Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Cervical Burst Fracture Caused by Brown Tumor(2015) Aydemir, Fatih; Kardes, Ozgur; Cekinmez, Melih; Tufan, Kadir; Kocer, Nazim Emrah; 0000-0002-5943-9283; 0000-0003-1509-4575; 0000-0003-2854-941X; 0000-0002-3400-9025; 25751484; AAM-5436-2021; AAK-1686-2021; P-5895-2018; A-3652-2017Item Does The Dominant Hand Factor Have an Effect on Postoperative Recovery in The Surgical Treatment of Carpal Tunnel Syndrome?(2018) Civi, Soner; Tanburoglu, Anil; Suner, Halil Ibrahim; Kardes, Ozgur; Durdag, Emre; Tufan, Kadir; https://orcid.org/0000-0002-1055-5152; https://orcid.org/0000-0001-9627-3502; https://orcid.org/0000-0002-5957-8611; https://orcid.org/0000-0003-2854-941X; https://orcid.org/0000-0001-6939-5491; https://orcid.org/0000-0003-1509-4575; U-2400-2018; AAK-1876-2021; AAJ-5381-2021; P-5895-2018; AAK-1734-2021; AAK-1686-2021Objective: Carpal Tunnel Syndrome (CTS) is the most frequently encountered entrapment neuropathy. Surgical treatment is usually suggested to patients with severe symptoms. In this study, we aimed to examine the effect of the dominant hand on the clinical results of CTS decompression surgery. Methods: Fifty (5M, 45F) patients were included in the study. The Edinburgh Handedness Inventory was used to identify the dominant hand of patients included in the study. Visual analogue scale (VAS) values were evaluated pre- and postoperatively. Results: Twenty-eight patients underwent surgery on the dominant hand and 22 patients had surgery to their non-dominant hand. The VAS values of patients who underwent non-dominant hand surgery were lower than those who underwent surgery on the dominant hand. Conclusion: In our study, it was determined that patient complacency after surgical procedures performed on dominant hands was less when compared with the non-dominant side. We believe that suitable exercise and protection programs for dominant hands in the postoperative period of carpal tunnel surgery, in addition to a good and careful surgical technique, positively affects the results of surgical treatment.Item Brain Metastasis of Penile Angiosarcoma(2018) Kardes, Ozgur; Aydemir, Fatih; Suner, Halil Ibrahim; Durdag, Emre; Civi, Soner; Tufan, Kadir; Kayaselcuk, Fazilet; https://orcid.org/0000-0003-2854-941X; https://orcid.org/0000-0002-5957-8611; https://orcid.org/0000-0001-6939-5491; https://orcid.org/0000-0002-1055-5152; https://orcid.org/0000-0003-1509-4575; https://orcid.org/0000-0002-1180-3840; 29150829; P-5895-2018; AAJ-5381-2021; AAK-1734-2021; U-2400-2018; AAK-1686-2021; AAE-2550-2021Angiosarcoma is a rare malignancy originating from vascular endothelial cells. Brain metastasis of aniosarcomas are uncommon up to the literature. Penile angiosarcomas are also seldom among all anjiosarcomas. A case with penile angiosarcoma with confirmed brain metastasis is aimed to be reported and contribute to the literature for similar cases.Item Prognostic Value of The Glasgow Prognostic Score For Glioblastoma Multiforme Patients Treated With Radiotherapy and Temozolomide(2018) Topkan, Erkan; Selek, Ugur; Ozdemir, Yurday; Yildirim, Berna A.; Guler, Ozan C.; Ciner, Fuat; Mertsoylu, Huseyin; Tufan, Kadir; https://orcid.org/0000-0001-8120-7123; https://orcid.org/0000-0002-2218-2074; https://orcid.org/0000-0001-6661-4185; https://orcid.org/0000-0001-6908-3412; https://orcid.org/0000-0002-1932-9784; https://orcid.org/0000-0003-1509-4575; 29696530; AAG-2213-2021; AAG-5629-2021; V-5717-2017; AAC-5654-2020; M-9530-2014; AAK-1686-2021To evaluate the prognostic value of the Glasgow Prognostic Score (GPS), the combination of C-reactive protein (CRP) and albumin, in glioblastoma multiforme (GBM) patients treated with radiotherapy (RT) and concurrent plus adjuvant temozolomide (GPS). Data of newly diagnosed GBM patients treated with partial brain RT and concurrent and adjuvant TMZ were retrospectively analyzed. The patients were grouped into three according to the GPS criteria: GPS-0: CRP < 10 mg/L and albumin > 35 g/L; GPS-1: CRP < 10 mg/L and albumin < 35 g/L or CRP > 10 mg/L and albumin > 35 g/L; and GPS-2: CRP > 10 mg/L and albumin < 35 