Giant gastrointestinal stromal tumor of the esophagus presenting with dyspnea.
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Adult↗
Biomedical subjects
Levent Yildiz
Publications and source records attributed to Levent Yildiz.
End-to-end microvascular anastomosis in the rat carotid artery using continuous horizontal mattress sutures.
This paper reports a continuous horizontal mattress suture technique with advantages such as decreased time for anastomosis, minimized anastomotic leakage, eversion around the vessel edges, and other advantages which the continuous anastomosis technique has. This technique was compared with the classical interrupted and classical continuous suture techniques on a total of 59 Sprague-Dawley rat common carotid arteries: Group 1 (n = 19), interrupted suture technique; Group 2 (n = 20), standard continuous technique, and Group 3 (n = 20), continuous horizontal mattress technique. Early (30 min) and late (21 days) patency rates, anastomosis time, leakage on clamp release, oozing duration, additional sutures needed, and total number of sutures placed were statistically compared between groups. Specimens were taken at the 21st day randomly, and light microscopy (LM), scanning electron microscopy (SEM), and angiographic studies were performed. Results revealed that the continuous mattress suture technique has the advantages of providing a water-tight anastomosis with less suture materials in a shorter time, and minimal intraluminal suture material which can incite thrombosis. On the other hand, a tendency to anastomotic stricture was found to be the sole disadvantage of this technique.
Anastomosis, Surgical↗
A new technique for microvascular anastomosis: eversion with 3 horizontal mattress sutures.
In our experimental study of a new microvascular anastomosis technique, we divided 30 Wistar albino rats into 2 groups. We performed the classic interrupted suture anastomosis technique in group 1 (n = 15) and our new technique, using 3 horizontal mattress sutures, in group 2 (n = 15). We checked patency immediately following anastomosis, at the end of the first hour, and at the end of the third week postanastomosis. While the patency rates for both techniques were 100% at the end of the first hour, the respective values were 100% and 93.4% by the end of the third week. Using light microscopy, lumen patency, intimal and medial damage, inflammation, and granulation were evaluated histopathologically. The mean anastomosis time for the experimental group (15 minutes) was shorter than that for the classic group (mean 21 minutes), and the difference was statistically significant (P < 0.01), while the difference between the patency rates was not significant (P = 0.05). Therefore, provided that the incisions are made correctly, our microvascular anastomosis technique using 3 horizontal mattress sutures can be used in experimental and clinical studies.
Anastomosis, Surgical↗
A hemodynamic study of the effects of arterial anastomoses with interrupted simple versus horizontal mattress sutures on rat epigastric flap perfusion.
The effects of interrupted simple versus horizontal mattress sutures and of the internal diameter of the arterial pedicle at the level of the anastomosis on rat epigastric flap perfusion were investigated. In the first group, a microclip was applied to the femoral artery for 30 minutes. In the second group, the artery was cut, and a classic 7- to 8-suture microarterial end-to-end anastomosis was performed. In the third group, the artery was cut, and a microarterial end-to-end anastomosis with 3 horizontal mattress sutures at 120-degree intervals was performed. Perfusion was measured using a laser Doppler flowmeter (Periflux 2B, Perimed, Sweden) at 3 zones of the flap at 30 and 60 minutes and at 21 days after the procedure. Internal vascular diameters were measured histopathologically. Perfusion was better in the control group than in the experimental groups. However, the internal vascular diameters were greater with the classic method than with the new method, and the perfusion did not differ statistically in the anastomosis groups. In conclusion, even when significant narrowing develops at the anastomosis, flap viability is not affected.
Anastomosis, Surgical↗
Renal amyloidosis due to pulmonary tuberculosis in a patient with Down syndrome.
A pulmonary-tuberculosis-related renal amyloidosis patient with Down syndrome, who presented with nephrotic syndrome, was studied.
Adolescent↗
The prevalence of coeliac disease as detected by screening in children with iron deficiency anaemia.
