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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3
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Publication Metadata only Technical aspects and difficulties in the management of head and neck cutaneous malignancies in xeroderma pigmentosum(Korean Soc Plastic & Reconstructive Surgery, 2016) Sibar, Serhat; Fındıkçıoğlu, Kemal; Erdal, Ayhan Işık; Barut, İsmail; N/A; Özmen, Selahattin; Faculty Member; School of Medicine; Koç University Hospital; 125951Background Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment. Methods Between 2005 and 2015, 11 XP patients with head and neck cutaneous malignancies were included in this study. Demographic data and treatment options of the patients were evaluated. Results The mean age of the patients was 32 years (range, 10-43) (4 males, 7 females). The most common tumor type and location were squamous cell carcinoma (6 patients) and the orbital region (4 patients), respectively. Free tissue transfer was the most commonly performed surgical intervention (4 patients). The average number of surgical procedures was 5.5 (range, 1-25). Six patients were siblings with each other, 5 patients had local recurrences, and one patient was lost to follow-up. Conclusions Although genetic components of the disease have been elucidated, there is no definitive treatment algorithm. Early surgical intervention and close follow-up are the gold standard modalities due to the tendency toward rapid tumor growth and possible recurrence. Treatment must be individualized for each patient. In addition, the psychological aspect of the disease is an important issue for both patients and families.Publication Metadata only The clinical utility of a pulsed bipolar system and its electrosurgical device during total laparoscopic hysterectomy(Mary Ann Liebert, Inc., 2017) N/A; N/A; Mısırlıoğlu, Selim; Türkgeldi, Engin; Boza, Ayşen; Öktem, Özgür; Ata, Mustafa Barış; Urman, Cumhur Bülent; Taşkıran, Çağatay; Doctor; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 329649; N/A; 102627; 232576; 12147; 134190Objective: The aim of this research was to evaluate the efficacy and safety of the PlasmaKinetic (PK) PKS OMNI (R) (Gyrus ACMI, Maple Grove, MN) sealing device in laparoscopic hysterectomy. Materials and Methods: For this retrospective observational study, 60 patients who underwent multiport total laparoscopic hysterectomy between January 2014 and January 2015 in a tertiary-care university-based teaching hospital and an academically affiliated hospital were included in this study. The PKS OMNI is a bipolar electrosurgical device that takes energy from a PK generator workstation G400. This pulsed wave system has two different modes; cutting (High Cut 1,2,3) and coagulation (Vaporization 1,2,3). Results: Records of 60 patients were analyzed. The median age was 50 (range: ages 40-84), median body mass index was 26kg/m(2) (range: 22-32kg/m(2)), and median parity was 2 (range: 1-8). The median total operation time was 100 minutes (range: 70-240 minutes), estimated blood loss was 80mL (range: 30-250mL), and uterine weight was 207g (range: 50-900g). Degree of Surgical Difficulty and postoperative pain scores at rest were evaluated with a visual analogue scale system, from 0 to 10, and the medians of these scores were 5 (range: 3-7) and 4 (range: 2-6), respectively. The median recovery time of bowel movement was 16 hours (range: 8-26 hours), median spontaneous urination time was 7 hours (range: 4-29 hours), and median postoperative mobilization time was 8 hours (range: 6-10 hours). Conversion to laparotomy was needed in 1 patient due to severe pelvic adhesions. The median duration of hospital stay was 2 days (range: 2-4 days). Vaginal cuff dehiscence was detected in 1 (1.7%) patient who engaged in sexual intercourse on the 122nd day after surgery. Cuff cellulitis in 1 (1.7%) patient and unexplained fever in 1 (1.7%) patient were the other recorded complications. The median follow-up time was 12 months (range: 6-17 months). Conclusions: The PKS OMNI is a novel, underused energy modality that promotes quick recovery and acceptable operation time with minimal blood loss.Publication Metadata only The impact of breathing exercises quality of life and anxiety in asthma patients(Edizioni Minerva Medica, 2022) Baskan, Bura; Alptekin, Kerem; Alptekin, Julide Oncu; N/A; Özyiğit, Sabiha Leyla Pur; Doctor; N/A; Koç University Hospital; 214687BACKGROUND: The single-center and randomly assigned controlled experimental method was applied to the study. Two groups, a subject and control group, were formed. METHODS: Twenty