·The authors describe a 2-month-old boy with nonsyndromic cleft lip and palate. On examination, he had bilateral inferior iris colobomas, vitreous veils, optic disc and choroid colobomas. Magnetic resonance imaging(MRI) revealed bilateral colobomatous microphthalmia, retrobulber cysts and thinned optic nerves. Every infant with cleft lip and palate should be examined by an ophthalmologist to detect possible associated ocular abnormalities.

AIM:To report a male patient with Pickwickian syndrome and obstructive sleep apnea(OSA) who presented with pseudotumor cerebri and visual loss. METHODS:Case report.RESULES:A 54-year-old obese man with a three-month history of bilateral visual deterioration was evaluated. His visual acuity was 20/200 in OD and 20/400 in OS. Color vision was impaired only in the left eye. Funduscopy revealed bilateral disc edema and peripapillary hemorrhages together with macular exudates in OS. Physical examination and laboratory investigations were consistent with OSA and Pickwickian syndrome. Lumbar puncture demonstrated an opening pressure of 350mm H2O and computed brain scan was normal. The diagnosis was pseudotumor cerebri in association with OSA and Pickwickian syndrome. Fundus findings and visual acuity improved with phlebotomy, blood pressure regulation, weight reduction and bi-level positive airway pressure therapy. CONCLUSION:OSA and Pickwickian syndrome should be kept in mind when facing a patient with pseudotumor cerebri.

No abstract available.
Coronary Vessels* ; Erythrocyte Indices*

This study aims to contribute to the literature on sustainable careers by studying the effect of t-anxiety on the career self-management dimensions which are Personal Mastery (PM), Verbal Persuasion (VP), and Vicarious Learning (VL), and the moderator effect of s-anxiety about layoffs due to COVID 19 pandemic on these relationships. The causal comparison screening approach was adopted. Hypotheses were investigated by the SEM method. The research data were collected online from 365 white-collar employees between July 1, and August 30, 2021, using a simple random sampling approach. The purpose of collecting the data between these dates was that the ban on lying off the employees due to the COVID 19 pandemic has been lifted on June 30, 2021. Empirically, a negative and significant relationship was found between t-anxiety and PM. It was also found that positive and significant relationships exist between t-anxiety and VP and VL. A negative relationship between s-anxiety about layoffs due to COVID 19 pandemic and PM was determined. S-anxiety about layoffs due to COVID 19 pandemic has been found to have moderating negative effect on the relationships between t-anxiety and VP and VL. High levels of anxiety (both for t-anxiety and s-anxiety) affect PM negatively whereas low levels of anxiety strengthen it. PM gets weaker in anxious individuals, while VP and VL get stronger. Because of the s-anxiety about layoffs due to COVID 19 pandemic white-collar professionals are likely to face a career shock, resulting in unsustainable trajectories.

PURPOSE: Surgical equipment used in breast cancer surgery that affects wound healing and minimizes complications seems to be a popular investigation topic. The aim of this study is to evaluate the effect of plasmakinetic cautery on wound healing in patients receiving mastectomy. METHODS: Forty-six consecutive breast cancer patients receiving modified radical mastectomy were evaluated prospectively. Plasmakinetic cautery was used in 24 operations and electrocautery was used in 22 operations in random order to manage skin flaps and excise breast tissue. In the postoperative period, vacuum drainage amount and duration time as well as the start time of arm exercises were recorded. Complications like seroma, surgical site infection, hematoma, and flap necrosis were determined. RESULTS: Age, body mass index, breast volume and flap area parameters were similar in each group. Mean drainage duration was found to be 5.5 days in the plasmacautery group and 7.9 days in the electrocautery group (p=0.020). In the plasmacautery and electrocautery groups, mean drainage volume was 707 and 1,093 mL, respectively (p=0.025). There was no statistical significance between the groups when operation duration, amount of blood loss, time to start arm exercises, seroma, hematoma, surgical site infection, and flap necrosis were considered. CONCLUSION: Plasmakinetic cautery is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal tissue injury. So, plasmacautery shortens the drainage amount and duration time compared to electrocautery without elongating operation duration or increasing the amount of blood loss.
Arm ; Body Mass Index ; Breast ; Breast Neoplasms ; Cautery ; Drainage ; Electrocoagulation ; Exercise ; Hematoma ; Hemostasis ; Humans ; Mastectomy ; Mastectomy, Modified Radical ; Necrosis ; Postoperative Period ; Prospective Studies ; Seroma ; Skin ; Surgical Equipment ; Surgical Instruments ; Vacuum ; Wound Healing

