali Nevzat Elmali Irfan Esenkaya Ahmet Harma 《European Journal of Trauma》2005,31(6):586-589
Abstract Traumatic knee dislocations are relatively rare and almost always respond to closed reduction; however, a small percentage
of knee dislocations are irreducible and in these cases open reduction is frequently required. A 65-year-old man with an unreduced
posterolateral knee dislocation with laterally dislocated patella was seen 3 weeks after a motor vehicle accident. Medial
femoral condyle was found buttonholed through the medial capsule together with the medial collateral ligament and lying in
the medial joint space that allowed posterior rotary dislocation of the joint. Both cruciate ligaments and medial meniscus
were torn. There was no evidence of any vascular or nerve injury. Reduction was accomplished by removal of the capsuloligamentous
structures which were incarcerated in the trochlea and intercondylar notch and by excision of meniscal tear. Following posterior
cruciate ligament reconstruction with patellar tendon autograft, lateral patellar release, vastus medialis advancement, and
gracilis transfer were done. 相似文献