ORIGINAL ARTICLE | |
1. | Prognostic Importance Of Radial Margin In Colon Cancer Mücahit Özbilgin, Selman Sökmen, Sülen Sarıoğlu, Emre Aras Canda, Mehmet Füzün doi: 10.5505/ktd.2018.83007 Pages 1 - 10 INTRODUCTION: In colon cancer surgery, tumor’s existence in the colon not covered with peritoneum or its being in the narrow mesenteric compartment is related with locoregional recurrence of the cancer and decreased survival. This study investigates the prognostic significance of the involvement of the radial margin (circumferential resection margin (CRM)) in colon cancer patients undergoing curative resection. METHODS: The records of 179 colon cancer patients (only pT3-pT4 colon tumors) undergoing radical resection in the Medical Faculty of Dokuz Eylul University between 2005 and 2008 were evaluated retrospectively. In the histopathologic examination, CRM was evaluated as the retroperitoneal or peritoneal adventitial soft tissue margin nearest to the deepest penetration of the tumor. RESULTS: CRM was present in 14% of the patients. CRM involvement was significantly correlated with differentiation grade, tumor invasion depth, lymph node involvement, venous invasion, lymphatic invasion, tumor invasion margin type and local recurrence development and also with the presence of venous invasion and tumor invasion depth. Local recurrence frequency was higher in patients with CRM. Disease free survival significantly decreased in patients with CRM involvement (355±74 days) than in patients without CRM involvement (609±45 days). DISCUSSION AND CONCLUSION: In this study, the presence of CRM involvement in colon cancers is the marker of advanced tumor spread. The presence of CRM is an important determinant of the possibility of recurrence or survival. Therefore, interpretation of this prognostic factor should be routine in the histopathological reports of colon cancer patients. |
2. | Evaluation of stroke frequency in non-small cell lung cancer patients receiving cisplatin and docetaxel Serhan Yıldırım, Zahide Yılmaz, Ülkü Türk Börü doi: 10.5505/ktd.2018.59454 Pages 11 - 15 INTRODUCTION: Stroke refers to a clinical condition following cerebrovascular disease and a sudden neurological failure. It's divided into two subgroups according to damage pathology. Cisplatin and docetaxel are drugs used in various cancer treatments. In this study, we aimed to investigate the frequency of stroke in non-small cell lung cancer patients receiving docetaxel with cisplatin during and after the therapy. METHODS: Patients, over 18 diagnosed with non-small cell lung cancer and receiving at least six therapies of docetaxel(75mg/m2) and cisplatin(75mg/m2) in every 21 days, were monitored prospectively in Medical Oncology Clinique for 6 months. Patients were questioned when they were diagnosed with cancer and if they have metastases, then the neurological examination was performed. When the drug treatment was completed, the patients were questioned as to whether they experienced stroke during or after the therapy. If they experienced stroke, its type (hemorrhagic / ischemic) was examined. RESULTS: During the follow-up period, ischemic stroke developed in six (3%) of the patients. Four of these patients(2.3%) were male, two (7.7%) were female. Lymph node metastasis in 61 (31 %) patients, brain metastasis in 25 (12.7%), bone metastasis in 24 (12.2%), surrenal metastasis in 7 (3.6 %) and liver metastasis in 4 patients (2 %) were determined. There wasn't correlation between brain and bone metastasis and ischemic stroke (p = 0,075, p = 0,169, p = 0,112, respectively). DISCUSSION AND CONCLUSION: Cisplatin and docetaxel use in patients with non-small cell lung cancer increase cerebrovascular diseases up to ten folds due to the cancer itself or side effects of treatments. |
