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Objective: The first imaging method to play an vital role in the diagnosis of COVID-19 illness is the chest X-ray. Because of the abundance of large-scale annotated picture datasets, convolutional neural networks (CNN) have shown remarkable success in image recognition and classification. The current study aims to construct a successful deep learning model that can distinguish COVID-19 from healthy controls using chest X-ray images. Material and Methods: The dataset in the study consists of subjects with 912 negative and 912 positive PCR results. A prediction model was built using VGG-16 with transfer learning to classify COVID-19 chest X-ray images. The data set was split at random into 80 % training and 20% testing groups. Results: The accuracy, F1 score, sensitivity, specificity, positive and negative values from the model that can successfully distinguish COVID-19 from healthy controls are 97.3%, 97.3%, 97.8%, 96.7%, 96.7%, and 97.8% regarding the testing dataset, respectively. Conclusion: The suggested technique might greatly improve on current radiology-based methodologies and serve as a beneficial tool for clinicians/radiologists in diagnosing and following up on COVID-19 patients.

Background: Due to its high mortality and morbidity rates, the surgical treatment for ruptured aortic arch aneurysms is challenging. There is no consensus on the optimal treatment modality in this patient group. Herein, we present a case of a ruptured giant atherosclerotic aortic arch aneurysm treated successfully with emergency surgical intervention. Case Report: A 74-year-old female patient was admitted to our emergency clinic with complaints of blurred consciousness, chest pain, and dyspnea. In physical examination arterial blood pressure, pulse, oxygen saturation was 80/40 mmHg, 122 beats/min, 85-90% respectively. In oscultation of left hemithorax breath sounds was decreased. Chest X-ray revealed a giant aortic aneurysm and opacity at left hemithorax which was suggestive of pleural effusion. A ruptured saccular aortic arch aneurysm with a size of 8x6 cm2 was detected in the contrasted tomography. Emergency surgery with right selective antergrade cerebral perfusion performed uneventfully. Because of pulmonary complications she wasnÂ’t tolerate extubation and re-intubated. After appropriate therapy in anesthesiology and reanimation clinic she was discharged in the postoperative 15th day. Conclusion: Recent outcomes of open arch repair and hybrid TEVAR demonstrate acceptable results, particularly early after the procedure, open arch repair provides more reliable outcomes during follow-up. These two surgical strategies, when properly selected according to the individual risk, can improve the surgical outcomes in patients with aortic arch aneurysms

BackgroundWhite-coat hypertension (WCH) is a disease based on the disparity of a patient-s blood pressure measurements between the physician-s office and the patient-s home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH.MethodsIn total, this study included 37 WCH (17 women, 20 men, mean age 48.45.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.97.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions.ResultsLA diameters were significantly higher in the patients compared with the controls (37 +/- 2.8 vs. 35 +/- 3.1mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1 +/- 6.9 vs. 35.5 +/- 3.7ml, P

A 43 year-old woman complained of palpitation and shortness of breath admitted to our hospital. Transthoracic echocardiography revealed severe mitral stenosis and moderate mitral regurgitation. In routine blood tests hemoglobin and lactate dehydrogenase levels were 7.6 g/dL, 520 IU/L respectively. Coombs test was negative. After studying the other intrinsic or extrinsic causes of hemolytic anemia patients anemia was diagnosed as intravascular hemolytic anemia due to tight mitral stenosis. Therefore, mitral valve replacement planned and performed. Hemolysis was resolved after the mitral valve replacement. In conclusion, we report a case of hemolyt ic anemia due to mitral stenosis resolved by mechanical mitral valve replacement. [Med-Science 2016; 5(2.000): 738-41]

With the development of microsurgical techniques and successfull multidisciplinary approach; many injuries that require amputation can be treated success fully by extremity preventing surgery. We present a case that admitted to our clinic with open fracture and although had amputation endication, treated with extremity reconstruction surgery.between the total average points of the pre-test and the re-test of the scale was not found statistically significant (p=0.30). As a result of the Turkish version of the scale of the values obtained from the PU is defined to be a reliable and valid scale. Key Words: Amputation, extremity reconstruction, prevention Ozet Mikrocerrahi tekniklerin gelismesi ve basarili multidisipliner yaklasim sayesinde amputasyon ile sonuclanabilecek pek cok yaralanma ekstermite koruyucu cerrahi ile tedavi edilmektedir. Klinigimize acik kirik ile basvuran; amputasyon endikasyonuna ragmen ekstremite rekonstruksiyon cerrahisi yapilarak takip edilen hastanin klinik seyrini sunduk. Anahtar Kelimeler: Amputasyon; ekstremite rekonstruksiyonu, onleme

