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Objective: Trans-apical off-pump mitral valve repair is a new minimally invasive surgical technique for the correction of mitral regurgitation caused by mitral leaflet prolapse. The purpose of this study is to evaluate, using clinical and echocardiographic follow-up data, the mid-term results of patients undergoing this procedure. Methods: A total of 26 patients diagnosed with severe mitral regurgitation underwent mitral valve repair with trans-apical off-pump neochord implantation using the NeoChord device at our hospital from July 2015 to July 2017. All patients were examined by transthoracic and transesophageal echocardiography. Eighteen (69.2%) patients had type A anatomy, 4 (15.4%) had type B anatomy, and 4 (15.4%) had type C anatomy. Preoperative, intraoperative, and postoperative demographic, echocardiographic, and clinical data were collected. Results: The patients' age ranged from 33 to 76 years (mean: 56+-10.1 years). The average preoperative EuroSCORE II was 1.04%+-0.7%. Acute procedural success was achieved in 25 (96.15%) patients. There was only 1 early death (30-day mortality rate: 3.8%) due to postoperative low cardiac output syndrome. Transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation in 87.5% of the patients and moderate regurgitation in 12.5% of the patients. During the follow-up period, transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation (MR) in 14 (58.3%) patients. Six (25%) patients presented with moderate MR and 4 (16.7%) patients had severe MR. At the 30-month follow-up, freedom from residual severe MR was 78.8%+-10.3% and freedom from reoperation was 87.5%+-6.8%. Conclusion: Trans-apical off-pump mitral valve repair with neochord implantation may be a suitable treatment option in patients with isolated posterior mitral valve leaflet prolapse.

Background Complex regional pain syndrome (CRPS) is a painful and disabling neurovascular condition. There is no consensus on the etiopathogenesis or the treatment. We present a patient with CRPS type 1 accompanied by a psychiatric disorder to discuss the relationship between CRPS and psychiatric disease and to emphasize the response of this case to treatment with pregabalin. Patient Description A 15-year-old girl presented with swelling, severe pain, edema, hyperesthesia, allodynia, and sweating changes in the left arm and was diagnosed as CRPS type 1. The presence of disturbed family relations was revealed on psychiatric examination, and a diagnosis of major depression was made. Her symptoms did not respond to selective serotonin reuptake inhibitors and noradrenergic and specific serotonergic antidepressives, gabapentin, or stellate ganglion blockage, but the patient's pain resolved with pregabalin. Symptom-oriented measures and psychiatric support enabled ongoing treatment. A social services evaluation led to her being placed in the care of social services to protect her from the chaotic and traumatic family life. Conclusion Detailed psycological and psychiatric evaluation is recommended in individuals with CRPS because psychiatric support and improvement of associated psychosocial concerns in addition to pregabalin seems to facilitate treatments in some patients.

Background.- Superficial siderosis of the nervous system is a rare condition caused by repeated subarachnoid hemorrhage.Observation.- We report a 58 year-old-man who had undergone surgery of cervical neurinoma 22 years ago. He was presented with progressive gait ataxia, hearing loss, dementia, anosmia and pyramidal signs. Disease - onset was 3 years ago. The diagnosis of superficial siderosis was made by means of Magnetic Resonance Imaging of the head, and was confirmed by increased iron level in the CSF. Since surgical treatment prevent further bleeding and possibly progression of the disease, the possible cause of bleeding and treatment options are discussed in this report.Saltık S, Kızıltan G, Bozluolcay M. Superficial siderosis of the nervous system: A case report. Cerrahpaşa J Med 2000; 31 (3): 163-167. * Anahtar Kelimeler: Superfisial siderosis, Kronik subaraknoid kanama* Key Words: Superficial siderosis, Chronic subarachnoid hemorrhage