3. | The relationship between coenzyme Q10 level and diastolic dysfunction in coronary artery disease patients with preserved left ventricular systolic function Bernas Altıntaş, Erkan Baysal, Rojhat Altındağ, Önder Bilge doi: 10.5505/ktd.2018.40469 Pages 16 - 22 INTRODUCTION: The aim of this study was to investigate the relationship between left ventricular diastolic functions and coenzyme Q10 levels in coronary artery disease (CAD) patients with preserved left ventricular systolic functions. METHODS: A total of 64 patients aged between 20 and 86 years, in whom coronary angiography were performed and documented significant CAD, were included in the study between July and October 2009. The patients were classified into two groups based on the presence and absence Left ventricular diastolic dysfunction (LVDD). RESULTS: : A total of 64 significant CAD patients were included in the study, of whom 42 (65.6%) were male. The mean age was 60.5±12.1 years. The mean plasma coenzyme Q10 level in all patients was 1408.2±346.5 µg/L. The groups were compared for coenzyme Q10 levels, which were found to be 1516.0±381.0 µg/L in the presence of LVDD (+) and 1285.7±472.6 µg/L in the absence of LVDD group (p =0.08). DISCUSSION AND CONCLUSION: A significant relationship was not observed between LVDD and coenzyme Q10 levels in the presence of significant CAD with preserved systolic functions. |
CASE REPORT | |
4. | Anesthesia Experience Of A Pediatric Patient With Arnold Chiari Type I Malformation Sedef Gülçin Ural, Meltem Aktay İnal, Yusuf Emrah Gergin doi: 10.5505/ktd.2018.02350 Pages 23 - 25 Arnold-Chiari malformation (ACM) is a congenital defect and some of the cases are accompanied by syringomyelia. There are four types of the malformation, type 1 being the most common in adults. Diagnosis of the malformation is usually difficult and therefore delayed. In this case report, we present our experience of anesthesia in a 4-year-old patient with ACM Type I with syringomyelia. |
ORIGINAL ARTICLE | |
5. | The Effect Of Lıdocaıne On The Effıcıency Of Electroconvulsıve Therapy Ayşe Zeynep Turan, Mehmet Yılmaz, Vildan Kılıç Yılmaz, Aslı Duygu Aydaş, Öyküm Fındık doi: 10.5505/ktd.2018.69875 Pages 26 - 32 INTRODUCTION: Electroconvulsive therapy is the most important therapeutic modality used in psychiatric disorders. The efficiency of the therapy is related to the duration of a seizure. Propofol is frequently chosen anesthetic agent for ECT anesthesia. Intravenous lidocaine is frequently used as an adjuvant agent during propofol induction. Anesthetic agents and also adjuvant agents as lidocaine used for sedation during ECT should not affect duration and quality of the seizure. In this study, we aimed to investigate the effect of lidocaine during electroconvulsive therapy on the length of seizures. METHODS: Current study designed prospectively randomized controlled double blind trial. Patients were randomly assigned into two groups: Group P (propofol, n=39) or Group PL (propofol-lidocaine, n=41) by sealed envelop method. Patients in Group P were given 5 ml (5 ml SF), patients in Group PL were given 5 ml (2 ml of 2% lidocaine + 3 ml SF) by the researcher, and then propofol induction was performed. All patients in Group P and Group PL were given 1mk/kg of succinylcholine to prevent muscle relaxation when the BIS value was 60. RESULTS: There was no statistically significant difference between two groups in terms of Demographic information, propofol amounts and bispectral index values (p>0,05). The incidence of cardiac arrhythmia was statistically significantly lower in Group PL than Group P (p=0.036). Duration of seizure was significantly higher in Group PL compared to Group P (p<0,05). DISCUSSION AND CONCLUSION: We concluded that adjuvant lidocaine administration for the ECT procedure prolongs the duration of the seizure and thereby positively impacts treatment. In addition, adding lidocaine decreases procedural adverse cardiovascular effects. |
6. | Acute Renal Failure in Patients with Massive Pericardial Effusion or Cardiac Tamponade Emrah Bozbeyoğlu, Özlem Yıldırımtürk, Yiğit Çanga, Mert İlker Hayıroğlu, Ayça Gümüşdağ, Koray Kalenderoğlu, Ahmet Okan Uzun, Seçkin Pehlivanoğlu doi: 10.5505/ktd.2018.47855 Pages 33 - 38 INTRODUCTION: Acute kidney injury (AKI) is an important complication in intensive care unit especially in critically ill patients. Prevalence of AKI is ranged from 3 to 25% in different intensive care unit series. Knowledge about incidence of AKI in intensive cardiac care units (ICCU) is limited especially in patients with massive pericardial effusion and cardiac tamponad (PEoT). Our aim was to clarify the prevalence and predictors of AKI in these patients. METHODS: Between October 2014-January 2016, 4,829 patients were hospitalized in our ICCU. Eigthy one of these patients (%1.67) were diagnosed with PEoT during their hospitalization. All patients' relevant data gathered retrospectively from hospital ICCU database. Patients were evaluated for AKI, its prevalence and predictors. Patients were