Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Letter: Sacroplasty Augmentation of Instrumented Pelvic Reconstruction After High Sacrectomy: A Technical Case Report(2022) Sahinturk, Fikret; Ayhan, Selim; Sonmez, Erkin; Gulsen, Salih; Yilmaz, Cem; https://orcid.org/0000-0002-0471-3177; https://orcid.org/0000-0003-0153-3012; 34982931; AAI-7972-2021; U-5409-2018; IYT-2145-2023Item Stereotaxic Biopsy Experience(2020) Dere, Umit Akin; Sahinturk, Fikret; Sonmez, Erkin; Gulsen, Salih; Yilmaz, Cem; Altinors, Mehmet NurAim: To review the outcomes and complications of stereotactic biopsy procedures performed at Neurosurgery Department of Baskent University and make an overall evaluation of the stereotactic biopsy system. Materials and Methods: Medical files of 151 patients who underwent stereotaxic biopsy procedure between 1996 and 2018 were retrospectively analyzed.The , age and gender of the patients, intracranial localization of the lesion and histopathologic diagnosis were evaluated. Result: The series included 84(55.6%) males and 67 (44.4%) females. The average age was 47.7 and the age spectrum was between 26-84 years of age. In 102 cases (67.55%) lesions had lobar localization and in 42 lesions (27.82%) the pathology was deep seated lesion. In 7(4.6 %) there were multiple lesions. A histopathologic diagnosis was obtained in 125 (82.79 %) cases. In 16 (%10.59 %) it was reported as brain tissue and in 10 cases (6.62 %) the histopathologic diagnosis was gliosis. A second stereotactic bipsy procedure was performed in 8 cases while in one patient a third biopsy became necessary. Thirteen patients underwent craniotomy and tumor excision as further therapy. Conclusion: Stereotactic biopsy sampling of intracranial space occupying lesions is a safe, simple and highly diagnostic method. In some cases it may contribute to further therapy. The problems encountered are inconclusive diagnosis, inadequate representation of the specimen due to its limited nature and some technical difficulties.Item Analysis of geriatric patients with minor spinal trauma admitted to the emergency department of a university hospital(2019) Giray, Tufan Akin; Kayipmaz, Afsin Emre; Sonmez, Erkin; Haberal, Kemal Murat; Yilmaz, Cem; Kavalci, Cemil; Oguzturk, HakanObjective: To retrospectively analyze patients aged 65 years and over, who were admitted to a level II trauma center in Turkey due to minor spinal trauma in a period of 4 years. Methods: The study included 64 patients aged 65 years and over, who were admitted to the Emergency Department of Baskent University Ankara Hospital between January 2011 and January 2015 and diagnosed with vertebral trauma. The information of the patients was obtained from the medical records. The clinical characteristics of patients including localizations and types of fracture, presence of additional system injuries and treatment options were investigated. Results: The most common cause was fall, accounting for 51 (79.7%), with 7 (10.9%) due to intra-vehicle traffic accident, and 6 (9.4%) due to out-of-vehicle pedestrian injury. The most common site of trauma was the lumbar region. Of the fractures, 46.9% (n=30) were in the lumbar region, 37.5% (n=24) in the thoracic region and 15.6% (n=10) were in the cervical vertebra region. Fourteen (21.9%) patients had an additional injury. Given the fracture types, 47 fractures (74.6%) were compression, 14 fractures (22.2%) were spinous process and 2 fractures (3.2%) were burst fractures. Twenty patients (31.2%) had multilevel vertebral fractures. Conclusions: The results of our study demonstrated the importance of vertebral fractures in the geriatric age group. In this age group, falls and motor vehicle accidents are the leading causes of vertebral traumas. Taking the necessary measures to prevent the risk factors which increase with aging is the most important step in preventing the mortality and morbidity that may occur as a result of vertebral fracture.Item Brown Tumor of the Thoracic Spine : First Manifestation of Primary Hyperparathyroidism(2015) Sonmez, Erkin; Tezcaner, Tugan; Coven, Ilker; Terzi, Aysen; 26587196Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.Item Prognostic Impact of Histologic Subtype in Non-Small Cell Lung Cancer Patients Treated with Gamma Knife Radiosurgery: Retrospective Analysis of 104 Patients(2017) Tufan, Kadir; Aydemir, Fatih; Cekinmez, Melih; Kardes, Ozgur; Sarica, Feyzi Birol; Topkan, Erkan; Sonmez, Erkin; Alkan, Ozlem; Ugurluer, Gamze; Altınors, Nur; 0000-0002-5693-3542; 0000-0003-2854-941X; 0000-0001-8120-7123; 0000-0003-1509-4575; 0000-0001-9658-9005; 0000-0001-9985-0184; 27593758; AAI-8820-2021; P-5895-2018; AAG-2213-2021; AAK-1686-2021AIM: In this study, factors affecting survival, local failure, distant brain failure, whole brain failure and whole-brain radiation therapy (WBRT) free survival according to histological subtypes were investigated in patients