Spontaneous rupture of the aorta without previous history of trauma, hypertension or apparent aortic pathology is rare. Delayed or nonoperative repair of this condition is usually lethal. We report spontaneous rupture of the ascending thoracic aorta in young man. A 20-year-old male who had complained of sudden onset of severe chest pain and dispnea was admitted to our hospital. Initially, acute type A closing aortic dissection was suspected but computed tomography (CT) showed no intimal flap, false lumen or aortic aneurysm. [Med-Science 2015; 4(1.000): 1809-17]

Objective: Pulmonary thromboembolism (PTE) named due to migration of clots formed in systemic venous system to pulmonary vascular bed is a serious clinical table. After acute DVT, asymptomatic PTE is seen about 40-60% and this situation can not be discovered because of silent clinical course. In this study, we aimed to compare sensivity and spesifity of multi detector computerized tomography (MDCT), which is used extensively in recent years, with ventilation-perfusion (V/P) scintigraphy which is used formerly for diagnosis of asymptomatic PTE developed after acute lower extremity DVT. Methods: The study was carried out 25 patients who were admitted to our clinic and treated for lower extremity acute DVT. Pregnants, and cases with recurrent DVT, presence of symptomatic PTE during admission, thrombosis extending to vena cava, and history of passed PTE were excluded from the study. DVTs in patients were diagnosed by color doppler, and confirmed by D-dimer test. After patients\'s admission, V/P scintigraphy and MDCT were used to detects asymptomatic PTE at 1st and 8 th day of the admission. Results: D-dimer was measured as higher in 24 of 25 patients with asemptomatic PTE. Ten patients were diagnosed by MDCT. Development of asymptomatic PTE related to acute DVT was determined as 40%. Conclusion: In terms of diagnostic value, MDCT was found more useful than V/P scintigraphy., Amaç: Pulmoner tromboemboli (PTE) sistemik venöz sistemde oluşan pıhtıların pulmoner vasküler yatağa göçü ile ortaya çıkan klinik tabloya verilen isimdir. Akut derin ven trombozu (DVT) sonrası ortalama %40-60 oranında asemptomatik PTE görülmekte ve bu durum sessiz klinik seyir nedeniyle fark edilmemektedir. Bu çalışmamızda akut alt ekstremite DVT\'sine bağlı gelişen asemptomatik PTE tanısında hala günümüzde önemli bir yer tutan ventilasyon-perfüzyon (V/P) sintigrafisi ile son yıllarda kullanılmaya başlanan multi-detektor bilgisayarlı tomografinin (MDBT) sensitivite ve spesifitesini karşılaştırmayı amaçladık. Yöntemler: Çalışma alt ekstremite akut DVT nedeniyle kliniğimize yatırılarak tedavisi planlanan 25 hastada gerçekleştirildi. Gebeler, nüks DVT vakaları, müracaat esnasında semptomatik PTE tablosu olanlar, vena kavaya uzanım gösteren trombüsü olanlar, önceden geçirilmiş PTE öyküsü olanlar çalışmaya dahil edilmedi. Hastalarda DVT tanısı renkli doppler USG ile konulup, D-dimer testiyle teyit edildi. Hastalara yatışının 1.ve 8. günlerinde V/P sintigrafisi ve MDBT yapılarak asemptomatik PTE varlığı araştırıldı. Bulgular: Pulmoner tromboemboli açısından asemptomatik olan 25 DVT hastasının 24\'ünde D-dimer normalin üstünde ölçüldü. MDBT ile 10 hastaya PTE tanısı konuldu. Akut DVT\'ye bağlı %40 oranında asemptomatik PTE geliştiği tespit edildi. Sonuç: Multi-detektor bilgisayarlı tomografi tanı değeri açısından V/P sintigrafisinden daha faydalı bulundu.

