Purpose: Latissimus dorsi (LD) flaps are frequently used in the prenatal meningomyelocele (MMC) repairs; on that basis, this study aims to reveal the morphometric features of LD, thoracodorsal artery (TDA) and nerve (TDN) in fetal cadavers with MMC defects, with an anatomical perspective. Methods: The study was conducted on 7 formalin-fixed human fetal cadavers (4 males and 3 females) with MMC defects, aged from 18 to 27 weeks of gestation. The size of LD, TDA, and TDN including their area, length, and width were measured by a digital caliper and digital image analysis software. Our direct measurements were compared with the corresponding estimations of a previous study in the literature which provides regression formulae based on gestational age. Results: The fetal cadavers with MMC had bilateral LD. No significant differences were found in the numerical data of anatomical structures between the sides or the sexes. LD size (ie, area, length and width) was approximately 3% to 10% smaller in the fetuses with MMC defects than that of the normal fetuses. Unilateral LD flap in a 22-week-old fetus with a large MMC was evaluated as insufficient to close the defects. Conclusion: Ten percent shrinkage in the area of LD might be too critical to be disregarded by surgeons during the closure of MMC defects. The dimensional findings about LD (area, length, and width) may be helpful in planning of LD flap harvesting for the repairs of MMC.
The results and data of this study can potentially be beneficial in planning of surgeries for many infancy diseases such as trapezius paralysis, obstetrical brachial plexus palsy, Sprengel's disease, or winged scapula. Linear functions calculated in this study are expected to provide a better understanding of the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor in fetal term and more precise estimation of muscle sizes.
The high prevalence of Bacillus species in nature and the detection of these bacteria as contaminant in cultures may lead diagnostic dilemma, however they should still be considered as a pathogen particularly in case of repeated positive cultures from patients with risk factors. Bacillus pumilus is a bacteria, though rarely, been reported as the causative agent of various infections such as sepsis, endocarditis, skin infections and food poisoning in human. In this report, a sepsis case in an immunocompetent patient caused by B.pumilus was presented. A 38-year-old female patient was admitted to emergency service of our hospital with the complaints of headache, dizziness and diarrhea. She had not any risk factors except a history of heart valve replacement operation two years ago. In physical examination, she had abdominal retention, high fever and hypotension, together with the high levels of sedimentation rate (ESR) and C-reactive protein (CRP). The patient was hospitalized with the preliminary diagnosis of sepsis. Three sets of blood samples at two different periods were taken for the culture. All blood culture vials had a positive signal at the second day of incubation in BD BACTEC™ 9050 system, therefore subcultures were performed in sheep blood agar, chocolate agar and MacConkey agar, and incubated in aerobic and anaerobic conditions. Beta-haemolytic, gray-colored large colonies were isolated from anaerobic culture at the end of 18-24 hours incubation, and Gram staining from colonies showed gram-positive rods. The isolate was identified as B.pumilus with 99% accuracy rate by using BD Phoenix™ 100 identification system. This result was also confirmed by MALDI-TOF based VITEK® MS system and 16S rRNA sequencing by Illumina MiSeq® platform. Antibiotic susceptibility test performed by BD Phoenix™ 100 system and the isolate was found to be resistant against penicillin, while it was susceptible to vancomycin, erythromycin, clindamycin, levofloxacin, and trimethoprim-sulfamethoxazole. Initial treatment of patient was started with intravenous ceftriaxone and metronidazole empirically. Hypotension and fever returned to normal levels at the second and third days of the treatment, respectively. Metronidazole treatment was stopped at seventh day, and treatment was completed to 14 day with ceftriaxone alone. At the end of the treatment course, general condition of the patient was completely good, ESR and CRP were also decreased to normal levels. In conclusion, although most of the reported bloodstream infections that are caused by B.pumilus are intravascular catheter-related, artificial heart valves should also be considered as a risk factor even though vegetation was not detected in our patient.
