RESUMO
Petroleuciscus ninae sp. nov. is described from the Büyük Menderes River drainage. The new species is distinguished by having a black lateral stripe from head to base of caudal fin, stripe distinct anteriorly and posteriorly, wider than eye diameter; numerous black pigments on anal-fin rays; body depth at dorsal-fin origin 27-30% standard length (LS ); head width at posterior margin of eye 16-19% LS ; and eye diameter smaller than snout length. Petroleuciscus ninae is also distinguished from other species in adjacent waters by having six fixed diagnostic nucleotide substitutions in the mitochondrial DNA coI barcode region.
Assuntos
Cyprinidae/classificação , Animais , Cyprinidae/anatomia & histologia , DNA Mitocondrial/genética , Pigmentação , Rios , TurquiaRESUMO
A 41-year-old man with myasthenia gravis was referred to our clinic to undergo a thymectomy by video-assisted thoracic surgery. After physical examination of the thorax and evaluation by computed tomography, a mass lesion was noticed in the neck and thymectomy was performed by partial sternotomy combined with a cervical incision. The cervical thymoma was discontinuous with the thymus. Thymoma in the neck has rarely been reported. In this case report we emphasize the possible presence of thymoma in the neck and the importance of neck evaluation in patients with myasthenia gravis.
Assuntos
Miastenia Gravis/diagnóstico , Timoma/cirurgia , Timo/anormalidades , Neoplasias do Timo/cirurgia , Adulto , Biópsia por Agulha , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Pescoço , Doenças Raras , Medição de Risco , Cirurgia Torácica Vídeoassistida/métodos , Timoma/diagnóstico , Neoplasias do Timo/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: The operations with proven effects on survival in Budd-Chiari syndrome are shunt operations and liver transplantation. PATIENTS AND METHODS: Between 1993 and 1999 (June), 13 cases of Budd-Chiari syndrome have been treated surgically. Four cases had concomitant thrombosis of the inferior vena cava; the others had marked narrowing of the lumen due to the enlarged caudate lobe. Mesoatrial (n = 12) or mesosuperior vena caval (n = 1) shunts were constructed with ringed polytetrafluoroethylene grafts. RESULTS: The median portal pressure fell from 45 (range 32 to 55) to 20 (range 11 to 27) cm H(2)O (P <0.001). Two patients died in the early postoperative period. One patient who did not comply with anticoagulant treatment had a shunt thrombosis in the second postoperative year. The other 10 patients are alive without problems during a median 42 (range 1 to 76) months of follow-up. CONCLUSION: Mesoatrial shunt with a ringed polytetrafluoroethylene graft is effective in Budd-Chiari syndrome cases with thrombosis or significant stenosis in the inferior vena cava.
Assuntos
Síndrome de Budd-Chiari/cirurgia , Veias Mesentéricas/cirurgia , Derivação Portossistêmica Cirúrgica/métodos , Veia Cava Inferior/cirurgia , Veia Cava Superior/cirurgia , Adolescente , Adulto , Prótese Vascular , Implante de Prótese Vascular/métodos , Síndrome de Budd-Chiari/diagnóstico , Doença Crônica , Feminino , Seguimentos , Átrios do Coração/cirurgia , Humanos , Masculino , Politetrafluoretileno , Fatores de TempoRESUMO
Any penetrating trauma to the mediastinum may cause great vessel damage resulting in massive bleeding or even shock. Associated tracheal injury increases morbidity and mortality. We report a case of a penetrating mediastinal injury with isolated tracheal laceration. The stab entered in the left supraclavicular fossa. The patient presented with right-sided pneumothorax, pneumomediastinum and respiratory collapse. Bronchoscopy revealed two injuries in the trachea that were repaired by right thoracotomy and left cervicotomy. The patient was discharged on postoperative day 6. Isolated thoracic tracheal injury is very rare in mediastinal stab wounds and operative strategy may change according to bronchoscopic findings.
Assuntos
Procedimentos Cirúrgicos Operatórios/métodos , Traqueia/lesões , Traqueia/cirurgia , Ferimentos Perfurantes/complicações , Ferimentos Perfurantes/cirurgia , Adolescente , Humanos , Masculino , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/cirurgia , Pescoço , Pneumotórax/etiologia , Pneumotórax/cirurgia , Insuficiência Respiratória/etiologia , Resultado do TratamentoRESUMO
BACKGROUND: The objective of this study was to assess the role of a modified stair climbing test in predicting postoperative cardiopulmonary complications. METHODS: A consecutive series of 150 patients who had undergone pulmonary resection for lung carcinoma formed the prospective database of this study. All patients performed a preoperative modified stair climbing test. Univariate and multivariate analyses were performed to identify predictors of postoperative cardiopulmonary complications. RESULTS: With univariate analysis, the patients with complications had a lower pre-exercise and postexercise percentage of oxygen saturation. PaO (2) levels were found to be lower and a greater change in oxygen desaturation during exercise was noted. Logistic regression analysis showed that the percent of oxygen saturation pre-exercise and the change in percent of oxygen desaturation during exercise were independent and reliable predictors of cardiopulmonary morbidity. CONCLUSIONS: A modified stair climbing test is a safe, economical and simple test capable of predicting cardiopulmonary complications.
Assuntos
Teste de Esforço , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/diagnóstico , Análise de Variância , Cardiopatias/diagnóstico , Humanos , Modelos Logísticos , Pneumopatias/diagnóstico , Prognóstico , Estudos ProspectivosRESUMO
A 76-year-old woman was found to have a large, substernal, intrathoracic goiter. During excision, the trachea was found to be malacic. The trachea was sutured to a 16-mm ringed Gore-Tex (Gore & Associates, Arizona, USA) graft with Vicryl (Ethicon, Johnson & Johnson, USA) sutures. The graft was placed on the external surface of the trachea and surrounded the trachea almost 300 degrees. The patient was discharged on postoperative day seven without complications. She was seen at follow-up six months later and found to be free of complications.
