Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Rare Cause of Small Intestinal Obstruction: Obturator Hernia(2014) Karagulle, Erdal; Turk, Emin; Yabanoglu, Hakan; 0000-0002-1161-3369; 0000-0003-4766-3373; AAJ-7865-2021; AAJ-5609-2021Obturator hernia is an uncommon disease and its diagnosis is challenging. It is more prevalent in thin, multiparous, elderly women. In this case report a 93-year-old woman patient with a right-sided strangulated obturator hernia was discussed with review of the relevant literature.Item Laparoscopic Transperitoneal Adrenalectomy: Experience with the First 10 Patients(2014) Cicek, Tufan; Karagulle, Erdal; Turk, Emin; Demir, Canan Cicek; Kosan, Murat; 0000-0003-4766-3373; AAJ-5609-2021; JBF-7113-2023; AAK-4857-2021Purpose: In this study we aimed to assess the outcomes and complications of laparoscopic transperitoneal adrenalectomy operation performed in our clinic Materials and Methods: Medical records of patients operated with laparoscopic transperitoneal adrenalectomy between February 2007 and November 2013 at Baskent University Konya Application and Research Center Urology Clinic are examined retrospectively. The demographic characteristics, preoperative and postoperative laboratory results, operation times, complications, and duration of hospital stay and follow- up were recorded. Results: A total of 10 patients underwent laparoscopic transperitoneal adrenalectomy. Seven of these were male and 3 were female. The mean age was 48 +/- 17.4 (27-71) years. The operation time was 104.4 +/- 36.5 (40-185) on average and the mean amount of blood loss was 43.5 +/- 121.2 ml. The average mass size was 41.6 +/- 23.8 (15-90) mm. The mean duration of hospital stay was 3.8 +/- 1.3 (2-6) days. The patients were followed for an average of 45.8 +/- 28.7 (4-85) months. The operation was turned to open technique in two patients. Mean preoperative and postoperative hemoglobin levels of the patients were 13.38 +/- 1.91 and 11.6 +/- 1.7 mg/dl, respectively. Postoperative hemoglobin level was on average lower than the preoperative level (p< 0.001). One patient required blood transfusion. Conclusion: We suggest that the complication rate of laparoscopic adrenalectomy would be lowered by selecting appropriate patients, more detailed assessment of adrenal functions, and increased surgical experience. Laparoscopic transperitoneal adrenalectomy is regarded as a safe and efficient treatment method.Item A Prospective Clinical Study of Flow-Mediated Dilatation in Burn Injury(2014) Turk, Emin; Caliskan, Mustafa; Karagulle, Erdal; Aydogan, Cem; Oguz, Hakan; Kulaksizoglu, Sevsen; Yildirim, Erkan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4766-3373; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0003-1547-1297; https://orcid.org/0000-0002-7613-2240; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24165669; AAJ-5609-2021; JYO-9455-2024; C-6247-2017; AAJ-5296-2021; AAI-8932-2021; ABI-3856-2020; AAE-1041-2021; AAJ-8097-2021Item Successful Skin Homografting From an Identical Twin in a Severely Burned Patient(2014) Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-4766-3373; https://orcid.org/0000-0002-8522-4956; https://orcid.org/0000-0002-1298-7944; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 23811789; AAJ-5609-2021; C-6247-2017; AAE-8704-2021; AAE-1041-2021; AAJ-8097-2021Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients. (J Burn Care Res 2014;35:e177-e179)Item Body Mass Index, Cholecystitis, Cholelithiasis, Pancreatitis and Imaging of Common Bile Duct Stones(2014) Coban, Gokcen; Yildirim, Erkan; Gokturk, Savas; Caliskan, Zuhal; Turk, Emin; Akcil, Mehtap; https://orcid.org/0000-0002-4010-2883; https://orcid.org/0000-0002-9057-722X; https://orcid.org/0000-0003-4766-3373; 23838577; P-7533-2014; ABI-3856-2020; AAJ-5609-2021Purpose:Studies to date have not investigated whether body mass index (BMI) affects the sensitivity and specificity of magnetic resonance cholangiopancreatography (MRCP). The purpose of this study was to investigate the effect of BMI and also concomitant pancreatitis, cholecystitis and cholelithiasis on the sensitivity and specificity of MRCP.Materials and Methods:Between January 2004 and December 2011, 185 patients were included in the study and divided into 3 groups according to BMI as normal, overweight or obese. Both MRCP and endoscopic retrograde cholangiopancreatography (ERCP) were performed in all patients. ERCP was accepted as the gold standard. The accuracy, sensitivity and specificity values of the 3 groups were calculated to determine any effects on the results of the MRCP.Results:Before separating into groups according to BMI, the statistical results for MRCP in the detection of stone disease were as follows: specificity 74.3%, sensitivity 81.7% and accuracy 79%. After dividing the patients into 3 groups according to BMI, the specificity of stone detection with MRCP in the normal-weight group was 93.8% but decreased to 65.5% in the overweight group and to 72% in the obese group. The sensitivity of stone detection with MRCP in the normal-weight group was 85.2% but decreased to 75% in the overweight group and increased to 88.9% in the obese group. The accuracy was 88.3% in the normal-weight group but decreased to 71.6% in the overweight group and to 81.9% in the obese group.Conclusion:Our study showed that MRCP performance was decreased in the overweight and obese groups.Item Neuroendocrine Tumour of the Gallbladder Diagnosed after Cholecystectomy(2022) Tasci, Halil Ibrahim; Coskunoglu, Esra Zeynep; Turk, Emin; Karagulle, Erdal; 0000-0003-2269-4798; AAJ-2989-2021Gallbladder cancer is a rare but aggressive malignancy. Neuroendocrine tumour of the gallbladder make up 2-3% of all the gallbladder tumour. A 67-year female patient underwent laparoscopic cholecystectomy because of symptomatic cholelithiasis and the histopathology revealed a neuroendocrine tumour of the gallbladder, stage pT2a. The patient's imaging study for metastasis workup were normal. A radical cholecystectomy procedure was planned as the tumour stage was pT2a. Postoperative chemotherapy and/ or radiotherapy were recommended. The patient, who had comorbidities, was refused both surgery and other treatment alternatives. The patient's one-year clinical, laboratory, and radiological follow-up did not reveal any findings of recurrence or metastasis. There is no standardised staging system for neuroendocrine tumours of the gallbladder since the number of such cases is quite limited. Guidelines are also insufficient. Multi-centred and large studies are needed in order to develop standardisation in treatment, prognosis, and factors affecting survival.Item Coexistence of Papillary Microcarcinoma and Hurthle Cell Adenoma: A Case of Thyroid Collision Tumor(2022) Tasci, Halil Ibrahim; Erinanc, Hilal; Turk, Emin; Karagulle, Erdal; 0000-0003-2269-4798; AAJ-2989-2021While thyroid cancers are usually present one type of cancer in the thyroid gland, rarely different thyroid cancers may found in one or two different lobes of the thyroid gland at the same time. A 70-years-old female patient presented with a long-standing neck swelling, especially on the left side, which was more prominent, recently increasing in size and causing shortness of breath. Due to tracheal compression and diagnosis of multi-nodular goiter, total thyroidectomy was performed. Histopathological examination revealed a thyroid collision tumor with papillary microcarcinoma on the right and hurtle cell adenoma on the left side. Due to its rarity, clinicians encountered difficulties in the diagnosis and treatment of thyroid collision tumors. We believe that to be aware of these rare entities by encouraging clinicians to report such cases enable to more solid conclusions to diagnosis and management of collision tumors.Item Coronary Flow Velocity Reserve in Burn Injury: A Prospective Clinical Cohort Study(2016) Caliskan, Mustafa; Turk, Emin; Karagulle, Erdal; Ciftci, Ozgur; Oguz, Hakan; Kostek, Osman; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0002-8522-4956; 0000-0002-1901-5603; 0000-0003-4766-3373; 26284645; AAJ-8097-2021; AAE-1041-2021; C-6247-2017; AAA-3604-2019; AAJ-5609-2021The authors sought to evaluate coronary microvascular function and left ventricular diastolic dysfunction using transthoracic Doppler echocardiography in burn patients. In this study, 32 adult burn patients with partial or full-thickness scald burns that were hospitalized and treated were included. The control group was matched for age and sex and was composed of otherwise healthy volunteers. Transthoracic Doppler echocardiography examinations and simultaneous laboratory tests for cardiac evaluation were performed on the sixth month after burn injury as well as with the control