divided into two groups according to development of AKI. RESULTS: Acute kidney injury was seen in 23 (%28.4) patients. Patients with AKI were significantly older, had higher chronic renal disease and congestive heart failure history and lower hypertension history. Left ventricular systolic functions were similar in both patient groups. Baseline serum creatinine and blood urea nitrogen (BUN) levels were higher in patients with AKI. Logistic regression analysis revealed that hypertension history and creatinine levels on admission were only predictors of AKI in these patients. In-hospital mortality was similar in both groups. DISCUSSION AND CONCLUSION: Massive pericardial effusion or cardiac tamponade is an important cause of AKI especially in patients with hypertension history and high creatinine levels on admission in ICCU. |
7. | Treatment Results Of The Ponsetı Method In Patıents Wıth Idıopathıc Pes Equınovarus Hasan Ulaş Oğur, Fırat Seyfettinoğlu, Ümit Tuhanioğlu, Alper Gültekin, Şükrü Solak doi: 10.5505/ktd.2018.97659 Pages 39 - 44 INTRODUCTION: Congenital clubfoot (pes equinovarus) treatment is currently applied with serial manipulation and plaster casting with the modern treatment method described by Ponseti. In orthopaedics, the plaster cast material used is usually the classic white plaster (plaster of Paris; POP) and more rarely semi-rigid, fibreglass (SRF). The aim of this study was to evaluate the efficacy of these two materials in the Ponseti method and to identify the advantages of each. METHODS: A total of 27 feet of 16 patients (12 male, 4 female) treated between 2006 and 2008 were included for evaluation. The patients were separated into 2 groups, as Group 1 with 16 feet of 9 patients applied with POP, and Group 2 with 11 feet of 7 patients applied with SRF. The efficacy of the two methods was evaluated in respect of the properties of the cast materials and complications. The Pirani and Dimeglio scores were examined. RESULTS: The mean Dimeglio score was 12.81 before treatment and 2.56 after treatment. The mean Pirani score was 4.125 before treatment and 0.531 after treatment. The mean follow-up period was 18 months. A statistically significant improvement in clinical scores was observed in both groups (p<0.05). In 3 feet in Group 1 (POP), skin pressure sores were observed. DISCUSSION AND CONCLUSION: Significant improvements in clinical scores and correction of the foot deformity were seen with both plaster cast materials using the Ponseti technique. No statistically significant difference was determined between the two groups (p>0.05). It was determined that less skin pressure injury could be seen with fibreglass synthetic plaster cast. |
CASE REPORT | |
8. | Minimal Change Disease and Toxic Hepatitis Due to Ecstasy İLTER BOZACI, Garip Şahin, Mustafa Açıkalın doi: 10.5505/ktd.2018.05945 Pages 45 - 49 Minimal change disease (NIL (Nothing In Light microscope) disease) is the most common cause of nephrotic syndrome in childhood; and one of the most common causes of nephrotic syndrome in adults. Characteristic findings are: diffuse foot process effacement in electrone microscopy, no complement or immunoglobulin deposits on immunofluorescence microscopy , severe functional defect in glomerular permselectivity. Most cases of MCD are idiopathic or primary. Secondary MCD is associated with the following: drugs, tumors, allergy, infections and other glomerular diseases. Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is a synthetic psychoactive compound with C11H15NO2 formula. Malign hypertension, tachycardia, hyperthermia, acute kidney failure, hyponatremia, rhabdomyolisis, neurologic symptoms like agitation, anxiety, hepatotoxicity can be seen due to ecstasy abuse. In our case, we wanted to mention that MCD cases can come with atypical clinical findings and we should keep ecstasy abuse in mind as secondary reason at these types of cases. |
ORIGINAL ARTICLE | |