patients, 10 in the control and 10 in the experimental group, followed by the American Hospital Adult Allergy and Immunology outpatient clinic were included in the study. Patients who were included in the control group (N. = 10) were asked to use the medication prescribed by their physicians regularly for one month and a reminder message was sent 3 days a week. In addition to medication treatments, respiratory exercise training was given to the experimental group (N. = 10). The subjects were asked to maintain the exercises for 20-30 minutes in the morning and evening for a month. A reminder message was sent 3 days a week. Asthma Quality of Life Questionnaire was employed to determine the Quality of Life of the subjects. The Asthma Control Scale was used for regular monitoring of patients and to determine asthma control levels. Beck Anxiety Scale was used to measure their anxiety levels. RESULTS: The data obtained as a result of the study indicate that there was a significant difference in Quality of Life scores before and after the study for the experimental group, F (1.9) =9,2, P4).014. There was no significant change in the control group, P=0.592. In addition, there was a significant decrease in activity limitation values (P=0.014) and symptoms (P=0.023) in the experimental group before and after the study. In the Asthma Control Assessment, the asthma control level of the experimental group increased significantly after the study (Mean=14.6) compared to the prestudy period (Mean=11.1). There was no significant difference in both groups in terms of evaluation of anxiety. CONCLUSIONS: The findings of the study show that the Quality of Life of asthma patients receiving breathing exercises increased compared to participants who did not receive breathing exercises. Besides. breathing exercises highlight a decrease in activity limitation and asthma symptoms. However, it is found that breathing exercises have no significant impact on anxiety.Publication Metadata only Non-vestibular schwannoma radiosurgery(S. Karger AG, 2019) Peker, Selçuk; Faculty Member; School of Medicine; Koç University Hospital; 11480There is a growing body of studies regarding the effects of Gamma Knife radiosurgery on vestibular schwannomas. However, due to their rare presence and variability, our experience with the management of non-vestibular schwannomas is relatively limited. Management strategies include radiological monitoring, microsurgical resection, microsurgery combined with radiosurgery, or upfront radiosurgery. The lack of large series and heterogeneous data makes it difficult to suggest a definitive treatment strategy and management should be tailored for each patient's radiological and clinical characteristics. Available data suggest that stereotactic radiosurgery, alone or combined with microsurgery, led to good outcomes with relatively low complication rates and constitutes an efficient treatment modality for patients with non-vestibular schwannomas. © 2019 S. Karger AG, BaselPublication Metadata only Comparison of long-term follow-up in patients with single or dual chamber pacemakers: is downtrodden or take its rightful place?(Edizioni Minerva Medica, 2019) Usalp, Songul; Demircan, Sabri; Baskurt, Murat; Kaplan, Ozgur; Canbolat, Ismail; Ciftci, Cavlan; Yazicioglu, Nuran; N/A; Yıldız, Ömer; Doctor; N/A; Koç University Hospital; N/ABackground: In this study, at a median follow-up of 7.9 years (3-22), the patients who had implanted either single chamber (VDD) or dual chamber (DDD) pacemakers were compared according to the changes in left ventricular function, pacemaker-related complications, and mortality. Methods: In between January 1985 and August 2016, a total of 1238 patients, who presented with a diverse set of clinical situations and had implanted a single or double chamber pacemaker were retrospectively included in the present study. Age, prior history of hypertension, diabetes mellitus, heart failure and coronary artery disease did not differ between the groups (P>0.05). Results: When pre-implantation echocardiographic data was compared to the post-implantation values, in both groups, there were a significant decrease in LVEF (P<0.001) and increase in LVEDD (P<0.001), LA size (P<0.001) and sPAP (P<0.008). Results: When the patients who had a pacemaker due to a complete AV block were analysed, regardless of having VDD or DDD pacemaker, a significant decrease in LVEF was observed (P<0.0001). When the current rhythm at the last visit was evaluated, we found that patients with VDD were mostly in sinus rhythm (P<0.001). During the long-term follow-up, pacemaker-related complications (tamponade, infection, and pneumothorax) did not differ between the two groups (P>0.05). The comparison of the two pacemaker groups according to the decline in LVEF (<=% 40) did not show any significant difference (P=0.122). Conclusions: Patients with VDD or DDD pacemakers have both a decline in LVEF and an increase in LV diameter during the long-term follow-up. Mortality and complication rates were not different between the two groups. When compared to the DDD group, left ventricular dimensions and functions were better preserved in VDD group.Publication Metadata only Comparison of resorbable mesh (Poly L-lactide/Glycolic acid) and porous polyethylene in orbital floor fractures in an experimental model(Sage, 2017) Aral, Ali Mubin; Kaya, Basar; Coskun, Neslihan; Omeroglu, Suna; Kilic, Koray; N/A; Özmen, Selahattin; Uygur, Halil Şafak; Faculty Member; Doctor; School of Medicine; N/A; N/A; Koç University Hospital; 125951; N/ABackground: Resorbable mesh and porous polyethylene are frequently used alloplastic materials for the treatment of the orbital blowout fractures. The literature lacks reports comparing their long-term effects on experimental models. Objective: Our aim was to radiologically and histologically evaluate the effectiveness and safety of porous polyethylene and resorbable mesh in a rabbit orbital blowout fracture model. Methods: Twelve New Zealand white rabbits (24 orbits) were randomized to 4 groups. In group 1, only orbital floor dissection was done. In group 2, following orbital floor dissection, a 10-mm defect was created without any extra procedure. In group 3, following a 10-mm defect creation, a 12-mm-round cut porous polyethylene was placed on the defect. In group 4, following a 10-mm defect creation, a 12-mm-round cut resorbable mesh was placed on the defect. Computed tomographic analysis was performed during follow-up period. Orbital floors were evaluated histologically at month 6. Results: No clinical complications were observed during follow-up period. In radiological evaluation, there was no statistically significant difference between groups regarding bone formation. In histological evaluation, the connective tissue was denser, and organized and better bone formation was observed in group 3 and 4 when compared with other groups. Conclusion: Although no significant radiological changes were present, porous polyethylene and resorbable mesh performed better histologically. They were effective and well tolerated for reconstruction of the isolated orbital floor defects.Publication Metadata only Surgical approaches for papillary microcarcinomas: Turkey's perspective(Aves, 2018) Makay, Özer; Ozdemir, Murat; Şenyürek, Yasemin Giles; Tunca, Fatih; Duren, Mete; Uludağ, Mehmet; Hacıyanlı, Mehmet; İçözz, Göokhan; İşgör, Adnan; Özbaş, Serdar; Özcan, Zehra; N/A; Tezelman, Tevfik Serdar; Faculty Member; School of Medicine; 114860Objectives: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of <10mm in size, has been increasing in the last decade. Herein, we present internet-based questionnaire results performed by the Turkish Association of Endocrine Surgery with the aim to evaluate the perspective of the management of papillary microcarcinomas in Turkey. Material and Methods: The user-friendly questionnaire consisted of 13 questions in total. These questions mainly addressed the surgical management of nodules and cancer of <1 cm in size. Patient management before, during, and after surgical intervention was also included; additionally, the "active surveillance approach" was questioned. Results: There were 420 responders in total who were of multidisciplinary origin (endocrinologists, surgeons, nuclear medicine specialists, pathologists, and oncologists). Total thyroidectomy was the predominant treatment approach (65%) for the classical type of microcarcinoma limited in one lobe, whereas in cases of microcarcinomas incidentally diagnosed during hemithyroidectomy, complementary surgery approach was advised by 40% of the responders. The responders found capsule invasion (86%) and patient based management (94%) of high importance. The percentage of the responders who recommended radioactive iodine ablation in incidental cancers having no aggressive criteria was 51%. The survey participants that were against routine central dissection in these cases accounted for 73% of the responders. The recommendation of active surveillance (follow-up without any interventional therapy) was limited with 9% responders. Conclusion: The results of the questionnaire demonstrated that there have been various choices in Turkey for the surgical treatment of the papillary microcarcinomas.