Diskapi Yildirim Beyazit Training and Research Hospital Ankara

Ankara, Turkey

Diskapi Yildirim Beyazit Training and Research Hospital Ankara

Ankara, Turkey

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Yilmaz E.R.,Diskapi Yildirim Beyazit Training and Research Hospital Ankara | Hasturk A.E.,Oncology Training and Research Hospital | Caglar S.,Ankara University
Journal of Neurological Surgery, Part A: Central European Neurosurgery | Year: 2013

ObjectIve We present the extremely rare case of sacral osteomyelitis due to an anterior sacral meningocele (ASM) with fistula to the skin. We also discuss the case's clinical significance and the importance of imaging in diagnosis. Methods A 28-year-old female patient was referred to our clinic due to back and hip pain, erythema, and purulent discharge from the right gluteal region. Neurological examination was normal except for pain in the gluteal region. Physical examination revealed a porus lateral to the right gluteal region. Lumbar magnetic resonance imaging (MRI)showed osteomyelitis and a minimal occult sacral meningocele in the anterior sacral region. Contrast-enhanced radiographic imaging clearly showed the fistula tract. The patient underwent surgery via the posterior approach; debridement of the sacral osteomyelitis was performed and the fistula tract toward the skin was closed. Results She was pain free after surgery. There were no postoperative complications. ConclusIon Although vertebral osteomyelitis due to ASMs is extremely rare, the risk of infection increases in cases of a fistula to the skin. When investigating the etiology of treatment-resistant infections, especially of the skin, sacral osteomyelitis and an underlying anomaly must be kept in mind. © 2013 Georg Thieme Verlag KG Stuttgart New York.


PubMed | Oncology Training and Research Hospital, Ankara University and Diskapi Yildirim Beyazit Training and Research Hospital Ankara
Type: | Journal: Journal of neurological surgery. Part A, Central European neurosurgery | Year: 2013

We present the extremely rare case of sacral osteomyelitis due to an anterior sacral meningocele (ASM) with fistula to the skin. We also discuss the cases clinical significance and the importance of imaging in diagnosis.A 28-year-old female patient was referred to our clinic due to back and hip pain, erythema, and purulent discharge from the right gluteal region. Neurological examination was normal except for pain in the gluteal region. Physical examination revealed a porus lateral to the right gluteal region. Lumbar magnetic resonance imaging (MRI)showed osteomyelitis and a minimal occult sacral meningocele in the anterior sacral region. Contrast-enhanced radiographic imaging clearly showed the fistula tract. The patient underwent surgery via the posterior approach; debridement of the sacral osteomyelitis was performed and the fistula tract toward the skin was closed.She was pain free after surgery. There were no postoperative complications.Although vertebral osteomyelitis due to ASMs is extremely rare, the risk of infection increases in cases of a fistula to the skin. When investigating the etiology of treatment-resistant infections, especially of the skin, sacral osteomyelitis and an underlying anomaly must be kept in mind.


PubMed | Samsun Education and Research Hospital, Ondokuz Mayis University and Diskapi Yildirim Beyazit Training and Research Hospital Ankara
Type: Journal Article | Journal: Journal of reconstructive microsurgery | Year: 2016

BackgroundEpigallocatechin gallate (EGCG) is a substance abundant in green tea. In this study, the effects of EGCG on perforator flap viability were investigated. MethodsA total of 40 rats were assigned to four groups of 10 each. In each subject, a 46 cm abdominal skin flap was raised and adapted back onto its place. In the control group, no further procedures were taken. In the flap group, 40 mg/kg/d EGCG was injected into the flap. In the gavage group, 100 mg/kg/d EGCG was given through a feeding tube. In the intraperitoneal group, 50 mg/kg/d EGCG was injected intraperitoneally. On the 7th postoperative day, flaps were photographed and the viable areas were measured and compared via a one-way analysis of variance. ResultsThe ratios of viable and contracted flap area were 9.15/12.01, 4.59/16.46, 11.56/11.20, and 11.65/10.77 cm(2) for the control, flap group, gavage group, and intraperitoneal group, respectively. While the flap group yielded the worst results in the sense of flap contraction and viability (p<0.001), the gavage and intraperitoneal groups were significantly better than those of the control group (p=0.03). Histologically, epidermal, papillary dermal, and capillary tissue volumes were evaluated. In comparison to the control group, the flap group yielded significantly increased epidermal and dermal volumes (p=0.03), however, these values were significantly decreased (p=0.04) in the gavage and intraperitoneal groups. Capillary volumes were significantly decreased in EGCG treatment groups (p<0.01). ConclusionOur experiment has shown that oral and intraperitoneal administration of EGCG increases the perforator flap viability when compared with controls, while direct injection decreases the viability.

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