Closure of transcatheter ventricular septal defect using LifetechTM Konar-MF Occluder in children weighing less than 10 kilograms: mid-term results, a tertiary single center experience.

OBJECTIVE: Transcatheter closure of medium and large ventricular septal defects (VSDs) in young children is limited due to the use of over-sized devices that can cause hemodynamic instability and arrhythmia. In this study, we aimed to retrospectively evaluate the safety and efficacy of the device in the mid-term in children weighing less than 10 kg whose transcatheter VSD was closed only with the Konar-MFO device. PATIENTS AND METHODS: Among 70 children whose transcatheter VSD was closed between January 2018 and January 2023, 23 patients weighing less than 10 kg were included in the study. Retrospectively, the medical records of all patients were reviewed. RESULTS: The mean age of the patients was 7.3 (4.5-26) months. 17 of the patients were females, 6 of them were males, F/M: 2.83. The average weight was 6.1 (3.7-9.9) kg. The mean the pulmonary blood flow/ systemic blood flow (Qp/Qs) was 3.3 (1.7-5.5). The mean defect diameter was 7.8 mm (5.7-11) for the left ventricle (LV) side, and 5.7 mm (3-9.3) for the right ventricle (RV) side. Based on the utilized device dimensions, the measurements on the LV side were recorded as 8.6 mm (range 6-12), while those on the RV side were recorded as 6.6 mm (range 4-10). Antegrade technique was applied to 15 (65.2%) patients and retrograde technique was applied to 8 (34.8%) patients in the closure procedure. The procedure success rate was 100%. The incidence of death, device embolization, hemolysis, or infective endocarditis was zero. CONCLUSIONS: Perimembranous and muscular VSDs in children under 10 kg can be successfully closed under the management of an experienced operator with the Lifetech Konar-MFO device. This is the first study in the literature to evaluate the efficacy and safety of the device in children under 10 kg in whom only Konar-MFO VSD occluder device is used for transcatheter VSD closure.

Multi-digit contracture release using medial sural artery perforator flap with syndactylization-desyndactylization method.

BACKGROUND: The medial sural artery perforator flap, with a long pedicle, has tremendous potential for applications in a variety of soft tissue defects. It can be used for reconstruction of multi-digit contractures of the palmar region. MATERIALS AND METHODS: We present herein the key features of the management of postburn multi-digit volar contractures, using medial sural artery perforator flaps with the syndactylization and desyndactylization method. We describe the use of the free medial sural artery perforator flap in two patients, to reconstruct complex composite hand defects including the second, third, fourth and fifth digits following thermal burns. RESULTS: Both flaps healed uneventfully. In both patients, the hand contractures released completely and adequate joint motion was achieved after a 3-month period of physiotherapy. CONCLUSIONS: The thin medial sural artery perforator flap permits high accuracy of soft tissue reconstruction of the hand and reduces the morbidity at the donor site. The MSAPF is a useful flap in areas such as the hands, in the case of soft tissue deficiency and tendon exposition. Hippokratia 2015; 19 (4): 366-368.

Frostbite injury of the breast: a case report.

This paper presents an unusual case of frostbite injury to the breast area caused by faulty cryotherapy application. Cryotherapy, commonly used by patients and health professionals, relieves pain and edema after trauma and sports injuries. However, applying cold therapy is not common for surgical procedures involving soft tissue. The frostbite injury to the breast presented here occurred due to persistent use of a self-prepared ice pack following a needle aspiration biopsy. Cold exposure to soft tissue may cause frostbite. It is crucial to inform patients about proper application of cryotherapy and possible complications, particularly for the procedures in which cold therapy is not widely used.

Cet article présente un cas inhabituel d'engelures à la zone de la poitrine provoqué par l'application inappropriée de la cryothérapie. La cryothérapie, couramment utilisée par les patients et les professionnels de la santé, soulage la douleur et l'oedème après un traumatisme et les blessures sportives. Toutefois, l'application de thérapie par le froid n'est pas commune pour les procédures chirurgicales impliquant les tissus mous. Les engelures au sein présentées ici ont eu lieu en raison de l'utilisation persistante d'un sac de glace auto-préparé à la suite d'une biopsie à l'aiguille. L'exposition au froid des tissus mous peut causer des gelures. Il est essentiel d'informer les patients sur la bonne application de la cryothérapie et les complications possibles, en particulier pour les procédures dans lesquelles la thérapie par le froid n'est pas largement utilisée.

An unusual cause of hoarseness: hydatid cyst of the thyroid.

Hydatid cyst is a parasitic infestation that is distributed world-wide. It may be found in nearly any part of the body, most often in the liver and the lungs, but occasionally in other structures such as the thyroid gland. Thyroid gland is very rarely involved by this parasitic infection even in Turkey where the echinococcal disease is endemic. In this article we report a very rarely encountered case of thyroid cyst revealed by hoarseness, and underwent subtotal thyroidectomy and diagnosed as primary hydatid cyst disease by histological studies.

