Illustrations of Hernia Surgery in the Early Period of the Ottoman Empire by Serefeddin Sabuncuoglu.

BACKGROUND: Imperial Surgery (Cerrahiyyetü'l- Haniyye), penned by Serefeddin Sabuncuoglu (C.E. 1385-1468), is an impressive medical book that was written in Turkish using the Arabic alphabet, containing color miniature drawings and human figures, depicted in a fantastic style. The purpose of this report is to present this unique contribution to the literature on the known history of hernia surgery. METHODS: Imperial Surgery is divided into three chapters, each of which is divided into sections that, in general, present patients and diseases in the form of case reports. Some sections detail the procedures to be performed on a patient, the surgical instruments used and the positioning of the patient, which are described in detail with color miniature drawings. CONCLUSIONS: Serefeddin Sabuncuoglu was a great surgeon in Turkish medical history. Given all of the hernia-related information in literature, the treatise written by Sabuncuoglu in fifteenth century and its suggested approaches to hernias show clearly the place that he should hold in the history of the art of healing. Hernia surgery is described step-by-step under four headings in two chapters, supported by four miniature drawings, including surgical tools.

Assessment of mucociliary clearance as an indicator of nasal function in patients with COVID-19: a cross-sectional study.

PURPOSE: We assessed the effects of COVID-19 infection on nasal mucociliary activity. METHODS: The study was conducted in the pandemic wards of Adiyaman University Training and Research Hospital during April and May 2020. All patients admitted to the COVID-19 pandemic wards during the study period were invited to participate in the study. The study included 40 adults who agreed to participate and underwent a mucociliary clearance test successfully. The primary outcome was mucociliary clearance time and the secondary variables of interest were age, sex, and sino-nasal outcome test-22 scores. The control group included 40 concomitant healthy patients who visited the outpatient ear, nose and throat clinic with non-nasal symptoms. RESULTS: The study included 40 COVID-19-positive patients and 40 healthy controls. The mean mucociliary clearance times of the study (15.53 ± 5.57 min) and control (9.50 ± 3.70 min) groups were significantly different (Z = 4.675, p < 0.001). However, the mucociliary clearance time was not significantly different between males and females (t = 0.590, p = 0.558). CONCLUSIONS: Nasal mucociliary clearance time was prolonged in COVID-19 patients compared to healthy controls. Thus, we conclude that smell and taste are crucial symptoms that should not be overlooked in patients suspected of COVID-19 disease.

Craniomaxillofacial Surgery Techniques of 15th Century Turkish Surgeon Serefeddin Sabuncuoglu.

INTRODUCTION: Serefeddin Sabuncuoglu, in his surgical medicine book entitled "Imperial Surgery" (Cerrâhiyetü'l-Hâniyye) that was published in the 15th century, described many diseases using colored miniatures, and explained the repair of these conditions using surgical methods and the required patient care after surgery. In his handwritten treatise, Sabuncuoglu raised the curtain on his surgical methods with his illustrations. As a first in medical history, Sabuncuoglu's book should be considered one of the most important original works from that era. MATERIALS AND METHOD: The handwritten "Imperial Surgery" is presented in three chapters divided into 194 sections, and describing 147 surgical procedures with miniature drawings, 160 surgical instruments and 10 types of incision. RESULTS: A separate chapter is allocated to craniomaxillofacial surgery in Imperial Surgery, containing 53 of the total 194 sections. The first chapter describes the use of branding (cauterization) for the treatment of headache and facial diseases. The second chapter describes the treatment of hydrocephalus, headache, vascular surgery, and the surgical treatment of tumors in the head and face. The third chapter describes in detail the treatment of cranial fractures, nasal fractures, mandibular fractures and mandibular dislocations. CONCLUSION: The basic craniomaxillofacial surgery concepts, the descriptions of craniomaxillofacial diseases, the scales indicating the general patient conditions, and the surgical therapies, incisions, surgical instruments, postoperative care and complications put forward in the book are discussed in the present study. In the light of this seminal study, the authors of the present study suggest that Sabuncuoglu should be considered and dignified as one of the leading pioneers of craniomaxillofacial surgery.

