... (13:39) Helal İlaç. (13:35) Türk doktora büyük onur. (13:32) Sosyal güvenlik 30,6 milyarlık a... more ... (13:39) Helal İlaç. (13:35) Türk doktora büyük onur. (13:32) Sosyal güvenlik 30,6 milyarlık açık verecek. ... REVIEW. Atriyal Septal Defekt Gül SAĞIN SAYLAM * * Prof.Dr., Dokuz Eylül Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları AD, Pediatrik Kardiyoloji BD, İZMİR. ...
Archives of the Turkish Society of Cardiology, Sep 1, 1996
We discuss the management of 10 children with cardiac masses produced by tumors, thrombus or vege... more We discuss the management of 10 children with cardiac masses produced by tumors, thrombus or vegetations. The ages of the patients ranged from five days to nine years, only two being more than five years old. In all cases, the diagnosis was made by cross-sectional and Doppler echocardiography. The masses were detected in the chambers of the right heart in five patients, in the left heart in four and on both sides in one patient. Five patients had predisposing factors. The clinical features were variable, but cardiac failure was the most common sign. All the patients underwent emergency surgery. Two patients died during the period of hospitalization and two in the late postoperative period. The six surviving patients are now asymptomatic.
Dokuz Eylül Üniversitesi Tıp Fakültesi dergisi, Dec 1, 2008
Özet defektlerde son dönem olumsuz etkiler oluşmadan önce, volüm yükü altında kalan sol ventrikül... more Özet defektlerde son dönem olumsuz etkiler oluşmadan önce, volüm yükü altında kalan sol ventrikülün fonksiyonlarındaki değişikliklerin halen kullanılmakta olan konvansiyonel yöntemler ile belirlenmesi bazen yetersiz kalabilmektedir. Bu amaçla kalbin sistolik ve diyastolik fonksiyonlarını ...
This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and t... more This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and the surgical treatment of vascular rings. Data for 44 patients (32 enrolled prospectively, 12 reviewed retrospectively) over a 10-year period in a tertiary referral center were analyzed. These patients comprised 25 patients with a left aortic arch and an aberrant right subclavian artery, 13 patients with a right aortic arch and a left subclavian artery originating from Kommerell's diverticulum, 1 patient with a right aortic arch and an aberrant left subclavian artery, 3 patients with a double aortic arch, and 2 patients with a pulmonary sling. Respiratory symptoms were found in 25 patients and dysphagia in 6 patients. Atypical symptoms such as reflex apnea, cyanosis, syncope episodes, and exercise-induced wheezing were noted in five patients. Associated congenital heart defects were detected in 41% of the patients. The diagnostic yield was 95.23% for barium esophagography, 54.54% for echocardiography, and 66.66% for computed tomography. The anatomy could be correctly identified by magnetic resonance imaging (MRI) in 97.43% and by angiography in 90.5% of the patients. Of the 30 patients who underwent surgery, 80% were completely relieved of symptoms during a mean follow-up period of 25 ± 33.5 months. Vascular rings should not be overlooked in infants with atypical symptoms. The authors' diagnostic procedure of choice is MRI because it is superior to angiography for delineating the relationship between abnormal vascular structures, trachea, and esophagus. Keywords Children Á Imaging modality Á Symptoms Á Vascular rings Vascular rings (VR) are a group of anomalies caused by abnormal embryologic development of the brachial arch system characterized by an anomalous branching pattern of the vessels originating from the aortic arch, abnormal positioning of the aortic arch itself, interrupted or supernumerary arches, or anomalous origin of the pulmonary