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In this study the effect of CO2 laser on spinal epidural fibrosis was examined in 24 guinea pigs which were divided into two groups. The first group was the control group, the second one the CO2 laser group. All animals had laminectomies at 3 levels. Re-exploration was performed three months after the laminectomy. In the second group the same procedure was performed but at the end of the re-exploration, CO2 laser irradiation of the epidural fibrotic tissue was done. The wounds in both groups were closed again. Four months later all animals were sacrificed. For verification and quantification of scar formation (postoperative fibrosis) light microscopic examinations and determination of hydroxyproline were done, using Bergman's spectrophotometric method. The differences which were observed between the two groups were statistically significant (U : 134, P < 0.05). This study demonstrates the reducing effect of CO2 laser irradiation on epidural scar formation. The findings encourage its use as an alternative method of prevention of epidural fibrosis after spinal surgery.

Tetanus is still responsible for many deaths, especially in the developing parts of the world. In this study, the prophylactic effect of ornidazole on experimental tetanus in mice was investigated. The initial minimum lethal dose (MLD) of Clostridium tetani spores was determined in mice and 100 MLD was applied to mice in experiments. Ornidazole was then administered at the dose of 20 mg, 40 mg and 80 mg/kg. In addition, penicillin and horse tetanus serum were also administered to other groups. According to the present results, ornidazole decreased the number of deaths in mice significantly in a dose and drug administration time dependent manner. These results suggest that, together with essential wound care and active immunization, ornidazole (or another nitroimidazole) may be a useful and supportive therapeutic agent in tetanus prophylaxis.

A fifty-year old woman, gravida 17, para 17, presented with profuse vaginal bleeding following curettage in another hospital. At emergency laparotomy total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed because of intractable hemorrhage. Histopathologic examination revealed endocervical placentation and adenomyosis uteri. The case is presented due to its rarity and possible predisposing factors are discussed.

A 20 year-old Turkish patient presented with superior sagittal and lateral sinus thrombosis. The frequency of cerebral venous thrombosis generally is underestimated and may be the first clinical manifestation. In case of intracranial hypertension, cerebral venous thrombosis and Behcet's disease should be taken into consideration, especially in the high risk population from Eastern Mediterranean countries and Japan. CT with enhancement and MRI study with T1- and T2- weighted images were used to detect the thrombosed veins and to evaluate the thrombosis. Treatment with anticoagulation and corticosteroid therapy in cerebral venous thrombosis is well established today. Clinical course and prognosis in cerebral venous thrombosis are generally benign if adequate management is started in time.

Sister-chromatid exchanges (SCE) have been studied to analyze genotoxic effects in epileptic patients on anticonvulsant therapy. All patients had an increased frequency of SCE per metaphase (p < 0.001) compared to controls, indicating a genotoxic effect of anticonvulsant drugs.

Three methods of deriving directional signals from phase quadrature Doppler signals, using digital techniques, are described. These are the phasing-filter technique, the Weaver receiver technique and the complex FFT. The basic theory behind the three methods is presented, together with the results of digital simulations. Each of the methods has been implemented in real time using a commercially available digital signal-processing board, and their relative processing times are compared. All the methods work well, and the decision to implement one or other in a specific application is likely to rest on secondary factors, such as the need to tape-record the time domain output.

Four possible quadrature-to-directional format conversion methods using digital techniques are described. These are the phasing-filter technique, the extended Weaver receiver technique, the Hilbert transform in the frequency domain, and the complex FFT. All methods are implemented to give separated time domain outputs as well as frequency domain outputs. The theoretical descriptions are verified by practical implementations. Each of the methods has been implemented in real-time using a commercially available digital signal processing board.

Seven cases of intracranial tuberculoma diagnosed in northern Turkey over a 2-year period are presented, with emphasis on the CT and clinical findings. CT alone cannot differentiate tuberculoma from an abscess or other granulomatous processes, but it is still one of the most sensitive techniques for detecting tuberculomas. It provides information on the nature of the lesion and the number of loci.

A 27-year-old man was found to have a low grade transitional cell tumour of the renal pelvis at pathological examination of his traumatically ruptured kidney. The kidney was also hydronephrotic due to urolithiasis of long duration. The medicolegal aspects of the case are evaluated.