9. | Effect of vitamin D level on post-thyroidectomy hypocalcemia Ali İmran Küçük, Yeşim Akdeniz, Havva Belma Koçer, Yusuf Arslan doi: 10.5505/ktd.2018.09821 Pages 50 - 54 INTRODUCTION: In this study, the effect of preoperative vitamin D levels on postoperative hypocalcemia was investigated. METHODS: We retrospectively investigated 106 patients who were operated for benign – malign thyroid nodules or thyrotoxicosis and whose preoperative vitamin D levels were measured in the General Surgery Clinic of Sakarya University Education and Reserch Hospital between January 2015 and March 2016. RESULTS: The average age of the patients is 50,6 (min: 19, max: 82). There were 94 female and 12 male patients. When the vitamin D levels of the patients undergoing thyroidectomy were evoluated, it was found that 59,8% (n: 63) deficient, 20,8% (n: 22) insufficient (<30 ng/dl) and 19,8% (n: 21) were normal (>30 ng/dl). Transient hypocalcemia symptoms developed in 18,9% of the postoperative patients and the patients had received calcium (Ca) therapy. When factors affecting the occurence of hypocalcemia symptoms were examined, it was seen that age, hyperthyroidism, thyroiditis, parathyroid gland removal and operation type did not affect the postoperative hypocalcemia symptom status; however, patients with vitamin D below 30 ng/dl had more hypocalcemia 23,3% & 0%)(p: 0,017). DISCUSSION AND CONCLUSION: As suggested by our study and other studies, preoperative vitamin D levels should be assested in every patient who will undergo thyroidectomy and vitamin D replacement should be performed in every patient who has insufficiency. |
10. | Safety of Esophageal Stent Placement Without Fluoroscopy Mürşit Dincer, Gamze Çıtlak, Hüda Ümit Gür, Ekrem Ferlengez, Muzaffer Akıncı doi: 10.5505/ktd.2018.50490 Pages 55 - 59 INTRODUCTION: Esophagial stents are placed endoscopically with or without aid of flouroscopy to patients with esophagus or gastric carcinoma presenting with dysphagia symptoms. In this study, we aimed to investigate the safety and feasibility of of upper gastrointestinal stenting without fluoroscopy. METHODS: Upper gastrointestinal stent placement procedure without aid of flouroscopy between April 2014 and July 2017 were analyzed retrospectively. Patients demographic profiles, stent indications and complications were examined. RESULTS: Thirty-six cases were analyzed. Twenty-three patients were male (63.9%) and 13 patients were female (36.1%). The average age was 62.54 (36-89). The most indication of stent placement was cardia cancers Siewert type II (36.11 %). A patient with cardia tumor had ileum obstruction due to migration of stent 6 months after procedure. This patient died due to sepsis caused by anastomosis leakage after surgery. DISCUSSION AND CONCLUSION: Esophagial stent placements without aid of flouroscopy are safely used in patients with dysphagia as a palliative treatment of anastomosis stenosis, leakage and fistulas. Easy appliance and low complication rates are advantages of the procedure but it should not be forgotten that its complications can be mortal. |
11. | Short-term Outcomes of Robotic Complete Mesocolic Excision for the Surgical Treatment of Colon Cancer Volkan Özben, Cansu De Muijnck, Hasan Kürşad Korkmaz, Hasan Can Demirkaya, Ömer Faruk Erdil, Erman Aytaç, Bilgi Baca, Tayfun Karahasanoğlu, İsmail Hamzaoğlu doi: 10.5505/ktd.2018.38335 Pages 60 - 68 INTRODUCTION: Since the description of complete mesocolic excision (CME) technique and use of robotic surgery, important advances have been made in the field of colorectal surgery in recent years. However, limited data exists regarding the feasibility of robotic surgery in the CME technique. In this study, we aimed to present the details of our operative technique and evaluate postoperative clinical outcomes in a series of patients undergoing robotic CME procedure. METHODS: Included in this study were 98 patients undergoing robotic CME for colon adenocarcinoma between November 2014 and May 2017. Patient data were recorded prospectively and reviewed retrospectively. Data on perioperative clinical findings, histopathologic data and postoperative 30-day outcomes were analyzed. RESULTS: There were 60 male (61.2%) and 38 female patients with a mean age of 64.4±12.2 years and body mass index of 27.3±4.6 kg/m2. In this series, sigmoid colon cancer was the most common (48.9%) and this was followed by right colon (23.5%), left colon (16.3%), transverse colon (%6.1) and synchronous cancers (5.1%). The mean operative time was 263.6±85.9 min and blood loss was 98.9±108.0 ml (median, 55 ml; range, 10-800 ml). Intraoperative complication occurred in 5 patients (5.1%). Two cases were converted to open surgery (2%). On histopathologic examination, all the surgical margins were clear and the mean number of harvested lymph nodes was 34.7±15.2. The mean time to first bowel movement and receiving oral solid diet were 3.5±1.3 and 3.5±1.7 days, respectively. The mean length of hospital stay was 6.3±2.6 days. The postoperative complication rate was 19.4%. DISCUSSION AND CONCLUSION: For the surgical treatment of colon cancer, CME can be safely performed with the technical advantages of the robot. Robotic CME may provide accurate staging of the disease with a high number of harvested lymph nodes and this may translate into favorable oncologic outcomes. |