Assuntos
Prótese Vascular , Bócio Subesternal/complicações , Procedimentos Cirúrgicos Torácicos/métodos , Doenças da Traqueia/cirurgia , Idoso , Feminino , Bócio Subesternal/diagnóstico por imagem , Bócio Subesternal/cirurgia , Humanos , Tomografia Computadorizada por Raios X , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/etiologiaRESUMO
An 8-year-old girl, who had been mechanically ventilated for 2 days, was referred to our clinic with total atelectasis of the right lung. Bronchoscopic examination showed an endobronchial mass lesion which was located on the right side of the carina. Carinal resection was performed and the patient was discharged on postoperative day 7. We presented this case report because of the rarity of tracheal tumors in childhood and to discuss the recommended surgical technique for pediatric carinal resection.
Assuntos
Atelectasia Pulmonar/cirurgia , Neoplasias da Traqueia/cirurgia , Broncoscopia , Criança , Feminino , Humanos , Atelectasia Pulmonar/etiologia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/diagnósticoRESUMO
BACKGROUND: The aim of this study was to compare the early postoperative results of thymectomy operations after partial sternotomy and videothoracoscopy for myasthenia gravis. METHODS: A total of 51 thymectomy operations were reviewed. The surgical procedure was simple thymectomy with partial sternotomy in the first 19 patients (Group I) and videothoracoscopic thymectomy (Group II) in the remaining patients. Both groups were compared in terms of preoperative data (age, gender, classification, duration of disease, medications), operative data (operation time, the mean amount of drainage, the duration of chest tube drainage), and postoperative data (duration of hospital stay, complications and pain). RESULTS: Groups were statistically uniform in terms of preoperative and operative data. Statistically significant differences were noted for the duration of chest tube drainage (48.8 vs. 29.8 hours, p < 0.001), the amount of drainage (264.4 vs. 178.6 ml, p = 0.001), the length of hospital stay (5.6 vs. 2.3 days, p = 0.000), and the visual analogue scale score (4.8 vs. 3.1, p < 0.001). CONCLUSIONS: Thymectomy with videothoracoscopic surgery demonstrated a more comfortable and faster recovery period without deterioration in myasthenic status.
Assuntos
Miastenia Gravis/cirurgia , Esterno/cirurgia , Cirurgia Torácica Vídeoassistida , Timectomia , Adulto , Estudos de Casos e Controles , Tubos Torácicos , Drenagem , Feminino , Humanos , Tempo de Internação , Masculino , Medição da Dor , Dor Pós-Operatória/terapia , Período Pós-Operatório , Fatores de TempoRESUMO
BACKGROUND: The aim of this study is to identify the effectiveness of perioperative pneumoperitoneum to prevent air leak after the lobectomy-bilobectomy operations for lung cancer. METHODS: A prospective study was designed on consecutive 50 patients who had lobectomy-bilobectomy operations for lung cancer and whose remnant lung had failed to fill the half of the hemithoracic cavity under 30 cm H(2)O positive pressure ventilation during the operation with totally relaxed diaphragm. The patients were divided into two groups: group 1 (25 patients) with perioperative pneumoperitoneum, group 2 (25 patients) without perioperative pneumoperitoneum. RESULTS: The statistical analysis between the two groups did not show any significant difference in terms of age, preoperative FEV1, and the type of resection. Perioperative pneumoperitoneum significantly reduced the duration of postoperative air leak (2.2 +/- 1.15 days vs. 6.04 +/- 3.27 days p < 0.0001) and total chest tube drainage time (3.84 +/- 0.98 days vs. 7.88 +/- 3.16 days p < 0.001). CONCLUSION: Perioperative pneumoperitoneum after lobectomy-bilobectomy operations for lung cancer is an effective method to decrease air leak and chest tube drainage time.
Assuntos
Lobectomia Temporal Anterior , Neoplasias Pulmonares/cirurgia , Pneumoperitônio/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Lobectomia Temporal Anterior/efeitos adversos , Volume Expiratório Forçado/fisiologia , Humanos , Neoplasias Pulmonares/fisiopatologia , Pessoa de Meia-Idade , Pneumoperitônio/fisiopatologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , TurquiaRESUMO
Multiple peripheral pulmonary carcinoid tumors or their smaller counterparts (tumorlets of carcinoid type) are the most unusual form of carcinoids as a cause of ectopic corticotropin syndrome. Only three case reports were found in the literature. We describe a 35 year-old female patient with ectopic corticotropin secretion due to multiple peripheral pulmonary carcinoid tumors and tumorlets. A high-dose dexamethasone suppression test result led to the diagnosis of Cushing's disease in our case. But no tumor was identified on sella imaging and bilateral inferior petrosal sinus sampling was non-diagnostic. Computed tomography of the lungs revealed multiple acinar-nodular parenchymal infiltrations confined to the left lung. Corticotropin-dependent hypercortisolism persisted after bilateral adrenalectomy. A second operation was necessary to remove the hyperplastic adrenal remnants. Meanwhile, computed tomography findings of the thorax were unchanged. We decided to explore these nodules by open lung biopsy. During the procedure multiple nodules ranging 12 to 3 mm in diameter scattered throughout the left lung were observed and left pneumonectomy was performed. Histopathological diagnosis was multiple peripheral carcinoid tumors and tumorlets of carcinoid type showing positive immunostaining with corticotropin. This observation emphasizes a rare form of carcinoids as a cause of ectopic corticotropin secretion and its unusual response to high dose dexamethasone suppression test.