Mevlana Tıp Bilimleri Archive

ABSTRACT

Herein we report a case of postoperative pyoderma gangrenosum in a 70-year-old man suffering from diabetic foot ulcer. When the wound was treated with split thickness skin graft, the patient developed pyoderma gangrenosum lesions on the donor site of split thickness skin graft. Since it has not been reported before that postoperative pyoderma gangrenosum can develop at this type of graft's donor area; we did not apply any more surgical interventions, and the patient treated with corticosteroids. Complete healing occurred after approximately 2 months of treatment.

Key words: Diabetes mellitus, Pyoderma gangrenosum, Skin graft

ABSTRACT
Objective: To evaluate the examination findings, follow-up results and surgeries of two cases diagnosed with Duane Retraction Syndrome (DRS)
Materials and Method: The clinical results of two patients who were diagnosed with different types of DRS and underwent different strabismus surgical techniques were retrospectively analyzed.
Results: Two cases, an 18-year-old male and a 25-year-old female, who did not have a family history or systemic disease were presented. The first case was diagnosed with unilateral type-3 Duane syndrome and lateral rectus recession and Y-split surgeries were performed. The second case was diagnosed with bilateral type-1 Duane syndrome and bimedial recession surgery was performed.
Conclusion: Although DRS accounts for approximately 1% of all strabismus cases, many other clinical features such as esotropia, exotropia, abnormal head position and vertical deviations are seen. Especially patients with high deviation angle, abnormal head position and patients with up/down shoots benefit from the planned surgical treatment at the appropriate time. We also improved the patients' clinics with the surgeries we performed on our cases.
Key Words: Duane retraction syndrome, Strabismus, Esotropia

ABSTRACT

Aim: To retrospectively evaluate the data of patients diagnosed with pulmonary hydatid cyst (PHC) who were followed up and treated in our clinic.

Materials and Method: 83 patients treated with the diagnosis of PCO in our clinic between November 2010 and November 2020; Factors such as age, gender, location and size of the patient, whether the cyst was ruptured at the time of admission, symptoms at the time of admission, relationship with liver cysts, and postoperative hospital stay were evaluated.

Results: 33 of our patients were male, 50 of them were female. The mean age of our patients was 34.71. A total of 109 cysts were removed from our patients, 9 of them were evaluated as giant cysts. There were 14 in the right upper lobe, 11 in the right middle lobe, 37 in the right lower lobe, 16 in the left upper lobe, and 31 in the left lower lobe. Nine patients had bilateral cysts. 52 of the cysts were perforated and 57 were intact. The most common symptom was cough. 16 patients were asymptomatic. 

Conclusion: PHC is a zoonotic disease that can affect any organ in our body. It is the second most common after liver hydatid cyst. It tends to grow easily due to the structure of the lung. In diagnosis, radiology is mostly sufficient and surgery is at the forefront in the treatment of AHC.

Key words: Echinococcus, Hydatid cyst, Lung

ABSTRACT
Aim: Renal artery are the largest vessels originating from the abdominal aorta. Renal artery arising from the abdominal aorta to the right and left enter the kidney between the renal veins located anteriorly and the renal pelvis located posteriorly. It splits into two or more branches before it enters the kidney. In pelvis and ureter duplication, each renal segment usually has a separate feeding. As the renal artery enters the kidney, it divides into anterior and posterior branches. The posterior branch supplies the middle segment of the posterior face. The anterior branch feeds the upper and lower poles and the anterior surface. 
Materials and Method: Our study was carried out on 700 Multidetector Computerized Tomography images taken with the request of imaging for the abdominal region of individuals.178 cases suitable for our study were selected from these images.
Results: The diameter where the right renal artery from the abdominal aorta was 0.58 ± 0.12 mm, and the diameter where the left renal artery separates from the abdominal aorta was determined as 0.65 ± 0.13 mm. The root exit angle where the right renal was 117.52º ± 14.05º.While there was only one renal artery feeding the right and left kidneys in 164 of the patients who were measured, 14 (7.86%) patients had two renal artery feeding the kidney. Of these, 9 (5.05%) were in women and 5 (2.80%) were in men. Within the scope of the study, three or more extra renal artery were not found. In the measurements made, it was found that the renal artery branch exit levels were mostly concentrated at the L1 and L2 levels, parallel to the data in other studies. 72 (43.9%) at L2 level in right renal artery - 62 (37.8%) at L1 level and 30 (18.3%) at other levels, 89 (54.26%) at L2 level in left renal artery - It was determined that it was 51 (31.09%) at the L1 level and 24 (14.65%) at the other levels.
Conclusion:We think that our study with the findings we have obtained will constitute a clinical importance especially for surgeons in the region.

