Tramadol as an adjunct for levobupivacaine in axillary plexus blockade: A prospective, randomized, double-blind study

Yurtlu, Bülent Serhan | Hancı, Volkan | Ege, Ahmet | Bostankolu, Selime Evrim | Ayoğlu, Hilal | Özkoçak Turan, Işıl

Article | 2012 | Turkish Journal of Medical Sciences42 ( 1 ) , pp.55 - 62

Aim: To evaluate the effect of tramadol addition to levobupivacaine in axillary plexus blockade in a prospective, randomized double-blind study. Materials and methods: A total of 60 patients scheduled to undergo hand and forearm surgery under axillary plexus blockade were randomly divided into 2 groups. Group L received 36 mL of racemic 0.5% levobupivacaine with 2 mL of saline, whereas Group LT received 2 mL (100 mg) of tramadol instead of saline. After routine monitorization, axillary block was performed with a multistimulation technique using a nerve stimulator. Motor (finger, wrist, and elbow movements) and sensory (pinprick sens . . .ation for the cutaneous supply) block characteristics for radial, median, ulnar, and musculocutaneous nerves were determined every 5 min. Postoperative motor and sensory block duration, analgesic consumption, and numeric rating scale (NRS) scores were also recorded. Results: In each group, 2 patients had block failures. The data for the remaining 56 patients were analyzed. There were no significant differences between the study groups according to motor and sensory block characteristics of 4 nerves, block durations, analgesic consumption, and NRS scores. Conclusion: The addition of 100 mg of tramadol to 0.5% levobupivacaine for axillary brachial plexus blockade neither improved the intraoperative block quality nor prolonged the duration of postoperative analgesia. © TÜBITAK Daha fazlası Daha az

Angiolupoid type cutaneous sarcoidosis on the auricle: A case report [Kulak kepçesinde anjiyolupoid tip kutanöz sarkoidoz olgusu]

Koca, Rafet | Çınar, Saniye | Numanoğlu, Gamze | Altınyazar, H. Cedet | Solak-Tekin, Nilgün | Muhtar, Şennur

Article | 2006 | Turkiye Klinikleri Journal of Medical Sciences26 ( 4 ) , pp.453 - 456

Sarcoidosis is a multisystem disorder of unknown etiology, which is histopathologically characterized by noncaseating granulomas. Cutaneous sarcoidosis localizing on the auricle may be observed in various clinical types. Angiolupoid sarcoidosis is a rare form of cutaneous sarcoidosis. We describe a 26-year-old white man with angiolupoid cutaneous sarcoidosis localized on the auricle without systemic involvement. Copyright © 2006 by Türkiye Klinikleri.

The value of cytokeratin-19 immunohistochemistry in the differential diagnosis of papillary thyroid carcinomas

Barut F. | Bektaş S. | Bahadir B. | Onak Kandemir N. | Karadayi N. | Özdamar Ş.O.

Article | 2009 | Turkiye Klinikleri Journal of Medical Sciences29 ( 1 ) , pp.42 - 47

Objective: The gold standard for diagnosis of papillary thyroid carcinoma is conventional histology, which depends on the characteristic nuclear features, regardless of whether papillary architecture is present or not. This study was carried on to evaluate the utility of cytokeratin-19 in the diagnosis and differential diagnosis of papillary thyroid carcinoma. Material and Methods: Expression of cytokeratin-19 was tested on formalin-fixed, paraffin-embedded tissues from 380 surgically resected thyroid lesions including hyperplasic nodules (n= 243), granulomatous thyroiditis (n= 3), lymphocytic (n= 53) and Hashimoto's thyroiditis (n= . . . 11), follicular adenomas (n= 17), Hurthle cell adenomas (n= 4), well-differentiated thyroid tumor with follicular architecture of uncertain malignant potenti al (n= 1), papillary carcinomas (n= 45), follicular carcinoma (n= 1), insular carcinoma (n= 1), and medullary carcinoma (n= 1). The immunoreactivity was scored as negative, 1+, 2+, 3+, and 4+, based on the extent of the reaction regardless of previous diagnosis. Results: Positive reaction with cytokeratin-19 was denoted in all of the 45 cases of papillary carcino mas with scores of 4+, 3+ and 2+ and the ratios were 57.8% (26/45), 33.3% (15/45) and 8.9% (4/45), respectively. There seemed to be a strong diffuse cytoplasmic reactivity with cytokeratin-19 in papillary thyroid carcinomas. The sensitivity and specificity for cytokeratin-19 in papillary carcinomas among neoplastic thyroid lesions were 91.8% and 86.2%, respectively. Conclusion: In additi on to careful histological evaluation, cytokeratin-19 seems useful for the diagnosis of papillary thyroid carcinomas. Copyright © 2009 by Türkiye Klinikleri Daha fazlası Daha az

Traumatic neuromas: A histopathologic and immunohistochemical study [Travmatik nöromalar: Histopatolojik ve i·mmünohistokimyasal bir çalişma]

Özdamar Ş.O. | Dogan Gün B. | Barut F. | Bahadir B.

