TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Which Material Should Be Used for Mast Cell Evaluation in Gastric Cancer: Endoscopic Material or Resection Material?(2023) Adali, Yasemen; Cantay, Hasan; Anuk, Turgut; Gonullu, Dogan; Binnetoglu, Kenan; Sulu, Barlas; Beşeren, HaticeAmaç: Mide tümörlerinin prognozunda önemli olan parametrelerin de- ğerlendirilmesinde histopatolojik inceleme önemli bir yer tutmaktadır. Histopatolojik incelemede kılavuzlarda yer alan prognostik verilerin dı - şında gözlenen tümör davranışı için önemli olabilecek diğer veriler de değerlendirilmektedir. İmmun sistem elemanları arasında yer alan mast hücreleri bu veriler arasında yer almaktadır. Bu çalışmada mast hüc - relerinin değerlendirilmesi için kullanılabilme potansiyeli olan endos - kopik biyopsi materyalleri ile rezeksiyon materyallerinin karşılaştırılması amaçlanmaktadır. Materyal ve Metot : Çalışmaya aynı hastaya ait endoskopik biyopsi ve rezeksiyon materyali bulunan 19 mide tümörü olgusu dâhil edilmiştir. Tümörü temsil eden preparatlara ait parafin bloklardan elde edilen kesit - lere toludin blue histokimyası uygulanmıştır. Işık mikroskopik değerlendir- mede mast hücrelerinin en yoğun olduğu alan 100× büyütmede seçilmiş ve sonrasında 400× büyütmede tümör içinde ve çevresinde 100 hücre sayılmıştır. Bu 100 hücrenin içinde yer alan toludin blue ile pozitif boyanan mast hücreleri not edilmiştir. Mast hücresi sayısının gruplar arası anlam - lılığı analizlerinde Mann-Whitney U, gruplar arası korelasyonda Pearson testi kullanılmıştır. Bulgular: Endoskopik biyopsi materyalinde tümör içinde yer alan mast hücre sayısı (TİMH) ortalama 1,32±2,65, tümör çevresi mast hücresi sayı- sı (TÇMH) ortalama 1,0±1,76; rezeksiyon materyallerinde TİMH sayısı or- talama 4,84±4,86, TÇMH sayısı ortalama 5,63±6,99 olarak hesaplanmış- tır. Analizlerde endoskopik biyopsiler ve rezeksiyon materyalleri arasında TİMH sayısı (p=0,001) ve TÇMH sayısı (p=0,000) arasında istatistiksel an- lamlı farklılık izlenmiştir. Tüm olgular incelendiğinde TİMH sayısı ile TÇMH sayısının pozitif korelasyon gösterdiği saptanmıştır. Ancak endoskopik biyopsiler ile rezeksiyon materyalleri kıyaslandığında TİMH veya TÇMH açısından herhangi bir korelsayon olmadığı dikkati çekmiştir. Sonuç: İmmun yanıtın önemli bir unsuru olan mast hücreleri çeşitli tümörlerde olduğu gibi mide kanserlerinde de farklı yönleri ile değer - lendirilmektedir. Sunulan çalışma sonuçları yanısıra tümör ve tümör mikroçevre incelemesinin önemi göz önünde bulundurulduğunda ge- lecekte mide tümörlerinde önemli bir belirteç olma potansiyeli bulunan mast hücrelerinin rezeksiyon materyalinde değerlendirilmesi gerektiği, endoskopik materyal değerlendirmelerinin gerçek tabloyu yansıtmadığı düşünülmektedir.Article The first uniportal VATS sleeve lobectomy in Türkiye: A case report(2024) Hakkı ULUTAŞ; Gülçek, İlham; Kalkan, Muhammed; Ulutas, HakkıIn recent years, video-assisted thoracic surgery (VATS) has become the gold standard approach in the surgical treatment of early-stage non-small cell lung cancer. Especially in cases of central tumors, sleeve lobectomies that preserve parenchyma and respiratory reserves are performed instead of pneumonectomies by experienced clinics. Here, we present the first case of uniportal VATS right bronchial sleeve upper lobectomy for right main bronchial invasion in Turkey, which was successfully performed in August 2022. A patient diagnosed with laryngeal carcinoma who had been in remission for 5 years complained of a cough. Computed thoracic tomography showed hilar peribronchial thickening and an endobronchial lesion (EBL) extending from the right upper lobe bronchus to the main bronchus, almost completely obstructing the upper lobe bronchus. Bronchoscopy revealed that the right upper lobe entrance was obstructed with EBL, and its distance to the carina was 1.6 cm. Bronchoscopic biopsy revealed squamous cell