Disseminated basal cell carcinoma.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to Bulent Erdogan.
Explore the source record for details and available documents.
Nasal augmentation required following a trauma or a rhinoplasty operation poses a challenging problem to many plastic surgeons. Currently, allografts and autologous tissues are used for nasal augmentation; however, an ideal technique has not yet been described. Although preferred for augmentation of different parts of the body, pure dermal graft use has not been described for nasal augmentation. The authors performed nasal augmentation using a dermal graft in 90 patients in their hospital between 1994 and 2000, and they followed up the patients for 6 months to 8 years. In this article, the early and late results of dermal grafts for nasal augmentation are presented, and their advantages and disadvantages are discussed with a review of the literature. It was concluded that the easily obtained dermal graft could be an appropriate alternative in nasal augmentation, though it has not been used widely for this purpose.
Conservative treatment of an epidural hematoma is not always effective in children. We describe an 8-year-old boy who had been followed up conservatively for 10 days at a local hospital due to acute epidural hematoma. A new CT revealed an expansion of the former hematoma accompanied by a thick hyperdense layer. Because the patient presented with symptoms of elevated intracranial pressure, an immediate craniotomy was performed to evacuate the hematoma. The ossified layer, which was densely adhered to the dura mater, was also completely removed. Rapid ossification and/or calcification of an epidural hematoma appearing 10 days after a head injury have not been reported previously. Possible mechanisms of rapid ossification are also discussed in relation to the present report, and the relevant literature is reviewed.
Hemangiomas are rare benign tumors of vascular origin and multiple location of these tumors in different organs is extremely unusual. We report a case with multiple hemangiomas, characterized by calvarial, hepatic and suspicious costal involvement. Organ involvement and multiplicity of the neoplasm made our case very interesting and distinct. Our search of the English literature has revealed that no similar case has ever been published.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: The incidence of symptomatic hemangioblastoma of the posterior fossa during pregnancy is extremely low. Previous reports have noted that pregnancy seems to aggravate the clinical course of intracranial tumors, but little is known about the possible reasons. Various theories have been proposed to explain the rapid neurologic deterioration of hemangioblastoma patients during pregnancy; however, the pathophysiologic behavior and histogenesis of this vascular tumor are still not well understood. CASE: A case of cerebellar hemangioblastoma was diagnosed during pregnancy. Urgent surgery was required due to rapid development of obstructive hydrocephalus and brainstem compression. CONCLUSION: Obstetricians and neurosurgeons should be aware of the rare clinic entity of hemangioblastoma during pregnancy. Surgery might be indicated as soon as the tumor becomes symptomatic.
This prospective study evaluated 60 reproductive-age and postmenopausal women with lumbar disc disease to demonstrate the short-term effects of lumbar disc surgery on bone mineral density (BMD). Lumbar BMD was measured preoperatively and 3 months postoperatively by dual-energy X-ray absorptiometry (DEXA). Surgery was performed at only one level (L3-L4) and consisted of partial hemilaminectomy, discectomy, and, if necessary, partial facetectomy. Before surgery, 50% of the patients had osteopenia, and 31.7% had osteoporosis. After surgery, BMD decreased 5.5% in L3 vertebrae (P=.07), 14% in L4 vertebrae (P=.003), and 4.6% in L1-L4 (P=.039). Six of 11 patients with normal BMD before surgery became osteopenic postoperatively; 9 of 30 women with osteopenia fulfilled criteria for osteoporosis after surgery. Reproductive-age and postmenopausal women undergoing surgery for lumbar disc disease are at risk of bone loss and should be spared an extensive procedure, which can further increase the amount of bone lost. All women for whom a surgical intervention is planned should be evaluated by DEXA preoperatively and postoperatively.
Anterior cervical discectomy and fusion, as originally described by Robinson, is highly successful in the treatment of neural compression caused by disc material or osteophytes. Although the necessity for fusion after anterior cervical discectomy is still debated, anterior cervical fusion with interbody bone graft and anterior plate implantation is a commonly accepted procedure. In this study, preliminary results with a recently developed PCB cervical plate system (SCIENT'X, Paris, France), which combines a hollow intradiscal cage with an integrated plate, in the management of cervical disc disease are reported.
The aim of early thrombolytic therapy in acute stroke is to obtain early recanalization of occluded cerebral arteries and prevent or reduce irreversible ischemic brain damage. In this study, Seldinger technique and digital subtraction angiography were used to verify thromboembolic occlusion of the common carotid artery by an autologous 12-hour-old thrombus in 28 rabbits. Thirty minutes after embolization, 2 mg/kg of recombinant tissue-plasminogen activator (rt-PA) was delivered intravenously by way of the femoral vein in group A (n = 8) and through a local intraarterial infusion in group B (n = 8). Twelve control animals received an equivalent volume of saline intravenously (group C, n = 6) or by local intra-arterial infusion (group D, n = 6). A comparison of posttreatment angiographs of the treatment groups and the control groups was used to demonstrate reperfusion induced by thrombolytic therapy. None of the control animals showed any evidence of recanalization. Both intravenously (group A) and intra-arterially (group B) treated animals achieved 100% recanalization, although the average time to recanalization was significantly longer in group A (P = .01; 123.7 vs 82.5 min). These results suggest that local intra-arterial administration of rt-PA within 30 minutes produces more rapid reperfusion compared with the intravenous route. Further studies and additional treatments are needed to widen the therapeutic window and decrease hemorrhagic side effects.
