Biomedical subjects

A Numanoglu

Publications and source records attributed to A Numanoglu.

22 records · Page 2Linked to original sources

PubMed1997

Delayed presentation of congenital diaphragmatic hernia.

Patients with congenital diaphragmatic hernias (CDH) usually present soon after birth with respiratory distress. Occasionally presentation is delayed. Twelve patients with delayed presentation (outside the neonatal period) of a total of 91 with CHD were seen over 17 years (1977-1994). Case records were reviewed to identify reasons for late presentation, evidence of morbidity, treatment and outcome. Age at presentation ranged from 6 weeks to 30 months (mean 8 months). Ten patients were aged 6 months or younger and there was an equal number of boys and girls. Seven cases were left-sided, 4 right-sided and 1 was anteriorly placed and bilateral. Ten patients presented acutely, 5 with small-bowel obstruction and 5 with respiratory distress, but all of the latter had a history of previous recurrent chest infection. Diagnosis was confirmed by radiographic examination of the chest in 10, barium meal in 1 and a 5-month-old patient had an inappropriate laparotomy and gastrojejunostomy for duodenal obstruction at an outlying hospital. Two had documented normal chest radiographs 3 and 6 months prior to diagnosis. Patients who presented with gastro-intestinal symptoms were older (mean age 1 year) compared with those with predominantly respiratory symptoms (mean age 19 weeks). None had any evidence of bowel strangulation. All were repaired via an abdominal approach. A hernial sac was found in half the cases (4/7 left and 2/5 right). Five had non-rotation of bowel. Primary repair without patch was carried out in all. One child with lung hypoplasia and multiple cardiac abnormalities died; the others recovered well. Delay in presentation of CDH is not uncommon (14% in this series). Most patients will have respiratory symptoms. A normal previous chest radiograph does not exclude the diagnosis. All patients with recurrent chest infection should have a contrast meal investigation early on. Long-term prognosis is favourable and postoperative morbidity is minimal, despite late presentation.

Child, Preschool↗

PubMed1993

Subepineural hyperplastic pacinian corpuscle: an unusual cause of digital pain.

A case is presented in which the patient's chief complaint was severe digital pain radiating to the arm. Even light touch was enough to produce unbearable pain, which prevented the patient from carrying out simple daily tasks. She had complete relief of her symptoms following removal of the hyperplastic pacinian corpuscle and returned to her normal life. A review of the literature revealed few reported cases of hypertrophied pacinian corpuscles in the hand. We believe that this diagnosis must be considered in the differential diagnosis of digital pain of unknown etiology.

Female↗

PubMed1993

Paired five-flap Z-plasty.

Web-like contractures may occur along both the outer borders of joints, creating double-parallel contracture bands that turn into webs during movements. A combination of two "five-flap z-plasties" lying in confrontation to each other was used to release such contractures. The two Vs face each other and meet at their upper ends, forming a rhomboid (Fig. 1, a and b) or hexagon (Fig. 1, c and d) whose position remains unchanged after the contractures have been released and all the flaps transferred or advanced. This method has been used to release a total of seven double-parallel web-like linear contractures with very satisfactory results. Paired five-flap z-plasty seems to be superior when release of double web-like contractures, with the presence of sufficient spared skin, is contemplated.

Adult↗

PubMed1992

The "lazy-V" de-epithelialised turn-over fasciocutaneous flap in the reconstruction of skin defects after tendo Achilles repair.

Few methods of closure of skin defects lying over the tendo Achilles have been described. The de-epithelialised turn-over flap is one of them but it cannot be used in the presence of a scar proximal to the defect. We describe a modification ("The Lazy-V") of the de-epithelialised turn-over flap which gives it a rotation arc, thus enhancing the versatility of the procedure. This modification is presented with an illustrative case report and a review of the literature.

Achilles Tendon↗