Management of Medially Displaced Sub-Condylar Mandibular Fractures in Pediatric Population Using Novel Atraumatic Approach.

ABSTRACT: The appropriate treatment of pediatric mandibular condyle fractures is subject to much debate and concern among surgeons, with improper treatment potentially resulting in a number of adverse outcomes. Such outcomes include the disruption of mandible growth, decreased posterior facial height, facial asymmetry, and temporomandibular joint ankylosis. Several surgical and nonsurgical approaches to these fractures have been described in the literature; however, each one carries its own risk of various complications. In this study, the authors illustrate a new atraumatic approach for mild to moderately displaced subcondylar fractures, with least possible complications and unexpected outcomes. In this study, 6 patients (2 female and 4 male) with unilateral medially displaced condylar base and neck fractures, angulated between 30 and 45 degrees, were treated using a novel intraoral approach. The follow-up period varied from 12 to 18 months. All patients achieved normal occlusion and had painless functioning of the temporomandibular joint with proper mouth opening (>35 mm) without any recurrence at long term follow up. This minimally invasive approach could eliminate the possibility of major complications and be considered a safe and feasible surgical technique for certain cases of pediatric mandibular condyle fracture.

A Retrospective Analysis of Central Physician Appointment System Data in a Tertiary Health Center in Turkey.

INTRODUCTION: Considerable advances have been made in hospital appointment systems in the past 60 years. In Turkey, the Central Physician Appointment System (CPAS) is used together with appointments made through direct presentations to the hospital. This study evaluated CPAS data. MATERIALS AND METHODS: CPAS data for the previous 2 years (2015, Group 1; 2016, Group 2) were evaluated retrospectively. Department-based analysis was also performed. Total number of clinics, CPAS capacity, number of appointments through CPAS, and numbers of patients keeping appointments and "no shows" and ratios calculated from these were investigated. RESULTS: Overall, 1,704,594 patients were examined in 20 departments during the 2-year period (January 1, 2015-December 31, 2016). Mean CPAS capacity per department was 12,831 ± 7,691 in Group 1 and 11,573 ± 6,849 in Group 2 (p = 0.588). Ratios of appointments made through CPAS to CPAS capacity were 0.7 in Group 1 and 0.84 in Group 2 (p = 0.009). The ratio of patients keeping appointments made through CPAS to the number of appointments made through CPAS was 0.772 in Group 1 and 0.775 in Group 2 (p = 0.831). The departments with the highest number of appointments made through CPAS to CPAS capacity were Neurosurgery in Group 1 (0.99) and Ophthalmology in Group 2 (0.99). The department with the lowest ratio was Infectious Disease and Clinical Microbiology in Group 1 (0.28) and Group 2 (0.45). CONCLUSIONS: The use of CPAS has increased. However, some CPAS vacancies remain unfilled, and some appointments are not kept. CPAS capacities must be adjusted in line with take-up rates through regular department-based analysis.

Flap Preconditioning by Electrical Stimulation as an Alternative to Surgical Delay: Experimental Study.

Partial flap failures are unpredictable complications of reconstructive surgery. Electrical stimulation increases blood flow, capillary density, angiogenesis and vascular endothelial growth factor, anti-inflammatory effects while decreasing oxygen tension in tissues. In this study, we investigated these effective properties of electrical stimulation preoperatively on flap surgery instead of the surgical delay procedure.Modified McFarlane flaps were raised on the backs of 50 Sprague-Dawley rats. In the control group, a skin flap was made and flap survival rate was assessed on the seventh day. In the surgical delay group, 14 days after creating the bipedicled flap, the flap was totally elevated and flap survival rate was assessed on the 21st day. In the preconditioning by electrical stimulation group, the flap was created after application of electrical stimulation for 7 days. Flap survival rate was assessed on the 14th day. In the electrically stimulated ischemic flap group, the flap was created and afterward, electrical stimulation was applied for 7 days. After that, flap survival rate was assessed on the seventh day. In the surgical delay plus electrical stimulation group, following the elevation and suturing of the bipedicled flap back into its bed, electrical stimulation was applied in the first 7 days of delay, the flap was created on the 14th day, and then flap survival rate was assessed on the 21st day. In all groups, blood flow was evaluated at particular times. After completing these procedures, the flap vascularities of 5 animals from each group were assessed with microangiography.The flap survival rate of the preconditioning by electrical stimulation group was significantly higher than those of the other groups (P < 0.05). According to the blood flow estimates, except the preconditioning by electrical stimulation group and surgical delay plus electrical stimulation group, blood flow decreased in all the other groups after the postprocedure. In the microangiographic assessment of the preconditioning by electrical stimulation group, there were thin but numerous networks like vascular structures.Electrical stimulation applied to the normal area before flap elevation increased the flap survival. This increase is paramount to surgical delay which is, so far, widely known as the most effective method of improving flap vascularity.