Although there is a controversy about success and failure of autologous fat tissue transfers, it is a widely accepted method for soft tissue augmentation and is performed by many plastic surgeons as well as dermatologists all around the world. Its advantages are that it does not cause reactions, its absorption rates have been reduced by increased knowledge, experience, and techniques, it can yield good, long-term results, and there are now preservation techniques that allow reinjections when necessary. However, no single ideal technique has been determined. In this paper a new, simple, T-shaped adaptor for easy, quick, and efficient fat harvesting during liposuction is described. This study not only describes the clinical use of the adaptor, but also histologically examines its effects on fat cells under various vacuum pressures (-250 mmHg, -500 mmHg, -700 mmHg). The study shows that the cell structure of fat tissue harvested under medium power (with vacuum pressures of -250 mmHg and -500 mmHg) is not disrupted, while that of tissue harvested with a vacuum pressure of -700 mmHg was traumatized and occasional cell wall fragmentation occurred. In conclusion, it is shown that the T-shaped adaptor allows harvesting of the desired amount of fat tissue without causing trauma to fat cells when it is used with medium-power suction.
Androgenic alopecia is a serious problem for a large proportion of the population, especially males, and causes them to seek medical help. Many methods have been described for treatment of androgenic alopesia. Among them are punch grafts, strip grafts, scalp grafts, scalp reductions, tissue expanders, and flap combinations, and hair transplantations with minigrafts and micrografts. The latter has become popular in the last two to three decades and has been investigated extensively. Improvements in hair replacement with minigrafts and micrografts may allow an ideal result with a nearly normal appearance. However, hair replacement with these grafts has important disadvantages. It requires a long operational time and only a limited number of grafts can be placed in one session. In this study, we investigated morphological structures of micrografts stored at 4 degrees C and those stored at -20 degrees C. We found that morphological structures of the grafts stored at 4 degrees C started to be impaired in the fifth day, but that the morphological structures of the grafts stored at -20 degrees C remained unaltered for 15 days. If this method is put into practice, the use of minigrafts and micrografts available will not only obviate the second graft harvesting, but also allow reconstruction of a large area in a short period of time.
Currently, both autogenous and nonautogenous materials are used to treat contour deformities. Autogenous grafts are preferable to nonautogenous grafts because they cause less reaction and are both inexpensive and easy to obtain. Currently, however, no consensus exists on an ideal autogenous graft. As autogenous materials, dermal grafts can be obtained from scar tissue, allowing simultaneous revision of scars, quicker vascularization than with other autogenous tissues, and a very short immobilization for their stabilization (i.e., they interact with surrounding tissues). The operation can be performed with the patient under local anesthesia, providing regular contours easily. Alternative techniques are needed to increase the viability and mass effects of autogenous grafts in the long term. With this as the objective, folded dermal grafts were used to increase the mass effects of dermal grafts. The current study compared long-term histopathologic and structural changes in unfolded and folded dermal autogenous grafts used for correction of soft tissue contour deformities. Thicknesses and histopathologic changes of the unfolded and folded dermal autogenous grafts were evaluated 6 and 12 months after placement of the grafts in the abdomens of 10 rabbits. Both the authors' observations and histopathologic examinations showed that the folded dermis caused a more severe granulomatous reaction and fibrosis. Graft thicknesses considerably increased in the first 6 months, but then almost leveled off in the following months. Increased fibrosis in the folded grafts had a masslike effect, which was preserved in the long term, suggesting that folded dermal grafts can be used clinically.
The umbilicus is a very important component of the abdominal aesthetic view. However, loss of the umbilicus for any reason is a challenging problem. Various methods for umbilicus reconstruction have been published. Most of these methods are complex, and the surgical outcome is mostly unsatisfactory for the patients. The authors have developed a simple method for umbilicus reconstruction using a bilobed flap.
The deviated nose is a particular challenge because both functional and aesthetic problems must be addressed. A most important challenge is resection of the hump. The nasal bones often are asymmetric in deviated noses. Several methods have been used for resection of the hump. Using the authors' method, it is possible to calculate the extent of hump resection. Clinical analysis of the nasal deviation is performed preoperatively. Digital photographs are taken, and all the landmarks are marked on the life-size photo prints. Planning begins on the deviated side. The ideal dorsal line is drawn, and the extent of hump resection is planned according to the preoperative measurements. Measurements on the deviated side are applied to the other side using the medial canthi and the most prominent part of the alar creases as landmarks. Classical methods emphasize the importance of the chisel position during hump removal. According to the classical approach, the chisel should be positioned lower on the deviated side to resect more bone. However, there is no method for calculating how the chisel should be positioned exactly during hump resection. Therefore, a precise plan has been devised to leave symmetric nasal bones after hump resection. The authors have applied this method in eight cases, achieving satisfactory results.