This study is intended to obtain the algebraic growth dynamics of the gracilis in fetuses and determine the variations of neurovascular pedicle(s) of the gracilis, to aid infant surgeries. Forty fetuses (19 males and 21 females) were included in the study. Gestational mean age of the fetuses was 22.40 ± 2.67 (range, 18–28) weeks. Numerical values were obtained using a digital caliper and a digital image analysis software. Linear functions for the surface area, width, anterior, and posterior margin lengths of the gracilis were calculated, respectively, as: y = −289.307 + 20.501 × age (weeks), y = −7.113 + 0.622 × age (weeks), y = −24.421 + 3.434 × age (weeks), and y = −24.397 + 3.314 × age (weeks). In addition, length and width of the gracilis tendon were calculated as y = −6.676 + 0.934 × age (weeks) and y = −0.732 + 0.074 × age (weeks), respectively. Parameters of the gracilis had no statistically significant difference regarding side and sex (P > 0.05). In all the specimens, the gracilis was innervated by the anterior branch of the obturator nerve. Blood supply of the gracilis was identified to be derived from 1 single artery in 38 sides of total 80 (47.5%), from 2 arteries in 36 (45%) and from 3 arteries in 6 (7.5%). In 74 sides (92.5%), the nerve was superficial to the main artery, whereas in 6 sides (7.5%), it was deeper. The data of the present study could be beneficial for surgeons in infant surgeries to treat conditions such as obstetrical brachial plexus paralysis, facial palsy, or anal incontinence. Linear functions can be utilized to better evaluate the growth course of the gracilis in fetuses and to predict the dimensions thereof. Additionally, comprehending the structure and recognizing the variations of the gracilis nerves and arteries can help to protect the neurovascular pedicle(s) of the gracilis during the operations.
ÖzMahmud Esad bin Emin Seydişehrîçok yönlü ilmî kişiliğiyle öne çıkan bir âlim, eğitimci, hukukçu ve devlet adamıdır. Osmanlı Devleti'nin son dönemlerindekimeşhur kişilerden olmasına rağmen günümüzde oldukça az tanındığı söylenebilir. Bu çalışmada onun Şeriat-ı İslamiyye ve Mister Carlyle kitabındaki oryantalizm algısı incelenmekte ve bu algı Edward Said'in söz konusu eserden yaklaşık seksen yıl sonraki oryantalizm analizi ışığında değerlendirilmektedir. Mahmud Esad oryantalizmi oldukça iyimser değerlendirir ve oryantalistlere çoğu zaman iyi niyet atfeder. Onun bu tavrı, Edward Said'inkinden belirgin derecede farklıdır. Çalışmada bu durum tespit edildikten sonra bunun sebepleri irdelenmekte ve temelde şu iki nokta vurgulanmaktadır: Birincisi, Mahmud Esad yaşadığı dönemin şartları sebebiyle oryantalizmin olumsuz yönlerini görme imkânına Edward Said'den daha az sahipti. İkincisi, Edward Said oryantalist geleneği eleştirirken,büyük ölçüde içeriden biri olarak, Batılı akademinin bir üyesi olarak hareket etmekteydi ve içinde bulunduğu Batılı akademik gelenekten yüksek standartlar beklemekteydi. Fakat Mahmud Esad için Batılıların oryantalist geleneği zaten yabancı bir medeniyete aitti. Ona göre, oryantalistler Batı medeniyetinin üyesi oldukları veBatı medeniyetinden üstün olan İslam hikmet geleneğinde yoğrulmadıkları için, İslam'ı ve Müslümanları daha iyi anlamaları ve daha sağlıklı bir bakış açısına sahip olmaları zaten beklenemezdi.Bu çalışmanın Yakın Çağ Osmanlı düşünce tarihi incelemelerine katkı sunacağı umulmaktadır.Anahtar Kelimeler: Mahmud Esad Seydişehrî, Oryantalizm, Yakın Çağ Osmanlı uleması, Edward Said, Thomas Carlyle, Çağdaş Türk Düşüncesi. AbstractMahmud Esad bin EminSeydişehrî was a scholar, educator, jurist and statesman distinguished for his versatile scholarly personality. Although he was one of the prominent personages of the late Ottoman period, it can be remarked that he is rather little known in the present. In this study, his perception of orientalism in his book Şeriat-ıİslâmiyyeve Mister Carlyle (The Islamic Path and Mr. Carlyle) is examined, and this perception is reviewed in the light of Edward Said's analysis of orientalism some eighty years later. Mahmud Esad assesses orientalism quite optimistically and most often attributes good will to orientalists. This attitude is distinctly different from Edward Said's critical viewpoint. After establishing this point in the study, the reasons for this are scrutinized, and essentially these two points are emphasized: Firstly, owing to the circumstances of the period in which he lived, Mahmud Esad had less chance to see through the negative aspects of orientalism than Said later would. Secondly, as Edward Said criticized the orientalist tradition, he acted to a great extent as an insider, as a member of the Western academia and expected high standards from the academic tradition of which he was a part. However, for Mahmud Esad, the Western orientalist tradition belonged to a foreign civilization after all. According to him, since orientalists were me...
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