PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Sliding hiatal hernia mimicking a left atrial mass(2019) Kocabas, Umut; Ozkalayci, Flora; Altun, Armagan; 0000-0002-3233-8263; 0000-0001-6424-9399; 32082840; ABB-5844-2020; AAG-5856-2020Item T1 Mapping by Cardiac Magnetic Resonance and Multidimensional Speckle-Tracking Strain by Echocardiography for the Detection of Acute Cellular Rejection in Cardiac Allograft Recipients(2019) Sade, Leyla Elif; Hazirolan, Tuncay; Kozan, Hatice; Ozdemir, Handan; Hayran, Mutlu; Eroglu, Serpil; Pirat, Bahar; Sezgin, Atilla; Muderrisoglu, Haldun; 29680337; X-8540-2019OBJECTIVES The aim of this study was to test the hypothesis that echocardiographic strain imaging, by tracking subtle alterations in myocardial function, and cardiac magnetic resonance T1 mapping, by quantifying tissue properties, are useful and complement each other to detect acute cellular rejection in heart transplant recipients. BACKGROUND Noninvasive alternatives to endomyocardial biopsy are highly desirable to monitor acute cellular rejection. METHODS Surveillance endomyocardial biopsies, catheterizations, and echocardiograms performed serially according to institutional protocol since transplantation were retrospectively reviewed. Sixteen-segment global longitudinal strain (GLS) and circumferential strain were measured before, during, and after the first rejection and at 2 time points for patients without rejection using Velocity Vector Imaging for the first part of the study. The second part, with cardiac magnetic resonance added to the protocol, served to validate previously derived strain cutoffs, examine the progression of strain over time, and to determine the accuracy of strain and T1 measurements to define acute cellular rejection. All tests were performed within 48 h. RESULTS Median time to first rejection (16 grade 1 rejection, 15 grade >= 2 rejection) was 3 months (interquartile range: 3 to 36 months) in 49 patients. GLS and global circumferential strain worsened significantly during grade 1 rejection and >= 2 rejection and were independent predictors of any rejection. In the second part of the study, T1 time >= 1,090 ms, extracellutar volume GLS >= 32%, GLS >-14%, and global circumferential strain >=-24% had 100% sensitivity and 100% negative predictive value to define grade >= 2 rejection with 70%, 63%, 55%, and 35% positive predictive values, respectively. The combination of GLS > 16% and T1 time >= 1,060 ms defined grade 1 rejection with 91% sensitivity and 92% negative predictive value. After successful treatment, T1 times decreased significantly. CONCLUSIONS T1 mapping and echocardiographic GLS can serve to guide endomyocardial biopsy selectively. (C) 2019 by the American College of Cardiology Foundation.Item Carpal Tunnel Syndrome: Evaluation of the Effects of Low-Level Laser Therapy With Ultrasound Strain Imaging(2019) Tezcan, Sehnaz; Ozturk, Funda Ulu; Uslu, Nihal; Nalbant, Merve; Yemisci, Oya Umit; 0000-0001-7204-3008; 29892976; ABC-5258-2020Objectives To evaluate the efficacy of low-level laser therapy on median nerve stiffness by using strain elastography in carpal tunnel syndrome (CTS). Methods This study included 37 wrists of 34 patients with mild or moderate CTS between January 2016 and August 2016. The control group comprised 17 patients (18 wrists) with CTS who were treated with wrist splinting for 3 weeks. The low-level laser therapy group included 17 patients (19 wrists) with CTS who were treated with a combination of splinting and low-level laser therapy, which was applied 5 times per week for 3 weeks. Clinical assessment scales, including the Symptom Severity Scale (SSS) and Functional Status Score (FSS), were obtained from our database. The cross-sectional area by ultrasound and strain ratio by elastography were studied. The differences in the strain ratio, cross-sectional area, SSS, and FSS between pretreatment and posttreatment periods in the groups were compared by the paired-sample t test. The correlations between changes in the strain ratio and the cross-sectional area, SSS, and FSS were analyzed by Pearson correlation coefficients. Results The control group included 13 women and 4 men, and the therapy group included 14 women and 3 men. In the therapy group, the mean values of the strain ratio, cross-sectional area, SSS, and FSS decreased significantly after laser therapy (P < .001) in contrast to the control group. No significant correlation was observed between the decreasing degree of the strain ratio and the cross-sectional area, SSS, and FSS after laser therapy. Conclusions The strain ratio and cross-sectional area of the median nerve decrease after low-level laser therapy. These changes may be related to the therapeutic effects of low-level laser therapy, such as nerve regeneration and improvement of the vascular supply.Item Can unenhanced brain magnetic resonance imaging be used in routine follow up of meningiomas to avoid gadolinium deposition in brain?