artery from the contralateral pulmonary artery or ascending aorta [7, 9, 10]. Vascular rings lead to variable degrees of respiratory problems or feeding difficulties by forming a complete or partial ring compressing the trachea, the bronchi, and the esophagus [11]. The presentation of VR varies from asymptomatic patients to infants, with severe symptoms such as respiratory distress, stridor, wheezing, dyspnea, recurrent respiratory tract infections, and dysphagia caused by compression of the trachea, the esophagus, or both [7, 9, 11]. Atypical symptoms such as reflex apnea and cyanosis episodes also may be encountered in rare cases. Barium esophagogram, echocardiography, computed tomography (CT), magnetic resonance imaging (MRI), and angiography are useful diagnostic tools in the diagnosis of VR [2, 5, 6, 8-10]. In this study, data from 44 cases of VR
Archives of the Turkish Society of Cardiology, May 1, 1996
Süperiyor vena kava-pulmoner arter anastomozunun (Glenn şantı) bilinen bir geç komplikasyonu olan... more Süperiyor vena kava-pulmoner arter anastomozunun (Glenn şantı) bilinen bir geç komplikasyonu olan pulmoner arteriovenöz fistüllerin (PAVF) sıklığının araştırılma sı ve tanıda kontrast ekokardiyografinin yerinin incelenmesi amacıyla, klasik veya iki-yönlü kavopu/moner anastomoz uygulanan, 21-38 (ort 28±4.8) yaşlarında 12 hasta,operasyondan 4-33 (ort 24±9) yıl sonra prospektif olarak değerlendirilmiştir. ll hastaya kalp kateterizasyonu ve anjiografi, 6 hastaya manyetik rezonans görüntülernesi uygulanmış, sonuçlar kontrast ekokardiyografi bulguları ile karşılaştırılmıştır. Kontrast ekokardiyografide 12 hastanın 8'inde bir üst ekstrem i te venine yapılan enjeksiyondan 1-8 saniye sonra sol atriyumda kontrast maddenin görülmesi ile PAVF tanısı konmuştur. Eko kontrastının sağ atriyumda belirlenmesi 2 hastada süperiyor vena kava ve sağ atriyum arasında rezidüel komünikasyon ve 1 hastada süperiyor vena kava ile inferiyor vena kava arası ko/latera/lerin varlığı ile açık lanmıştır. PAVF saptanan 8 hastada sistemik arteriyel oksijen satürasyonları istirahatte (% 51-94, ort. 75±15.3) ve modifiye Bruce protokolü ile egzersiz sonrasında (% 23-91, ort. 53±24.2) PAVF olmayan hastalardan daha düşük bulunmuştur (p<0.005). Sağ akciğerinde PAVF saptanan hastalarda sağ pulmoner arter basıncı normal iken, karşı akciğerde pulmoner hipertansiyon daha sık (ort. sol pulmoner arter basıncı 22-110 mmHg, p=0.014) bulunmuş tur. Kavopulmoner anastomoz uygulanan hastalarda özellikle geç dönemde sık görülen, siyanozda artma ve klinik dereriorasyon ile seyreden bir kornp/ikasyon olan PAVF'Ierin tanısında pratik ve hassas bir yöntem olduğu gösterilen kontrast ekokardiyografi, bu hastaların izleminde düzenli olarak uygulanmalıdır. Anahtar kelimeler: pulmoner arteriovenöz fistül, kavopulmoner anastomoz, kontrast ekokardiyografi The cavopulmonary anastomosis (Glenn shunt) introducted in the 1950's (1-3) for patients with cyanotic
Journal of Pediatric Endocrinology and Metabolism, 2000
Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinica... more Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinically overt diabetes. Impaired left ventricular function has been reported in young patients with diabetes mellitus type 1 (IDDM), but severe cardiomyopathy as the first early major complication of IDDM is very rare. We report a 14 year-old girl with a 5-year history of IDDM and very poor compliance with treatment and follow-up. She was referred to our clinic upon the development of congestive heart failure and dilated cardiomyopathy was diagnosed based on clinical findings, electrocardiogram, chest X-ray and echocardiography. She had no evidence of other major complications of IDDM such as retinopathy, nephropathy or neuropathy.