group. High-sensitivity C-reactive protein levels were significantly higher in the burn patients than in controls (5.17 +/- 3.86 vs 2.42 +/- 1.78; P =.001). Lateral isovolumic relaxation time was significantly higher in the burn injury group than in the control group (92.7 +/- 15.7 vs 85.5 +/- 8.3; P =.03). Baseline coronary diastolic peak flow velocity of the left anterior descending artery was similar in both groups. However, hyperemic diastolic peak flow velocity and coronary flow velocity reserve (2.26 +/- 0.48 vs 2.94 +/- 0.47; P <.001) were significantly lower in the burn injury group than in the control group. Coronary flow velocity reserve was significantly and inversely correlated with high-sensitivity C-reactive protein, burn ratio, creatinine, and mitral A-wave max velocity. At the sixth month of treatment, burn patients had high-sensitivity C-reactive protein levels during this period, suggesting that inflammation still exists. In addition, subclinical coronary microvascular and left ventricular diastolic dysfunction can occur in burn patients without traditional cardiovascular risk factors. However, these results must be supported by additional studies.Item Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis(2022) Tasci, Halil Ibrahim; Turk, Emin; Erinanc, Ozgur Hilal; Erkan, Serkan; Gundogdu, Ramazan; Karagulle, Erdal; https://orcid.org/0000-0003-2269-4798; 35108784; AAJ-2989-2021Objective: To investigate factors that may have an effect on recurrence by retrospectively analysing the data of patients who were followed up and treated for idiopathic granulomatous mastitis in this clinic. Study Design: Analytic study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Baskent University, Konya and Adana Practice and Research Hospitals between January 2010 and January 2021. Methodology: The data of patients who were histopathologically diagnosed with granulomatous mastitis were retrospectively analysed. The patients included in the study were divided into two groups: Recurrence (Group 1) and non-recurrence (Group 2). Patients with underlying etiological factors that may cause granulomatous inflammation such as infection, trauma, tuberculosis, sarcoidosis, and autoimmune disease were excluded from the study. The effects of other parameters (involvement area, followup duration, the time from the onset of complaints to diagnosis, side of involvement, breastfeeding, oral contraceptive use, redness, ulceration and/or discharge, preoperative histopathological diagnosis, diagnosis by any of the preoperative imaging techniques, preferred treatment method) on recurrence, were statistically analysed. Results: Furthermore, the analysis results showed no significant difference between the groups with and without recurrence with regard to any of the other variables such as follow-up period, size of the involvement area, presenting complaints, breast-feeding,preferred treatment alternative (steroid, steroid + surgery, surgery), and preferred surgical technique (p>0.05). The time from the onset of complaints to diagnosis was significantly longer in the recurrence group (p=0.001). In addition, the frequency of oral contraceptive use was statistically significantly higher in the recurrence group (Odds ratio=7.6, p=0.044). Conclusion: The results of this study suggest that early diagnosis could prevent recurrence in patients with idiopathic granulomatous mastitis. Prospective randomised controlled studies are needed to support this thought.Item A model for acute kidney injury in severe burn patients(2022) Karakaya, Emre; Akdur, Aydincan; Aydogan, Cem; Turk, Emin; Sayin, Cihat Burak; Soy, Ebru Ayvazoglu; Yucebas, Sait Can; Alshalabi, Omar; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-8726-3369; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0002-3462-7632; 33879373; AAD-5466-2021; AAA-3068-2021; AAA-3068-2021; AAC-5566-2019; AAJ-8097-2021Introduction: In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. Methods: We retrospectively evaluated 437 adult patients with >20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a "decision tree method" to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. Results: Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-tolymphocyte ratio, and platelet count. Conclusion: The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury. (c) 2021 Published by Elsevier Ltd.