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Single versus double Hem-o-lok clips to secure the apendiceal stump during laparoscopic appendectomy: a prospective randomized multicentric clinical trial
(Springer Science and Business Media Deutschland GmbH, 2024) Aday, Ulaş; Çetin, Erman; Kafadar, Mehmet Tolga; Oğuz, Abdullah; Bahadır, Mehmet Veysi; Ülger, Burak Veli; Gedik, Ercan; Girgin, Sadullah; Yılmaz, Mehmet
Purpose: Polymeric clips (Hem-o-lok ligation system) are now widely used to securing the base of the appendix during laparoscopic appendectomy. Studies comparing the use of single or double hem-o-lok clips are limited. The aim of this study was to compare the reliability of a single hem-o-lok clips with a double hem-o-lok clips for closure of an appendiceal stump. Methods: This prospective randomized study includes patients from two centers who underwent laparoscopic appendectomy with the diagnosis of appendicitis between September 2020 and March 2023. Demographic, operative and clinical outcomes of the use of single or double hem-o-lok clips for closure of the appendiceal stump were compared. Factors affecting long postoperative hospital stay were investigated using univariate and multivariate analyzes. Results: One hundred forty two (48.3%) patients in the single hem-o-lok arm and 152 (51.7%) patients in the double hem-o-lok arm were included in the analysis.The shortest operative time was noted in the single hem-o-lok group (52.1 ± 19.9 versus 61.6 ± 24.9 min, p < 0.001). The median hospital stay was 1 day (range 1–10) in the single hem-o-lok group and 1 day (range 1–12) in the double hem-o-lok group, and was shorter in the single hem-o-lok arm (1.61 ± 1.56 vs 1.84 ± 1.69, p = 0.019). Based on multivariate analysis, drain placement was identified as an independent predictive factor for long hospital stay. Conclusions: The use of single hem-o-lok clips for appendiceal stump closure during laparoscopic appendectomy is safe and effective. Trial registration NCT04387370 (http://www.clinicaltrials.gov).
Evaluation of plasma inflammatory markers in patients with nonarteritic retinal artery occlusion
(2023) Karahan, Mine; Ava, Sedat; Erdem, Seyfettin; Keklikçi, Uğur; Dursun, Mehmet Emin; Hazar, Leyla; Vural, Esra
Purpose: To examine the clinical characteristics, comorbid status and laboratory parameters of patients followed up with a diagnosis of retinal artery occlusion (RAO) and to compare blood inflammation parameters with control subjects. Methods: The medical records of 49 patients who were followed up for RAO at Dicle University Medical Faculty between 2017 and 2020 were retrospectively analysed. The occlusion type was divided into two groups, central retinal artery occlusion (CRAO) and branch retinal artery occlusion (BRAO). The demographic characteristics and clinical and laboratory tests of the groups were compared. The blood WBC, neutrophil, lymphocyte, monocyte and platelet counts of the patients were also recorded, and the neutrophil/lymphocyte, monocyte/lymphocyte and platelet/lymphocyte counts were calculated by simple division and compared with 41 age- and gender-matched controls. Results: There was no difference in age and gender between the CRAO and BRAO groups (p = 0.220 and p = 0.303 respectively). Heart disease was significantly more common in CRAO patients (p = 0.004), and hypertension was observed more often, although not significantly (p = 0.084). WBC, neutrophil and monocyte values were found to be significantly higher in those with RAO than in the controls (p = 0.005, p < 0.001, p = 0.035 respectively). The neutrophil-lymphocyte ratio (NLR) was found to be significantly higher in those with RAO (p = 0.007). Conclusion: RAO is associated with significant elevation in WBC and NLR. The association of CRAO with cardiovascular disease is prominent.