AIM: Iron deficiency anaemia is a frequent finding seen in coeliac disease, which can be diagnosed alone or with other findings. In this study, our aim was to determine the prevalence of coeliac disease in children with iron deficiency anaemia without significant gastrointestinal symptoms. METHODS: There were 135 children with iron deficiency anaemia in the patient group (group 1), and 223 healthy children without iron deficiency anaemia in the control group (group 2) in this study. Antiendomysial antibody (EMA) IgA test was given to both groups. Antiendomysial antibody-positive patients underwent small intestine biopsy. RESULTS: The mean age was 7.2+/-4.6 (2-16) y in the patient group (group 1) and 8.2+/-3.8 (2-16) y in the control group (group 2), and no significant difference between the two groups was detected. In terms of gender, there was a significant difference between groups 1 and 2 (M/F: 74/61 and 98/125, respectively) ( p<0.05). EMA was positive in six cases in group 1 (4.4%), and villous atrophy and/or inflammation in the lamina propria with increased intraepithelial lymphocytes was seen on small intestine biopsy in these patients. In the control group, EMA was negative in all children. In detailed histories of patients with coeliac disease diagnosis, recurrent iron deficiency anaemia/pica was found in four patients (66.7%) and occasionally foul-smelling or watery stool attacks were seen in four patients (66.7%). Three of these six patients (50%) had short stature. CONCLUSION: The prevalence of coeliac disease was high in patients with iron deficiency anaemia; therefore, gastrointestinal findings should be further examined for coeliac disease, and the possibility of coeliac disease should be investigated in patients with recurrent iron deficiency anaemia and short stature.
Adolescent↗
Pulmonary actinomycosis mimicking chest wall tumor in a child.
Actinomycosis is an uncommon disease in children and most cases are cervicofacial infections. To date, there have been only a few reports on children with chest wall involvement due to actinomycosis. Here we report a 9-year-old girl with a mass lesion in the chest wall mimicking Ewing's sarcoma of the rib. Thoracic actinomycosis without typical features of the disease is often evaluated with the suspicion of neoplasia. This rare entity should be considered in the differential diagnosis of mass lesions of the chest wall in children. The disease responds well to penicillin treatment.
Actinomyces↗
Effects of splenohepatopexy and omentopexy in experimentally induced infrahepatic portal hypertension in rats.
The purpose of this study was to determine whether splenohepatopexy (SHP) or omental transposition (OP) could reverse the portal hypertension (PH) induced by portal vein ligation (PVL). Fifty-eight Wistar rats divided into four groups: in group A (22 rats) PH was produced by calibrated PVL. In group B (8 rats), SHP was performed. Group C animals (13 rats) underwent SHP and PVL. In group D (15 rats) both PVL and OP were done. In all of the rats, the portal pressures (PP) were measured before and after the production of PVL. For SHP, small areas on the spleen and liver capsula were stripped off, and these two areas were placed together. In group D, an omentum patch was tied on the prepared liver surface. Twelve weeks after surgery, the PP were measured again and portal angiography was done. The liver, omentum and spleen were histopathologically examined. In all of the groups, the PP after PVL were significantly higher than before PVL. Twelve weeks after surgery, the PP of SHP and OP groups were significantly lower than those with PVL alone. Angiographic study showed many collaterals between transposed tissue and liver. Histopathologically, the collaterals of animals with SHP or OP were found to be well developed to allow sufficient flow for PP reduction. Both SHP and OP may reverse the increased PP in PVL model of PH. In the future; these methods may be alternative techniques for PP reduction in human beings as well.
Animals↗
Use of longitudinal invaginating matrix sutures in microarterial sleeve anastomoses.
A different approach to end in end anastomosis was tested to minimise the undesirable traits of classic and sleeve (telescoping) methods. Our approach aimed to maintain full contact at the level of the anastomosis by using longitudinal matrix sutures as a new invaginating suture technique in microarterial sleeve anastomosis. Classic end-to-end anastomosis with seven to eight stitches, Lauritzen's end-in-end anastomosis with four stitches, and our modified end-in-end anastomosis with two horizontal matrix sutures were made in 10, 20, and 25 rat femoral arteries, respectively. Nine, 17, and 18, respectively were patent at early evaluation; and eight, 13, and 14 at the time of late evaluation. There was no significant difference in between the patency rates of the groups. Histopathological examination showed large strictures and the formation of intra-luminal organised thrombus with thin intramural fibrin precipitation in occluded specimens. The longitudinal matrix sutures in the sleeve anastomoses, which passed through all layers of the vascular wall, injured the intima (a vertical rupture) and constricted the lumen.