Antibacterial diterpenes from the roots of Salvia blepharochlaena.

The roots of Salvia blepharochlaena have yielded two new diterpenoids, blephaein (1) and O-methylpisiferic acid methyl ester (2), together with eight known diterpenoids. The structures of the new compounds were established by spectroscopic analysis and by some chemical reactions. Potent antibacterial activity was exhibited by the known compounds horminone (9) and 7-acetylhorminone (10) against Staphylococcus aureus ATCC 6538 P, Staphylococcus epidermidis ATCC 12226, and Bacillus subtilis ATCC 6633. Horminone was also found to be active against Enterococcus faecalis ATCC 29212.

A new antibacterial diterpene from the roots of Salvia caespitosa.

From the roots of Saliva caespitosa Montbret and Aucher ex. Bentham a new diterpene 6beta-hydroxyisopimaric acid (1) has been isolated together with four known diterpenes, one new triterpenoid, 3-acetylvergatic acid (2), as well as five known triterpenoids, two steroids and a flavone. The structures of the compounds were established by spectroscopic analyses. The isolated compounds were tested against standard bacterial strains. Only the new diterpene, 6beta-hydroxyisopimaric acid has strong activity (MIC 9 microg/ml) against S. aureus and (MIC 18 microg/ml) against S. epidermidis as well as against B. subtilis (MIC 9 microg/ml).

Cardioactive terpenoids and a new rearranged diterpene from Salvia syriaca.

From the roots of Salvia syriaca L., in addition to known terpenoids, a new rearranged diterpene, named salvisyrianone, was isolated. The structure of the new compound was assigned from spectral data. The crude extract and the single compounds were tested for cardiovascular parameters using Wistar Albino rats. Antihypertensive activity was established in the crude extract of the roots as well as in two compounds, ferruginol and 3 beta-hydroxystigmast-5-en-7-one.

Antibacterial diterpenes from the roots of Salvia viridis.

Three new diterpenes, salviviridinol, viridinol, viridone, five known diterpenes, sugiol, 1-oxoferruginol, ferruginol, aethiopinone and microstegiol, abietane and rearranged abietane diterpenes were isolated from the roots of Salvia viridis. These compounds were assayed against S. aureus ATCC 6538 P, E. coli ATCC 8739, P. mirabilis ATCC 14153, K. pneumonia ATCC 4352, P. aeruginosa ATCC 27853, S. epidermidis ATCC 12228, E. faecalis ATCC 29212 and a yeast C. albicans ATCC 10231. 1-Oxoferruginol showed activity against B. subtilis, S. aureus, S. epidermidis and a modest activity against P. mirabilis, migrostegiol had a little activity against B. subtilis. The structures of the compounds were established by 1D and 2D NMR spectroscopic techniques.

Triterpenoids and a diterpene from Euphorbia iberica.

From the aerial parts of Euphorbia iberica, an ingenane diterpene ester, ingenol 20-eicosanoate, and three ursanetype triterpenoids, 3beta-acetoxy-urs-12-ene-1beta,11alpha-diol, 3beta-( E)-coumaroyloxy-urs-12-ene, and 3beta-( Z)-coumaroyloxy-urs-12-ene have been isolated together with known cylcoartane-type triterpenes, a flavone, and coumarins. The first four compounds are new and their structures were determined by spectroscopic methods.

Diterpene polyesters from euphorbia seguieriana

An Me2CO extract of Euphorbia seguieriana (Euphorbiaceae) afforded seven new diterpene polyesters (1-7). Five of them (1-5), having a new parent alcohol that was named 17-hydroxymyrsinol, were structurally related to myrsinol. The other two compounds (6, 7) were new derivatives of the known parent alcohols cyclomyrsinol and lathyrane. The structure elucidations of the new compounds by highfield spectroscopic methods, including 1D and 2D NMR techniques, are described.

Aleppicatines A and B from Euphorbia aleppica.

Two new pentacyclic diterpene polyesters, aleppicatine A and B, have been isolated from the acetone extract of the whole plant of Euphorbia aleppica, in addition to five known cycloartane-type triterpenes (24-methylenecycloartanol, cyclolaudenol cycloart-25-en-3 beta-ol-24-one, cycloart-22-en-3 beta,25-diol and cycloart-25-en-3 beta,24-diol), scopoletin, kaempferol and 4-hydroxybenzoic acid and its methyl ether. The structures of the new compounds and their hydrolysis products have been extensively characterized by high-field NMR spectroscopic methods, including 2D NMR techniques.

Four diterpene esters from Euphorbia myrsinites.

The Turkish species Euphorbia myrsinites has yielded four new tetracyclic diterpene tetraesters from a cytotoxic acetone extract, in addition to the known cycloartane-type triterpenoids and betulin. The new compounds and their hydrolysis product have been extensively characterized by high field spectroscopic techniques, and were shown to be four new tetraesters of the parent alcohol, myrsinol.