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Öğe Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma(Elsevier Science Bv, 2003) Kara, M.; Dikmen, E; Erdal, H.H.; Simsir, I.; Kara, S.A.Objective: Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of chest X-rays in showing the rib fractures is limited particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures, those overlooked on chest X-rays, with the use of ultrasonography in minor blunt chest trauma. Methods: A total of 37 patients, with minor blunt chest trauma showing no evidence of a rib fracture on chest X-rays, were examined with ultrasonography performed with a 7.5-MHz linear transducer. Logistic regression analysis was done to outline the clinical predictors of these insidious rib fractures. Results: A total of 15 (40.5%) patients showed rib lesions, whereas 22 (59.5%) patients had no evidence of rib lesions. Fracture of the rib associated with a subperiosteal hematoma was the most common finding in ten (66.7%) patients followed by the fracture of the rib alone in four (26.7%) patients, and subperiosteal hematoma alone in one (6.7%) patient. A total of eight (53.3%) patients had bony rib fractures, whereas seven (46.7%) patients had chondral rib fractures. Age (P = 0.617), gender (P = 0.552), type of etiology (P = 0.954), duration of pain (P = 0.234) and site of trauma (P = 0.740) did not appear as significant predictors for these rib fractures. However, the involved part of the rib showed a significant correlation with either age (P = 0.042) or duration of pain (P = 0.033). Bony rib fractures significantly occurred in elderly patients, and the duration of pain in patients with bony rib fractures was significantly longer than that of patients with chondral rib fractures. Conclusions: Ultrasonography is a useful imaging method in showing the rib fractures those overlooked on chest X-rays in minor blunt chest trauma, and no significant clinical feature exists as a predictor for these insidious fractures. However, bony rib fractures significantly Occur in elderly patients and result in a longer duration of pain. (C) 2003 Elsevier B.V. All rights reserved.Öğe Recurrent laryngeal nerve paralysis resulting from a metastatic lymphadenopathy caused by a right-sided lung cancer(Elsevier Science Bv, 2004) Kara, M; Dikmen, E; Arikan, OK; Kara, SA…Öğe Unilateral hyperhydrosis in Pourfour du Petit syndrome(Elsevier Science Bv, 2004) Kara, M; Dikmen, E; Akarsu, C; Birol, AUpper limp hyperhydrosis is an idiopathic disease with bilateral involvement. However, Pourfour du Petit syndrome, the opposite of Horner syndrome, may result in unilateral upper limb hyperhydrosis. It occurs following hyperactivity of the sympathetic cervical chain as a consequence of irritation secondary to trauma. We report herein two cases with Pourfour du Petit syndrome showing unilateral upper limb hyperhydrosis. The patients presented with right-sided mydriasis and ipsilateral hemifacial hyperhydrosis. The onset of disease was followed by a trauma in both patients. They underwent upper thoracic sympathectomy with favorable outcome. A history of an antecedent trauma in patients with unilateral upper limb hyperhydrosis and anisocoria may imply a possible diagnosis of Pourfour du Petit syndrome. (C) 2004 Elsevier B.V. All rights reserved.