Efficacy of taxifolin in the prevention of renal injury due to liver ischemia and reperfusion
(2023) Ülger, Burak Veli; Durgun, Hasan Mansur; Aşır, Fırat; Varlı, Metin; Gündüz, Ercan
Aim: During surgical procedures such as liver resection and transplantation, ischemia/reperfusion (I/R) injury and related complications may occur at a rate of approximately 10%. Our study, we planned to investigate histologically and biochemically the efficacy of Taxifolin in the prevention of renal tissue damage in liver ischemia reperfusion. Methods: A total of 28 Wistar Albino rats with an average age of 8-10 weeks and weights of 250-300 grams were used in our study. Group 1 (n=7): control group, Group 2 (n=7): Taxifolin group; Taxifolin was administered orally at a dose of 50 mg/kg for 3 weeks, Group 3 (n=7): Liver I/R group, 30 minutes ischemia and 120 minutes reperfusion was performed. Group 4 (n=7): Taxifolin+Liver I/R group. Results: Kidney tissues of the liver I/R group showed atrophy, degeneration of tubule epithelium and increased TNF-? expression. In addition, deterioration in renal function tests was also monitored in this group. In the Taxifolin+Liver I/R group, a significant difference was observed on both histologic and biochemical basis compared to the Liver I/R group and a positive effect was observed (p<0.05). Outcome: As a consequence of hepatic ischemia and reperfusion, impairment in the function and histological appearance of renal tissues was observed and Taxifolin was monitored to be effective in eliminating these adverse effects.
A conservative approach to rectus sheath haematomas
(Tıp Araştırmaları Derneği, 2011) Önder, Akın; Kapan, Murat; Gümüş, Metehan; Böyük, Abdullah; Tekbaş, Güven; Girgin, Sadullah; Taçyıldız, İbrahim
Aim: Rectus sheath haematoma (RSH) is the result of a rupture of epigastric vessels or rectus muscle occurring mostly in infraumblical region. Etiological factor is predominantly trauma and rarely spontaneous. Generally, misdiagnosed or delays in diagnosis result in unnecessary surgical intervention. Method: Between December 2008 and September 2009, five patients diagnosed for RSH in our hospital retrospectively analyzed in terms of the demographical characteristics, clinical and radiological findings and length of stay in hospital. Result: The average age of the patients was 67 (59-76) years and all were female. At least one of the patients had a systematic disease. All the patients were using anticoagulant and none of them had trauma story. On physical examination, we determined palpable masses loca ted as follows; in left lower quadrant of three patients, in right lower quadrant of one patient and in left upper quadrant of one patient. The types of RSH in radiological imaging were Type 1 in one patient, Type 2 in three patients and Type 3 in one patient. Anticoagulant treatments were stopped and all patients were treated conservatively. The average stay in hospital time of the patients was 8 days. The computed tomography control at the end of the first month revealed that the mass disappeared in cases with Type 1 RSH while the other four cases had a marked decrease in the mass size. Conclusion: RSH should be taken into consideration in differential diagnosis when elder patients - especially females - with anemia, palpable mass, anticoagulant medication history admitted to clinics with acute abdomen. Early diagnosis of RSH provides the preventing of the unnecessary surgical interventions and determines the success of conservative treatment.
Results of two different surgical techniques in the treatment of advanced-stage Freiberg's disease
(Medknow Publications & Media Pvt Ltd, 2016) Özkul, Emin; Gem, Mehmet; Alemdar, Celil; Arslan, Hüseyin; Boğatekin, Ferit; Kişin, Bülent
Background: Freiberg's disease is an osteochondrosis most commonly seen in adolescent women and characterized by pain, swelling and motion restriction in the second metatarsal. The early stages of this disease can be managed with semirigid orthoses, metatarsal bars and short leg walking cast. Number of operative methods are suggested which can be used depending on the pathophysiology of the disease, including abnormal biomechanics, joint congruence and degenerative process. We evaluated the outcomes of the patients with Freiberg's disease who were treated with dorsal closing-wedge osteotomy and resection of the metatarsal head. Patients and Methods: 16 patients (11 female, 5 male) with a mean age of 24.5 (range 13u49 years) years who underwent dorsal closing wedge osteotomy or resection of the metatarsal head were included in this retrospective study. Second metatarsal was affected in 13 and third metatarsal in three patients. According to the Smillie's classification system, ten patients had type IV osteonecrosis and six patients had type V. The results of the patients were evaluated using the lesser metatarsophalangeal-interphalangeal (LMPI) scale. Results: According to the LMPI scale, the postoperative scores for the osteotomy and excision groups were 86 (range 64u100) and 72.6 (range 60u85), respectively. In the osteotomy group, mean passive flexion restriction was 18 degrees (range 0 degrees u35 degrees) and mean passive extension restriction was 12 degrees (range 0 degrees u25 degrees). Mean metatarsal shortening was 2.2 mm (range 2u4 mm) in the osteotomy group as opposed to 9.8 mm (range 7u14 mm) in the excision group. Significant pain relief was obtained in both groups following the surgery. Conclusions: The decision of performing osteotomy or resection arthroplasty in the patients with advanced-stage Freiberg's disease should be based on the joint injury and the patients should be informed about the cosmetic problems like shortening which may arise from resection.