Anastomosis, Surgical↗
Coexistence of HLA-B*08 and HLA-B*18 in four siblings with Lichen sclerosus.
BACKGROUND: Lichen sclerosus (LS), is characterized by localized patches of atrophy and whitening of the skin. The cause of LS remains unknown, but genetic, hormonal, immunologic factors and autoimmune mechanisms have been incriminated. There are conflicting data regarding the association between LS and human leukocyte antigens (HLA). METHODS: We have analyzed the HLA alleles of a family, in which 4 of 5 children have lichen sclerosus. RESULTS: HLA-B*08 and HLA-B*18 alleles were detected in children with LS, but not in a healthy sister. None of the patients had autoimmune disease. CONCLUSION: In our opinion, coexistence of these two alleles may play a role in the development of LS.
Adolescent↗
Granulomatous glossitis: a case report.
A 50-year-old man was admitted to our clinic with a complaint of lingual enlargement. Detection of non-caseous epithelioid granuloma on histopathological examination led to a diagnosis of a granulomatous glossitis. Extensive investigation for the presence of associated disorders yielded negative results. Metranidazole and clofazimine were totally ineffective and tetracycline led to a minimal improvement. No associated disorder was detected at a 4-year follow-up examination. The position of granulomatous glossitis within the spectrum of orofacial granulomatous conditions is discussed.
Glossitis↗
Submacular surgery for choroidal neovascularization secondary to optic nerve drusen.
PURPOSE: To report a case of bilateral choroidal neovascularization (CNV) secondary to optic nerve drusen (OND). DESIGN: Interventional case report. METHODS: A 9-year-old girl presented with peripapillary CNV of the right eye and peripapillary and subfoveal CNV of the left eye secondary to OND. The CNV was excised with submacular surgery in the left eye. RESULTS: Visual acuity increased from 0.05 to 0.3 in the left eye after submacular surgery and did not change from 0.3 in the right eye during 6-month follow-up. Partial retinal pigment epithelial atrophy, but no recurrence of CNV, was observed after CNV excision. CONCLUSION: Subfoveal CNV is an uncommon complication of OND and surgical excision may be useful in selected cases.
Child↗
The sequencing of radiation therapy and chemotherapy after mastectomy in premenopausal women with breast cancer.
OBJECTIVE: The purpose of this study was to evaluate the prognostic importance of the sequencing of radiation therapy and chemotherapy after mastectomy in high-risk premenopausal women with breast cancer in addition to other known prognostic factors in the literature. METHODS: In this retrospective study, 176 premenopausal women with breast cancer were evaluated. The median age at referral was 39 years (range, 28-59 years); 106 patients had stage II and 70 had stage III disease. All were subjected to mastectomy. The median number of lymph nodes removed was 19. The influence of age, histological grade, number of nodes removed, number of positive nodes, tumor size, estrogen receptor status, lymphovascular invasion and sequencing of radiotherapy and chemotherapy on 5-year locoregional disease-free survival, 5-year systemic disease-free survival, 5-year disease-free survival and 5-year cancer-specific survival were studied. RESULTS: The 5-year locoregional disease-free survival was 94% for the entire patient population. Because of the small number of locoregional recurrences, none of the evaluated factors was prognostically significant for locoregional recurrence. The 5-year systemic disease-free, disease-free and cancer-specific survival rates were 72, 70 and 77%, respectively. On multivariate analysis of host, tumor and treatment-related factors, the number of positive nodes [RR 1.9 (95% CI: 1.36-2.63), RR 2 (1.46-2.84 ) and RR 1.8 (1.3-2.71), respectively], histopathological grade [RR 1.8 (95% CI: 1.24-2.65), RR 1.9 (1.34-2.88), RR 2.5 (1.65-4.07), respectively], estrogen receptor status [RR 3.5 (95% CI: 1.5-8.6), RR 3.9 (1.64-9.41), RR 2.5 (1.05-6.24), respectively] and the sequencing of radiotherapy and chemotherapy [RR 1.6 (95% CI: 1.17-2.39), RR 1.7 (1.25-2.54), RR 1.6 (1.14-2.43), respectively] were all significant independent predictors of outcome. CONCLUSIONS: Our results show that in addition to traditional prognostic factors, the sequencing of radiation therapy and chemotherapy also predict for increased risk of any type of recurrence or further tumor death.