(2019) Rahatli, Feride Kural; Donmez, Fuldem Yildirim; Kesim, Cagri; Haberal, kema Murat; Turnaoglu, Hale; Agildere, Ahmet Muhtesem; 0000-0002-8211-4065; 0000-0002-8964-291X; 30343167; R-9398-2019; AAB-5802-2020; AAD-5996-2021; AAE-5528-2021Purpose: We hypothesized that unenhanced brain MRI can be used in follow up of patients with intracranial meningioma to avoid gadolinium deposition in the brain and allow measurement of meningioma dimensions from pre-contrast T2-weighted images. Methods: Dimensions of meningiomas were measured on pre-contrast T2, post-contrast T1 weighted images. Results: The sizes of meningiomas in post-contrast axial T1-weighted images were similar with that in pre-contrast axial T2-weighted images. Signal intensity increase was detected in dentate nucleus and globus pallidus (P < 0.05). Conclusion: Gadolinium deposition could be avoided in patients with meningioma by using unenhanced brain MRI for follow up scans.Item Turkish Board of Neurological Surgery(2019) Bulduk, Erkut Baha; Yilmaz, Cem; 30614509AIM: To provide information on the process and the results of the Turkish Board of Neurological Surgery and increase the relevant awareness. MATERIAL and METHODS: The number of applications to the written and oral board exams organized by the Turkish Neurosurgical Society Proficiency Board since 2006, the number of successful and unsuccessful participants, and the number of the neurosurgery residents and specialists who applied to the exam were evaluated. RESULTS: A total of 554 candidates took the exam since 2006 when the first TBNS was applied. Two hundred and sixty of the candidates were successful (46.9%), and 294 (53.1%) were unsuccessful. Two hundred and forty six (44.4%) of those who took the test were neurosurgeons, 308 (55.6%) were neurosurgery residents who had completed their 3rd year in their training. The highest score in the written exams was 93/100, and the lowest score was 33/100. In verbal exams, a total of 73 candidates participated, and 66 (90.4%) of them were successful while 7 of them (9.6%) were unsuccessful. CONCLUSION: Board exams are inevitable to provide a certain level of education and standardization in the training of neurosurgery. Our duty as neurosurgeons is to participate in these exams and work to increase participation for continuing education.Item Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: "upper lateral closing"(2019) Cagici, Can Alper; 29175036Introduction: Following nasal hump removal during septorhinoplasty, the middle vault should be Lateral nasal reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. Objective: To present the results of reconstructing the middle vault with a technique that covers Covering the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Methods: Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. Results: No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. Conclusion: The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Item The success rate and safety of internal jugular vein catheterization under ultrasound guidance in infants undergoing congenital heart surgery(2019) Altun, Dilek; Nurac, Salih Hakan; Toprak, Verda; Eti, Emine Zeynep; 32082823Background: In this study, we aimed to investigate the effect of central venous catheterization under ultrasound guidance on the success and complication rates in low-weight infants (under 5 kg) undergoing surgery due to congenital heart disease. Methods: A total of 70 infants (38 boys, 32 girls; mean age of patients <1 month was 16.4 +/- 9.5 days [n=20; 28.6%]; 1-7.5 months was 126.3 +/- 47.8 [n=50; 71.4%]) who underwent ultrasound-guided internal jugular venous catheterization between October 2014 and October 2015 were retrospectively analyzed. All catheterizations were done under the guidance of ultrasound by two skilled anesthesiologists. Data including demographic characteristics of the patients, procedural success rate, catheter access time, number of attempts, and complications were recorded. Results: The overall success rate of the procedure was 92.8% (n=65). In 82% of the patients (n=53), the insertion was successful at the first attempt. The mean catheter access time (time from the first puncture to the catheter insertion) was 214 +/- 0.48 