Primitive robotic procedures: Automotions for medical liquids in 12th century Asia minor
(Pagepress Publ, 2014) Penbegül, Necmettin; Atar, Murat; Kendirci, Muammer; Bozkurt, Yaşar; Hatipoğlu, Namik Kemal; Verit, Ayhan; Kadioğlu, Ateş Comma
In recent years, day by day, robotic surgery applications have increase their role in our medical life. In this article, we reported the discovery of the first primitive robotic applications as automatic machines for the sensitive calculation of liquids such as blood in the literature. Al-Jazari who wrote the book Elcami 'Beyne'l -'ilm ve'l -'amel en-nafi 'fi es-sinaa ti'l hiyel, lived in Anatolian territory between 1136 and 1206. In this book that was written in the twelfth century, Al-Jazari described nearly fifty graphics of robotic machines and six of them that were designed for medical purposes. We found that some of the robots mentioned in this book are related to medical applications. This book reviews approximately 50 devices, including water clocks, candle clocks, ewers, various automata used for amusement in drink assemblies, automata used for ablution, blood collection tanks, fountains, music devices, devices for water lifting, locks, a protractor, a boat-shaped water clock, and the gate of Diyarbakir City in south-east of Turkey, actually in northern Mesopotamia. We found that automata used for ablution and blood collection tanks were related with medical applications; therefore, we will describe these robots.
Analysis of sensitivity, specificity, and positive and negative predictive values of smear and colposcopy in diagnosis of premalignant and malignant cervical lesions
(Int Scientific Literature, Inc, 2015) Barut, Mert Ulaş; Kale, Ahmet; Kuyumcuoğlu, Umur; Bozkurt, Murat; Ağaçayak, Elif; Özekinci, Server; Gül, Talip
Background: This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. Material/Methods: The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. Results: Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. Conclusions: Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions.
Investigation of HEG1, VISTA (VSIR) and PD-L1 expression levels in malignant mesothelioma by immunohistochemical methods and their relationship with histological subtypes
(Taylor & Francis Ltd, 2024) Dicleli, Medine; Keleş, Ayse Nur; Alabalık, Ulaş
Malignant Mesothelioma is a primary malignant tumor of the mesothelium lining the pleura, pericardium, peritoneum and tunica vaginalis of the testis with a poor prognosis. The epithelioid subtype is graded as high and low grade in the 2021 WHO classification of thoracic tumors. Recently, promising results from clinical trials of treatment with immune checkpoint inhibitors are reported. The aim of our study was to shed light on clinical studies on potential immune checkpoint inhibitors by examining VISTA and PD-L1 expression levels as well as HEG1 in malignant mesothelioma subtypes. Our study included 69 cases diagnosed with 'malignant mesothelioma, well-differentiated papillary mesothelial tumor, atypical mesothelial hyperplasia' at Dicle University Faculty of Medicine Department of Pathology between 2015 and 2021. Primary antibodies against HEG1, VISTA, and PD-L1 were used in the immunohistochemical study. The results showed a significant relationship between PD-L1 expression and sarcomatoid and high-grade epithelioid malignant mesotheliomas. VISTA was detected at a high rate in epithelioid malignant mesotheliomas and was negative in non-mesothelial tumors. HEG1 was positively monitored in mesothelial-derived tumors and negatively monitored in non-mesothelial tumors. The obtained results suggest that HEG1 could be further explored as a useful marker in determining mesothelial origin and that the expression levels of VISTA and PD-L1 markers may vary in histological subtypes in the selection of drugs for the treatment of malignant mesothelioma.
