Makale Arama

\r\n Aim: The aim of this study is to determine the relationship between pregnancy outcomes and histopathology examination of the intended placenta and umbilical cord specimens.

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\r\n Patients and Methods: 112 placenta materials were scanned as retrospective in an archive of Usak University Education and Research Hospital of Pathology Department. Term placentas measurement were based on Kaufmann’s Pathology thus; 37-40 week, size 18 cm, weight 350-750 gr, thickness 2-2,5 cm. Umbilical cord's vessel number, membrane structure, chorioangioma, infarct, hematoma, hemorrhage were recorded. Infarct, chorioamnionitis, subchorionic fibrin deposit, congestion of chorionic vessel, subchorionic hemorrhage, corangiosis, chorioangioma, calcification, perivillous fibrin deposit, an effect of meconium, fibrinoid necrosis, villitis, ectasia of a chorionic vessel were detected as histopathologic findings. Gender, mode of delivery, maternal disease, birth weight, maternal age, parity, birth length, head circumference, APGAR between 0-9 were recorded.

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\r\n Results: 112 placentas; 4 of 29 (13,7%) placental infarct, 2 of 19 (10,5 %) placental corangiosis, one of 17 (5,8%) subchorionic haemorrhage, 2 of 29 (6,8%) chorioamnionitis, one of 12 (8,3%) umbilical cord congesione cases were detected with abnormal pregnancy outcomes. Statistically significant results were found between subchorionic haemorrhage and placenta size (P = 0, 004), maternal age and umbilical cord dimension (P = 0, 0001), birth weight and placenta and umbilical cord dimensions (p = 0.000). However, no association was found between these parameters and pregnancy outcomes. Relationship between baby weight and placenta and umbilical cord size was determined in diabetic, preterm, ablatio placenta, and stillbirths and pregnancies. No significant association was found between histopathologic findings and pregnancy outcomes.

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\r\n Conclusion: When placenta and umbilical cord specimens are evaluated, the location and size of the lesion should be indicated along with the presence of the lesion in order to explain regular clinical follow-up and adequate anamnesis as well as the effect on the pregnancy outcome.

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Successful management of inguinal hernia depends on not only prevention of recurrence but also patient comfort. Although recurrence is lower in procedures using prosthetic meshes, complications related to these meshes negatively affect patient comfort. The procedure described by Desarda, draws attention due to lower recurrence, conformance to physiology and higher patient comfort. In this study we present results of patients treated using desarda procedure. Seventy two patients admitted to our clinic with inguinal hernia between 2010 and 2012 and treated using Desarda procedure were included in this study. Patients with recurrent inguinal hernias, femoral hernias, patients below 18 years of age and patients with systemic disease excluded. Demographic properties, types of hernias, postoperative complications and recurrence of the patients were recorded. Of the patients, 71 were male and 1 was female. Median age was 51 (range 18-85). Median operating time was 34.7±11.5 for single sided cases and 76.1±15.4 minutes for bilateral cases. Mean hospitalization was 1.02 days (range 1-2), mean follow up was 22.0±4.2 months. Early recurrence was observed in 1 (1.3%) patient at 6th month. One (1.3%) patient had scrotal edema, 3 (4.1%) patients had edema of spermatic cord, 2 (2.7%) patients, one of these using anticoagulant, developed hematomas. None of the patients required analgesics beside routinely used non-steroid analgesics and no neuralgia was observed. Desarda procedure is a remarkable technique for treatment of inguinal hernias of suitable patients, which is non-expensive, easy to learn and more physiologic technique providing lower recurrence and higher patient comfort.