CASE REPORT | |
12. | Cases of Unilateral Breast Atrophy during Lactation Nuray Voyvoda, Tülay Özer doi: 10.5505/ktd.2018.09327 Pages 69 - 71 Unilateral breast atrophy is a relatively rare pathology, and is most commonly seen as a congenital condition. To date, acquired form of this condition is rare and no case associated with lactation has been reported. In this report, we present three cases who developed unilateral breast atrophy during the lactation period. |
ORIGINAL ARTICLE | |
13. | Evaluation of the small diamater trochar chest tube efficacy in management of traumatic hemothorax and pneumothorax Aykut Eliçora doi: 10.5505/ktd.2018.04880 Pages 72 - 75 INTRODUCTION: Chest tubes are mainly used to drain air or fluid that accumulates in the pleural space. Tube thoracostomy is a life-saving procedure in an emergency. In chest tube placement, two main techniques are used as with trochar and without trochar. In this study, it was aimed to compare the techniques with trochar and without trochar in terms of efficacy in patients who underwent tube thoracostomy due to thoracic trauma. METHODS: ; In this study, 145 patients to whom I applied tube thoracostomy due to thoracic trauma at three different centers where I worked between the years of 2012-2017 were examined retrospectively. Two groups were created in our study. Group A was consisted of 20 French (F) (Bıçakcıoğlu, Turkey) chest tube with trochar, Group B was consisted of 32F (Bıçakcıoğlu, Turkey) patients with chest tube without trochar. RESULTS: The ages of the patients ranged from 19 to 77 (mean age 56.8 ± 10.6).. There was no statistically significant difference between the groups in terms of age and sex distribution (P = 0.410). There was no significant difference between the two groups in terms of tube malposition, tube complication, empyema and additional tube requirement (p> 0,005). DISCUSSION AND CONCLUSION: When the techniques with trochar and without trochar were compared, the technique with trochar provides faster intervention to patients who have trauma with technique with trochar. |
14. | Does preoperative knee flexion angle affect postoperative knee flexion angle and function in patients with total knee arthroplasty? Serkan Bakırhan, Bayram Ünver doi: 10.5505/ktd.2018.96658 Pages 76 - 80 INTRODUCTION: The aim of this study was to investigate the effects of preoperative and postoperative knee flexion angle and HSS knee score in patients with bilateral total knee arthroplasty (TKA). METHODS: The study included 59 patients who underwent primary TKA. The participants’ preoperative and postoperative knee movements were assessed with the goniometer and their preoperative and postoperative knee functions were assessed with the HSS scoring. RESULTS: The comparison of the preoperative and postoperative knee flexion scores of the patients with TKA revealed a significant increase (p<0.05). The postoperative HSS knee scores of the patients were significantly higher than their preoperative HSS knee scores (p<0.05). There was a weak correlation between the preoperative and postoperative knee flexion HSS scores of patients with TKA (r=0.142, p=0.126), and the correlation between their preoperative knee flexion and postoperative HSS knee scores was also weak (r=0.424, p=0.633). DISCUSSION AND CONCLUSION: In TKA, the preoperative knee flexion angle has no effect on the postoperative knee flexion or development of the knee functions. |