sec. Complications were seen in five patients (7.14%), and the body weight of these patients was less than 2,500 g There was no arterial puncture in any patients. One patient (1.42%) developed pneumothorax and four patients (5.7%) developed hematoma due to repeated attempts. Conclusion: Our study results suggest that ultrasound-guided central venous cannulation is a safe and effective technique in pediatric population weighing less than 5 kg undergoing congenital heart surgery.Item Recurrence patterns and prognostic factors in lymphovascular space invasion-positive endometrioid endometrial cancer surgically confined to the uterus(2019) Sahin, Hanifi; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Kocaman, Eda; Cuylan, Zeliha Fırat; Yalcin, Ibrahim; Coban, Gonca; Ozen, Ozlem; Sirvan, Levent; Gungor, Tayfun; Ayhan, Ali; 30638487Objective: The purpose of this study was to determine the patterns of failure and prognostic factors for lymphovascular space invasion (LVSI)-positive endometrioid endometrial cancer (EC) patients in the setting of negative lymph nodes (LNs). Materials and methods: A multicenter, retrospective department database review was performed to identify LVSI-positive patients with disease surgically confined to the uterus at two gynecologic oncology centers in Turkey. Demographic, clinicopathological and survival data were collected. Results: We identified 185 LVSI-positive women with negative LNs during the study period. Fifty-five (29.7%) were classified as Stage IA, 94 (50.8%) as Stage IB, and 36 (19.5%) as Stage II. The median age at diagnosis was 59 years and the median duration of follow-up was 44 months. The total number of the recurrences was 12 (6.5%). We observed 5 (2.9%) loco-regional recurrences, 3 (1.5%) retroperitoneal failures, and 4 (2.0%) distant relapses. The 5-year progression-free survival (PFS) was 86.1% while the 5-year overall survival (OS) rate was 87.7%. Grade 3 histology (Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.02-8.50; p = 0.04), cervical stromal invasion (HR 4.5, 95% CI 1.61-12.79; p = 0.004) and age > 60 years (HR 5.8, 95% CI 1.62-21.32; p = 0.007) were found to be independent prognostic factors for decreased OS. Adjuvant treatment did not appear as a prognostic factor for OS even in univariate analysis. Conclusion: The recurrence rate among LVSI-positive endometrioid EC patients is low in the setting of negative LNs. However, one out of three patients with a recurrence experiences distant relapses which usually portend worse outcomes. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.Item Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey(2019) Ugurlu, A. O.; 30745939OBJECTIVE: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey. METHODS: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey. RESULTS: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 +/- 2.85 and 0.92 +/- 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation. CONCLUSIONS: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.Item A highly efficient and faithful MDS patient-derived xenotransplantation model for pre-clinical studies(2019) Song, Yuanbin; Rongvaux, Anthony; Taylor, Ashley; Jiang, Tingting; Tabaldi, Toma; Balasubramanian, Kunthavai; Bagale, Arun; Terzi, Yunus Kasim; Gbyli, Rana; Wang, Xiaman; Fu, Xiaoying; Gao, Yimeng; Zhao, Jun; Podoltsev, Nikolai; Xu, Mina; Neparidze, Natalia; Wong, Elice; Torres, Richard; Bruscia, Emanuela M.; Kluger, Yuval; Manz, Markus G.; Flavell, Richard A.; Halene, Stephanie; 0000-0001-5612-9696; 30664659; B-4372-2018Comprehensive preclinical studies of Myelodysplastic Syndromes (MDS) have been elusive due to limited ability of MDS stem cells to engraft current immunodeficient murine hosts. Here we report a MDS patient-derived xenotransplantation model in cytokine-humanized immunodeficient "MISTRG" mice that provides efficient and faithful disease representation across all MDS subtypes. MISTRG MDS patient-derived xenografts (PDX) reproduce patients' dysplastic morphology with multi-lineage representation, including erythro- and megakaryopoiesis. MISTRG MDS-PDX replicate the original sample's genetic complexity and can be propagated via serial transplantation. MISTRG MDS-PDX demonstrate the cytotoxic and differentiation potential of targeted therapeutics providing superior readouts of drug mechanism of action and therapeutic efficacy. Physiologic humanization of the hematopoietic stem cell niche proves critical to MDS stem cell propagation and function in vivo. The MISTRG MDS-PDX model opens novel avenues of research and long-awaited opportunities in MDS research.