Diagnostic and therapeutic cardiac catheterization attempts have recently been increasing. Numerous complications may develop after cardiac catheterization, including local complications, such as thrombosis, pseudoaneurysm, arteriovenous fistula, bleeding, infection, and distal embolization at the catheter insertion site, as well as complications associated with the anesthetic agents, such as respiratory depression, tachycardia and bradycardia. A total of 120 patients, who underwent cardiac catheterization between June 2010 and June 2012 were retrospectively evaluated. The patients were aged from 9 days to 15 years (mean 3.5±4.2 years) and 58 (48%) were female and 62 (52%) were male. Of the 120 patients, 102 (85%) underwent a diagnostic cardiac catheterization procedure, whereas in 18 (15%) patients an interventional procedure was performed. Complications were encountered in 7 (5.8%) patients, aged from 9 days to 15 years (3.5±4.2 years). There were femoral hematoma in two patients, femoral bleeding in one patient, femoral thrombosis in two patients, bradycardia in one patient, and a patient developed respiratory arrest during sedation (with midazolam). Femoral venous thrombosis, which was seen in two patients, was treated with low molecular weight heparin in one case and with low molecular weight heparin and pentoxifylline in the other. Two patients who developed femoral hematoma underwent local treatment. One patient developed resistant bradycardia, for which a temporary pacemaker was inserted. A patient with femoral hemorrhage was treated with protamine sulfate. One patient, who developed respiratory arrest due to midazolam, was treated with respiratory support. All patients were discharged in a good condition after the treatment. The complications in patients who underwent cardiac catheterization in our clinic, and the risk factors for these complications were analyzed retrospectively. Patients undergoing cardiac catheterization should be closely monitored in terms of possible local and general complications. The incidence of the complications can be reduced by taking appropriate measures. The morbidity and the mortality can be reduced by early diagnosis and treatment of the complications.

The liver is the most frequently wounded organ in the abdominal traumas and the rate of mortality is still very high. We aimed to present a case that was treated with non-operative methods which led to hepatitis because of increase in intraparenchymal hematoma in the late period. Seventeen-year-old male patient who had liver laceration after blunt abdominal traumas was treated with embolectomy due to liver hematoma. In late period, liver parenchymal hematoma can be increased and patients can develop hepatitis because of increased hematoma pressure on intraparenchymal biliary tract and this situation can be effectively treated with non-surgical methods.

Aim: To highlight the neurovascular complications of hemodialysis and discuss the therapeutic approaches with the relevant literature. Case Report: A 19- year old man on maintenance hemodialysis who admitted to our clinic with intracerebral hematoma is discussed. Conclusion: Neurovascular complications are being recognised as the major causes of mortality and morbidity in hemodialysis patients. Prevention of neurovascular complications of uremia and accelerated hypertension requires the cooperation of both the neurologists and nephrologists.

Betvveen the period December 1999 and February 2001, 93 women who undervvent excision biopsy of the breast were included into a controlled randomized trial to determine the effect on postoperative morbidity and hospital stay of drainage of the biopsy cavity. Among the 93 patients, drain was used in 45 (group I) and 48 (group II) had no drain. The vvounds were examined seven days after operation vvith ultrasonography. Collections such us haematoma or seroma were present in 41 (%91.1) patients with undrained vvounds compared with 39 (%81) patients wuth drained vvounds. Median collection volüme was 30.67 ml±24.87 (SD) (range 0-140) in the undrained group and 25.00±16.47 mİ (SD) (range 0-80) in the drained group. There vvas one infection (% 2.2) in undrained group and two (% 4.1) in drained group. While there vvas no significant difference betvveen two groups in terms of vvound infection and seroma (p>0.05), the length of hospital stay vvas statistically longer in drainage group (p<0.01). We conclude that breast biopsy cavity drainage with penrose drain, does notprevents vvound collections and infections.

Multiple intracerebral hemorrhage represents 2 % of ali intracranial hemorrhages. Multiple intracerebral hemor- rhages have been known to occur most frequently in patients with coagulation defects, neoplasms, angiopathies or sinüs thrombosis. The finding of recurrent intracerebral hemorrhages is not unusual in patients with systemic arterial hypertension, but simultaneous occurence of multiple hemorrhages is rare in these patients. However, multiple spontaneous intracerebral hemorrhages vvithout an identifiable etiology were also reported in the literatüre. Here, we describe a hypertensive patient who developed multiple intracerebral hematomas. The patient had bilateral thalamic hematoma that extended the lentiform nucleus. There was apathy, loss of emotional concern, upvvard gaze palsy, tetraparesis and hypertensive retinopathy in the neurologic examination. Conditions other than hypertension that might cause intracerebral hemorrhage were excluded by laboratuary investigations.