Journal of Pediatric Endocrinology and Metabolism, 2000
Cyanotic congenital heart disease in children commonly causes more pronounced growth retardation ... more Cyanotic congenital heart disease in children commonly causes more pronounced growth retardation in comparison with acyanotic congenital heart disease. Chronic hypoxemia has been suggested as the cause of poor growth in these patients, but the relationship between serum IGF-I levels and chronic hypoxemia is unclear. Serum IGF-I concentrations, oxygen saturation and nutritional status were evaluated in 29 patients with cyanotic congenital heart disease, and serum IGF-I levels were compared with a group of 20 well-nourished, age-matched control children to assess the relationship between IGF-I levels and chronic hypoxemia. The nutritional status of each patient was determined by using anthropometric parameters and calorie and protein intake ratios. The patients were divided into malnourished and well-nourished groups (21 and 8 patients, respectively) according to their nutritional status. Serum IGF-I concentrations were measured in the two patient groups and the controls. The malnourished group had the lowest IGF-I levels (48.14 ± 21.8 ng/ml, ρ < 0.05). However, the well-nourished group's IGF-I levels were significantly lower than the control subjects' despite improved nutritional status (85.5 ± 30.2 and 107 ± 19.7 ng/ml, respectively, ρ < 0.05). In addition, we found a positive correlation between serum IGF-I levels and oxygen saturation of the patients (r = 0.402, ρ <
Arzu BABAYİĞİT Dokuz Eylul Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD İnciraltı,... more Arzu BABAYİĞİT Dokuz Eylul Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD İnciraltı, 35340, İZMİR Tel: (232) 4123660 (232)4123661 Faks: (232) 2599723 e-posta: arbabayigit@yahoo.com ÖZET Pulmoner vasküler sling, sol pulmoner arterin sağ pulmoner arterden çıkıp trakea etrafında bir halka ve basıya neden olduğu çok nadir olarak rastlanan gelişimsel konjenital vasküler bir anomalidir. Burada; tekrarlayan hışıltı ve alt solunum yolu enfeksiyonları nedeni ile hastanemize gönderilen ve pulmoner vasküler sling tanısı almış 13 aylık bir erkek hasta sunuldu. Hastanın baryumlu özefagus grafisinde özefagus anterior lateral kesiminde indentasyon izlendi ve toraks manyetik rezonans görüntüleme ve anjiografi tetkikleri ile de pulmoner arter slingi tanısı doğrulandı. Operasyondan hemen sonra hastanın semptomları düzeldi. Sonuç olarak, tekrarlayan hışıltı ve alt solunum yolu enfeksiyonu olan çocuk hastalarda, pulmoner vasküler sling ayırıcı tanılar arasında düşünülmelidir. Anahtar sözcü...
... (13:39) Helal İlaç. (13:35) Türk doktora büyük onur. (13:32) Sosyal güvenlik 30,6 milyarlık a... more ... (13:39) Helal İlaç. (13:35) Türk doktora büyük onur. (13:32) Sosyal güvenlik 30,6 milyarlık açık verecek. ... REVIEW. Atriyal Septal Defekt Gül SAĞIN SAYLAM * * Prof.Dr., Dokuz Eylül Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları AD, Pediatrik Kardiyoloji BD, İZMİR. ...
Archives of the Turkish Society of Cardiology, Sep 1, 1996
We discuss the management of 10 children with cardiac masses produced by tumors, thrombus or vege... more We discuss the management of 10 children with cardiac masses produced by tumors, thrombus or vegetations. The ages of the patients ranged from five days to nine years, only two being more than five years old. In all cases, the diagnosis was made by cross-sectional and Doppler echocardiography. The masses were detected in the chambers of the right heart in five patients, in the left heart in four and on both sides in one patient. Five patients had predisposing factors. The clinical features were variable, but cardiac failure was the most common sign. All the patients underwent emergency surgery. Two patients died during the period of hospitalization and two in the late postoperative period. The six surviving patients are now asymptomatic.
Dokuz Eylül Üniversitesi Tıp Fakültesi dergisi, Dec 1, 2008
Özet defektlerde son dönem olumsuz etkiler oluşmadan önce, volüm yükü altında kalan sol ventrikül... more Özet defektlerde son dönem olumsuz etkiler oluşmadan önce, volüm yükü altında kalan sol ventrikülün fonksiyonlarındaki değişikliklerin halen kullanılmakta olan konvansiyonel yöntemler ile belirlenmesi bazen yetersiz kalabilmektedir. Bu amaçla kalbin sistolik ve diyastolik fonksiyonlarını ...
