AIM： TO evaluate seven patients with non-traumatic splenic rupture （NSR）. NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient＇s sur...AIM： TO evaluate seven patients with non-traumatic splenic rupture （NSR）. NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient＇s survival. METHODS： Within 11 years, seven cases were evaluated for patient characteristics, anamnesis and symptoms, method of diagnosis, findings of laparotomy, and etiology of NSR. RESULTS： There were six （86%） male and one female （14%） patient, whose mean age was 36 ± 12.8 （17-56） years. We report here four cases of Plasmodium vivax malaria （cases Ⅰ-Ⅳ）, one case of hemodialysis （case Ⅴ）, one case of spontaneous splenic rupture （case Ⅵ）, and one case of hairy cell leukemia （case Ⅶ）. Splenectomy was performed in all patients. All of them made an uneventful recovery and were discharged in stable condition. CONCLUSION： NSR is a rare entity that needs a high index of suspicion for diagnosis. Using ultrasonography or computer tomography, and peritoneal aspiration of fresh blood may assist in the diagnosis of NSR. Increased awareness of NSR can enhance early diagnosis and effective treatment.展开更多
Behcet’s disease (BD) is a chronic inflammatory disorder that can affect many systems in the body. Cardiac involvement increases the risk of cardiovascular mortality and occurs in 1%-5% of patients with BD. Ventricul...Behcet’s disease (BD) is a chronic inflammatory disorder that can affect many systems in the body. Cardiac involvement increases the risk of cardiovascular mortality and occurs in 1%-5% of patients with BD. Ventricular arrythmias are believed to be the cause of this increased risk of cardiovascular mortality and it is also thought to be related with cardiac autonomic dysfunction. Heart rate turbulence (HRT) is a new predictor of cardiac autonomic activity. HRT is an independent and powerful predictor of mortality. In this study, we investigated the cardiac autonomic activity which can be determined by HRT in patients with BD. Forty patients with BD (20 men, mean age: 40 ± 9 years, range: 27-55 years) were diagnosed according to the International Study Group Criteria (ISGC) and gender and age matched healthy volunteers (20 men, mean age: 39 ± 8 years, range: 26-56 years) were included in this study. All of the participants (patients and controls) underwent 24 hours Holter electrocardiogram. HRT parameters, turbulence onset (TO) and turbulence slope (TS) were calculated with HRT (View Version 0.60-0.1 of Software Program). There were no significant differences in TO and TS values between patients with BD and control subject (TO-BD: 0.014 ± 0.03, TO-Control: 0.011 ± 0.04;TS-BD: 7.88 ± 4.9, TS-Control: 9.42 ± 6.7 respectively). Although increased cardiovascular mortality rates in BD have been shown in many studies, HRT values—detecting the risk of sudden death—do not seem to be altered in this disease.展开更多
Background: Endovenous laser ablation is a relatively newer alternative to treat great saphenous vein insufficiency. We evaluated the efficiency and safety of treatment endovenous laser procedures on the different sap...Background: Endovenous laser ablation is a relatively newer alternative to treat great saphenous vein insufficiency. We evaluated the efficiency and safety of treatment endovenous laser procedures on the different saphenous vein diameters with different energy levels. Methods: Data regarding endovenous laser ablation of symptomatic chronic great saphenous venous insufficiency in 209 patients were prospectively recorded. Patients were grouped into two main groups based on their diameters as 5 to 7 millimeters (Group A) or more than 7 millimeters (Group B). Patients in each group was randomized into two groups as >90 J/cm (A1 and B1) or 80-90 J/cm (A2 and B2). Postoperative outcome and complications were recorded during follow-ups at 1st week;1st, 3rd and 6th months to examine the venous reflux and recanalization. Results: Perioperative complaints as pain, cramps and ankle swelling were more commonly observed in A1 group. Fatigue was more common in A2 and B2 groups. No major complications as deep vein thrombosis or skin burns were observed. Conclusions: Endovenous laser ablation is a safe and effective procedure with a high satisfaction rate shortening hospitalization durations and early ambulant activity. Pain, ankle swelling and fatigue are the most common minor complaints in the early postoperative period.展开更多
Ventricular fibrillation seen just after declamping of the aorta is an undesirable condition causing myocardial injury. To return to normal rhythm, often internal shocks are applied. But defibrillation itself can also...Ventricular fibrillation seen just after declamping of the aorta is an undesirable condition causing myocardial injury. To return to normal rhythm, often internal shocks are applied. But defibrillation itself can also contribute to myocardial injury. So prevention of fibrillation is more important than treatment. 236 patients undergoing coronary artery by-pass surgery were included in this retrospective clinical study. 144 of those patients were operated using modified St. Thomas’ Hospital cardioplegic solution, for stopping the heart. In the other 92 patients, plegisol cardioplegic solution was used. We compared the two groups for the development of ventricular fibrilation after declamping of the aorta. In the modified St. Thomas’ Hospital group, ventricular fibrillation after declamping of the aorta was seen less frequently, this being statistically significant (22.2% vs. 52.2%, p = 0.026). This study shows that the modified St.Thomas’ Hospital cardioplegic solution is preferred for avoiding ventricular fibrillation occuring just after declamping of the aorta.展开更多
文摘AIM： TO evaluate seven patients with non-traumatic splenic rupture （NSR）. NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient＇s survival. METHODS： Within 11 years, seven cases were evaluated for patient characteristics, anamnesis and symptoms, method of diagnosis, findings of laparotomy, and etiology of NSR. RESULTS： There were six （86%） male and one female （14%） patient, whose mean age was 36 ± 12.8 （17-56） years. We report here four cases of Plasmodium vivax malaria （cases Ⅰ-Ⅳ）, one case of hemodialysis （case Ⅴ）, one case of spontaneous splenic rupture （case Ⅵ）, and one case of hairy cell leukemia （case Ⅶ）. Splenectomy was performed in all patients. All of them made an uneventful recovery and were discharged in stable condition. CONCLUSION： NSR is a rare entity that needs a high index of suspicion for diagnosis. Using ultrasonography or computer tomography, and peritoneal aspiration of fresh blood may assist in the diagnosis of NSR. Increased awareness of NSR can enhance early diagnosis and effective treatment.