The relationship between primary ovarian insufficiency and gene variations: a prospective case-control study
(Routledge Journals, Taylor & Francis Ltd, 2024) Gündüz, Reyhan; Tekeş, Selahaddin; Özpak, Lütfiye; Ağaçayak, Elif; Tunç, Senem Yaman; İçen, Mehmet Sait; Evsen, Mehmet Siddik
Around 70 percent of cases of Primary Ovarian Insufficiency (POI) etiology remain unexplained. The aim of our study is to contribute to the etiology and genetic background of POI. A total of 37 POI patients and 30 women in the reproductive period were included in this prospective, case-control study between August 2020 and December 2021. The women were examined for 36 genes with next-generation sequencing (NGS) panel. Gene variations were detected in 59.5 percent of the patients in the case group. FSHR p.S680N (rs6166, c.2039 G>A) and FSHR p.A307T (rs6165, c.919 G>A) gene variants, which are most frequently located in exon 10 of the FSHR gene, were detected in both groups. Although it was not found that these gene variants were significantly different between the groups, it was also found that they were significantly different in POI patients under 30 years of age and in those with a family history of POI. Variations were detected in 12 genes in POI patients. Two gene variants (FGFR1 [c.386A>C, rs765615419] and KISS1 [c.58 G>A, rs12998]) were detected in both groups, and the remaining gene variants were detected only in POI patients. No differences were detected between the groups in terms of gene variations. However, the gene variations detected only in POI patients may play a role in the etiology of POI.
Investigation of two new grafting techniques for dorsal augmentation rhinoplasty: An experimental study with New Zealand white rabbits
(Springer, 2024) Özdemir, Mehmet; Akkoç, Mehmet Fatih; Tunik, Selçuk
Introduction Cartilage is an important source in supporting the structure of the nose for dorsal augmentation rhinoplasty. However, it is known that its viability is not always on the ideal level. Various wrapping materials are used to increase the strength of cartilage. Donor site morbidity, which develops following the harvesting of both cartilage and fascia as one such cover material, has attracted interest in recent years. Objective In this study, we aimed to investigate the potential of dermis and tendon autografts as alternatives to fascia and cartilage. Material and Method The sample of the study included 16 New Zealand white rabbits. The right auricular cartilage of all rabbits was amputated, and it was transformed into diced cartilage autografts. The dermis autografts from the right gluteal areas of the rabbits were deepithelialized, and lumbosacral fascia autografts were harvested from the same incision. Additionally, the Achilles tendon of each rabbit was harvested and transformed into diced tendon autografts. Four different autografts were embedded under the skin of each rabbit from 4 different pouches opened in the back of the rabbit. These autografts included diced cartilage alone (Intervention 1), fascia-wrapped cartilage (Intervention 2), dermis-wrapped cartilage (Intervention 3) and fascia-wrapped tendon (Intervention 4) autografts. Results Intervention 1 had the most irregular appearance, the outcomes in Intervention 4 were volumetrically smaller and softer. Connective tissue formed between the diced pieces in all interventions, and it was observed that the dermis and fascia had a capsule-like appearance, and their viability was preserved. The differences between the initial and final measurements of the volumes of interventions 1, 2 and 3 were statistically significant (p < 0.05). There was no significant difference between the initial and final volumetric measurements of intervention 4 (p > 0.05). More peripheral proliferation was observed in the interventions of fascia-wrapped and dermis-wrapped diced cartilage compared to the other interventions. The intervention including fascia-wrapped diced tendon grafts had displayed more fibrosis, fragmentation and collagen fibers, while it showed a lower amount of elastic fiber. There were no significant differences among the intervention in terms of other histological parameters. Conclusion Tendon autografts may be a good option for dorsal augmentation rhinoplasty as they are easily harvested and have minimal donor site morbidity. Dermis autograft usage is more advantageous than fascia usage in terms of accessibility and convenience.
Apparently novel genetic syndrome of pachygyria, mental retardation, seizure, and arachnoid cysts
(Wiley-Liss, 2007) Güzel, Aslan; Tatlı, Mehmet; Bilgüvar, Kaya; DiLuna, Michael L.; Bakkaloğlu, Betül; Öztürk, Ali K.; Bayraklı, Fatih
We report on an apparently new syndrome in a consanguineous family with seven members, three of whom have cerebral anomalies including pachygyria and arachnoid cysts along with mental retardation and seizures. The two patients with seizure disorders also had multiple enlarged perivascular spaces seen in the white matter of the centrum semiovale. Our data provide a contribution to the acacumulating knowledge on familial cerebral anomalies including arachnoid cysts and lissencephaly. Given the lack of mutation in known lissencephaly genes such as LIS1, 14-3-3 epsilon, and DCX, this syndrome may constitute a new phenotype with autosomal recessive inheritance.(c) 2007 Wiley-Liss, Inc.
