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A Case of Pituitary Hemorrhage Following Cardiopulmonary Bypass Surgery

Surgical Science 2011年第3期2卷 159-162页

作者： Ozgen Ilgaz Kocyigit Serdar Kabatas erdinc civelek Ezgi Tuncay Oguz Omay Tufan Cansever Ayda Turkoz 不详

A 68-year-old female patient with previous history of transsphenoidal hypophysectomy operation underwent three-vessel coronary artery bypass graft (CABG) surgery for extensive coronary artery disease. Preoperative neurological examination revealed sequelae visual loss at right temporal visual field. Follow-up Magnetic Resonance Imaging studies showed a residual hypophyseal tumor tissue extending to suprasellar area. No additional pathology was detected in the early postoperative cranial control CT, but aggravation of visual field defect was determined. Coincidently, cranial magnetic resonance imaging (MRI) showed hemorrhage into the tumor tissue. We decided to follow-up the patient who exhibited no additional symptoms and was discharged well on the fifth day due to the signs of resolution of hemorrhage. Follow-up controls of the patient at sixth and twelfth months demonstrated normal hormone levels without any additional clinical complaints. We present preoperative assessment, perioperative anesthesia management, and postoperative clinical follow-up of a patient with a residual hypophyseal tumor.

关键词： Anesthesia Coronary Artery Bypass Graft Surgery Hemorrhage Hypophyseal Tumor

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Comparison of Histopathology of Transverse Carpal Ligament in Patients with Idiopathic Carpal Tunnel Syndrome and Hemodialysis Patients with Carpal Tunnel Syndrome

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Surgical Science 2011年第1期2卷 8-12页

作者： erdinc civelek Tufan Cansever Serdar Kabatas Ebru Demiralay Emre Demircay Cem Comunoglu Cem Yilmaz Nur Altınors Department of Neurosurgery Baskent University Istanbul HospitalIstanbulTurkey Department of Pathology Baskent University Istanbul HospitalIstanbulTurkey Department of Orthopedics Baskent University Istanbul HospitalIstanbulTurkey Department of Neurosurgery Baskent UniversityAnkaraTurkey

The aim of this paper is to point out the growing clinical importance of Carpal tunnel syndrome in patients on hemodialysis especially in aspect of the diagnosis, treatment and possible cause of the syndrome. Sixty patients with clinical diagnosis of Carpal Tunnel Syndrome was defined as the presence of two subjective symptoms (numbness, tingling in the median nerve distribution). The diagnosis was confirmed by electromyography. The patients with rheumatoid arthritis, thalasemia and thyroid dysfunction and the patients having pain due to arthritis or tenosynovitis were excluded. Fifty patients with clinical diagnosis of idiopathic CTS and seven hemodialysis patients having CTS were analyzed. Of 50 patients (47 female, 3 male) with clinical diagnosis of idiopathic CTS, 11 patients (22%) were involved bilaterally, 25 patients (50%) were affected only on the right and 14 patients (28%) were symptomatic only on the left. Of 7 hemodialysis patients (2 female, 5 male) with CTS, 1 patient (14%) was involved bilaterally (having two-sided A-V fistula), 4 patients (57%) were affected only on the right and 2 patients (28%) were symptomatic only on the left. There was significant correlation between the arteriovenous fistula and subsequent development of CTS. The all patients had fistulas in the affected side (5 of them were patent and 2 were occluded). In the relation between the duration of hemodialysis and development of CTS, 4 patients were over 10 years of hemodialysis, 2 patients were between 5 to 9 years and only 1 patient was below 4 years of duration. Amyloid deposit was demonstrated in 4 of 7 operated hands in the hemodialysis group. When we compared the presence of amyloid deposits in these groups, the difference between these two groups were found as statistically significant (p < 0.009). Although hemodialysis has no significant effect on development of fibrosis, the incidence of fibrosis was found as statistically significant in idiopathic carpal tunnel syndrome (p

关键词： Carpal Tunnel Syndrome Hemodialysis Chronic Renal Failure

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