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Öğe Radial arter kanülasyonunda ultrason rehberliği ile palpasyon tekniğinin karşılaştırılması(Anestezi Dergisi, 2024) Salık, Fikret; Turgut, Mehmet Ali; Kaydu, Ayhan; Yıldırım, Zeynep Baysal; Andan, İbrahim; Erbatur, Meral Erdal; Kızıltaş, AyşeObjective: This study aims to evaluate ultrasound-guided radial artery cannulation versus conventional digital palpation techniques in terms of first-trial success, number of attempts, intervention time, and complication rates. Methods: The study was designed as a prospective, randomized, controlled study. The study included 44 patients and divided into two groups: Group US (ultrasound guided cannulation group) and Group P (palpation cannulation group). Demographic data and clinical characteristics of the patients were recorded. Procedure time, number of cannulas used, success rate on the first attempt, complications and number of attempts were analyzed in both groups. Results: Demographic and clinical characteristics of the patients were similar between the groups. In the ultrasound-guided cannulation group, the cannulation time was significantly shorter (p=0.023), the success rate on the first attempt was higher (p=0.042), the number of cannulas used was lower (p=0.030), and the number of attempts was lower (p=0.039) compared to the palpation method. However, complication rates were similar between both groups. Conclusion: This study demonstrates that ultrasound-guided radial artery cannulation is superior to digital palpation with higher first-trial success, shorter procedure time, and less cannula use. The results support the standardization of ultrasound-guided cannulation in larger populations. © 2024 Anestezi Dergisi. All rights reserved.Öğe Clinical outcomes of transcervical and transoral approaches in parapharyngeal abscesses(Istanbul University Press, 2024) Can, Şermin; Ayral, Muhammed; Kozan, Günay; Akdağ, MehmetObjective: The aim of this study was to identify the microorganisms cultured from abscesses in patients who underwent drainage with transoral and transcervical approaches and to compare the demographic data, anaesthesia duration, and length of hospital stay of patients using both techniques. Material and Methods: We included 96 patients who underwent surgery for parapharyngeal abscesses at the Dicle University, Faculty of Medicine, Ear, Nose, and Throat and Head and Neck Surgery Clinic between 2015 and 2023. Drainage was performed using a transoral approach in 48 patients and using a transcervical approach in 48 patients. We compared both groups based on gender, age, comorbidities, bacteriology, length of hospital stay, and duration of anaesthesia. Results: Upon evaluating the culture results for all patients in both groups, we found that no growth was detected in 50% of the cultures, whereas growth was detected in the other 50%. The average duration of anaesthesia in the transcervical group was 85 min, whereas in the transoral group, it was 52 min, with the duration of anaesthesia in the transoral group being significantly shorter than in the transcervical group. The average length of hospital stay in the transcervical group was 10 days, whereas in the transoral group, it was 8 days, indicating a significantly shorter hospital stay in the transoral group. Conclusion: In our study, we found that patients undergoing transoral drainage had less morbidity, shorter anaesthesia duration and length of hospital stays. © 2024, Istanbul University Press. All rights reserved.Öğe The role of maternal blood elabela levels in the prediction of placenta previa and accreta(W B Saunders Co Ltd, 2025) Demir, Ömer; Özalp, Miraç; Yaman, Hüseyin; Fındık, Fatih MehmetIntroduction: Placenta previa and Placenta Accreta Spectrum are life-threatening obstetric conditions that are challenging to diagnose accurately. Currently, there is no biochemical parameter available for their diagnosis. The aim of our study is to investigate the potential of Elabela as a laboratory marker that could predict placenta previa and placenta accreta, both of which can lead to severe, life-threatening complications for the mother. Methods: In this study, which was conducted prospectively in two tertiary centers between 2020 and 2022, Elabela levels were examined in patient groups with placental insertion and invasion anomalies. SPSS program was used for comparative statistical analysis between groups. Results: Of the 67 analyzed patients, 32 were in the control group, 12 were in the previa group, and 23 were in the accreta group. There was no statistically significant difference between the groups regarding age, BMI, number of curettages, presence of previous cesarean section, and smoking status. The Elabela level was measured at 135.6 +/- 72.1 in the control group, 988.3 +/- 925.5 in the previa group, and 376 +/- 364.6 in the accreta group, with a statistically significant difference between the groups. The cut-off value of Elabela levels in the previa group was determined to be 304, with a sensitivity of 83.30 % and a specificity of 83.60 % (AUC = 0.909). In the accreta group, the cut-off value was 195.5, with a sensitivity of 60.90 % and a specificity of 61.40 % (AUC = 0.658). Discussion: By showing that the prediction of placenta previa and placenta acreata can be made with a biochemical parameter in our study, young researchers will focus more on this subject and thus make many contributions to science.