carcinoma. The thorax was entered through an incision of approximately 3 cm in the right fifth intercostal space. First, the right upper lobe pulmonary arteries and superior pulmonary vein were dissected and cut. The main bronchus was divided until the intermediate bronchus. With the help of an endoscissor, the main and intermediate bronchus were incised with appropriate surgical margins, and the lobectomy material was removed. Both macroscopic appearance and frozen and microscopic main and intermediate bronchus surgical margin tumor negativity were confirmed. One suture was passed through the lateral cartilage from the inside out, and the needle was fixed to the posterior pleura. Membranous and cartilage parts were continuously anastomosed with a double-needle 3/0 prolene suture at 2–3 mm intervals. Pathological evaluation confirmed squamous cell carcinoma with a tumor diameter of 1.7 cm, hilar 1/11 lymph node metastasis, and negative surgical margin. Adhering to oncologic principles, sleeve resections, which are difficult even with the currently known open techniques, can be performed effectively and safely with uniportal VATS in experienced centers.Article Endoscopic Botulinium Toxin-A Application in the Treatment of Obesity: the Effect of Dose and Application Area on Treatment Success(2023) Özsan, İsmail; Tuzun, Ahmet YektaAim: In this study, it was aimed to examine the effect of dose and region on the effectiveness of Endoscopic botulinum toxin A application in the fight against obesity. Materials and Methods: A total of 446 patients who applied to our clinic with the complaint of weight were included in the study. Endoscopic botulinum toxin A was administered at doses of 300 U (n=74), 400 U (n=172) and 500 U (n=200) according to the weight and Body Mass Index (BMI) values of the patients. Patients were divided into three groups in the Preploric, Cardia and Fundus regions, after 125 U of Endoscopic Botulinum toxin A application to each region, and 125 U application to one region. Results: Initial BMI, weight difference, last BMI and BMI differences were statistically significant between patient groups according to dose and area (p=0.000). All BMI differences between paired dose and area groups were statistically significant (p=0.000). BMI difference was significantly correlated with gender (r=0.108; p=0.023), Initial BMI (r=0.266; p=0.000), weight (r=0.219; p=0.000), dose (r=0.834; p=0.000), and area (r=0.200; p=0.000). Effects of initial BMI (B=0.031; p=0.031), dose (B=1.423; p=0.000) and area (B=0.316; p=0.000) on BMI difference were statistically significant. Conclusion: Optimum results are obtained in the application of fundus region with a density of 500 U in total, but at levels or values below this, the results may not be effective. Weight loss with the Endoscopic botulinium toxin-A method with the appropriate dose and area is an effective and usable method in the fight against obesity.Article Laparoscopic Right Hemicolectomy: Comparison of Medial and Lateral Approach(2023) Ünal, Ali Ekrem; Vatansever, Safa; Erözkan, Kamil; Tamam, Selim; Benk, Mehmet Şah; Azılı, Cem; Bayar, SancarAim: We aimed to examine the early oncological and clinical outcomes of the medial and lateral approaches for right hemicolectomy. Materials and Methods: Laparoscopic right hemicolectomy patients who underwent medial and lateral approach techniques in our clinic between March 2010 and September 2022 were retrospectively reviewed. Demographic data of the patients, tumor, and operation characteristics, operation, clinical, pathological, mortality, and morbidity outcomes were recorded. Data were compared with the Chi-square test or Fisher Exact test according to the expected value for categorical variables. The Mann-Whitney U test was used because the data for continuous variables were not normally distributed. Results: In total, hundred and fourteen patients who underwent laparoscopic right colon resection were included. 