Purpose: To explore the protective and curative effects of molsidomine (MOL) on doxorubicin (DOX)-induced cardiac damage in the in vivo rat heart. Methods: Forty rats were randomized into five groups (n = 8): (1) the control group; (2) the MOL group (10 mg/kg for 21 days); (3) the DOX group (a single dose of 20 mg/kg); (4) the DOX + MOL group (3 days after the single dose of DOX, 10 mg/kg MOL continued for 21 days), and (5) the MOL + DOX group (24 h after a 21-day regimen of 10 mg/kg MOL, a single dose of DOX). The rats were monitored for mean arterial blood pressure, heart rate, O2 saturation, and electrocardiography. Heart tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and nitric oxide (NO) were determined. Results: Blood pressure and O2 saturation values indicated a significant decrease in the DOX group compared with the control group. T negativity was observed in 4 of 8 rats in the DOX group, in 1 of 8 rats in the DOX + MOL group, and in 4 of 8 rats in the MOL + DOX group. MDA levels were significantly higher in the DOX group. SOD, GSH, and NO levels were significantly lower in the DOX group compared with the other groups. There was no statistically significant difference in the CAT levels in any of the study groups compared with controls. DOX treatment induced morphological alterations, such as disorganization of cardiomyocytes, loss of myofibrils, and cytoplasmic vacuolization in the heart. On the other hand, histological damage was significantly reduced in the DOX + MOL and MOL + DOX groups. Conclusion: This study implies that there are cardioprotective effects of MOL on DOX-induced cardiotoxicity.

Infective endocarditis (IE) is still associated with severe complications and poor prognosis. The surgery of IE has various technical difficulties due to severe infection, inflammation of heart tissue, and systemic effects, so controversies continue about the optimal timing of operation. This study presents the treatment approaches, early and late-term outcomes of IE patients, who underwent surgery.This retrospective descriptive study is conducted with 46 patients (31males) operated between 2002-2018. The demographics and preoperative, intraoperative and postoperative data of patients were analyzed from the clinical database and patient records. Emergency surgery was performed to 15 (32.26%) patients.Numbers of patients with mitral valve, aortic valve, and prosthetic valve endocarditis were 14, 25, 7 respectively. Aortic valve replacement (AVR), mitral valve replacement (MVR), MVR + AVR and mitral valve repair were performed in 24, 12, 8 and 2 patients, respectively. Additionally, pericardial patch repair (periannular abscess or damage (n=12), aorta-right atrial fistulae (n=3)), debulking of associated tricuspid valve vegetation (n=2), tricuspid De Vega annuloplasty (n=3), Bentall operation (n=1) and aortic root enlargement (n=5) were performed. The mean follow-up period and mortality rates were 24.86 ± 38.98 months, 13.04% respectively. The mean survival and reoperation-free time were 179.02 ± 13.78 and 203 ± 10.09 months, respectively. Patients can be managed appropriately with early diagnosis, aggressive medical and surgical treatment via a multidisciplinary approach with customized management according to guidelines in terms of individual characteristics. In cases of worsening hemodynamic status, uncontrolled infection, large and mobile vegetations surgery should be performed as soon as possible.

ABS TRACT Pri mary hyda tid di se a se in the musc le is very ra re. Usu ally, in tra mus cu lar hyda tid cysts are se con dary, re sul ting eit her from the spre ad of cysts spon ta ne o usly or af ter surgery. We re port an unu su al ca se of pri mary hyda ti do sis wit hin bi ceps brac hi i musc le. It was di ag no sed on the basis of the com pu ted to mog raphy ap pe a ran ce, cli ni cal and pat ho lo gi cal fin dings. Un der ge ne ral anest he si a we ca re fully tri ed to iso la te the cyst from the sur ro un ding musc les. However, the mass was ruptured inadvertantly. Fol lo wing ir ri ga ti on of cystic ca vity with hyper to nic sa li ne so lu ti on, the cyst wall was ex ci sed. The re is no re cur ren ce in the postoperative second year. In ge og rap hic re gi ons whe re hyda ti do sis is en de mic, hyda tid cyst sho uld be inc lu ded in the dif fe ren ti al di ag no sis of a cystic mass in the musc le to avo id fi ne-ne ed le bi opsy and it must be ca re fully dissected from the sur ro un ding musc les. The rupture of the cyst may not only result in recurrence and dissemi nation, but may also cause anaphylaxis and its surgical resection is difficult.