g/L. Primary end-point was the association between the GPS groups and the overall survival (OS) outcomes. A total of 142 patients were analyzed (median age: 58 years, 66.2% male). There were 64 (45.1%), 40 (28.2%), and 38 (26.7%) patients in GPS-0, GPS-1, and GPS-2 groups, respectively. At median 15.7 months follow-up, the respective median and 5-year OS rates for the whole cohort were 16.2 months (95% CI 12.7-19.7) and 9.5%. In multivariate analyses GPS grouping emerged independently associated with the median OS (P < 0.001) in addition to the extent of surgery (P = 0.032), Karnofsky performance status (P = 0.009), and the Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA) classification (P < 0.001). The GPS grouping and the RTOG RPA classification were found to be strongly correlated in prognostic stratification of GBM patients (correlation coefficient: 0.42; P < 0.001). The GPS appeared to be useful in prognostic stratification of GBM patients into three groups with significantly different survival durations resembling the RTOG RPA classification.Item The Effects of Infusion of Perineural Pregabalin in the Experimentally Created Sciatic Nerve Anastomosis in Rats(2018) Civi, Soner; Bulduk, Erkut Baha; Kocer, Nazim Emrah; Kardes, Ozgur; Suner, Halil Ibrahim; Durdag, Emre; Tufan, Kadir; 0000-0002-5943-9283; 0000-0003-2854-941X; 0000-0002-5957-8611; 0000-0001-6939-5491; 0000-0003-1509-4575; 30569903; AAM-5436-2021; P-5895-2018; AAJ-5381-2021; AAK-1734-2021; AAK-1686-2021INTRODUCTION AND OBJECT: The aim of our study was to assess the effect of perineural pregabalin administration on the success of coaptation in experimental rat sciatic nerve anastomosis by measuring the expression of anti-inflammatory cytokine TGF-beta. It is thus to provide alternative solutions to this problem which we often see in clinical practice and whose results are not satisfactory. METHODS: In our study, 40 adult, male, Sprague-Dawley rats; 5 groups were randomly assigned Group 1: This group's sciatic nerves were dissected and the surgical site was sutured. Group 2: Rats whose sciatic nerves are sectioned transversely through the fill-thickness and end-to-end anastomosis is performed and no additional procedure is performed. Group 3: Intraperitoneal administration of 30 mg / kg pregabalin for 7 days with anastomosis. Group 4: 30 mg/kg pregabalin given orally for 7 days with anastomosis. Group 5: Given 10 microliters / h pregabalin subcutaneous perineural infusion for 7 days with anastomosis. After 60 days of surgery, the experiment was terminated with high dose thiopental (50 mg/kg). The right sciatic nerves of all animals were taken and sections obtained were examined immunohistopathologically. RESULTS: Inflammation was significantly less in the 5th group than in the other groups. TGF-beta expression in Groups 3, 4, and 5 is significantly higher than Groups 1 and 2, which also supports this situation. Although the expression in group 5 was not statistically significant, the number of TGF-beta expression was higher than Groups 3 and 4. In terms of immunohistochemical properties; 1 to 3, 1 to 4, 1 to 5, 2 to 5 groups were statistically significant (p<0,05). CONCLUSIONS: In conclusion, perinural infusion of pregabalin into the anastomotic region has not been previously tried in the literature and it has been found that immunohistochemistry provides positive contributions to healing of anastomosis. More research is needed to demonstrate that this effect is superior to other methods of administration of the drug.Item Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050(2021) Suner, Halil İbrahim; Tanburoglu, Anil; Durdag, Emre; Civi, Soner; Gunesli Yetisken, Aylin; Kardes, Ozgur; Andic, Cagatay; Tufan, Kadir; 0000-0002-5957-8611; 0000-0003-2854-941X; 0000-0001-9627-3502; 0000-0001-8581-8685; 33890450; AAJ-5381-2021; P-5895-2018; AAK-1876-2021; AAM-1671-2021Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients < 60 and > 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically.Item Significance of the Cerebellopontine Cistern Cross-Sectional Area and Trigeminal Nerve Anatomy in Trigeminal