New flap for the reconstruction of the perinasal region.

Various reconstructive methods ranging from secondary healing to free flap applications are used for the reconstruction of perinasal defects caused by trauma or tumor surgery. The method to be used for the reconstruction of this region is chosen considering many factors because of specific determining structures. The number of studies on the subcutaneous tissue and vascular configurations of this region are gradually increasing along with the accumulation of knowledge in this region. Herein, we describe the nasal superficial musculoaponeurotic system-pedicled island skin flap for the reconstruction of the nasal tip, supratip, lateral nasal margin, and infraorbital area. The described skin flap was performed for defects resulting from basal cell carcinoma excision in all the patients. Of the patients, 12 were females and 5 were males. The mean age was 67.8 years (range, 56-82 years). All patients were operated on under general anesthesia. The flap donor areas were closed primarily. None of the patients developed flap necrosis. Although mild edema and venous insufficiency were observed in the flaps in the acute period only in patients who underwent nasal tip reconstruction, these improved during follow-up. In the operated patients, no problem was observed in the donor area and nasal dorsal skin. The nasal superficial musculoaponeurotic system-pedicled island skin flap which we describe for the perinasal area reconstruction is a safe, easily performed and versatile flap. The multidimensional use of this flap together with a relatively easy reconstruction plan and surgical procedure would be effective in flap choice.

A one-year extensive molecular survey on SARS-CoV-2 in companion animals of Turkey shows a lack of evidence for viral circulation in pet dogs and cats.

Current evidence have now demonstrated that SARS-CoV-2 infects a wide array of mammalian animals; however, the full range of hosts and the viral circulation in companion animals remains to be clarified. In this context, as no such evidenced cases have been reported from Turkey, we aimed to screen for SARS-CoV-2 nucleic acid in housed dogs and cats clinically evaluated for respiratory symptoms and reared in different locations of Samsun province in the black sea region of Turkey from July 2020 to July 2021. Nasal swabs were collected from a total of 415 pets (65 cats and 350 dogs) aged between 1 and 9 years old. All the specimens were tested for SARS-CoV-2 RNA presence by real-time RT-PCR targeting two genomic regions of SARS-CoV-2, but none showed positive results. Our findings suggest that SARS-CoV-2 does not circulate in local pets and is not responsible for respiratory symptoms. However, further comprehensive molecular and serological surveys are required to have a better picture of the zoonotic, reverse zoonotic and pathogenic consequences of the ongoing COVID-19 pandemic in Turkey.

Spin relaxation in InGaN quantum disks in GaN nanowires.

The spin relaxation time of photoinduced conduction electrons has been measured in InGaN quantum disks in GaN nanowires as a function of temperature and In composition in the disks. The relaxation times are of the order of ∼100 ps at 300 K and are weakly dependent on temperature. Theoretical considerations show that the Elliott-Yafet scattering mechanism is essentially absent in these materials and the results are interpreted in terms of the D'yakonov-Perel' relaxation mechanism in the presence of Rashba spin-orbit coupling of the wurtzite structure. The calculated spin relaxation times are in good agreement with the measured values.

The effect of mesenchymal stem cell lyophilizate on the recovery of the zone of stasis following thermal burns.