The syndrome of pachygyria, mental retardation, and arachnoid cysts maps to 11p15
(Wiley, 2009) Bilgüvar, Kaya; Öztürk, Ali Kemal; Bayraklı, Fatih; Güzel, Aslan; DiLuna, Michael L.; Bayri, Yaşar; Tatlı, Mehmet; Tekeş, Selahattin; 0000-0003-1707-6055
Recently, we delineated a syndrome of pachygyria, mentalimpairment, seizures, and arachnoid cysts [Guzel et al., 2007].This syndrome was found in a consanguineous family fromSoutheastern Turkey. The three affected sibs in this family werethe ﬁrst generation to present with this condition, strongly suggest-ing autosomal recessive inheritance.
Identifying septal support reconstructions for saddle nose deformity the cakmak algorithm
(American Medical Association, 2015) Çakmak, Özcan; Emre, İsmet Emrah; Özkurt, Fazıl Emre
IMPORTANCE The saddle nose deformity is one of the most challenging problems in nasal surgery with a less predictable and reproducible result than other nasal procedures. The main feature of this deformity is loss of septal support with both functional and aesthetic implications. Most reports on saddle nose have focused on aesthetic improvement and neglected the reestablishment of septal support to improve airway. OBJECTIVES To explain how the Cakmak algorithm, an algorithm that describes various fixation techniques and grafts in different types of saddle nose deformities, aids in identifying saddle nose reconstructions that restore supportive nasal framework and provide the aesthetic improvements typically associated with procedures to correct saddle nose deformities. DESIGN, SETTING, AND PARTICIPANTS This algorithm presents septal support reconstruction of patients with saddle nose deformity based on the experience of the senior author in 206 patients with saddle nose deformity. Preoperative examination, intraoperative assessment, reconstruction techniques, graft materials, and patient evaluation of aesthetic success were documented, and 4 different types of saddle nose deformities were defined. MAIN OUTCOMES AND MEASURES The Cakmak algorithm classifies varying degrees of saddle nose deformity from type 0 to type 4 and helps identify the most appropriate surgical procedure to restore the supportive nasal framework and aesthetic dorsum. RESULTS Among the 206 patients, 110 women and 96 men, mean (range) age was 39.7 years (15-68 years), and mean (range) of follow-up was 32 months (6-148 months). All but 12 patients had a history of previous nasal surgeries. Application of the Cakmak algorithm resulted in 36 patients categorized with type 0 saddle nose deformities; 79, type 1; 50, type 2; 20, type 3a; 7, type 3b; and 14, type 4. Postoperative photographs showed improvement of deformities, and patient surveys revealed aesthetic improvement in 201 patients and improvement in nasal breathing in 195 patients. Three patients developed postoperative infection and 21 patients underwent revision septal surgery. CONCLUSIONS AND RELEVANCE The goal of saddle nose reconstruction should be not only to restore an aesthetic dorsum but also to restore the supportive nasal framework. The surgeon should provide more projected and strengthened septal support before augmentation of saddle nose deformity to improve breathing and achieve a stable long-term result. The Cakmak algorithm is a mechanism that helps surgeons identify the most effective way to maximize septal support and aesthetic appeal.
Ischaemia-reperfusion injury of the peripheral nerve: An experimental study
(Wiley-Liss, 1999) Saray, Aydın; Can, Belgin; Akbıyık, Filiz; Aşkari İbrahim; 0000-0002-0469-7998
Although the neuropathology of ischaemic fibre degeneration is relatively well known, its pathogenesis is poorly understood. One of the presumed mechanisms is oxidative stress, causing the breakdown of the blood-nerve barrier (BNB) and ending in lipid peroxidation, We evaluated the effect of ischaemia and reperfusion on the sciatic-tibial nerve of the rat and investigated the biochemical, pathological, and functional evidence of BNB disruption and lipid peroxidation. The distal portion and trifurcation of the sciatic nerve were rendered ischaemic by clamping the femoral vessels for 3 h and followed by varying durations of reperfusion. Reperfusion resulted in an increase in lipid peroxidation beginning from the first hour and increasing until the seventh day, followed by a gradual decline over the following weeks, Nerve oedema and ischaemic fibre degeneration (IFD) consistently became more severe and prominent with reperfusion, indicating that oxidative stress damages the BNB and causes IFD, Results of functional testing by the sciatic function index correlated with other parameters as walking track analysis results got worse as reperfusion periods increased. impairment of walking patterns was more striking after the first day and continued up to the third week, These data indicate that severe ischaemia of the peripheral nerve results in reperfusion injury, functional impairment, and disruption of the BNB, Microvascular events, which may occur during reperfusion, may be important in amplifying the nerve fibre degeneration that initiated during ischaemia, (C) 1999 Wiley-Liss, Inc.