Öğe Investigation of IDO1 and TDO2 expression in breast tumors by immunohistochemistry and real-time polymerase chain reaction methods(Taylor & Francis Ltd, 2024) Yıldız, Gülden; Büyükbayram, Hüseyin ; Alabalık, Ulaş; Keleş, Ayşe NurAlthough diagnostic and therapeutic advances have been made in the treatment of breast cancer, the challenge of effectively controlling tumor progression persists. The objective of this study was to determine the relationship between IDO1 and TDO2 expression in breast cancer by immunohistochemistry and real-time polymerase chain reaction, hormone receptor status, Ki67 proliferation index, molecular classification, metastasis, and to investigate whether IDO1 and TDO2 expression can be used in combination with targeted therapy or as a marker to increase treatment efficacy in selected cases. The study included 74 cases of breast cancer and 14 cases of normal breast tissue as controls. All cases were analyzed for IDO1 and TDO2 by both immunohistochemistry and real-time polymerase chain reaction. The immunohistochemical analysis revealed that IDO1 immunoreactivity was significantly higher in tumor tissue compared to normal breast tissue. A statistically significant correlation was observed between IDO1 immunoreactivity and histologic subtypes. Furthermore, IDO1 gene expression was correlated with IDO1 immunoreactivity. TDO2 immune reactivity did not differ between tumor and non-tumor tissues and no correlation was found between histological subtypes. There was no correlation between TDO2 immunoreactivity and gene expression. The significant increase in IDO1 levels in tumor tissue and high positivity in age, HER2 positive and triple negative cases compared to other cases suggest that IDO1 inhibitors may be suitable for the target patient group in treatment selection.Öğe 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, MehmetPurpose: 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).Öğe 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, EsraPurpose: 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.Öğe 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, ErcanAim: 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.Öğe A conservative approach to rectus sheath haematomas(Tıp Araştırmaları Derneği, 2011) Önder, Akın; Kapan, Murat; Gümüş, Metehan; Böyük, Abdullah; Tekbaş, Güven; Girgin, Sadullah; Taçyıldız, İbrahimAim: 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.Öğe 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, BülentBackground: 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.Öğe 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 CommaIn 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.Öğe 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, TalipBackground: 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.Öğe 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, UlaşMalignant 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.Öğe 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 SiddikAround 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.Öğe 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, SelçukIntroduction 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.Öğe 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, FatihWe 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.Öğe 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; 0000-0003-1707-6055Recently, 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.Öğe Identifying septal support reconstructions for saddle nose deformity the cakmak algorithm(American Medical Association, 2015) Çakmak, Özcan; Emre, İsmet Emrah; Özkurt, Fazıl EmreIMPORTANCE 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.Öğe Ischaemia-reperfusion injury of the peripheral nerve: An experimental study(Wiley-Liss, 1999) Saray, Aydın; Can, Belgin; Akbıyık, Filiz; Aşkari İbrahim; 0000-0002-0469-7998Although 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.Öğe Addressing saddle nose deformity reply(Amer Medical Assoc, 2016) Çakmak, Özcan; Emre, İsmet Emrah; Özkurt, Fazıl Emre[Abstract Not Available]Öğe Comparison of iliac and femoral autograft practices in pemberton pelvic osteotomy(Lippincott Williams and Wilkins, 2021) Bulut, Mehmet; Azboy, İbrahim; Özkul, Emin; Karakurt, LokmanBackground: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.