INTRODUCTION AND AIM: Mesenchymal Stem Cells (MSCs) are known to contribute to wound healing by increasing tissue regeneration. This study examined the effect of MSC-Lyophilizate (MSC-L) on the recovery of the zone of stasis in thermal burns. METHODS: A comb was used to induce second-degree thermal burns (1 × 2 cm) on the dorsum of the rats. Within 30 min after the burn, MSC-L derived from the umbilical cord was administered to the experimental group and 1.5 ml of 0.9% isotonic sodium chloride to the sham group. The control group did not receive any intervention. Tissue samples were collected on postoperative day 7. Histopathological assessments were made using a microscope with digital camera attachment. SPSS for IBM 25 was used for data analysis. RESULTS: Epithelial loss and subepidermal bullae were observed in the control and sham groups on day 7. In the experimental group, the MSC-L administration was found to increase epithelial tissue formation and neovascularization in the dermis. We found no significant pathological findings in the epidermis and dermis in the experimental group. CONCLUSION: Administration of umbilical cord-derived MSC-L is of potential importance in wound healing. In our study, we observed that MSC-L that contained 1.5 million cells contributed significantly to the recovery of the stasis zone of burn.

Beta-glucan effects on 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxicity in liver and brain.

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a common environmental contaminant that is toxic to brain, heart, kidney and liver. TCDD toxicity is due to free radical formation. Beta-glucan is an antioxidant that exhibits beneficial effects on health. We investigated the effects of beta-glucan on brain and liver tissues of rats with TCDD induced toxicity. We used female rats divided into four groups: control, TCDD group treated with TCDD 2 µg/kg/week, beta-glucan group treated with 50 mg/kg/day beta-glucan for 3 weeks, TCDD + beta-glucan group treated with 2 µg/kg/week TCDD and 50 mg/kg/day beta-glucan together for 3 weeks. We found that the thiobarbituric acid reactive substance (TBARS) levels were increased significantly in the TCDD group compared to the other groups. Glutathione (GSH) levels, and superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) activities were reduced in the TCDD group compared to the control group. SOD, CAT, GPx activities and GSH levels were increased in the TCDD + beta-glucan group. Histopathological observations were consistent with our biochemical findings. The oxidative stress and histopathology caused by TCDD were ameliorated by beta-glucan treatment. Beta-glucan should be explored for preventing brain and liver damage caused by TCDD toxicity.

Two-Dimensional Electron Gas at the Spinel/Perovskite Interface: Suppression of Polar Catastrophe by an Ultrathin Layer of Interfacial Defects.

Two-dimensional electron gas (2DEG) at the interface between two insulating perovskite oxides has attracted much interest for both fundamental physics and potential applications. Here, we report the discovery of a new 2DEG formed at the interface between spinel MgAl2O4 and perovskite SrTiO3. Transport measurements, electron microscopy imaging, and first-principles calculations reveal that the interfacial 2DEG is closely related to the symmetry breaking at the MgAl2O4/SrTiO3 interface. The critical film thickness for the insulator-to-metal transition is approximately 32 Å, which is twice as thick as that reported on the widely studied LaAlO3/SrTiO3 system. Scanning transmission electron microscopy imaging indicates the formation of interfacial Ti-Al antisite defects with a thickness of ∼4 Å. First-principles density functional theory calculations indicate that the coexistence of the antisite defects and surface oxygen vacancies may explain the formation of interfacial 2DEG as well as the observed critical film thickness. The discovery of 2DEG at the spinel/perovskite interface introduces a new material platform for designing oxide interfaces with desired characteristics.

Interface-based tuning of Rashba spin-orbit interaction in asymmetric oxide heterostructures with 3d electrons.

The Rashba effect plays important roles in emerging quantum materials physics and potential spintronic applications, entailing both the spin orbit interaction (SOI) and broken inversion symmetry. In this work, we devise asymmetric oxide heterostructures of LaAlO3//SrTiO3/LaAlO3 (LAO//STO/LAO) to study the Rashba effect in STO with an initial centrosymmetric structure, and broken inversion symmetry is created by the inequivalent bottom and top interfaces due to their opposite polar discontinuities. Furthermore, we report the observation of a transition from the cubic Rashba effect to the coexistence of linear and cubic Rashba effects in the oxide heterostructures, which is controlled by the filling of Ti orbitals. Such asymmetric oxide heterostructures with initially centrosymmetric materials provide a general strategy for tuning the Rashba SOI in artificial quantum materials.