No abstract available.
Coronary Vessels* ; Dilatation, Pathologic* ; Humans

PURPOSE: In this study, three bioceramic materials, [IPS Empress CAD (Ivoclar), IPS e.max CAD (Ivoclar), and Lava Ultimate CAD (3M ESPE)] were treated with three commercial mouthrinses [Listerine, Tantum Verde, and Klorhex]; and changes in colour reflectance and surface roughness values were then quantitatively assessed. MATERIALS AND METHODS: One hundred and twenty ceramic samples, with dimensions of 2 × 12 × 14 mm, were prepared and divided into nine sample groups, except three control samples. The samples were immersed in the mouthrinse solutions for 120 hrs, and changes in colour reflectance and surface roughness values were measured by UV light spectrophotometry (Vita Easyshade; VITA Zahnfabrik) and by profilometer device (MitutoyoSurftest SJ-301), respectively. The change of surface roughness was inspected by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: There was a positive correlation between the ΔE and increase in the surface roughness. Two of the ceramic materials, IPS Empress and Lava Ultimate, were affected significantly by the treatment of the mouthrinse solutions (P<.05). The most affecting solution was Tantum Verde and the most affected material was Lava Ultimate. As expected, the most resistant material to ΔE and chemical corrosion was IPS e max CAD among the materials used. CONCLUSION: This work implied that mouthrinse with lower alcohol content had less deteriorating effect on colour and on the surface morphology of the bioceramic materials.
Benzydamine ; Ceramics ; Corrosion ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Refractometry ; Spectrophotometry ; Ultraviolet Rays

The first extensor compartment of the wrist is a distinctly variable anatomical area. Anatomical variations in this region contribute to the pathophysiology and treatment failure of de Quervain’s disease, which is a kind of tenosynovitis that develops in the first extensor compartment of the wrist. We aim to describe the first extensor compartment morphology, to evaluate the septum frequency, location of the septum, and the number of tendons of abductor pollicis longus (APL) and extensor pollicis brevis muscles (EPB). First extensor compartment of 87 wrists of 45 cadavers were dissected. The presence or absence of septum and number of tendon slips of APL and EPB revealed. The proximal and distal widths of the compartments were measured. Septums were detected in 60.9% (n=53) of the wrists. Incomplete (distal) and complete (proximal) septa were present in 35.6% (n=31) and 25.3% (n=22) of the cases. Only 26.4% of the wrists had a single slip of APL tendon. The Remaining had multiple slips. The median inner width of the proximal and distal compartments in all wrists were calculated as in the order of 9.11±1.14 mm and 8.55±1.12 mm. We believe that understanding the anatomy of the first extensor compartment in the Turkish population would be helpful to surgeons, radiologists, and physiotherapists to diagnose and manage de Quervain’s disease.

PURPOSE: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. METHODS: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. RESULTS: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). CONCLUSION: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.
Anastomotic Leak ; Constriction, Pathologic ; Hospitalization ; Humans ; Ileostomy* ; Laparoscopy ; Length of Stay ; Male ; Multivariate Analysis ; Rectal Neoplasms* ; Reoperation ; Risk Factors ; Surgical Wound Infection ; Survival Rate

OBJECTIVETo evaluate the dimensions of atrial septal aneurysm (ASA), the presence and characteristics of interatrial shunt, the movement of the wall of the aneurysm, and correlation between these findings and sign and/or symptoms suggesting embolism in Manisa, a district of a western Anatolian city of Turkey.

METHODSTwo thousand five hundred cases were examined by routine transthoracic echocardiography (TTE) in both pediatric and adult cardiology outpatient clinics. ASA was detected in 20 cases and evaluated by two-dimensional color Doppler echocardiography (CDE). The length of the base, the maximum radius and the maximum displacement of ASA were measured. The shunt between the atria was examined by CDE. In cases where a shunt could not be found, galactose and palmitic acid was injected. Standard 12-lead electrocardiogram (ECG) and exercise stress test were also performed.

RESULTSNo clinical signs or symptoms were found, suggesting a systemic or cerebral embolism. The maximum displacement of ASA was between 2 and 5 mm. All of the aneurysms were localized in the right atrium, and the walls of the aneurysm did not move beyond the base of the left atrium during the maximum displacement. Interatrial shunt was detected in 14 of 20 patients (70%) by CDE and in the remaining six cases by contrast TTE. Frequent ventricular ectopic beats were observed in one patient.

CONCLUSIONSDuring routine TTE we observed 0.8% asymptomatic ASA in our population. The use of a contrast agent was found to be a valuable additional method in patients with ASA when the shunt could not be detected by CDE. The risk for embolism is not high when the maximum displacement of the wall of ASA was 5 mm or less and no bulge into the left atrium was observed. Based on our experience with this method, TTE is easy to perform, well-tolerated and acceptable.

Adolescent ; Adult ; Child ; Child, Preschool ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Female ; Heart Aneurysm ; diagnostic imaging ; Heart Atria ; Humans ; Infant ; Male ; Middle Aged