Adult↗
Subcision surgery for the correction of ear deformities.
The authors report the application of subcision surgery to ear deformities for crosscutting and weakening of the deformed cartilage. The subcision techniques for correction of a deformed cartilage are divided into two groups. With the first method, termed "horizontal subcision," a 18-gauge needle is inserted horizontally through a puncture in the skin surface, and multiple passes are made. With the second method, termed "vertical subcision," a sweeping motion of the needle is used for crosscutting of the deformed cartilage. An experimental study was conducted using 10 rabbits (20 ears) to test the authors clinical observations. On the basis of histologic analysis, the authors hypothesized that with the horizontal subcision technique, the sharp edge of the needle damages the perichondrium and weakens the cartilage by creating multiple irregular microincisions. With regard to the vertical incision technique, gross examination showed partial or complete cuts of the cartilage. Subcision surgery was successfully used in eight cases.
Adolescent↗
Radiologic and histologic assessment of diced cartilage grafts for cranial bone defects of rabbits: an experimental study.
This study was performed to experimentally evaluate the viability and coverage of diced cartilage grafts for cranial defects. Biparietal bone defects were prepared in each of 20 rabbits. Otogenous bone grafts were fixed to one side, whereas cartilage grafts taken from the right ear, diced, and wrapped with oxidized regenerated cellulose (Surgicel) were placed on other side. Parenchymal impression, contour, and ossification of all grafts in the 16 rabbits surviving after 8 weeks were evaluated with computed tomography and magnetic resonance imaging. The existence of ossification was examined pathologically. Parenchymal impression was significantly more frequent in bone grafts than in cartilage grafts (p < 0.05). This difference probably is attributable to the application technique. There was no significant radiographic difference in other parameters between the two groups. No significant difference in ossification was found. In conclusion, ossification was seen radiologically and pathologically in diced cartilage grafts. Because of autogenicity, ease of shaping, absence of postoperative warping, reduced resorption rates, and inherent viability and ossification properties, the authors suggest that diced cartilage grafts may be an alternative material for cranial defects, especially for frontal cranial reconstruction in which deformities may cause aesthetic and functional disabilities. The authors believe that further long-term studies also are needed.
Animals↗
Pulmonary tuberculosis and cutaneous mycobacterial infection in a patient with incontinentia pigmenti.
Lupus vulgaris is reinfection tuberculosis of the skin and may result from direct extension, or hematogenous or lymphatic spread from a tuberculosis focus. Lupus vulgaris following bacille Calmette-Guerin (BCG) vaccination is a rare entity. Incontinentia pigmenti is an X-linked dominant genodermatosis in which vesicular, verrucous, and pigmented lesions are associated with various developmental defects. There is evidence of altered immunologic reactivity in some patients with incontinentia pigmenti. A 12-year-old girl hospitalized for pulmonary tuberculosis presented with bizarre-shaped brown macules following Blaschko lines on the left deltoid area, compatible with incontinentia pigmenti, which had appeared following BCG vaccination at the age of 7 years. Histopathologic examination found noncaseated granulomas in the dermis. Antituberculous treatment for pulmonary and cutaneous tuberculosis was initiated along with genetic counseling. Immunologic abnormalities have been reported in conjunction with incontinentia pigmenti. Simultaneous occurrence of pulmonary and cutaneous tuberculosis in our patient might be either coincidental or indicate derangements in the cellular immune system.
BCG Vaccine↗
Diffuse panbronchiolitis, a potentially misdiagnosed sinopulmonary syndrome.
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Adult↗