15. | Comparıson Of The Results Of Pemberton And Salter Osteotomıes Applıed In Developmental Dysplasıa Of The Hıp Ümit Tuhanioğlu, Alper Gültekin, Hasan Ulaş Oğur, Fırat Seyfettinoğlu, Ulaş Serarslan doi: 10.5505/ktd.2018.94546 Pages 81 - 86 INTRODUCTION: When developmental hip dysplasia (DHD)is not treated, it is one of the most important orthopaedic pathologies in childhood that causes permanent function impairment. The aim of this study was to determine and evaluate the early clinical and radiological results of Pemberton and Salter osteotomies applied to patients aged over 1 year who were diagnosed with DHD. METHODS: Two different patient groups applied with Pemberton acetabuloplasty and Salter osteotomy in our clinic between 2014 and 2016 for a diagnosis of DHD were compared in respect of preoperative and postoperative acetabular inclination angles, preoperative and postoperative acetabulum depth, the degree of abduction in the plaster cast, hip range of movement at the final follow-up examination and complications that developed. RESULTS: Group 1 comprised 21 patients with a mean age of 24.8 months and mean follow-up period of 30.2 months. Group 2 comprised 18 patients with a mean age of 20.7 months and mean follow-up period of 32.1 months. In the clinical evaluation of Group 1, the Pemberton group, 18 patients were evaluated as excellent, 2 as good and 1 as fair, and in Group 2, the Salter group, the results obtained were excellent in 15 patients, good in 1 and fair in 2. DISCUSSION AND CONCLUSION: Both interventions have different advantages and it can be considered that both can be applied safely according to the surgeon’s preference and experience. |
CASE REPORT | |
16. | Visual Improvement after Hyperbaric Oxygen Therapy in a Late Referral Central Retinal Artery Occlusion Case Mustafa Gök, Hüsamettin Aksoy doi: 10.5505/ktd.2018.14471 Pages 87 - 91 40 years old female patient was presented to Karaman State Hospital (Karaman/Turkey) eye clinic with acute vision loss in the right eye, beginning 9 days before. The patient's initial visual acuity was at the level of hand movements in the right eye and 10/10 in the left eye. There was a marked central retinal artery occlusion (CRAO) view with preserved superior posterior pole in right eye fundus examination. Fundus fluorescein angiography (FFA) revealed central retinal artery recanalization, and patent cilioretinal artery. Hematological, cardiovascular and other etiologic examinations were also performed. Subsequently patient redirected to the hyperbaric oxygen therapy with the diagnosis of central retinal artery occlusion. Visual acuity improved at 10/10 level, after 20 sessions of HBO therapy at 6th week control in the right eye |
ORIGINAL ARTICLE | |
17. | The Effect of Kinesiotaping on Pain, Balance and Falling Risks in Patients with Plantar Fasciitis Mustafa Yemliha Ayhan, Engin Çakar, Ahmet Salim Göktepe, Mehmet Ağırman doi: 10.5505/ktd.2018.87587 Pages 92 - 97 INTRODUCTION: Investigation of the effect of kinesiotaping on pain, balance, risk of falls and functional status in patients with plantar fasciitis syndrome. METHODS: Thrity patients with plantar fasciitis were divided into two groups randomly. Exercise and ice application were suggested to both groups. Kinesiotaping was applied to intervention group and placebo taping was applied to the other group. Patients were evaluated before intervention and one week after the intervention. We used visual analog scale (VAS) for pain evaluation. Foot Function Index (FFI), Nottingham Health Profile were filled and measurements were taken with the Biodex Balance system to assess balance-and-falls risk. RESULTS: There was a decrease in VAS values in both groups but there was no statistically significant difference between the groups. A statistically significant difference was found in treatment group in FFI-Disability score in functional comparison. DISCUSSION AND CONCLUSION: It was found that kinesiotaping for plantar fasciitis syndrome had a significant effect on pain, but this effect did not make a statistical difference compared to placebo. |
18. | Relation among obstructive sleep apnea, obesity, age and gender: A retrospective study Seyhan Us Dülger, Tekin Yıldız, Özlem Şengören Dikiş, Halide Kaya doi: 10.5505/ktd.2018.57338 Pages 98 - 102 INTRODUCTION: The obstructive sleep apnea’s main risk factors include the male gender, old age, obesity, anatomical abnormalities and heredity. This study’s aim is to evaluate the relationship between age, gender and the severity of obesity with the apnea-hypopnea index (AHI). METHODS: 292 patients were studied retrospectively. Of these, 5 patients who were diagnosed with central sleep apnea were excluded from the study. Patients included in the study (n=287) were divided into subgroups according to Body Mass Index (BMI): BMI<25 kg/m² group 1 (regular); BMI 25-29.99 kg/m² group 2 (overweight); BMI 30-39.99 kg/m² group 3 (obese); BMI 40-49.99 