with brain metastases from non-small cell lung cancer (NSCLC). MATERIAL and METHODS: Patients with positive pathology reports for adenocarcinoma (ACA) and squamous cell carcinoma (SCC) were included in the study. Seventy-eight ACA and 26 SCC patients were included in the study. Patients with previous history of cerebral metastasis surgery and WBRT were excluded from the study. RESULTS: The median survival was calculated as 12.6 months for patients with ACA and 5.9 months for patients with SCC. One-year distant brain failure was calculated as 65.1% in ACA patients and 39.6% in SCC patients. One-year whole brain failure was calculated as 58.1% in ACA patients and 39.6% in SCC patients. The one-year freedom from WBRT rate was calculated as 72.8% in ACA patients and 56.3% in SCC patients. SCC histology was considered as a significant factor in deterioration of overall survival in multivariate analysis. SCC histology, the increase in the number of metastases and RPA class were factors that caused an increase in distant brain failure. Also, SCC histology, the increase in the number of metastases and RPA class were factors that caused an increase in whole brain failure. CONCLUSION: SCC histology may be an important prognostic factor for overall survival. Also, due to high distant brain failure rate in SCC histology, WBRT can be added to treatment early.Item Patient Selection and Efficacy of Intradiscal Electrothermal Therapy with Respect to the Dallas Discogram Score(2017) Kircelli, Atilla; Coven, Ilker; Cansever, Tufan; Sonmez, Erkin; Yilmaz, Cem; 0000-0002-2353-8044; 0000-0002-5693-3542; 0000-0003-2109-1274; 27593796; AAK-2948-2021; AAI-8820-2021AIM: Intervertebral disc degeneration can cause severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. We aimed to evaluate 12-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET with respect to the Dallas Discogram Scale (DDS). MATERIAL and METHODS: This was a retrospective analysis of patients undergoing IDET for low back pain from 2009 through 2014 at Baskent University, Department of Neurosurgery. A total number of 120 consecutive patients data were collected retrospectively. The degree of disc degeneration was graded using the DDS during discography, and the presence of a high intensity zone (HIZ) on magnetic resonance (MR) imaging was noted. The primary outcome measure was assessment of back pain severity based on the Visual Analogue Scale (VAS); function was assessed by the Oswestry Disability Index (ODI). Follow-up examinations for ODI and VAS scores were assessed at 1, 6, and 12 months post-treatment. Outcomes were discussed with respect to morphological changes in intervertebral discs on discogram. RESULTS: There was an average 57.39% and 47.16% improvement in VAS and ODI scores, respectively, between pretreatment and 12 months follow-up (p<0.0001 for both comparisons). Predictors of 12-month clinical success was depended on DDS (p< 0.0001), a HIZ on MR imaging (p<0.0001). CONCLUSION: Durable clinical improvements can be realized after IDET in select surgical candidates with mild disc degeneration and HIZ, discography, and low-grade DDS, with more effective treatment results.Item Turkish Contribution to Journal of Neurosurgery and Acta Neurochirurgica(2017) Altinors, Nur; Comert, Serhat; Sonmez, Erkin; Altinel, Faruk; 0000-0002-5693-3542; 0000-0002-8326-3900; 27593822; AAI-8820-2021; AAJ-5382-2021AIM: To evaluate the contribution of Turkish scientists to four journals published by Journal of Neurosurgery (JNS) Publishing Group and to Acta Neurochirurgica (AN) and to its Supplement (ANS). MATERIAL AND METHODS: We reviewed every issue of those journals to December 2015 for the total number of articles, articles produced from studies performed entirely in Turkey, and for publications overseas co-authored by the Turkish scientists using the websites of these journals. Citations were searched using "Web of Science" and "Google Scholar" databases. RESULTS: The total number of articles published was 19822 for JNS, 3227 for JNS Spine, 2526 for JNS Pediatrics and 2997 for Neurosurgical Focus. Turkish contribution was 556 articles. 337 (60.61%) articles were the products of studies performed entirely in Turkey, while 219 (39.38%) articles came from overseas, co-authored by Turkish scientists. Overall contribution was 1.94%. A total of 6469 articles were published in AN. 340 papers were the products of studies performed entirely in Turkey. Turkish scientists working overseas co-authored 37 articles. Total contribution was 377 articles (5.82%). 4134 papers had been published in ANS. Contribution was 69 articles (1.66%). CONCLUSION: Turkish contribution to these journals has started late. The gap has been compensated with publications in the last two decades. Manuscripts of higher scientific level with greater number of citations are needed to increase Turkish contribution to such journals.