Key words: Renal artery, Multidetector computed tomography, Variation

ABSTRACT
Aim: 18F-fluorodeoxyglucose (18F-FDG) is a radioactive agent used to show the metabolic characterization of lesions in positron emission tomography / computed tomography (PET / CT) imaging. The majority of 18F-FDG administered intravenously (IV) is excreted through the kidneys and accumulates diffusely in the bladder. However, it rarely shows layering in the posterior part of the bladder. Our study investigates why 18F-FDG is more layered in the posterior part of the bladder to determine the common characteristics of the patients with this finding and the clinical importance of this situation.
Materials and Methods: As of September 1, 2017, images of 500 consecutive patients who had 18F-FDG PET / CT imaging for various malignancies were examined, and 18F-FDG layers were detected in the bladder 12 patients. Clinical features, laboratory findings, and radiological imaging of these patients were evaluated from the hospital archive.
Results: Layering in the bladder was found in 2.4% of the patients screened. The bladder was observed to be distended in all of these patients. Blood albumin level was found to be below the reference range in 11 patients. Only four patients could obtain a complete urinalysis, and 1 of them had signs of urinary tract infection. This value was high in all nine patients in which we could reach C-reactive protein (CRP) values. Foci showing 18F-FDG uptake consistent with malignancy were observed in all patients. In addition, all patients had Karnofsky Performance scores of 50 or less.
Conclusion: The layering of 18F-FDG observed in the bladder may be related to infection, tumor burden, immobility of the patient, and distended bladder, as well as low blood albumin levels. For this phenomenon to guide clinicians, it should be investigated in more extensive series.
Key words: Urinary bladder, Layering, FDG, PET/CT

ABSTRACT
Aim: Diabetic foot osteomyelitis, is one of the devastating and sophisticated complications of diabetes mellitus. Wound care and closure techniques are as important as surgical and medical treatments in the management of this unfavorable condition. Appropriate and effective wound care facilitates healing process of osteomyelitis making infected wound more responsive to medical treatment.
Methods: Between years 2016-2020, the patients with biopsy-confirmed osteomyelitis were included in the prospective study. The patients were divided into groups according to randomization. The patients with conventional wound dressing were included in group 1, while negative pressure wound therapy applied ones incuded in group 2. Demographic data (age, sex), affected bone with osteomyelitis, localization and size of wound, hospitalization length, and number of operations were recorded. To evaluate the efficacy of two different wound care applications, mean infected periods, number of operations and mean durations of hospitalization were compared.
Results: Length of hospitalization stay was 24,49 ± 16,5 in group 1 and 17,15 ± 14,7 in group 2, respectively. Besides, infected period of group 1 was 19,0 ± 16,89, while it was 17,33 ± 16,46 in group 2. Mean number of operations was 1,55 ± 1,0 in the negative pressure wound therapy applied patients, as it was 2,15 ± 1,0 in the patients with conventional wound dressing. There was a significant difference between two groups in terms of length of hospitalization and number of surgical procedures, while no statistical significance found between the infected periods.
Conclusion: Consequently, shortening in hospitalization period and lesser number of surgical procedures due to rapid healing process demonstrated the benefits of negative pressure wound therapy.
Key Words: Osteomyelitis, Diabetic foot, Negative pressure wound therapy, Vacuum assisted closure

ABSTRACT
Aim: Bimanual in-phase movement, which is frequently seen in infancy, disappears in the first decade of life with central nervous system maturation. Hand dominance becomes evident and interhemispheric inhibition is initiated to suppress the opposite hand. However, in-phase movements are frequently used in our daily lives.
Materials and methods: Thirty students (14 female, 16 male) with right hand dominance were included in the study. Two screw assemblies placed on a wooden plane were designed to perform tightening or loosening orders. Test 1: ordered to tighten screws at the same time with both hands.  Test 2: ordered to tighten the screw with only left hand. Fisher's exact test was used to compare the ratios between the sex. P <0.05 was considered significant.
Results: Test 1: In the bimanual tightening test, the left hand performed mirror symmetrical movement instead of voluntary correct antiphase movement in 11 persons (78.6%) in females, and the left hand unwantedly loosened the screw. This rate was 37.5% in males (6 persons). The error rate was higher in female gender (χ2: 0.021, p: 0.033). Test 2: In the unimanual left hand tightening test, mirror symmetric movement instead of antiphase movement was seen in 7 female persons (50%) and in 5 male persons (31.3%). The left hand therefore made a loosening motion instead of tightening the screw. The difference between the two groups was not found for this test (chi-square: 0.295, p: 0.457).
Conclusion: The relatively higher error in the female gender in the bimanual task, which is more otomatic movement, may be due to the fact that the male gender knows the use of this device in advance. There was no difference in the unimanual task with more voluntary attention between genders. It is discussed in the light of the literature that the cause of left-hand errors may be in confliction with visomotor information on the real trajectory of movement of the nondominant hand.
Key words: Hand preference, Motor learning, İn-Phase movement