kg/m² group 4 (morbid obese); and BMI≥50 kg/m² group 5 (super morbid obesity). BMI subgroups were compared in terms of AHI. Correlations between AHI, BMI subgroups, gender and age were evaluated statistically. Statistical analyses were carried out with the IBM statistical analysis package for the Social Sciences. RESULTS: The mean age of patients was 46.78±11.44 years. One hundred and ninety (66.2%) were males and ninety seven (33.8%) were females. The mean BMI and the mean AHI were found to be 31.94±6.61kg/m² and 28.48±30.27kg/m², respectively. Mean AHI value was significantly higher in men than in women (p=0,005). A significant correlation was found (p <0.001) between AHI and the BMI values and between AHI and age. There were statistically significant differences (p <0.001) in the AHI between BMI subgroups. DISCUSSION AND CONCLUSION: In this study, it was observed that the severity of OSAS increased as the obesity ranking based on the BMI increased. |
19. | Causes and prognostic Factors of epistaxis in children Nagihan Bilal, Can Acıpayam, İsrafil Orhan, Saime Sağıroğlu doi: 10.5505/ktd.2018.56933 Pages 103 - 108 INTRODUCTION: In our study it was aimed to evaluate the current approaches in pediatric patients and to identify the diseases that may cause etiology. In addition to determine the effect of allergy and rhinosinusitis on the duration of treatment with epistaxis and to emphasize the importance of hemogram and coagulation tests. METHODS: In this retrospective, clinical, cross-sectional study, a retrospective analysis was made of 101 pediatric patients who presented at the otorhinolaryngology polyclinic with a diagnosis of epistaxis between 2015 -2017. Data were retrieved from patient records of age, gender, duration of bleeding, the month of bleeding, the region of bleeding, the presence of infection, cauterisation, tampon, antibiotherapy, local treatment, duration of treatment, presence of allergy or additional disease, and haematology consultation. RESULTS: The total of 101 patients comprised 64 (63.36%) males and 37 (36.64%) females with a mean age of 10.02±4.35 years. The bleeding was on the right side in 38 (37.6%), on the left side in 31 (30.6%) and bilateral in 32 (31.6%) patients. The mean duration of treatment was 1.79±5.31 months in the patient group as a whole, 1.71± 3.83 months in those with infection and 3.05±3.57 months in those with allergic rhinitis. DISCUSSION AND CONCLUSION: This study demonstrated that the most common cause of epistaxis in children is due to infection. It has also been found that seasonal changes significantly affect the epistaxis and the use of silver nitrate cautery in pediatric patients is safe in the treatment of epistaxis. |
20. | Eculizumab Experince at a Patient With Atypical Hemolitic Uremic Syndrome İLTER BOZACI, Gökhan Temiz, İbrahim Vasi, Tugay Avcı doi: 10.5505/ktd.2018.82905 Pages 109 - 112 Thrombotic microangiopathy discribes a specific pathologic lesion in which abnormalities in the vessel wall of arterioles and capillaries lead to microvascular thrombosis. Microangiopathic hemolytic anemia is a descriptive term for non-immun hemolytic anemia resulting from intravascular red blood cell fragmentation that produces schistocytes on the peripheral blood smear. Atypical hemolytic uremic syndrome is a type of primer thrombotic microangiopathy and using eculizumab in the early phase of therapy reduces the risk of irreversible renal damage. We mentioned both the importance of early diagnosis at the patients presenting with microangiopathic hemolytic anemia and thrombocytopenia like our patient and the benefit of eculizumab therapy at the early phase of atypical hemolytic uremic syndrome therapy. |
21. | The Efficacy of Ultrasound to Evaluate The Neck Structures Before Tracheostomy and To Determine The Methods of Tracheostomy: Percutaneous or Surgical? Aykut Sarıtaş, Çiler Zincircioğlu, Pelin Uzun Sarıtaş, Uğur Uzun, Işıl Köse, Nimet Şenoğlu doi: 10.5505/ktd.2018.43760 Pages 113 - 118 INTRODUCTION: The aim of this study was to evaluate the influence of neck examination with ultrasound on making the decision of surgical tracheostomy or PDT and complication rates due to PDT. METHODS: This restrospective study was included 72 patients between 2015-2017 years. All the data was obtained by scanning from the electronic data base in Tepecik Training and Research Hospital. US was used to identify the position of the