Amaç: Tüberoskleroz kompleksinde en sık görülen nörolojik sorun epilepsidir Bu çalışma epileptik tüberoskleroz kompleksi tanılı hastaların epilepsi özeliklerini ve klinik seyrini incelemek epilepsi seyrini etkileyebilecek etmenleri araştırmak amacıyla planlandı.Gereç ve Yöntem: Çocuk Nörolojisi Kliniği rsquo;mizde epilepsi nedeniyle 9 ay 10 yıl izlenen 1 14 7 5 plusmn;4 2 yaşları arasında 21 tüberoskleroz kompleksi tanılı hasta 11 10: E K çalışmaya alındı Hastalara ait aşağıdaki bilgiler elde edildi: epileptik nöbet özellikleri muayene bulguları zeka veya bilişsel gelişim düzeyleri antiepileptik tedavi kraniyal manyetik rezonans görüntüleri ve elektroansefalogram bulguları Epileptik nöbet seyri iyi ve kötü olarak gruplandırıldıktan sonra ilk nöbet yaşı öyküde status infantil spazm varlığı ilk tedavi seçeneğinin vigabatrin olması ilk elektroansefalogram bulguları elektroansefalogramda epileptik aktivite yeri hastalarda otizm veya zeka ve bilişsel gelişim geriliği varlığı kortikal tüberlerin sayı ve yerleşimleri astrositom varlığı açısından istatiksel olarak karşılaştırıldı.Bulgular: Hastaların nöbet başlama yaşı üç gün ile 2 5 yaş arasında olup 16 hastada 76 bir yaş ve altındaydı Hastalarımızın en sık nöbet tipi 95 kısmi nöbet olup sekizer hastada 38 infantil spazm ve status epileptikus saptandı İzlemleri sonucunda nöbet seyri 11 rsquo;inde kötü 10 rsquo;unda iyi olarak değerlendirildi Nöbet başlangıç yaşı bir yaş altı ve üstü status veya infantil spazm öyküsü ilk elektroansefalogram bulguları ilk ilaç olarak vigabatrin kullanılması hastada otizm veya zeka ve gelişim geriliği varlığı kraniyal manyetik rezonans görüntülemede kortikal tüber sayısı yerleşimi ve astrositom varlığının nöbet seyri ile ilişkisi saptanmadı.Çıkarımlar: Tüberoskleroz kompleksi tanılı hastalarda epilepsinin klinik seyrinin her hasta özelinde çeşitli etmenlere bağlı değişkenlik gösterebilmesi nedeniyle bu hastaların klinik ve elektroansefalogram ile yakın izlemi gereklidir., Aim: Epilepsy is the most common neurological problem in tuberous sclerosis complex TSC The aim of this study is to investigate the clinical features and prognosis of epilepsy associated with TSC and to determine the factors that may affect the course of epilepsy in TSC patients Material and Method: Our study included 21 TSC patients 11 10: M F aged between 1 14 years 7 5 plusmn;4 2 and followed up for 9 months 10 years because of epileptic seizures After epileptic seizures were classified as seizures with good and poor prognosis they were were statistically compared in terms of age at seizure onset history of status and infantile spasms initial treatment with vigabatrin initial EEG findings presence of autism or mental retardation or cognitive impairment the number of cortical tubers and presence of astrocytoma Results: The age at seizure onset ranged between 3 days and 2 5 years The most common seizure type in our patients was partial seizure and eight patients had infantile spasms and status epilepticus As a result of follow up the prognosis was evaluated as poor in 11 and good in 10 patients No statistical relationship was found between seizure prognosis and age at seizure onset younger and older than 1 age the history of status and infantile spasms initial EEG findings use of vigabatrin as the first drug the presence of autism or mental retardation or cognitive impairment the number and localization of cortical tubers and the presence of astrocytoma p gt;0 05 Conclusions: The prognosis of epilepsy in patients with TSC varies in each patient depending on several factors For this reason close follow up of these patients with clinical evaluation and EEG is required Turk Arch Ped 2013; 48: 123 30