Article | 2007 | Turkiye Klinikleri Journal of Medical Sciences27 ( 1 ) , pp.16 - 20

Objective: Traumatic neuroma is an exuberant, probably non-neoplastic proliferation of a nerve occurring in response to injury or surgery. We studied six cases of traumatic neuroma with light microscopic, histochemical and immunohistochemical methods to assess the cellular compositions of these lesions. Material and Methods: Sections from the formalin-fixed parafin-embedded tissues were stained with hematoxylin-eosin, Gomori's trichrome, Verhoeff elastica-von Gieson, reticuline, and S-100 protein, Epithelial Membrane Antigen, CD34 and CD68. Results: All cases revealed large numbers of small and haphazardly arranged regenerating nerv . . .e fascicles within a densely collagenous and fibroblastic stroma. A focal chronic mononuclear cell inflammatory reaction was observed in three cases. In all cases, Gomori's trichrome revealed collagen. Axonal morphology was detected in nerve fibers histochemically by reticulin. In all cases, fascicles were stained diffusely with S-100 protein, and Epithelial Membrane Antigen showed a positive reaction in a thin band of cells surrounding the fascicles in three of the cases. CD34 positive cells were present in five cases. CD68 expressing cells were present in only in two specimens. Conclusion: In traumatic neuromas, specific staining of fascicles with S-100 protein, perineural cells reactive for Epithelial Membrane Antigen and the presence of CD34 positive cells may contribute to our understanding of their pathogenesis and differentiation of these lesions from mimickers. Copyright © 2007 by Türkiye Klinikleri Daha fazlası Daha az

Comparison of the diagnostic results of bronchoalveolar lavage with synchronous transbronchial biopsies [Bronkoalveoler lavaj-transbronşiyal biyopsi tanilarinin karşilaştirilmasi]

Barut F. | Özdamar Ş.O. | Bahadir B. | Dogan Gün B. | Bektaş S. | Çolak S. | Mocan Kuzey G.

Article | 2007 | Turkiye Klinikleri Journal of Medical Sciences27 ( 2 ) , pp.179 - 183

Objective: Bronchoalveolar lavage performed during bronchoscopic examination is a type of cytologic sampling with great diagnostic significance. Its diagnostic value is enhanced when biopsy is unavailable and bronchoalveolar lavage is the unique sample. Determining the diagnostic accuracy of bronchoalveolar lavage by comparing it with the diagnostic yield of synchronous biopsies is an indicator of its effectiveness. Material and Methods: In this study, 435 bronchoalveolar lavage and 273 bronchoscopic biopsy specimens obtained from January 2003 to December 2005 in the Department of Pulmonary Diseases were retrospectively evaluated in . . . the Department of Pathology, Faculty of Medicine, Zonguldak Karaelmas University. Results: Overall, 373 cases (85.8%) were diagnosed as benign and 12 cases (2.8%) were reported as malignant, while 18 cases (4.1%) were suspected to be malignant; the remaining 32 cases (7.3%) were reported as inadequate. The numbers and percentages of benign, malignant, suspected malignant and inadequate diagnoses of the 273 bronchoalveolar lavage cases with synchronous transbronchial biopsies were 229 (83.9%), 12 (4.5%), 16 (5.8%), and 16 (5.8%), respectively. After suspected malignant and inadequate samples were excluded, coomparison of cytologic and histologic diagnoses revealed that the diagnostic accuracy of bronchoalveolar lavage cytology was 79.4% and 91.6% for benign and malignant diagnoses, respectively; the rate of false negativity was 20.5% and false positivity was 8.3%. Conclusion: While sampling errors seemed to be the primary reason for false negative and false positive diagnoses, the rate of false cytologic evaluation was lower. Considering the false negative diagnoses for cases without biopsy specimens, comparison of bronchoalveolar lavage diagnoses with synchronous biopsies may serve as a quality control programme, since this condition may significantly influence the clinical course. Copyright © 2007 by Türkiye Klinikleri Daha fazlası Daha az

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