47 patients were operated on with the medial approach, and 67 with the lateral approach. In terms of harvested lymph node number, operation time, estimated blood loss, first fluid intake, first solid intake, first flatus, blood transfusion history, length of stay, anastomotic leaks, and mortality were not significantly different between the two approaches (p>0.05). However, the number of positive lymph nodes was significantly higher in the medial approach (p=0.013). Conclusion: The medial and lateral approaches are feasible and effective techniques for right hemicolectomy. There is no difference between the short-term oncologic results. However, randomized controlled studies are needed for long-term resultsArticle Citation - Scopus: 1Operating Room Nurses’ Metaphorical Perceptions of Coronavirus Disease 2019, Quarantine, and Mask Concepts: A Qualitative Study(AVES, 2023-09-04) Savsar, Adile; Damar, Hale Turhan; Ogce, Filiz; Turhan Damar, Hale; Öğce Aktaş, FilizAmaç: Bu çalışmanın amacı ameliyathane hemşirelerinin COVID-19, maske kullanımı ve karantina sürecine ilişkin algılarını, metaforlar aracılığıyla ortaya çıkarmaktır. Yöntemler: Bu tanımlayıcı kalitatif çalışma ameliyathane hemşireleri ile yapılmıştır (n = 96). Çalışma verileri tanıtıcı özellikler formu ve yarı yapılandırılmış form kullanılarak Eylül 2020-Mart 2021 tarihleri arasında toplanmıştır. Ameliyathane hemşirelerinden “COVID-19”, “maske kullanımı” ve “karantina süreci” kavramlarını neye benzettiklerini, benzetme nedeniyle birlikte yazması istenmiştir. Veriler, “içerik analizi” yöntemiyle incelenmiştir. Bulgular: Araştırmadaki üç farklı kavrama ilişkin toplam 181 metafor üretilmiştir. “COVID-19” kavramına ilişkin benzetmeler “Kontaminasyon ve mutasyon,” “Zarar verici” ve “Başetme ve uyum süreci” olarak üç kategoride toplanmıştır. “Karantina süreci” kavramına ilişkin benzetmeler “Özgürlüğün Kısıtlaması” ve “Değişim Süreci” olarak iki kategoride toplanmıştır. “Maske kullanımı” kavramına ilişkin benzetmeler ise “olumlu yönleri,” “olumsuz yönleri” ve “hem olumlu hem de olumsuz” olarak üç kategoride toplanmıştır. Sonuç: Bu çalışma ameliyathanelerde çalışan hemşirelerin pandemide yaşadıkları zorlukların yansıra bu sürecin olumlu yönlerine de odaklandığını göstermektedir.Article Factors Affecting Bilirubin Levels Following Drainage Proceduresin Obstructive Jaundice(2019) Aydın, Cengiz; Çapar, Ahmet Ergin; Günay, Süleyman; Karaca, Avni Can; Ustun, Mehmet; Karaca, CanIntroduction: Measuring serum bilirubin levels is easy and readily available invirtually every healthcare facility. It is practically used by physicians for thefollow up of the patients with obstructive jaundice.Despite its common use as amarker for follow up, the literature lacks clear data about its interpretation as aclinical marker.We don’t have clearly set prognostic rules and cutoff pointsespecially about the rate of bilirubin decrease following biliary drainageprocedures.We conducted a retrospective study to determine the likely factorsthat affect bilirubin levels following the interventional relief of obstructivejaundice.Material-Method: We retrospectively analyzed data from 73 patients withobstructive jaundice who underwent interventional drainage procedures over atime period of 4 years in a tertiary healthcare center.Results: Decrease in the bilirubin levels was most rapid in the first 48hour following the drainage. From the analyzed variables, only age andselected type of the drainage procedure significantly affected the rateof bilirubin decrease in our patient group. We failed to establish cutoffpoints that can accurately predict the patients with slower bilirubindecrease.Conclusion: Serum bilirubin level is an important and commonly usedmarker predicting the success of treatment and the prognosis of thepatients with obstructive jaudince. Type of drainage and