It is claimed that the use of ultrasound-assisted liposuction in bodyshaping surgery produces less blood loss and more skin contraction than conventional liposuction. In the literature, however, we could not find any studies comparing the efficacy of conventional liposuction with ultrasonic liposuction in the treatment of arm contour deformities. In this study, therefore, it is aimed to compare the efficacy, complications and bleeding rates of conventional liposuction with ultrasonic liposuction in the treatment of arm contour deformities. Twenty patients with the complaints of arm contour deformity during the period of 2012-2016 were included in the study. All of the patients were treated with liposuction. The patients were divided into two groups; ultrasonic liposuction (Group 1; n: 10) and conventional liposuction (Group 2; n: 10). Necrosis was defined as a major complication. Seroma, hematoma, asymmetry and roughness in the skin were defined as minor complications. The location of the thickest part of both arms of patients in both groups were measured at the end of the surgery and at the end of the first postoperative year. A total of 5 ml lipoaspirate samples were taken from each patient intraoperatively. The specimens were stained with hematoxylin-eosin and the numbers of erythrocytes per unit area were determined. According to Triceps Skin Classification, 4 of the patients were Type 2, 3 were Type 3 and 3 were Type 4, in Group 1. In Group 2, 3 of the patients were Type 2, 3 were Type 3 and 4 were Type 4. The average arm circumference of the patients in Group 1 was 36 cm (minimum 32 cm - maximum 40 cm), while in Group 2 the average arm circumference was 35 cm (minimum 31 cm - maximum 39 cm). At the end of the operation, the average arm circumference of the patients in Group 1 was 31 cm (minimum 28 cm - maximum 32 cm) while in Group 2 the average arm circumference of the patients was 32 cm (minimum 28 cm - maximum 33 cm). At the end of the first postoperative year, the average arm circumference was decreased to 30 cm in Group 1 and 31.8 cm in Group 2. Moreover, the number of erythrocytes calculated in cm2 in Group 2 was 50-60 / 1HPF (HPF: high power field) at 40x magnification and this value was calculated as 20 / 1HPF in Group 1. The mean arm thickness before the surgery was similar in both groups. However, the mean postoperative arm thickness of the patients in Group 1 was significantly lower than Group 2 (p <0.05). Moreover, the number of erythrocytes seen in the lipoaspirate unit area was significantly lower in Group 1 than in Group 2 (p<0.05). In this study, we have demonstrated that ultrasonic liposuction could provide more skin contraction in the treatment of arm contour deformities with appropriate patient selection. In this indication, a better appearance can be obtained with less sagging compared with conventional liposuction.

The excessive maternal alcohol drinking results in Fetal Alcohol Syndrome which is a pathology caused by the embryotoxic effects of ethanol in prenatal period. The mechanisms of ethanol action at the cellular or molecular levels are scarce. In this study it was aimed to investigate the effects of ethanol on growth and development of mammalian embryos as well as the morphological structure and the role of free radicals on these effects. Wistar rats were obtained from the Selcuk University Experimental Medicine Research Center and their 9.5 days embryos were explanted and cultured for 48 hours in rat serum. Whole rat serum used as a culture medium fort he control group while different concentrations of ethanol (250-500 mg%) were added tor at serum fort he experimental groups. Also, the lowest effective concentration of ethanol for all parameters was added to the culture media in the presence of an antioxidant superoxide dismutase (SOD). Ten embryos were used for each experimental condition. Dose-dependent effects of ethanol on embryonic developmental parameters such as; total morphological score, yolk sac diameter, crown-rump length, somite number, embryo and yolk sac protein contents were compared using morphological and biochemical methods. Each embryo was evaluated for the presence of any malformations. Compared to the control embryos, ethanol significantly decreased all developmental parameters döşe-dependently (p<0.05) with an increase in overall dismorphology. The haematoma in different regions, especially in the neural tube was most frequently observed. When the SOD was added to theculture media in the presence of ethanol, growth and developmental parameters were improved (p<0.05) and there was a decrease in the incidence of malformations (p<0.05). A döşe dependant developmental toxicity of ethanol on rat embryos during organogenesis wasdetermined, these effects might involve free oxygen radicals.