Rare Giant Angiokeratoma of the Vulva: A Case Report.

BACKGROUND: Angiokeratoma of fordyce occurring over on the vulva is a rare condition. Fordyce angiokeratoma is observed more frequently among men than women. In women, it is generally observed in later life, and appears as multiple dark purple papules, measuring 2-4 mm, on the vulva. CASE REPORT: We present the case of a 17-year-old white teenage girl with giant Fordyce angiokeratoma on the right vulva. The angiokeratoma was removed and a V-Y advancement flap was made. CONCLUSION: In the literature, this is the first childhood case reported in which a reconstruction of the vulva was performed.

A very interesting traditional method in the treatment of skin lesions: aqua regia and related complications.

BACKGROUND: Aqua regia, a highly corrosive mixture of concentrated nitric acid and hydrochloric acid, is used to dissolve various metals such as gold and platinum that are not soluble in other types of acids. For the first time in the literature, we report the adverse effects that were observed following the utilization of this strong acid solution in the treatment of various skin lesions. METHODS: Between 2010 and 2013, 43 patients (55.8 % female) with a mean age of 40.2 years, were admitted to our hospital for scars, wounds or malign lesions related to the use of aqua regia on skin lesions. Sixteen patients reported to use aqua regia for treating wounds and 27 of them used it for their scars. RESULTS: Out of 43 patients, 9 patients developed necrosis, 12 had hypertrophic scars, 15 had scars and 7 had non-healing wounds resembling malignant lesions. The non-healing wounds were located in the facial region in five patients, in the cervical region in one and on the finger-tip in another. Histopathological examination of these non-healing wounds revealed basal and squamous cell carcinoma. The patients were admitted to the plastic surgery department approximately 6-24 months after aqua regia application with complaints of growing lesions. Secondary healing in the lesions with scar development in 55 % of the patients is an acceptable result. However, 27 % of the patients with hypertrophic scars and 16 % of the patients with malignant lesions required intervention. CONCLUSION: This present study showed that non-medical alternative treatments have major risks. Aqua regia application might have resulted in the development or rapid progression of malignant tumours in seven patients. In the literature, it has been reported that a number of physical traumas may cause skin cancer. Based on this information, the possibility of such an effect of aqua regia cannot be excluded.

Novel biogeometric designs of first dorsal metacarpal artery flap in hand reconstruction.

Reconstruction of the soft tissue defects of the first web space and proximal dorsal thumb is still one of the most challenging problems in reconstructive surgery. Depending on the defect size, various reconstructive methods have been described, including local, regional, distant and free flaps. The authors described new biogeometric designs of first dorsal metacarpal artery flap for the reconstruction of the soft tissue defects of the first web space and the proximal dorsal thumb. These modifications are bilobed and V-Y advancement first dorsal metacarpal artery flaps. Three patients had burn wound adduction contractures of the first web space and three had acute wounds resulting from electrical burns, the defects of which were located on the first web space and on the dorsum of the thumb. The defect sizes ranged from 2.5 × 2 cm to 3.5 × 4 cm, and were reconstructed with the bilobed and V-Y advancement first dorsal metacarpal artery flaps. None of these flap modifications had any problems related to the perfusion of the flap, such as arterial insufficiency or venous congestion. The mean follow-up period was 16 months and all the patients were satisfied with the functional result and the donor site scars appearance. The bilobed and V-Y advancement first dorsal metacarpal artery flaps described by the authors for the hand reconstruction are safe, easily performed, and are versatile without skin grafts at the donor site because of inherent excellent elasticity and mobility of the dorsal hand skin.

Congenital epidermoid cyst results in muscle fusion defect in the upper lip.

Epidermoid cysts are rarely detected malformations in the oral cavity. Their development sites are the sublingual, submaxillary, and submandibular spaces. In this paper, we report a three-month-old infant who was admitted to our hospital due upper lip swelling. Magnetic resonance imaging showed that she had a two-centimeter cystic lesion and fusion defects of orbicularis oris muscle. The cyst was surgically removed and histopathological diagnosis was "epidermoid cyst." In recent literature, we could not find reports related to orbicularis oris muscle fusion defects because of epidermoid cyst.