Neuralgia: An Anatomical Study Using Magnetic Resonance Imaging(2020) Gunesli, Aylin; Tufan, Kadir; 0000-0003-1509-4575; 32091126; AAK-1686-2021AIM: To evaluate the relationship between trigeminal neuralgia (TN) and potential magnetic resonance imaging (MRI)-related measurements in patients with TN. MATERIAL and METHODS: Retrospective analysis of 104 patients with TN was performed. MRI studies of 98 healthy controls were included in the study to compare the parameters with TN patients' measurements. MRI measurements of cerebellopontine cistern (CPC) cross-sectional area, trigeminal-pontine angle (TPA) width, and trigeminal nerve cisternal segment length and thickness were assessed on both symptomatic and asymptomatic sides using 1.5T MRI with constructive interference in steady-state sequences. The images were interpreted by two radiologists blinded to the affected sides of the patients. RESULTS: There were significant differences between the symptomatic and asymptomatic sides in terms of mean trigeminal nerve length (8.8 +/- 2.34 mm vs. 9.39 +/- 2.29 mm; respectively, p=0.001) and thickness (20.9 +/- 9.6 mm(2) vs. 25 +/- 9.98 mm(2), respectively; p<0.001). The median cerebellopontine cistern cross-sectional area was considerably lower on the symptomatic side compared with the asymptomatic side [201 mm(2) (interquartile range=93) vs. 224.5 mm(2) (interquartile range=77), respectively; p<0.001]. There were no significant differences between the trigeminal-pontine angle width on either side (38.32 +/- 10.38 vs. 38.78 +/- 10.9, respectively; p=0.679). There were no statistically significant differences between the right and left sides regarding these parameters in the control group. CONCLUSION: Smaller CPC cross-sectional area, trigeminal nerve length, and trigeminal nerve thickness on MRI were demonstrated to commonly exist on the symptomatic side in patients with TN. We suggest that this narrow space may increase the risk of vascular compression on the nerve.Item Treatment of Cavernous Sinus Hemangiomas with Gamma Knife Radiosurgery as a Primary and Sole Therapy(2019) Kardes, Ozgur; Tufan, Kadir; 30900734AIM: To evaluate the effectiveness of Gamma Knife radiosurgery (GKRS) as the primary and only therapy for the treatment of cavernous sinus hemangiomas (CSH) and to report the tumor volume dynamics, course of symptoms, and complications after stereotactic radiosurgery. MATERIAL and METHODS: A total of 10 CSH patients were treated with GKRS using a median margin dose of 14.2Gy (range 13-16Gy). The median follow-up period was 42 months (range 12-85 months). Tumor volumes were calculated from magnetic resonance images before treatment and compared with those after treatment. RESULTS: Prior to the treatment, all patients complained of headache and retro-orbital pain, and six patients complained of diplopia due to abducens nerve paralysis. Within six months of treatment, all patients declared some improvement in headache and retro-orbital pain, and abducens nerve paralysis recovered fully in all six patients. At the first-year follow-up, at least 74% decrease in tumor volume was noted with average tumor volume reduction of 90.2% in all treated patients. Tumors less than 6 cm(3) in volume nearly disappeared at 24 months. No tumor progression, re-growth, or radiation-induced adverse effects were noted in our patients. CONCLUSION: Characteristic radiological features that enable identification of CSH avert the need for an open biopsy for diagnosis. Under suitable circumstances, GKRS may be considered as the primary and only therapy for CSH. GKRS has favorable outcomes in the treatment of CSH, demonstrating good tumor shrinkage, symptom recovery, and low incidence of side effects.Item Massive Calcified Cerebellar Pilocytic Astrocytoma with Rapid Recurrence : A Rare Case(2016) Aydemir, Fatih; Kardes, Ozgur; Kayaselcuk, Fazilet; Tufan, Kadir; 0000-0002-1180-3840; 0000-0003-2854-941X; 0000-0003-1509-4575; 0000-0002-3400-9025; 27651876; AAE-2550-2021; P-5895-2018; AAK-1686-2021Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses.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.