Yusuf Kenan Coban

Ischemic preconditioning reduces the severity of ischemia-reperfusion injury of peripheral nerve in rats

Background and aim Allow for protection of briefly ischemic tissues against the harmful effects of subsequent prolonged ischemia is a phenomennon called as Ischemic Preconditioning (IP). IP has not been studied in ischemia-reperfusion (I/R) model of peripheral nerve before. We aimed to study the effects of acute IP on I/R injury of peripheral nerve in rats. Method 70 adult male rats were randomly divided into 5 groups in part 1 experimentation and 3 groups in part 2 experimentation. A rat model of severe nerve ischemia which was produced by tying iliac arteries and all idenfiable anastomotic vessels with a silk suture (6-0) was used to study the effects of I/R and IP on nerve biochemistry. The suture technique used was a slip-knot technique for rapid release at time of reperfusion in the study. Cytoplasmic vacuolar degeneration was also histopathologically evaluated by light microscopic examination in sciatic nerves of rats at 7th day in part 2 study. Results 3 hours of Reperfusion resulted in an increase in nerve malondialdehyde levels when compared with ischemia and non-ischemia groups (p < 0.001 and p < 0.0001 respectively). IP had significantly lower nerve MDA levels than 3 h reperfusion group (p < 0.001). The differences between ischemic, IP and non-ischemic control groups were not significant (p > 0.05). There was also a significant decrease in vacoular degeneration of sciatic nerves in IP group than I/R group (p < 0.05). Conclusion IP reduces the severity of I/R injury in peripheral nerve as shown by reduced tissue MDA levels at 3 th hour of reperfusion and axonal vacoulization at 7 th postischemic day.

Effects of preoperative local ropivacaine infiltration on postoperative pain scores in infants and small children undergoing elective cleft palate repair.

Previous data have shown that preoperative analgesia may reduce postoperative analgesic demands. The aim of the current study was to determine if preincisional ropivacaine infiltration may reduce postoperative oral pain in infants and small children undergoing elective cleft palate patients. Twenty nonsyndromic cleft palate patients were randomly divided into 2 groups. Injection with ropivacaine hydrochloride, at dose of 0.2 mg/kg, was performed by submucous infiltration of the proposed incisional site groups of patients. In control group, no medication was given before cleft palate repair under general anesthesia. Postoperative pain scores were measured according to Children and Infants Postoperative Pain Scale. Heart rate recordings and noninvasive blood pressure measurements were also done in all the patients. Measurements of Children and Infants Postoperative Pain Scale scores at all the observational postoperative periods showed significantly favorable values in ropivacaine group than in control group (P < 0.05). Six patients in the control group required rescue analgesia, whereas 2 patients required analgesic therapy in the treatment group. Preemptive analgesia using ropivacaine may enhance early postoperative comfort by reducing early postoperative pain in primary cleft repair.

An ideal composite graft donor site for postburn alar rim deficiencies: root of helix.

One of the challenging postburn face deformities is alar rim defects or deformities. Small through-and-through defects of the nasal ala may be managed with a composite graft of auricular tissue, obtained from the earlobe, the helical rim, and the root of the helix. We use usually the root of the helix for postburn alar defect correction as a composite graft donor site. The advantage of these composite grafts is that the procedure is a single-stage operation with excellent contour correction and a well toleration of donor site morbidity by the patient.

Pierre Robin Sequence With Esophageal Atresia and Congenital Radioulnar Synostosis

A wide spectrum of anomalies can be associated with Pierre Robin sequence. This report presents a 3-day-old infant with micrognathia, U-shaped cleft palate, low-set right ear with microtia, glossoptosis, esophageal atresia, and right congenital radioulnar synostosis. The association of congenital radioulnar synostosis and esophageal atresia with Pierre Robin sequence has not been previously described.

A case of perforating pilomatricoma

Pilomatricoma is a rare skin neoplasm, most commonly seen in the head and neck region, and occurring in the first two decades of life. It is usually solitary and varies from 0.5 to 2 cm in diameter. Its etiology is unknown. Perforating pilomatricoma is a rare clinical variant that presents as a draining, crusted nodule or ulcer, and is reported to arise faster than the classic pilomatricoma. Herein, we report a case of 35‐year‐old female, who had a 4‐month history of a growing mass on her leg. On physical examination, a 4‐cm diameter, asymptomatic, erythematous, ulcerated mass was noted on the left anterio‐lateral upper leg. The first histopathological analysis of a punch biopsy from the lesion was reported as basal cell carcinoma. Therefore, the lesion was totally excised. There were shadow cells, squamoid cells, and basaloid aggregations more prominently in the one area in the tumor. In addition, calcification, foreign body giant cells and inflammatory cells were present. Punch or excisional biopsies are preferred as a method of diagnosis for the majority of cutaneous neoplasms. If total excision is not the method of choice, multiple punch biopsies should be made from different areas in large skin tumors for correct diagnosis.