the ageproven to significantly affect the rate of bilirubin decrease regardless ofunderlying pathologyArticle Histomorphometric Analysis of the Effects of Grape Seed Extract (vitis Vinifera) and Low-Level Laser Therapy (lllt) on Fracture Healing(2020) Kara, Muhammed İsa; İnan, Sevinç; Aydemir, Işıl; Taysı, Seyithan; Aras, Mutan Hamdi; Altundağ Kahraman, Sevil; Ege, Bilal; Kahraman, Sevil Altundag; Kara, İsa; Akgül, HasanAim: In this study, we aim to investigate the effects of supplementary Grape Seed Extract (GSE) and Low-Level Laser Therapy (LLLT)on fracture healing, oxidant and anti-oxidant system in experimental mandible fractures.Materials and Methods: 48 Wistar Albino rats (adult male, n=48) were used in our study. For all the subjects, a vertical fracture linethrough molar teeth in right mandibles was created and internally fixed using a four-hole microplate and four micro screws. Firstly,these subjects were randomly divided into 4 main groups (Control, GSE, LLLT, GSE+LLLLT) of 12 animals each, and then these wereindividually separated into two sub-groups of 7th and 21st days. The number of groups (n=6) was 8 in total. GSE of 300 mg/kg/day were provided to the subjects before they were sacrificed. LLLT of 23 J/cm2 was administered to two different points alongwith the fracture line at intervals of 48 hours for 7 days in the 7th day sub-groups and for 14 days in the 21st day sub-groups. Afterthe procedure, while biochemical values such as TAS, TOS and OSI are measured; histopathologically it was examined in termsof capillary number and width, inflammatory cell, fibroblast count, collagen fibers, osteoblast count, ossification and mature boneformations.Results: For biochemical analyses, there was statistically significant difference only in TAS values on either the 7th or 21st day forthe groups. Histological analyses showed that mandibular fracture healing were significantly better in the GSE and GSE+LLLT groupscompared to the control group. The group of only LLLT had limited recovery while the combination of GSE+LLLT was the best forossification.Conclusions: It is concluded that GSE may be one of the potential methods to accelerate fracture healings in mandibular fracturescommon in oral and maxillofacial surgery clinic and thus help patients recover in shorter time, and however LLLT can have positiveeffects on the process of ossification and recovery only when combined with the extract, which may result in better outcomes inclinical use.Article Management of Gallbladder Polyps: a Tertiary Center Experience(2019) Aydın, Cengiz; Üstün, Mehmet; Karaca, Avni Can; Karaca, CanObjective: The main purpose of the management of gallbladder polyps is to establish an early diagnosis and toprevent the development of gallbladder cancer.Methods: Fifty-six patients who underwent cholecystectomy with the diagnosis of gallbladder polyp betweenJanuary 2012 and September 2018, were retrospectively evaluated.Results: Twenty-one patients (39.3%) were female and 34 (60.7%) were male. The indications for cholecystectomywere ? 10 mm polyps in (n=22, 39.3%), increase in polyp size during follow-up (n=8, 14.3%), symptomatic polypssmaller than 10 mm (n=24, 42.9%), polyps smaller than 10 mm with concomitant risk factors (n=2, 3.6%).Histopathological examination of gallbladders revealed the presence of cholesterol polyps in 51 (91.1%), inflammatory polyps in 1 (1.8%), and adenoma in 1 (1.8%) patient. Three patients (5.4%) had no polyps and only gallstoneswere detected. Malignancy was not detected in any patient.Conclusion: The management of gallbladder polyps is still a controversial issue. The recommendations publishedin guidelines, can be used as a guide in the management of gallbladder polyps. The characteristics of symptomsand their response to cholecystectomy should be evaluated in symptomatic cases.Article Prospective Comparison of the Efficacy of Two Common Appendicitis Scoring Systems: Is Combination a Solution?