文摘Behcet’s disease (BD) is a chronic inflammatory disorder that can affect many systems in the body. Cardiac involvement increases the risk of cardiovascular mortality and occurs in 1%-5% of patients with BD. Ventricular arrythmias are believed to be the cause of this increased risk of cardiovascular mortality and it is also thought to be related with cardiac autonomic dysfunction. Heart rate turbulence (HRT) is a new predictor of cardiac autonomic activity. HRT is an independent and powerful predictor of mortality. In this study, we investigated the cardiac autonomic activity which can be determined by HRT in patients with BD. Forty patients with BD (20 men, mean age: 40 ± 9 years, range: 27-55 years) were diagnosed according to the International Study Group Criteria (ISGC) and gender and age matched healthy volunteers (20 men, mean age: 39 ± 8 years, range: 26-56 years) were included in this study. All of the participants (patients and controls) underwent 24 hours Holter electrocardiogram. HRT parameters, turbulence onset (TO) and turbulence slope (TS) were calculated with HRT (View Version 0.60-0.1 of Software Program). There were no significant differences in TO and TS values between patients with BD and control subject (TO-BD: 0.014 ± 0.03, TO-Control: 0.011 ± 0.04;TS-BD: 7.88 ± 4.9, TS-Control: 9.42 ± 6.7 respectively). Although increased cardiovascular mortality rates in BD have been shown in many studies, HRT values—detecting the risk of sudden death—do not seem to be altered in this disease.
文摘Background: Endovenous laser ablation is a relatively newer alternative to treat great saphenous vein insufficiency. We evaluated the efficiency and safety of treatment endovenous laser procedures on the different saphenous vein diameters with different energy levels. Methods: Data regarding endovenous laser ablation of symptomatic chronic great saphenous venous insufficiency in 209 patients were prospectively recorded. Patients were grouped into two main groups based on their diameters as 5 to 7 millimeters (Group A) or more than 7 millimeters (Group B). Patients in each group was randomized into two groups as >90 J/cm (A1 and B1) or 80-90 J/cm (A2 and B2). Postoperative outcome and complications were recorded during follow-ups at 1st week;1st, 3rd and 6th months to examine the venous reflux and recanalization. Results: Perioperative complaints as pain, cramps and ankle swelling were more commonly observed in A1 group. Fatigue was more common in A2 and B2 groups. No major complications as deep vein thrombosis or skin burns were observed. Conclusions: Endovenous laser ablation is a safe and effective procedure with a high satisfaction rate shortening hospitalization durations and early ambulant activity. Pain, ankle swelling and fatigue are the most common minor complaints in the early postoperative period.
文摘Ventricular fibrillation seen just after declamping of the aorta is an undesirable condition causing myocardial injury. To return to normal rhythm, often internal shocks are applied. But defibrillation itself can also contribute to myocardial injury. So prevention of fibrillation is more important than treatment. 236 patients undergoing coronary artery by-pass surgery were included in this retrospective clinical study. 144 of those patients were operated using modified St. Thomas’ Hospital cardioplegic solution, for stopping the heart. In the other 92 patients, plegisol cardioplegic solution was used. We compared the two groups for the development of ventricular fibrilation after declamping of the aorta. In the modified St. Thomas’ Hospital group, ventricular fibrillation after declamping of the aorta was seen less frequently, this being statistically significant (22.2% vs. 52.2%, p = 0.026). This study shows that the modified St.Thomas’ Hospital cardioplegic solution is preferred for avoiding ventricular fibrillation occuring just after declamping of the aorta.