Critical ischemic time for the rat ovary: Experimental study evaluating early histopathologic changes

The aim of the present study was to determine a critical ischemic time for ovary in an experimental study in rats. An experimental model using slip‐knot tying of all ovarian arteries and veins in cycling female rats was developed. Rat ovaries were tied using the technique through an explorative laparotomy. Complete ischemia times of 1, 2 and 3 h were used for the study. At the end of the ischemic times, the ovaries were harvested following 1 h of reperfusion. Histology indicated a gradually increased congestion correlating with the respective increased ischemic times. According to the present findings 2 h complete ischemia yields a significant injury. The model used in the present study may be used for complete ischemia–reperfusion injury of the rat ovary.

The Effects of Increased Ischemic Times on Adipose Tissue: A Histopathologic Study Using the Epigastric Flap Model in Rats

Little study has investigated the ischemic injury of mature adipocytes. This study researched the effects of different ischemic times on fat histology the 7th postischemic day in a rat epigastric flap model. For this study, 24 rats were randomly divided into four groups subjected, respectively, to 1, 2, 3, and 4 h of ischemia. The most severe inflammation and fat necrosis scores were seen in groups 3 and 4 (p < 0.05). According to the findings of this study, it is possible to say that fat tissue undergoes a gross necrosis after 3 or more hours of ischemia. After that ischemic time, the necrotic volume of fat tissue subjected to ischemic insult does not increase with increased ischemic time.

Superficial burns secondary to misuse of acetic acid solution.

Topical use of acetic acid solutions is one of the treatments for human papillomavirus infections, although the disease can spontaneously resolve. Over-the-counter availability of acetic acid solutions for medical use presents a potential hazard for misuse. Here we present an example of accidental use. A 13-year-old boy was wounded as a result of using an acetic acid solution for cosmetic purposes. Superficial burns on the left side of his face were managed with topical wound care, and minimal scar formation occurred.

The use of a silicone-coated acrylic vaginal stent in McIndoe vaginoplasty and review of the literature concerning silicone-based vaginal stents: a case report

BackgroundMc Indoe vaginoplasty is one of the mostly performed surgical interventions in Mullerian agenesis.Case presentationsWe present our experience on the use of a new designed vaginal stent that was coated with silicone in two mullerian agenesis cases who had Mc Indoe vaginoplasty. Both full thickness and splitt thickness skin graft were used with the stent. No graft loss or hyperthrophic scarring which may be seen at the apex of neovagina after Mc Indoe vaginoplasty was observed during the follow-up period and adequate neovaginal depth were obtained in both of the patients.ConclusionWe think that the incorporation of silicone to a vaginal stent for postoperative wound care improves skin graft take and decreases a possible constriction band formation in neovagina.Background Mc Indoe vaginoplasty is one of the mostly performed surgical interventions in Mullerian agenesis. Case presentations We present our experience on the use of a new designed vaginal stent that was coated with silicone in two mullerian agenesis cases who had Mc Indoe vaginoplasty. Both full thickness and splitt thickness skin graft were used with the stent. No graft loss or hyperthrophic scarring which may be seen at the apex of neovagina after Mc Indoe vaginoplasty was observed during the follow-up period and adequate neovaginal depth were obtained in both of the patients. Conclusion We think that the incorporation of silicone to a vaginal stent for postoperative wound care improves skin graft take and decreases a possible constriction band formation in neovagina.

Lipoma due to chronic intermittent compression as an occupational disease.

A total of 15 coppersmiths who do the job as a traditional profession in Kahramanmaras Province were retrospectively analyzed for revealing a possible relationship of lipoma formation and chronic compression, as the work characteristic related to mechanical pressure to the right thoracal and shoulder region. The workers were examined and their historical data were noted. Chronic compression sites in the patients were also evaluated by magnetic resonance imaging and ultrasonography. The ages were between 30 and 52 years. Body mass index ranged from 18.6 to 38.8. Five were operated for visible lipomatous masses at their injured sites. All of the specimens were reported as containing mature adipocytes. An increased subcutaneous fat thickness at the injured sides of the patients was seen when compared with the uninjured contralateral sides using ultrasonography. At the magnetic resonance images, no capsule intensity was observed in the lipomatose masses. Subcutaneous fat of injured right mammarial regions was thicker than the other contralateral sides in all of the cases. The most prominent lipomas were seen in obese workers, and strong evidence for chronic trauma and lipoma formation as an occupational disease was obtained from the study.