(2020-06-10) Karaca, Avni Can; Akpınar, Göksever; Karaali, Cem; Ustun, Mehmet; Atıcı, Semra Demirli; Karaca, CanAim: The diagnosis of acute appendicitis mostly relies on history taking and physical examination findings supported by laboratory and imaging studies. A number of different diagnostic scoring systems have been developed to facilitate diagnosis, and their accuracies vary among patient populations. This prospective study aims to evaluate the accuracy of the two most frequently used scoring systems in the Turkish patient population and to analyse the possible diagnostic advantage of using these two systems in combination. Method: Patients admitted to the emergency department of a tertiary healthcare centre with acute abdominal pain who eventually underwent appendectomy between July 2018 and January 2019 were enrolled in the study. Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores, as well as other laboratory parameters, were recorded for each patient. Using histopathologic examination as the gold standard, the sensitivity, specificity and positive and negative predictive values of each scoring system were calculated and combined using McNemar’s x2 test. Results: Data from a total of 203 patients were analysed. The sensitivity of the RIPASA system (95%) was far superior to that of the Alvarado system (35.6%). However, the Alvarado scoring system had much higher diagnostic specificity than the RIPASA system (80% vs 33.3%). The combined sensitivity and specificity of the tests rose to 88% and 62.5%, respectively. Conclusion: The RIPASA system has high sensitivity; however, the Alvarado system has high specificity for the Turkish population. Both the Alvarado and RIPASA scoring systems are useful clinical tools with different strengths. Using these two systems in combination increases diagnostic power by combining the strongest aspects of both tests.Article Efficacy of Preoperative Mri in Detecting Biceps Tendon Pathologies in Rotator Cuff Tears: Correlation of Mri and Intraoperative Findings(2022-03-01) Biçen, Ahmet Çağdaş; Ünal, Abdullah Meriç; Ekin, Ahmet; Özkan, Mustafa; Unal, MericObjective The aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in detecting biceps lesions in patients with rotator cuff tears. Material and Methods A total of 168 patients operated on between January 2012 and February 2020 were included in the study. All the patients underwent arthroscopic surgery with the diagnosis of rotator cuff tears. All patients were operated on under general anesthesia and in the beach chair position. Demographic data and preoperative MRI findings were recorded. Arthroscopic findings were accepted as the standard reference and correlated with preoperative MRI records. Results In preoperative images, full-thickness rotator cuff tears were identified in 118 (70.2%) cases and partialthickness tears in 50 (29.8%) cases. Labrum/SLAP lesions were detected in 18 (10.7%) cases. Biceps disorders were reported in 51 (30.4%) cases. During the surgeries, we observed additional pathologies in 41 (24.4%) cases besides the preoperatively detected lesions. Rotator cuff and labrum/SLAP repairs were performed in the same surgical sessions. The majority of newly detected lesions were biceps lesions, being identified in 26 (15.5%) cases. In 41 (24.2%) cases tenodesis, tenolysis, or tenotomy were performed for biceps lesions. LHBT surgery was performed in 26 cases with negative MRI. Biceps lesions were confirmed in 77 (45.8%) cases intraoperatively; therefore, the accuracy of MRI in detecting these lesions was 66.2%. Conclusion Biceps lesions are among the common pathologies of the shoulder. Preoperative MRI is important in evaluation of the shoulder, but the efficacy of MRI may be limited in detecting biceps disorders. Arthroscopic surgery is crucial in diagnosis and treatment of LHBT lesions.