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    Atypical presentation of congenital lymphedema
    (Professional Medical Publications, 2011) Silfeler, Ibrahim; Genens, Mikayir; Sumengen, Dilek; Guler, Salih; Acar, Yesim
    Lymphedema, lymphatic fluid is due to an abnormal accumulation in the body in a regional body edema. Congenital lymphedema represents all forms that are clinically evident at birth and accounts for 10-25% of all primary lymphedema cases. The patient was born from consanguineous parents as the first child after two abortion and history of a child death at 14 month of age. On examination the patient had pitting edema at all extremities and abdomen. Lymphangiosintigraphy was performed and no lymph nodes were seen so hereditary primary lymphedema diagnosis was confirmed. Primarily, often caused by a congenital anomaly or dysfunction. As a secondary, acquired disorder is caused by lymphatic flow. Congenital lymphedema, occurs in the first weeks of life. After resolution of the edema the patient was malnourished and had feeding problems. In English literature, congenital lymphedema case with organomegaly, ascites and pitting generalized edema is rarely defined. We report this case because of its unique presentation.
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    EBV-induced fulminant hepatic failure treated with liver transplantation
    (Professional Medical Publications, 2010) Silfeler, Ibrahim; Kurnaz, Hilal; Acar, Yesim; Dorum, Bayram Ali; Arica, Vefik; Pekun, Fugen
    Viral hepatitis is the leading cause of fulminant hepatitis. Infectious mononucleosis caused by primary infection of EBV is a self-limiting lymphoproliferative disease, and shows concomitant clinical features such as pyrexia, cervical lymphadenopathy, liver dysfunction and hepatosplenomegaly. Even though approximately more than 90 percent of all humans are infected with EBV it rarely causes hepatitis and even if it does it is usually benign and it rarely causes hepatic failure in which the outcome has a high mortality rate. We report a case of fulminant hepatic failure in an immunocompetent 3.5 years old girt caused by primary EBV infection that was treated by orthotropic liver transplantation. This observation emphasizes that EBV must be known as a possible cause of fulminant hepatitis and that liver transplantation is probably the unique therapeutic option to avoid a usually fatal course.
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    Spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in a term newborn
    (Professional Medical Publications, 2011) Silfeler, Ibrahim; Kurnaz, Hilal; Acar, Yesim; Arica, Vefik; Tutanc, Murat; Pekun, Fugen
    Neonatal pneumomediastinum is a rare condition which often occurs during the setting of assisted ventilation of premature or diseased lungs. Brachial palsy occurs in presence of impression on cervical and throcal nerve roots due to birth-related trauma. In this case; we present a progressive spontaneous pneumomediastinum. Although subcutaneous emphysema was involving the whole neck, right cervical region was predominantly involved. Even though there was no diagnosed brachial palsy just after delivery, in time, we realized that the right arm was affected. In the literature, we couldn't find any reported case of spontaneous pneumomediastinum associated with subcutaneous emphysema causing brachial plexus palsy in neonatal period.