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Öğe Bilateral septic arthritis complicating knee osteonecrosis in renal transplant recipient: Case report [Böbrek nakli hastasinda dizde osteonekroza eşlik eden bilateral septik artrit: Olgu sunumu](2012) Tatar E.; Güngör O.; Kirçelli F.; Arda B.; Argin M.; Töz H.; Hoşcoşkun C.Septic arthritis is rarely seen in transplant patients and differs from the general population with regards to gram negative and/or atypical agents being the prominent causes. In renal transplant patients, osteonecrosis is one of the major musculo-skeletal complications. In transplant patients, immunosupressive drugs, delayed graft function, genetics, HD duration before transplantation, cause of renal failure are among the risk factors for ostenecrosis. In this case report, we present a renal transplant patient with bilateral knee osteonecrosis and septic arthritis due to Escherichia coli.Öğe Gluteal artery pseudoaneurysm, a rare cause of sciatic pain: Case report and literature review(Lippincott Williams and Wilkins, 2002) Yurtseven T.; Zileli M.; Tavmergen Göker E.N.; Tavmergen E.; Hoşcoşkun C.; Parildar M.This article describes a very unusual case of sciatic pain and motor dysfunction resulting from gluteal artery pseudoaneurysm, A 36-year-old woman with primary infertility sustained an iatrogenic injury to her left gluteal artery during transvaginal ultrasound-guided follicle aspiration. Twenty-five days after the procedure she developed severe left sciatic pain and motor dysfunction. Pelvic computed tomography and magnetic resonance imaging revealed a huge pelvic hematoma. Angiography demonstrated a gluteal artery pseudoaneurysm. Because endovascular occlusion of the aneurysm did not relieve the pain, the patient underwent surgery for evacuation of the hematoma and release of the lumbosacral plexus, This eliminated all her sciatic pain and restored her motor dysfunction completely, The English literature details only five other cases of sciatic pain resulting from gluteal artery aneurysm, and these reports are also discussed.Öğe Incidence and Importance of C4d Deposition in Renal Allograft Dysfunction(2008) Demirci C.; Şen S.; Sezak M.; Sarsik B.; Hoşcoşkun C.; Töz H.Recent studies showed that peritubular capillary deposition of C4d is a marker of humoral immune responses directed against a renal allograft. The aim of this retrospective study was to investigate the incidence, clinical features, and prognostic implications of C4d deposition in renal allograft biopsy specimens. The biopsies had been performed due to acute graft dysfunction. This study of 104 renal allograft biopsies performed in 2004 classified histopathological findings according to Banff criteria. All paraffin-embedded biopsy samples were stained with an immunohistochemical method for C4d deposition. Demographic data, clinical findings, and biochemical findings were obtained from patients' charts. C4d staining was positive in 15/104 (14%) samples. The staining pattern was diffuse in 8 and focal in 7 patients. Nine patients were males. The overall mean age was 33 ± 6 years. Ten received live-donor grafts. The biopsy occurred at a mean of 1007 ± 1415 (range, 15-4712) days after the operation with a mean serum creatinine (SCr) level of 2.8 ± 1.5 (1.25-6.0) mg/dL. Patients were divided into 2 groups according to the occurrence time: early (before 100 days) and late (after 100 days). Among the early group (n = 5), the mean SCr level was 2.8 ± 1.5 mg/dL; a diffuse staining pattern was seen in 4 (80%) patients. Histological findings were acute rejection in 3, borderline changes in 1, or thrombotic microangiopathy in 1 patient. Two patients were treated with pulse steroids and 3 with ATG, intravenous immunoglobulin, and plasmapheresis. Three patients lost their grafts at the mean of 118 ± 100 days after the biopsy. In the late group (n = 10), the mean SCr level was 2.8 ± 1.7 mg/dL with a diffuse staining pattern in 4 (40%) patients. The histological findings included acute rejection in 6, chronic vascular rejection in 2, thrombotic microangiopathy in 1, and chronic allograft nephropathy in 1 patient. Six patients were treated with pulse steroids, and 3 with ATG and intravenous immunoglobulin. Five patients lost their grafts at a mean of 200 ± 270 days. The overall incidence of C4d deposition was 14%; it was seen both in the early and late posttransplantation period. Although a diffuse staining pattern was more frequently seen in the early period, C4d deposition indicated a poor allograft prognosis in both periods. Introduction of C4d staining into the routine may guide more specific treatments directed toward the humoral alloresponse. © 2008 Elsevier Inc. All rights reserved.Öğe Pediatric renal transplantation: Single center experience(2005) Mir S.; Erdogan H.; Serdaroglu E.; Kabasakal C.; Hoşcoşkun C.Although renal transplantation (RTx) is actually the first choice of treatment for children with end-stage renal disease, the number of transplanted children remains low in comparison with adults. The experience of the individual pediatric transplant center is very important in the outcome of pediatric transplant recipients. In this study, our pediatric renal transplantation experience is presented. We retrospectively analyzed the results of 72 pediatric renal transplants performed at Ege University Pediatric Nephrology Transplantation Center between June 1989 and May 2003. They were 40 girls, 32 boys and their mean RTx age was 13.27 ± 3.73 yr (range 3-20 yr). Thirty-eight (52.8%) of the transplanted kidneys came from a living related donor, and 34 (47.2%) from a cadaveric donor. Preemptive RTx was performed in one patient and a second RTx was performed in one patient after two-period hemodialysis. Hypertension (31.9%), acute rejection (27.8%) and chronic rejection (13.9%) were the most common complications. Cytomegalovirus (CMV) infection occurred in 15 children (20.8%), none of whom died or lost their graft as a result of the infection. Pretransplant acquired hepatitis C virus (HCV) infection was detected in 12 patients (16.7%). Urinary tract infections (UTIs) were seen in 31 (43.1%) recipients. The 1, 5 and 10 yr graft survival rates were 91, 84 and 77%, respectively, and corresponding patient survival rates were 97, 84 and 77%, respectively by Kaplan-Meier method. The graft and overall survival was not correlated with sex, donor type, treatment modality, acute rejection episodes, hypertension, UTIs, CMV and HCV infection.Öğe A rare cause of mechanical obstruction: Intestinal myeloid sarcoma [Nadirbir mekanik barsak tikaniklig? nedeni: Intestinal miyeloid sarkom](AVES Ibrahim Kara, 2014) Yoldaş T.; Erol V.; Demir B.; Hoşcoşkun C.Myeloid sarcoma is a rare aggressive tumour that originates from immature extramedullary myeloid cells. It can be seen as a relapse in patients with acute myeloid leukaemia. Sometimes it can be seen in the form of a solid tumour without any evidence of leukaemia. A case of a 44-year-old male patient who was admitted with symptoms and signs of mechanical intestinal bowel obstruction was operated on. The operation findings showed small bowel obstruction due to a mass. The mass was then resected with end-to-end intestinal anastomosis. The resected mass pathology results were consistent with myeloid sarcoma. The post-operative period was uneventful and adjuvant therapy was applied. In this case report we aimed to evaluate the clinical signs and treatment modalities of small intestinal myeloid sarcoma. ©Copyright 2014 by Turkish Surgical Association.