This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and t... more This study aimed to evaluate the presenting symptoms, the effectiveness of imaging methods, and the surgical treatment of vascular rings. Data for 44 patients (32 enrolled prospectively, 12 reviewed retrospectively) over a 10-year period in a tertiary referral center were analyzed. These patients comprised 25 patients with a left aortic arch and an aberrant right subclavian artery, 13 patients with a right aortic arch and a left subclavian artery originating from Kommerell's diverticulum, 1 patient with a right aortic arch and an aberrant left subclavian artery, 3 patients with a double aortic arch, and 2 patients with a pulmonary sling. Respiratory symptoms were found in 25 patients and dysphagia in 6 patients. Atypical symptoms such as reflex apnea, cyanosis, syncope episodes, and exercise-induced wheezing were noted in five patients. Associated congenital heart defects were detected in 41% of the patients. The diagnostic yield was 95.23% for barium esophagography, 54.54% for echocardiography, and 66.66% for computed tomography. The anatomy could be correctly identified by magnetic resonance imaging (MRI) in 97.43% and by angiography in 90.5% of the patients. Of the 30 patients who underwent surgery, 80% were completely relieved of symptoms during a mean follow-up period of 25 ± 33.5 months. Vascular rings should not be overlooked in infants with atypical symptoms. The authors' diagnostic procedure of choice is MRI because it is superior to angiography for delineating the relationship between abnormal vascular structures, trachea, and esophagus. Keywords Children Á Imaging modality Á Symptoms Á Vascular rings Vascular rings (VR) are a group of anomalies caused by abnormal embryologic development of the brachial arch system characterized by an anomalous branching pattern of the vessels originating from the aortic arch, abnormal positioning of the aortic arch itself, interrupted or supernumerary arches, or anomalous origin of the pulmonary artery from the contralateral pulmonary artery or ascending aorta [7, 9, 10]. Vascular rings lead to variable degrees of respiratory problems or feeding difficulties by forming a complete or partial ring compressing the trachea, the bronchi, and the esophagus [11]. The presentation of VR varies from asymptomatic patients to infants, with severe symptoms such as respiratory distress, stridor, wheezing, dyspnea, recurrent respiratory tract infections, and dysphagia caused by compression of the trachea, the esophagus, or both [7, 9, 11]. Atypical symptoms such as reflex apnea and cyanosis episodes also may be encountered in rare cases. Barium esophagogram, echocardiography, computed tomography (CT), magnetic resonance imaging (MRI), and angiography are useful diagnostic tools in the diagnosis of VR [2, 5, 6, 8-10]. In this study, data from 44 cases of VR
Archives of the Turkish Society of Cardiology, May 1, 1996
Süperiyor vena kava-pulmoner arter anastomozunun (Glenn şantı) bilinen bir geç komplikasyonu olan... more Süperiyor vena kava-pulmoner arter anastomozunun (Glenn şantı) bilinen bir geç komplikasyonu olan pulmoner arteriovenöz fistüllerin (PAVF) sıklığının araştırılma sı ve tanıda kontrast ekokardiyografinin yerinin incelenmesi amacıyla, klasik veya iki-yönlü kavopu/moner anastomoz uygulanan, 21-38 (ort 28±4.8) yaşlarında 12 hasta,operasyondan 4-33 (ort 24±9) yıl sonra prospektif olarak değerlendirilmiştir. ll hastaya kalp kateterizasyonu ve anjiografi, 6 hastaya manyetik rezonans görüntülernesi uygulanmış, sonuçlar kontrast ekokardiyografi bulguları ile karşılaştırılmıştır. Kontrast ekokardiyografide 12 hastanın 8'inde bir üst ekstrem i te venine yapılan enjeksiyondan 1-8 saniye sonra sol atriyumda kontrast maddenin görülmesi ile PAVF tanısı konmuştur. Eko kontrastının sağ atriyumda belirlenmesi 2 hastada süperiyor vena kava ve sağ atriyum arasında rezidüel komünikasyon ve 1 hastada süperiyor vena kava ile inferiyor vena kava arası ko/latera/lerin varlığı ile açık lanmıştır. PAVF saptanan 8 hastada sistemik arteriyel oksijen satürasyonları istirahatte (% 51-94, ort. 75±15.3) ve modifiye Bruce protokolü ile egzersiz sonrasında (% 23-91, ort. 53±24.2) PAVF olmayan hastalardan