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Karaman M.,Umraniye Training and Research Hospital
Kulak burun boǧaz ihtisas dergisi : KBB = Journal of ear, nose, and throat

In this study, we aimed to determine the possible relationship between the indications for tonsillectomy in adult population and to estimate the incidence of postoperative hemorrhage. Medical records of 200 adult patients who underwent tonsillectomy between January 2003 and October 2008 were retrospectively analyzed. The indications for adult tonsillectomy were chronic infection in 153 patients (76.5%); upper airway obstruction secondary to tonsillar hypertrophy in 37 patients (18.5%) and suspected neoplasms in 10 patients (5%). Sixteen patients (8%) had postoperative hemorrhage. Fourteen patients of 153 patients (9.2%) who underwent surgery with the indication of chronic infection and two of 37 patients (5.4%) who underwent surgery with the indication of upper airway obstruction secondary to tonsillar hypertrophy had also postoperative hemorrhage. None of the 10 patients who operated with the indication of suspected neoplasm had postoperative hemorrhage. Although the incidence of postoperative hemorrhage according to the indications of adult tonsillectomy in descending order was chronic infection (9.2%), upper airway obstruction secondary to tonsillar hypertrophy (5.4%) and suspected neoplasms (0%), it was found that the incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. The incidence of postoperative hemorrhage was not statistically significantly related to the indications for tonsillectomy. In addition, we believe that surgery is a more common cause of postoperative hemorrhage rather than chronic infections. Source

Ozgurhan E.B.,Beyoglu Eye Training and Research Hospital | Akcay B.I.S.,Umraniye Training and Research Hospital | Kurt T.,Beyoglu Eye Training and Research Hospital | Yildirim Y.,Beyoglu Eye Training and Research Hospital | Demirok A.,Istanbul Medeniyet University
Journal of Refractive Surgery

PURPOSE: To report the outcomes of accelerated corneal collagen cross-linking in patients with thin corneas (minimum corneal thickness < 400 μm). METHODS: Thirty-four eyes of 34 patients with a minimum corneal thickness less than 400 μm were included. All patients underwent accelerated corneal collagen cross-linking (irradiance power of 30 mW/cm2 at 3 minutes with a total surface dose of 5.4 J/cm2). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), manifest refraction (diopters [D]), and topography were evaluated at baseline and at the 1-, 6-, and 12-month follow-up visit. Endothelial cell density (cells/mm2) was calculated preoperatively and postoperatively at 12 months. The corneal stromal demarcation line was measured using anterior segment optical coherence tomography at 1 month postoperatively. RESULTS: The mean age of all patients (14 women and 20 men) was 23.08 ± 3.90 years (range: 16 to 29 years). UDVA and CDVA increased but not significantly. UDVA improved from 0.67 ± 0.32 (20/93 ± 20/41 Snellen) to 0.56 ± 0.28 logMAR (20/72 ± 20/38 Snellen) (P = .033) and CDVA improved from 0.49 ± 0.19 (20/61 ± 20/30 Snellen) to 0.42 ± 0.19 logMAR (20/52 ± 20/30 Snellen) (P = .009) at the last follow-up visit. The mean spherical and cylindrical refractions did not significantly change (P = .100 and 0.139, respectively). At the last follow-up visit, the flat keratometry decreased from 47.40 ± 2.52 to 46.95 ± 2.48 D, steep keratometry decreased from 51.04 ± 3.71 to 50.62 ± 3.57 D, and apex keratometry decreased from 57.58 ± 4.49 to 56.26 ± 4.47 D (P = .001, = .0019, = .001, respectively) from baseline. The mean endothelial cell density changed from 2,726.02 ± 230.21 to 2,714.58 ± 218.26 cells/mm2 at 12 months postoperatively (P =.086). CONCLUSION: The results of this study revealed that accelerated corneal collagen cross-linking stabilized the progression of keratoconus without a significant endothelial cell density loss during the 12 months of follow-up. Copyright © SLACK Incorporated. Source

PURPOSE:: To evaluate the efficacy and safety of peripheral vitrectomy under air infusion in comparison with fluid infusion in patients undergoing 23-gauge pars plana vitrectomy for primary rhegmatogenous retinal detachment. METHODS:: A total of 80 eyes of 80 patients with primary rhegmatogenous retinal detachment were enrolled into the study. Forty cases underwent peripheral vitrectomy under air infusion (air group), and a control group of equal number underwent peripheral vitrectomy under fluid infusion (fluid group). Peripheral iatrogenic retinal breaks during peripheral vitrectomy, postoperative visual acuities, and retinal redetachment rates were compared. RESULTS:: The number of eyes with peripheral iatrogenic retinal breaks in air group during peripheral vitrectomy was statistically comparable with that in fluid group (1/40 and 4/40, 2.5% and 10%, respectively; P = 0.16). Scleral depression was necessitated in 7 of 40 cases (17.5%) during the operation in the air group. There were no statistically significant differences between the groups in means of postoperative visual acuity and retinal redetachment (P = 0.18 and P = 1.0, respectively). CONCLUSION:: Peripheral vitrectomy under air infusion for primary rhegmatogenous retinal detachment revealed comparable results with fluid infusion in terms of intraoperative and postoperative complications and surgical outcomes. © 2015 by Ophthalmic Communications Society, Inc. Source

Object. The authors reviewed the results of "skip" corpectomy in 29 patients with multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL). Methods. The skip corpectomy technique, which is characterized by C-4 and C-6 corpectomy, C-5 osteophytectomy, and C-5 vertebral body preservation, was used for decompression in patients with multilevel CSM and OPLL. All patients underwent spinal fixation using C4-5 and C5-6 grafts, and anterior cervical plates were fixated at C-3, C-5, and C-7. Results. The mean preoperative Japanese Orthopaedic Association score increased from 13.44 ± 2.81 to 16.16 ± 2.19 after surgery (p < 0.05). The cervical lordosis improved from 1.16 ± 11.74° to 14.36 ± 7.85° after surgery (p < 0.05). The complications included temporary hoarseness in 3 cases, dysphagia in 1 case, C-5 nerve palsy in 1 case, and C-7 screw pullout in 1 case. The mean follow-up was 23.2 months. The final plain radiographs showed improved cervical lordosis and fusion in all cases. Conclusions. The authors conclude that the preservation of the C-5 vertebral body provided an additional screw purchase and strengthened the construct. The results of the current study demonstrated effectiveness and safety of the skip corpectomy in patients with multilevel CSM and OPLL. Source

Kadanali A.,Umraniye Training and Research Hospital
Mikrobiyoloji Bulteni

Toscana virus which is an arbovirus transmitted to humans by sandflies (Phlebotomus spp.), can cause febrile illness and meningitis mainly during summer. It has a tropism for central nervous system and is a major cause of meningitis and encephalitis in endemic countries. Majority of the clinical and epidemiologic studies on Toscana virus have been reported from Italy, France, Spain, Portugal and other Mediterranean countries. Although Toscana virus infections has been identified, data on virus activity in Turkey are limited. In this review article, the epidemiological, clinical and laboratory features of Toscana virus as a cause of febrile diseases, meningitis and encephalitis during summer in Turkey were discussed. Source

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