Extrapleural haematoma (EH) is a rare clinical condition of which four cases are presented. Different etiologies were encountered. Identical findings were found on the chest X-ray. Two cases were secondary to spontaneous rib fracture and the other two were iatrogenic. Surgical exploration was necessary in one patient following pleural biopsy. Medical treatment and clinical observation were the treatment of choice in the remaining three stable patients.

ORIGINAL ARTICLE PURPOSE Endovenous laser ablation has replaced surgical methods in the treatment of saphenous insufficiency. The aims of this study were to compare the effectiveness of 1470-and 980-nm wavelength (WL) laser systems, to compare the postoperative complication rates, and to determine the effect of laser WL on postoperative pain scores. MATERIALS AND METHODSBetween October 2010 and November 2011, 79 consecutive patients with saphenous vein insufficiency were examined. The patients who received the 980-nm treatment were defined as Group 1; 54 extremities of 47 patients were treated in this group. The patients who received the 1470-nm treatment were defined as Group 2; 36 extremities of 32 patients were treated in this group. RESULTSEarly technical success was 100% in both groups. Both major and minor complications were seen in Group 2. The complications in Group 1 were mostly major; however, three minor complications were reported in this group. The complication rates of the two groups were not significantly different. There was no statistically significant difference between the pain scores of the two groups. CONCLUSION Early postoperative pain was the major factor that impaired quality of life. There was no relationship between the postoperative pain scores and laser WL or energy density. The laser WL did not affect technical success or occurrence of complications. Use of a suitable energy density resulted in complete occlusion in all patients with saphenous vein insufficiency. Lower extremity venous insufficiency is a very common medical condition that affects approximately 25% of females and 15% of males (1). Great saphenous vein reflux is the most common underlying cause of symptomatic varicose veins. Other causes are reflux in other truncal veins, such as the small saphenous vein, the anterior or posterior thigh circumflex vein, the Giacomini vein, and perforating veins. Treatment options for varicose veins include conservative management, minimally invasive procedures, and surgery.In 1999, Salat (2) first reported the delivery of endoluminal laser energy with an 810-nm diode laser for the treatment of varicose veins. Early success with this device prompted development of other devices that supplied wavelengths (WLs) more specific to the hemoglobin chromophore (810-, 940-, and 980-nm devices) in an effort to achieve 100% saphenous vein closure (2-7). In contrast to these laser systems, the 1320-and 1470-nm WL laser systems affect interstitial water (8, 9). Goldman (6) introduced the 1320-nm WL, which better exploits water as the energy-absorbing molecule. Two comparative studies indicated that patients treated with water-specific laser WLs reported less postoperative pain, used less painkillers, and were less likely to have ecchymosis (8, 10).There is increasing focus on reducing postoperative pain and bruising, while maintaining high saphenous vein ablation rates. Because the 1470-nm WL is absorbed by water at a level 40-times more than the 980-nm WL, the manufacturer hypothesized that it woul...

Myxomas are the most common benign primary cardiac tumors. As many patients with cardiac myxoma suffer from cerebral or systemic embolism, which are serious complications, diagnosis of the tumor is vital. Between 1990 and 2000, 18 patients (6 males, 12 females), aged 24 to 73 years (mean, 55.3 years), were operated on for cardiac myxoma. The most common location of the myxoma was the left atrium (78%), and the transseptal surgical approach was preferred (78%) as it allows total resection of the left atrial myxoma along with its pedicle. Carney complex, a familial autosomal dominant form of atrial myxoma, was not found in any of the patients. There had been no operative or postoperative mortality and morbidity. The mean postoperative follow-up period was 5 years (mean, 1 to 10 years). No recurrence had been seen. We believe that the transseptal approach, in allowing total resection of the myxoma, prevents recurrence.

A 17-year-old boy presented with drop foot and loss of extension in his left knee after penetrating injury to the popliteal region. Color duplex ultrasonography and angiography revealed a popliteal artery pseudoaneurysm in the popliteal fossa. Electrodiagnostic tests demonstrated nearly total common peroneal nerve injury. The delay in diagnosis from the time of injury was 1 month. The pseudoaneurysm was repaired with primary suture through a medial incision. Epineurolysis of the common peroneal nerve was performed a week later through a posterolateral incision. Pain and knee contracture resolved after surgery. Drop foot recovered completely after 1 year.

Mediastinal lymphangiomas are very rare tumors among the slow-growing mediastinal masses in the literature. We present the successful resection of a 52-year-old woman who was referred to our hospital. Past medical history consisted of surgical treatment for cervical mass and pathological diagnosis of lymphoma nine years earlier. She underwent postoperative radiotherapy. Preoperative chest roentgenogram and computed tomogram of the chest showed a cystic mass in the anterior mediastinum. The tumor was completely resected. The preoperative diagnosis was never questioned until the histopathological examination confirmed that the lesion was a cystic lymphangioma. Cystic lymphangiomas are benign tumors with the evidence of progression in tumor size and invasion into the vital structures. As our case shows, the tumor involvement with the vital structures causes difficulty in removal.