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    Arterial thrombosis and thalidomide
    (Springer, 2008) Goz, Mustafa; Eren, M. Nesimi; Cakir, Omer
    Arterial emboli are largely a reflection of cardiac disease. Thalidomide is an antiangiogenic drug used in cancer therapy. Venous thrombosis incidence increased during treatment with thalidomide. We reported arterial thrombosis in two cases with multiple myeloma implemented in thalidomide treatment. Standard emergency intervention was applied. In the postoperative period, enoxiparine was given to all the patients. Warfarin treatment was started in the level of INR 2-2,5. ASA with a dose of 100 mg/day was added to the treatment. In conclusion, this side effect of the use of thalidomide should be taken into consideration while doing examinations with respect to the etiology in arterial thromboembolism and because of this vascular complication that threatens life; we suggest stopping the thalidomide treatment.
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    Huge popliteal arterial aneurysms in Behcet's syndrome: Is ligation an alternative treatment?
    (B C Decker Inc, 2007) Goz, Mustafa; Cakir, Omer; Eren, M. Nesimi
    Behcet's syndrome is a multisystemic disease characterized by relapsing uveitis, oral and genital ulcerations, and vascular system involvement. The vascular involvement is seen as venous occlusion, arterial occlusion, and aneurysm formation in this disease, and the surgical treatment of a Behcet's aneurysm has technical difficulties. In this report, we suggest that the huge popliteal artery aneurysm in Behcet's syndrome can be treated by ligation of the popliteal artery. A 58-year-old male patient was admitted to our clinic because of an infrapopliteal great mass at the left leg. Color Doppler ultrasonography and arteriography revealed a 71 X 54 mm aneurysmal dilatation at the distal popliteal artery. Surgery did not reveal any suitable arterial formation for bypass to the distal area of the popliteal artery and tibial arteries. For this reason, we applied ligation of aneurysmal dilatation at the distal popliteal artery. The patient tolerated the operation well and had no signs of ischemia during the postoperative period. In conclusion, especially in aneurysm of arteries such as the popliteal artery, which has critical importance for maintaining distal perfusion, ligation may be a treatment method if there are no other alternatives.
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    Multiple coronary artery aneurysms that cause thrombosis: 22-month follow-up results with multi-slice spiral computerized tomography without surgery
    (Elsevier Ireland Ltd, 2007) Goz, Mustafa; Cakir, Omer
    Aneurysms of the coronary arteries are extremely rare. The most common cause is atherosclerosis. Coronary aneurysms may be asymptomatic, or they may be complicated by thrombosis and rupture. We report a multiple coronary artery aneurysm that caused thrombosis in a patient, along with follow-up results with multi-slice spiral computerized tomography. A 43-year-old man was admitted to hospital with a diagnosis of acute inferior myocardial infarction. He underwent thrombolytic treatment with streptokinase. Cardiac catheterization revealed multiple large aneurysms of the proximal coronary arteries and intracoronary thrombosis in the midportion of the circumflex coronary artery. His multi-slice spiral computerized tomography revealed an organized thrombus in the CX coronary artery, no critical stenosis and no change in the coronary aneurysm after 22 months. The patient did not experience any problem during the 22-month follow-up period. In our opinion, middle diameter coronary artery aneurysms that are asymptomatic and not accompanied by critical stenosis can be followed up with medical treatment, and multi-slice spiral computerized tomography is a safe way to follow up these patients. C (c) 2(X)7 Published by Elsevier Ireland Ltd.
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    Penetrating cardiac trauma in children
    (Turkish Assoc Trauma Emergency Surgery, 2010) Goz, Mustafa; Cakir, Omer; Eren, Mehmet Nesimi
    BACKGROUND Penetrating cardiac traumas in children are dramatic and fatal. Many of the patients are admitted to hospital either in a state of shock or they are dead at presentation. In this study, we aimed to present our experience in penetrating cardiac trauma in children. METHODS Seventeen pediatric cases of penetrating cardiac trauma were retrospectively evaluated. The effects on the results of the demographic characteristics of patients, etiology of penetrating trauma, time of presentation to the hospital, physical examination findings in the emergency department, diagnostic methods used, and the surgical techniques applied were evaluated. RESULTS The male to female ratio of the 17 retrospectively evaluated cases was 16:1, with an age range of 3-15 years. The patients' mean age was 12.94 +/- 3.52 years. In all patients, the penetrating cardiac trauma was due to incisive/penetrating tools. The mean Ivatury physiologic index score was 8.23 +/- 0.78, whereas the mean cardiac injury organ scale score was 5.00 +/- 0.00. The hospital mortality rate was 5.9% due to the loss of one patient. CONCLUSION Shock may develop in pediatric penetrating cardiac trauma in a short time due to hemorrhage and/or cardiac tamponade. The prime factors for patient survival are early diagnosis and emergency thoracotomy.
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    Spontaneous rectus sheath and retroperitoneal hematoma caused by single dose tinzaparin therapy
    (Int Scientific Literature, Inc, 2008) Goz, Mustafa; Cakir, Omer; Ozdemir, Ferit
    Background: Retroperitoneal and rectus sheath hematoma (RSH) have been described with the use of low molecule heparine. Case Report: We report a patient with no known risk factors for bleeding, who developed a rectus sheath and retroperitoneal hematoma after being treated with a single dose of tinzaparin. A 72-year-old woman was admitted to our clinic with acute deep venous thrombosis. After the single dose of tinzaparin applied subcutaneously on her admission, she complained of the sudden onset of severe pain in the left lower quadrant. A multi-slice spiral computerized tomography scan of the abdomen with contrast showed a mass of homogeneous density in the left rectus sheath with extravasated contrast and a downward extension of this hematoma into the intra-and retroperitoneal area. Conclusions: The early diagnosis of hematomas can be achieved and conservative treatment applied in large hematomas. An IVC filter may be used in these patients to allow a break from anticoagulant therapy.