cricoid cartilages, trachea rings, thyroid and vascular structures. After the neck examination with US, surgical tracheostomy was decided on unsuitable cases. RESULTS: Tracheostomy decision was made to 72 patients with in 2 years. After the US neck examination, 13 patients (%18) underwent surgical tracheostomy. Surgical tracheostomy decision was made in 4 patients due to vascular structures, in 7 patients due to the difficulty of identifying tracheal rings and in 2 patients due to the thyroid gland. DISCUSSION AND CONCLUSION: US provides information regarding the anatomy of the neck region, including vascular structures. US examination of the neck is effective in reducing complications and determining percutaneous dilatational tracheostomy which may be difficult to perform. |
22. | Investigation of distortion product otoacoustic emission values in superior semicircular canal dehiscence Sanem Okşan Erkan, Zeynel Abidin Erkan, Birgül Tuhanioğlu, Nezahat Erdoğan, Semih Öncel doi: 10.5505/ktd.2018.29964 Pages 119 - 126 INTRODUCTION: Superior semicircular canal dehiscence has been found in patients with vertigo symptoms. Patients may have otophonia,conductive hearing loss,nistagmus with vertigo.Otoacustic emission is a non-invasive test used for monitoring cochlea function due to outer hair cell activity. In our study we investigated otoacustic emission results in superior semicircular canal dehiscence patients. METHODS: Patients were divided into two groups. Patients with unilateral superior semicircular canal dehiscence were compared with the opposite normal side of their ear, using distortion product and signal-noise ratio values at 1-8 kHz. Patients with bilateral semisircular canal dehiscence were compared with control group patient’s ears. RESULTS: Distorsion product otoacustic emission measurements and signal noise ratio values were significantly decreased at 1 kHz and 6 kHz in unilateral patients respectively(p<0.05),and significantly decreased at 1-6 kHz in bilateral superior semicircular canal dehiscence patients(p<0.05). DISCUSSION AND CONCLUSION: We showed the damage of the outer hair cell with emission measurements in superior semicircular canal dehiscence patients but we can not mention about its contribution to diagnosis. |
CASE REPORT | |
23. | A Rare Malign Tumor Of The Parotid Gland Lymphoepithelial Carcinoma: Case Report Eda Aydın, Aykut İkincioğulları, Süleyman Emre Karakurt, Nurcan Kum, Zekiye Orhan, Hüseyin Dere doi: 10.5505/ktd.2018.09779 Pages 127 - 130 Malign salivary gland tumors constitues %3 of all kinds of malign head and neck tumors. Among these tumors, which are relatively rare, lymphoepithelial carcinoma is the one that is extremely rare in histology and it has relation with Epstein-Barr Virus (EBV) positivity. In this presentation, we aim to present our diagnosis and treatment approach to a72 year-old male patient who has parotid lymphoepithelial carcinoma with a review of the literature. |
ORIGINAL ARTICLE | |
24. | Morphometric analysis of coracoid process and glenoid cavity in terms of surgical approaches: an anatomical study Sibel Cirpan, Goksin Nilufer Yonguc, Mustafa Güvençer doi: 10.5505/ktd.2018.50455 Pages 131 - 137 INTRODUCTION: In order to treat the recurrent shoulder dislocations surgically, the coracoid process (CP) transfer procedures are used to restore the native glenohumeral anatomy. The aim of this study is to measure the dimensions of the CP and the glenoid cavity (GC) and to evaluate the correlation between their measurements. METHODS: Sixty two adult dried human scapulae belonging to the Anatomy Department Laboratory of Dokuz Eylul University School of Medicine were examined macroscopically. The study parameters measured by using a digital caliper sensitive to 0.01 mm were as follows: the CP (length, heigth at the root,width at the tip and at the root), the GC (the superoinferior height and the widest antero-posterior diameter) and from the CP tip to the supraglenoid tubercle of GC. RESULTS: The mean length and width of the GC and root width, root height, tip width and length of the CP were measured as 37.27 ± 3.40 mm, 26.25 ± 3.04 mm, 13.98 ± 1.69 mm, 18.59 ± 2.55 mm, 13.95 ± 1.73 mm, 42.36 ± 4.28 mm, respectively. The distance between supraglenoid tubercle of GC and CP tip was measured as 27.56 ± 3.75 mm. DISCUSSION AND CONCLUSION: The dimensions of the CP may differ according to geographical differences. |