Addressing saddle nose deformity reply
(Amer Medical Assoc, 2016) Çakmak, Özcan; Emre, İsmet Emrah; Özkurt, Fazıl Emre
[Abstract Not Available]
Comparison of iliac and femoral autograft practices in pemberton pelvic osteotomy
(Lippincott Williams and Wilkins, 2021) Bulut, Mehmet; Azboy, İbrahim; Özkul, Emin; Karakurt, Lokman
Background:There is no consensus in regard to grafts used after pelvic osteotomy in developmental dysplasia of the hip in the literature. The aim of this study was to compare iliac and femoral autografts used after Pemberton pelvic osteotomy (PPO).Methods:In this prospective, randomized study, 60 hips with dysplasia of the hip were included. All patients underwent open reduction, PPO, and femoral shortening osteotomy. Iliac autograft (group I; n=30 hips; mean age, 39.07; range, 18 to 72 mo) and femoral autograft (group II; n=30 hips; mean age, 42.53; range, 19 to 70 mo) were used to fill the iliac osteotomy. The height and width of the iliac and femoral autografts were measured intraoperatively. Anteroposterior pelvic radiographs were obtained on the 45th day, and in the 2nd, 3rd, 6th, and 12th months postoperatively. Acetabular index angle, height of the graft, loss of graft position, graft resorption, operative time, blood loss, and union time were compared between the groups.Results:There was a significant difference in each group in terms of loss of graft height between the intraoperative measurement and the postoperative measurement at the 6th week and 3rd month. The intraoperative width of the grafts was significantly greater, loss of graft height was significantly less, and the amount of bleeding was significantly lower in group II (P<0.001 for all 3). However, time to union was significantly shorter in group I (P<0.001). There was no significant difference between the groups in terms of acetabular index angle at the last controls. There were loss of graft position in 2 cases and graft resorption in 1 case for group I, but no such cases occurred for group II.Conclusions:Graft height and position loss, donor site morbidity, and graft resorption were less in the femoral autografts group compared with the iliac autografts group in the treatment PPO with femoral shortening osteotomy.Level of Evidence:Level II.
Risk factors for the development of pneumonia post cardiac surgery
(2012) Topal, Aşkın Ender; Eren, Mehmet Nesimi
Objectives: Postoperative pneumonia is a devastating complication after cardiac surgery that increases morbidity and mortality. The objective of this study was to identify potential risk factors for the development of nosocomial pneumonia post cardiac surgery by the way of logistic regression analysis. Design: Data of the last 162 patients undergoing cardiac surgery before November 2009 were retrospectively collected and analysed. Results: The mean age of the patients was 65.57 ± 10.48 years and 83 (51%) were male. Postoperative pneumonia was diagnosed in 21 (13%) patients. The mean remaining time in the intensive care unit and mean length of hospitalisation were longer for patients with postoperative pneumonia. Pre-operative heart rate, previous diabetes mellitus, previous chronic obstructive pulmonary disease, postoperative urea, creatinine and potassium levels, extubation time, postoperative atrial fibrillation, and number of units of transfused packed red blood cells (pRBC) and fresh frozen plasma were associated with higher occurrence of postoperative pneumonia on univariate analysis. Conclusions: On logistic regression analysis, pRBC transfusion, previous chronic obstructive pulmonary disease and postoperative atrial fibrillation remained as independent predictors for the development of postoperative pneumonia.