Novvadays, patients suffering from blunt abdominal trauma are examined by abdominal ultrasonography, routinly. Subcapsular bleeding of the spleen in these patients can be overlooked if there isn't free fluid in the abdominal cavity, ultrasonographic examination carried out in suboptimal contitions and after the trauma attention was in- tensified on the Central nervous system injury. İn 3 cases who have been examined by abdominal ult­ rasonography just after the trauma, any pathological finding was not been determined related with their spleen also examined by upper abdominal computed tomography because of their some complaints after the trauma (1 wk-1 yr) and splenic subcapsular hematomas were establised in these patients. İn patients with delayed de- velopment of splenic subcapsular hematoma following abdominal trauma can cause late rupture of the spleen, so we think that the patients suffering from blunt abdominal trauma must be examined by the control radiological methods after the trauma.

Time management and making a correct diagnosis are very important for survival of patients with altered state of consciousness. In our study, we aimed to determine the value of the infrascanner device, which is a non-invasive and a fast method in detection of intracranial hemorrhage. A total of 38 patients who had been admitted to the emergency department of our hospital with the complaint of altered state of consciousness were included in the study. The patients underwent investigations with regard to hemorrhage immediately after admission using the infrascanner device by trained residents of emergency medicine. 20 (52.6%) of the patients were male. The mean age was 51.8 years and the Glasgow Coma Scale was 10.6 (15-3). While hemorrhage was detected on cerebral CT in 22 (57.9%) patients, it was not detected in 16 (42.1%). In the infrascanner device examination, negative results were detected in 24 (63.2%) patients and positive results were detected in 14 (36.8%) patients. The sensitivity of the infrascanner device was found to be 63.6%, specifity was found as 100%, the positive predictive value was found as 100%, and the negative predictive value was found as 66.7%. The results obtained from the study indicate that the infrascanner device provided beneficial clinical data in addition to symptoms and neurological examination in patients who required further imaging procedures. The high specificity puts forth that patients in whom hemorrhages are detected using the infrascanner device, should definitely be evaluated with further tests.

Anterior abdominal wall hematoma is a rare pat-hological condition.It may simulate the acute surgi-cal abdomen. Ilematoma was diagnosed by utilizing ultrasonography (USG) and computerized tomogra-phy (ST) in six patients who vere thouht to have acute abdomen orland abdominal mass. Although the diagnosis was made by USG, CT had been used to investigate localization, extension and associated pathological conditions of the hematoma. In !his article,differential diagnosis of andominal wall hematomas from acute surgical abdomen in six patients by using USG and CT are presented.

Idiopathic retroperitoneal hematoma is a rare condition, affecting apparently histopathological normal retroperitoneal blood vessels. In cases of idiopathic retroperitoneal hematoma no definite cause can be identified. We report on a patient idiopathic retroperitoneal hematoma presenting as acute abdomen.

A twelve years old virgin patient who was menstruating regularly for one year presented with severe pelvic pain associating with her menstruation. She was diagnosed to have right renal agenesis before 4 months. In her physical examination she had annular hymen and normal external genital organs. Vaginal depth was 6 cm. In her pelvic ultrasonography, the endometrial thickness was 8 mm on left side uterus and 8x10 cm hematometra appearance was seen on right side. Laparotomy was planned for the patient. During the operation double uterus and double endometrial cavities were seen with fusion line in the middle. Double cervices were palpated by hand. Hematometra was seen on right side. Bilateral ovaries were normal. Uterus was incised from the middle the separating fibrous tissue was removed, hematoma was evacuated and the two cavities united. The patient was discharged on the 2nd postoperative day without complications. After two weeks she presented with severe vaginal bleeding for which laparotomy was done. The metroplasty line was opened. A bleeding arterial end was noticed on left lateral isthmic wall and it was not related to the incision line. The vessel was sutured and the patient was discharged on the 4th postoperative day without complication.