daha düşük bulunmuştur (p<0.005). Sağ akciğerinde PAVF saptanan hastalarda sağ pulmoner arter basıncı normal iken, karşı akciğerde pulmoner hipertansiyon daha sık (ort. sol pulmoner arter basıncı 22-110 mmHg, p=0.014) bulunmuş tur. Kavopulmoner anastomoz uygulanan hastalarda özellikle geç dönemde sık görülen, siyanozda artma ve klinik dereriorasyon ile seyreden bir kornp/ikasyon olan PAVF'Ierin tanısında pratik ve hassas bir yöntem olduğu gösterilen kontrast ekokardiyografi, bu hastaların izleminde düzenli olarak uygulanmalıdır. Anahtar kelimeler: pulmoner arteriovenöz fistül, kavopulmoner anastomoz, kontrast ekokardiyografi The cavopulmonary anastomosis (Glenn shunt) introducted in the 1950's (1-3) for patients with cyanotic
Journal of Pediatric Endocrinology and Metabolism, 2000
Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinica... more Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinically overt diabetes. Impaired left ventricular function has been reported in young patients with diabetes mellitus type 1 (IDDM), but severe cardiomyopathy as the first early major complication of IDDM is very rare. We report a 14 year-old girl with a 5-year history of IDDM and very poor compliance with treatment and follow-up. She was referred to our clinic upon the development of congestive heart failure and dilated cardiomyopathy was diagnosed based on clinical findings, electrocardiogram, chest X-ray and echocardiography. She had no evidence of other major complications of IDDM such as retinopathy, nephropathy or neuropathy.
Journal of Pediatric Endocrinology and Metabolism, 2000
Cyanotic congenital heart disease in children commonly causes more pronounced growth retardation ... more Cyanotic congenital heart disease in children commonly causes more pronounced growth retardation in comparison with acyanotic congenital heart disease. Chronic hypoxemia has been suggested as the cause of poor growth in these patients, but the relationship between serum IGF-I levels and chronic hypoxemia is unclear. Serum IGF-I concentrations, oxygen saturation and nutritional status were evaluated in 29 patients with cyanotic congenital heart disease, and serum IGF-I levels were compared with a group of 20 well-nourished, age-matched control children to assess the relationship between IGF-I levels and chronic hypoxemia. The nutritional status of each patient was determined by using anthropometric parameters and calorie and protein intake ratios. The patients were divided into malnourished and well-nourished groups (21 and 8 patients, respectively) according to their nutritional status. Serum IGF-I concentrations were measured in the two patient groups and the controls. The malnourished group had the lowest IGF-I levels (48.14 ± 21.8 ng/ml, ρ < 0.05). However, the well-nourished group's IGF-I levels were significantly lower than the control subjects' despite improved nutritional status (85.5 ± 30.2 and 107 ± 19.7 ng/ml, respectively, ρ < 0.05). In addition, we found a positive correlation between serum IGF-I levels and oxygen saturation of the patients (r = 0.402, ρ <
Arzu BABAYİĞİT Dokuz Eylul Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD İnciraltı,... more Arzu BABAYİĞİT Dokuz Eylul Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları AD İnciraltı, 35340, İZMİR Tel: (232) 4123660 (232)4123661 Faks: (232) 2599723 e-posta: arbabayigit@yahoo.com ÖZET Pulmoner vasküler sling, sol pulmoner arterin sağ pulmoner arterden çıkıp trakea etrafında bir halka ve basıya neden olduğu çok nadir olarak rastlanan gelişimsel konjenital vasküler bir anomalidir. Burada; tekrarlayan hışıltı ve alt solunum yolu enfeksiyonları nedeni ile hastanemize gönderilen ve pulmoner vasküler sling tanısı almış 13 aylık bir erkek hasta sunuldu. Hastanın baryumlu özefagus grafisinde özefagus anterior lateral kesiminde indentasyon izlendi ve toraks manyetik rezonans görüntüleme ve anjiografi tetkikleri ile de pulmoner arter slingi tanısı doğrulandı. Operasyondan hemen sonra hastanın semptomları düzeldi. Sonuç olarak, tekrarlayan hışıltı ve alt solunum yolu enfeksiyonu olan çocuk hastalarda, pulmoner vasküler sling ayırıcı tanılar arasında düşünülmelidir. Anahtar sözcü...
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