We retrospectively analyzed 238 patients with esophageal carcinoma treated between 1983 and 1991; 120 underwent transthoracic esophagectomy, and 118 underwent transhiatal esophagectomy. The two groups were statistically similar in preoperative characteristics, except that upper esophageal cancer was more frequent in the transhiatal esophagectomy group than in the transthoracic esophagectomy group (p < 0.01). The rate of postoperative complications differed significantly in wound infection (21% in patients who underwent transthoracic esophagectomy, 10% in those who underwent transhiatal esophagectomy; p < 0.05) and empyema (11% with transthoracic esophagectomy, 1% with transhiatal esophagectomy; p < 0.01). Pneumothorax was detected in 24% of the transhiatal esophagectomy cases. Intraoperative blood loss was 1340 +/- 490 ml in the transthoracic esophagectomy group and 930 +/- 340 ml in the transhiatal esophagectomy group (p < 0.001). Hospital mortality was 11% in the transthoracic esophagectomy group and 6.7% in the transhiatal esophagectomy group. Late complication rate was lower with transhiatal esophagectomy than with transthoracic esophagectomy (11% and 51%, respectively). There was no significant difference in actuarial survival of patients in both groups. Transhiatal esophagectomy, which can be performed in almost all levels of the esophagus, is the safer of the two operations.

A 23-year-old man had been coughing with hemoptysis, and had received tuberculostatic medication for four months without any benefit. Upon referral, two-dimensional echocardiography showed a cystic mass located in the anterior right-ventricular wall, without any protrusion into the ventricular cavity. CT examination revealed three cysts in the lung fields bilaterally, additionally a multilocular cystic image in the right-ventricular wall was observed. All components of hydatid cysts in the heart and lungs were removed in the same session by median sternotomy. Extracorporeal bypass was used in this operation.

The cyst stage of Echinococcus granulosus is commonly located in the liver, which frequently results in a long symptomless period. We present a sudden death due to a freshly hemorrhagic hydatid cyst following blunt trauma to the liver in a 19-year-old boy. The possible mechanism was thought to be an anaphylactoid reaction to the leakage of the cyst fluid.

We report the case of a young man suffering from the rare combination of livedo reticularis and recurrent ischemic cerebrovascular disease (Sneddon's syndrome). He also had a circulating anticardiolipin antibody. in the absence of systemic lupus erythematosus, we suggest the likelihood of a primary antiphospholipid syndrome.

Three patients with leiomyosarcoma of the urinary bladder are presented. One case showed urothelial carcinoma in situ also. The mode of presentation and operative findings were similar in two female patients, whereas the lesion seemed to be more aggressive in a male patient.

22 Bacillus anthracis isolates were tested for susceptibility to 27 antimicrobial agents by agar dilution. All isolates were sensitive to penicillins and did not produce beta-lactamase. Although all isolates were sensitive to cefazolin, cephalothin, cephradine and cefoperazone 19 isolates were resistant to cefuroxime, 18 to cefotaxime, 18 to ceftizoxime, 9 to ceftriaxone and 21 to ceftazidime. All isolates were also found to be sensitive to other antimicrobials tested. The new antimicrobial agents, ofloxacin and ciprofloxacin showed very good activity with MICs of 0.03-0.06 mg/l.

A previously well 42-year-old man presented with a three-hour history of pain in the right flank of acute onset. At laparotomy he was found to have a ruptured right kidney which was treated by nephrectomy. Eight days later he developed similar symptoms on the left: at operation 21 of blood were drained and nephrostomy and catheterisation carried out. He recovered after a complicated postoperative course, and histological examination of the removed kidney, and biopsy specimens, showed classic polyarteritis nodosa. This is a rare cause of spontaneous rupture of the kidney but must be considered whenever a patient presents with renal haemorrhage of unknown cause.

Ergot derivatives have been used in the treatment of migraine for more than 50 years. We have compared the efficacy of dihydroergotamine (DHE) nasal spray with that of placebo in patients with classic or common migraine attacks. The study was performed in accordance with a double-blind, crossover design. In this study a great placebo effect was observed with a dose of 1.36 mg/attack, and the overall efficacy was rated by the patients to be 41% and 52% for placebo and DHE, respectively.

A case of hereditary multiple exostoses with spinal cord compression by a costal exostosis is reported in a 12-year-old boy. Paraplegia is an unusual complication of hereditary multiple exostoses. In the patient with spinal cord signs, the offending exostoses should be defined with appropriate roentgenograms and myelographic and CT scanning investigations.