We describe the case of a 60-year-old male hypertensive patient who was admitted to our department with intermittent claudication. An echocardiography evaluation detected apical hypertrophy without an intracavity pressure gradient. Transthoracic echocardiography has been the first-line imaging method for patients with suspected hypertrophic cardiomyopathy (HCM), but the method's shortcomings in evaluating the apex are well known. Thus, images from the patient's magnetic resonance imaging and angiography examinations confirmed the classic features of apical HCM. In addition, a 3-dimensional computed tomography evaluation disclosed Leriche syndrome concurrent with severe bilateral stenosis of the renal arteries. Apical HCM combined with severe renal artery stenosis is very rare and has not previously been reported with Leriche syndrome.

The optimal management of moderate ischemic mitral regurgitation (MR) remains controversial. Some surgeons advocate coronary artery bypass alone, while others suggest concomitant mitral valve annuloplasty. We aimed to evaluate the early results of isolated coronary artery bypass operation on the cases with mild-to-moderate ischemic MR. Between May 2010 and May 2011, 59 patients (64% male, mean age: 50.5 years) with a preoperative diagnosis of mild-to-moderate ischemic MR underwent a coronary bypass operation. Patients evaluated with preoperative and postoperative (in twelve-month period with an average of five months) transthoracic echocardiogram (TTE). Postoperative mortality was not observed in study group. The preoperative functional capacity of the patients as well as the variables of mild MR and moderate MR showed a statistically significant difference in a positive way when compared with the postoperative functional capacity and MR variables. Postoperative TTE evaluation revealed that only 2 cases have severe MR (3,4%) also 62,7 % of patients have mild and 33.9% of patients have moderate MR. While there was a significant difference in a positive way between the preoperative and postoperative period in terms of left atrial diameter, no significant difference was found for the variables of ejection fraction and pulmonary artery pressure. Among the patients whom undergoing coronary bypass surgery, if there is mild or moderate MR revealed with the TTE prior to the operation, performing only coronary bypass operation will be adequate, and our early results in this matter are satisfactory. But, if severe MR revealed with TTE, performance of mitral valve repair or replacement should be evaluated additional to coronary bypass operation. [Med-Science 2018; 7(1.000): 114-117]

The objective of the present study was to investigate the possible impact of specific endothelin-A (ETA) receptor blockage by BQ-123 on myocardial ischemia-reperfusion (MI/R) induced apoptosis in rats. To produce MI/R, a branch of the descending left coronary artery was occluded for 30 min followed by 2 h reperfusion. Thirty-two rats were randomly assigned to four groups equally: (1) sham-operated group, (2) MI/R group, (3) MI/R+BQ-123-treated group, and (4) MI/R+ET-1+BQ-123-treated group. TUNEL staining, caspase-3 and caspase-9 activities were determined immunohistologically. MI/R group revealed extensive TUNEL positive cardiomyocytes especially in the free wall of the left ventricule, interventicular septum, and apex zone. Intensity of TUNEL-positive cardiomyocytes reduced as a result of BQ-123 treatment compared to the sham group in the same sections. Result of the caspase activity was found to correlate with TUNEL evaluation. BQ-123 administrations to MI/R group with or without ET-1 caused significant decrease both in lipid peroxidation and nitric oxide (NO) generation. Also, BQ-123 leads to augmentation of superoxide dismutase, catalase and glutathione contents. We propose that selective ETA antagonism by BQ-123 has a worthwhile effect on apoptotic cell death following MI/R, and that scavenging of free radicals by selective ETA antagonist is part of this beneficial effect. [Med-Science 2012; 1(4.000): 254-70]

We present a woman having congenital anomalies of the inferior vena cava and partial anomalous pulmonary venous return from the right lung with atrial septal defect in a 38-year-old. Congenital anomalies of inferior vena cava are rare. They are seen more often in young males. If there are not other anomalies, they are latent for a long time. Peripheral venous thrombosis, chronic venous insufficiency, dyspnea and fatigue are often the first symptoms of these anomalies. Surgical repair of atrial septal defect with partial anomalous pulmonary venous return include provision of durably unobstructed systemic and pulmonary venous pathways, closure of the atrial septal defect, and avoidance of arrhythmias. The diagnosis has been determined by compression ultrasonography with color doppler assessment, multidetector computed tomography angiography and echocardiography.