Investigation of ZIP4, ZO-1, and CLAUDIN-1 expression in thyroid tumours by immunohistochemistry and real-time polymerase chain reaction methods
(Termedia Publishing House Ltd., 2023) Nacir, Mustafa; İbiloğlu, İbrahim; Alabalık, Ulaş
Thyroid neoplasms are the most common endocrine malignancies. ZIP4 is an intramembranous zinc trans membrane protein. Zinc plays a central role in the activation of transcription factors, and zinc transporters. This affects tumour migration, invasion, and cell proliferation. ZO-1 and Claudin-1 are important tight junction proteins whose amounts increase and decrease in various cancers. In this study, we aimed to investigate the expression of ZIP4, ZO-1, and Claudin-1 in thyroid tumours and the relationship of this expression with tumour types and prognostic parameters. ZIP4, ZO-1, and Claudin-1 were studied in all cases by immunohistochemical and Real-Time PCR methods. ZIP4 and Claudin-1 tended to be expressed more in cases with tumours, while ZO-1 in cases with and without tumours. Expression of ZIP4 and Claudin-1 by real-time polymerase chain reaction showed a significant difference between histological subtypes, and this difference was not observed with ZO-1. It was observed that the presence of metastasis increased with the expression of ZIP4 and Claudin-1, and there was no significant change with ZO-1. We think that Claudin-1 and ZIP4 expression can be used as an important marker in terms of showing poor prognosis and susceptibility to metastasis in thyroid tumours, and in developing targeted therapy.
TOX, TWIST1, STAT4, and SATB1 protein expressions in early-stage mycosis fungoides
(John Wiley and Sons Inc, 2024) Örnek, Sinem; Özekinci, Selver; Ipin, Tuğba; Kocatürk, Emek
Background: Diagnosis of early mycosis fungoides (eMF) is challenging and often delayed as many of its clinical and histopathologic features may mimic various benign inflammatory dermatoses (BIDs). The products of the thymocyte selection-associated high mobility group box (TOX), twist family BHLH transcription factor 1 (TWIST1), signal transducer and activator of transcription 4 (STAT4), and special AT-rich sequence-binding protein 1 (SATB1) genes function as transcription factors and are involved in the pathogenesis of MF. Objectives: We aim to determine the diagnostic value of TOX, TWIST1, STAT4, and SATB1 protein expressions in eMF. Methods: This non-randomized, controlled, prospective analytic study was conducted by performing immunohistochemistry staining with TOX, TWIST1, STAT4, and SATB1 polyclonal antibodies in lesional skin biopsies of eMF and BID patients. Nuclear staining of lymphocytes was compared between eMF and BIDs, and the capacity of these antibodies to predict eMF was determined. Results: Immunostainings with anti-TWIST1 showed an increase in protein expression (p = 0.003) and showed a decrease with anti-SATB1 antibodies in eMF compared to BIDs (p = 0.005) while anti-TOX and anti-STAT4 antibodies did not exhibit significant differences (p = 0.384; p = 0.150). Receiver operating characteristic analysis showed that immunohistochemical evaluations of TWIST1 and SATB1 protein expressions can differentiate eMF (area under the curve [AUC]: 0.728, 95% confidence interval [CI]: 0.605–0.851, p = 0.002; AUC: 0.686, 95% CI: 0.565–0.807, p = 0.013). Conclusions: TWIST1 and SATB1 are potential diagnostic markers for the histologic diagnosis of eMF.
Comparative outcomes of early, elective, and delayed treatment for lateral condyle fracture of the humerus in children: A retrospective study from a single center in Turkey (2013-2021)
(2024) Ulus, Sait Anıl; Yiğit, Şeyhmus; Özkul, Emin
Background: Lateral condyle fracture of the humerus in children should be diagnosed and treated quickly to avoid the complications of malunion and varus deformity of the elbow. Worldwide, pediatric orthopedic departments experienced delays in patient diagnosis and treatment during the COVID-19 pandemic. This retrospective study from a single center in Turkey aimed to compare outcomes from early treatment, elective treatment, and delayed treatment in 140 children with lateral condyle fracture of the humerus between 2013 and 2021. Material/Methods: In the study, 140 patients with Milch type 2 fractures were included. Patients underwent fixation with K-wires or screws after open or closed reduction. Data collected included age, sex, trauma details, surgery timing, operating conditions, perioperative issues, and rehabilitation outcomes. Fracture union and complications were monitored through clinical examinations and X-rays. Clinical outcomes were evaluated using the Mayo Elbow Performance Score (MEPS). Results: There were 58 patients in the early group, 52 in the elective group, and 30 in the delayed group. Surgery durations varied among the groups (P=0.000). The early and delayed groups as well as the early and elective groups had significantly different incision sizes (P=0.000 for both). The early and delayed groups and the early and elective groups had significantly different MEPS scores (P=0.002 and P=0.011, respectively). Conclusions: In patients with late-presenting lateral condyle fractures, although complications increase, surgical treatment does not yield worse outcomes. Standardization of fracture management should be maintained during periods such as COVID-19.

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