Aim: We aimed to report the long-term results of the patients undergone posterior preperitoneal tension-free mesh hernioplasty operation for inguinal hernia. Patients and Methods: IVe icnluded in this study 624 patients undergone posterior preperitoneal tension-free mesh hernioplasty operation for inguinal hernia betvveen October 1992 and June 2000. The patients were invited for control in the first and third postoperative months and yearly. The patients who did not come to control were asked by telephone and letter if they had any recurrences and problem with their operation. The patients lost their communication with us after the operation were excluded from this study. The patients were examined and evaluated for urinary retention, bleeding, spermatic cord edeme, wound infection, neuralgia and recurrence in the early and late postoperative periods. Results: 584 of the patients were men and 40 were women. The patients were follovved 37.4 months (range: 6-108 months) after the operation. We found 1.8% recurrence, 0.3%> bleeding, 2.7%> infection, 4.2% spermatic cord edeme, 0.6% neuralgia and 0%> urinary retention ratio. Conclusion: We concluded that, posterior preperitoneal tension-free mesh hernioplasty operation is a safe method with low morbidity and recurrence rate in inguinal hernia repair.

n determination the ethiology of subarachnoid haemorrhage some radiological diagnostic methods are used. Su- barachnoid haemorrhage, intracranial haemotoma and intravetricular bleeding can be correctly detected by com- puted tomography (CT), but in demostration of small aneurysm or trombosed aneurysm CT can be insufficient. Angiography which is an invasive examination also effective in the diagnosis of intracranial aneurysms and de­ termination of surgical strategy. 98 patients (45 M, 53 F) who have been admitted the hospital because of their acute neurological findings have intracranial aneurysms which were shown by angiography. Ali of these patients have been examined by CT also before angiography. 96 of 98 patients (97.9%) had subarachnoid haemorrhage and in 98 patients there were 103 aneurysms. Only 24 of 103 (23.3%) aneurysms were shown by CT exa- mination. We think that in patients with intracranial haemorrhage which are shown by CT examination, con- ventional angiography or digital substraction angiography remains the gold standart for detailed aneurysms de- tection and also for surgical planning.

Post-traumatic pseudocysts of lung are rarely seen complications of blunt chest traumas. Usually spontaneous resolution is seen in 2- 4 months after trauma, but a few of them are get into abscess or tension cyst formation after Progressive expansion and in these circumstances surgical resection is indicated. Radiologically they are frequently seen as thin-wall cysts consisting air-liquid levels. Unless they had a drainage bronchus in the beginning they are usually seen as pulmonary hematomas due to hemorrhage. 14/e herein report 15, 17, 47 and 49 year old four cases who were hospitalized for blunt chest traumas in our clinic. Three of them were male and one was female. Ali the pseudocysts localized in the right lung, and in two of the case the cysts resolved in a period of 2.5 and 4 months with medical treatment. But in two cases surgical treatment needed for their Progressive expansions.

Epidural hematomae are one of the most seen emergency neurosurgical pathologies. Acute epidural hematomae generally depends on the bleeding of the arteria meningia media and its branches and collection of the hematoma at the epidural space. Epidural hematomae rarely depend on the venous sinusal bleedings. The management is generally surgical decompression of the hematoma. In this report, we present a case which is not operated after the detection of epidural hematoma and managed conservatively.

The recuıTence rate and testicular complications seen (iter COnventional inguinal hernıa repair are stili being dehated. Reilıforcement of the inguinal prepe-ritoneal space between the peritoneal and musculo-fascial planes may have some advantages over the conventional hernia repair. Between November 1988 and December 1992,84 groin hernias in 56 patients >vere treated with preper-itoneal svnthetic mersilen mesh hernioplasty through a suprapubic transverse incision. During hernioplasty, lower abdoıninal operations (12 trans-vesical prostatectomy, 2 Ripstein operations and 2 oyarian cystectomies) vere pelformed on 10 of the patients. Early recurrence in one patient and hematoma in 8 patients developed

Fine needle aspiration biopsy %vas pet:formed in 6 patients with diagnosed retroperitoneal masses by routine •adiologic investigation in our clinic in the last I year. In 4 patients renal cell carcinoma, in 1 patient hematoma, in .1 patient perirenal abscess was di-agnosed with fine needle aspiration biopsies. Renal cell carcinomas MU corrected with histopathologic examination of nephrectomy specimen. The patient ►•ith hematoma was treated conservatively. We conclude that fine needle aspiration biopsy to be a simple, cheap and relatively noninvasive for preoperative tissue diagnosis.