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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6
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Publication Open Access Liver transplantation in hepatic myelopathy(Kare Yayıncılık, 2022) Acar, Sencan; Dinçkan, Ayhan; Akyıldız, Murat; Faculty Member; School of Medicine; 123080Hepatic myelopathy (HMy) is a rare neurological complication of liver cirrhosis that involves spastic paraplegia caused by lateral cord demyelination especially due to the accumulation of some metabolites such as ammonia and manganese. We report a young adult woman presenting with spasticity and paraparesis in extremities after intrahepatic portosystemic shunting (TIPS) application and underwent deceased liver transplantation (LT). A 39-year-old woman underwent deceased LT because of cryptogenic liver cirrhosis. She underwent a TIPS procedure 5 years ago. After that, hepatic encephalopathy and spasticity appeared. She was on the waiting list for 3 years. Neurological findings after LT significantly decreased, but did not return to normal. After the emergence of neurological findings, the earlier LT can provide improvement in neurological findings.Publication Open Access Pneumonia in HIV-infected patients(Aves, 2016) Önür, Seda Tural; Dalar, Levent; Yalçın, Arzu Didem; İliaz, Sinem; Doctor; Koç University Hospital; 168584Acquired immune deficiency syndrome (AIDS) is an immune system disease caused by the human immunodeficiency virus (HIV). The purpose of this review is to investigate the correlation between an immune system destroyed by HIV and the frequency of pneumonia. Observational studies show that respiratory diseases are among the most common infections observed in HIV-infected patients. In addition, pneumonia is the leading cause of morbidity and mortality in HIV-infected patients. According to articles in literature, in addition to antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART), the use of prophylaxis provides favorable results for the treatment of pneumonia. Here we conduct a systematic literature review to determine the pathogenesis and causative agents of bacterial pneumonia, tuberculosis (TB), nontuberculous mycobacterial disease, fungal pneumonia, Pneumocystis pneumonia, viral pneumonia and parasitic infections and the prophylaxis in addition to ART and HAART for treatment. Pneumococcus-based polysaccharide vaccine is recommended to avoid some type of specific bacterial pneumonia.Publication Open Access Quadrant and dermatomal analysis of sensorial block in ultrasound-guided erector spinae plane block(Aves, 2022) Selvi, Onur; Tulgar, Serkan; Şerifsoy, Talat Ercan; Lance, Robert; Thomas, David Terence; Gürkan, Yavuz; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 154129Objective: as a novel procedure now gaining popularity, erector spinae plane block has been the subject of many studies. However, dermatomal coverage of the sensory block caused by erector spinae plane block has been rarely studied. The goal of this study is to evaluate the sensory block resulting from erector spinae plane block applied at the T9 vertebral level. Materials and methods: this observational, prospective, blinded study was conducted on 50 adult patients undergoing laparoscopic abdominal surgery. All patients underwent bilateral erector spinae plane block at the T9 level after completion of the surgery while under general anesthesia. In order to further evaluate the sensory blockade, we divided the hemiabdomen-hemithorax region into 4 quadrants: dorsal-medial, dorsallaterel, ventral-lateral, and ventral-medial. The sensorial evaluation was performed using the pinprick test, 2 hours following the application of erector spinae plane block. Results: a total of 28 female and 22 male patients were examined in this study. Complete failure of the block was recorded in 7 patients, with no thoracic/lumbar segmental or quadrant involvement. Successful sensory block was achieved in 67% of the dorsolateral quadrants, 58% of the dorsomedial quadrants, 69% of the ventrolateral quadrants, and 55% of the ventromedial quadrants. Conclusion: cutaneous sensory block of erector spinae plane block at T9 vertebral level revealed variable results and low failure rates. Administration of erector spinae plane block for postoperative analgesia in thoracoabdominal surgeries requires further randomized controlled trials to confirm its effectiveness and convenience.Publication Open Access Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy : a case report(Elsevier, 2016) Sağlıcan, Yeşim; N/A; N/A; N/A; N/A; Acar, Ömer; Sağ, Alan Alper; Falay, Fikri Okan; Selçukbiricik, Fatih; Tabak, Levent; Esen, Tarık; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; School of Medicine; 237530; N/A; N/A; N/A; N/A; N/A; 50536INTRODUCTION: Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. CASE PRESENTATION: A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the [18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. DISCUSSION: Late recurrence of RCC has been reported to occur in 10-20% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. CONCLUSION: To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnosticPublication Open Access High-throughput automated phenotyping of two genetic mouse models of huntington's disease(Public Library of Science, 2013) Oakeshott, Stephen; Shamy, Jul Lea T; El-Khodor, Bassem Fouad; Filippov, Igor V.; Mushlin, Richard A.; Port, Russell G.; Connor, David; Paintdakhi, Ahmad; Menalled, Liliana B.; Ramboz, Sylvie; Howland, David S.; Kwak, Seung; Brunner, Dani; Department of Psychology; Department of Psychology; Balcı, Fuat; Faculty Member; College of Social Sciences and Humanities; 51269Phenotyping with traditional behavioral assays constitutes a major bottleneck in the primary screening, characterization, and validation of genetic mouse modelsof disease, leading to downstream delays in drug discovery efforts. We present a novel and comprehensive one-stop approach to phenotyping, the PhenoCube™. This system simultaneously captures the cognitive performance, motor activity, and circadian patterns of group-housed mice by use of home-cage operant conditioning modules (IntelliCage) and custom-built computer vision software. We evaluated two different mouse models of Huntington's Disease (HD), the R6/2 and the BACHD in the PhenoCube™ system. Our results demonstrated that this system can efficiently capture and track alterations in both cognitive performance and locomotor activity patterns associated with these disease models. This work extends our prior demonstration that PhenoCube™ can characterize circadian dysfunction in BACHD mice and shows that this system, with the experimental protocols used, is a sensitive and efficient tool for a first pass high-throughput screening of mouse disease models in general and mouse models of neurodegeneration in particularPublication Open Access TFOS European Ambassador meeting: unmet needs and future scientific and clinical solutions for ocular surface diseases(Elsevier, 2020) Erickson, Susan; Sullivan, Ammy Gallant; Barabino, Stefano; Begovic, Enesa; Benitez-del-Castillo Jose M.; Bonini Stefano; Borges Jose Salgado; Brzheskiy, Vlademir; Bulat, Nina; Cerim, Alma; Craig, Jennifer P.; Cușnir, Valeriu Jr.; Cusnir, Valeriu; Cusnir, Vitalie; Doan Serge; Dülger, Erol; Farrant, Sarah; Geerling, Gerd; Goldblum, David; Golubev, Sergey; Gomes, Jose A.P.; González-Méijome, Jose Manuel; Grupcheva, Christina N.; Gündüz, Ömür Uçakhan; Horwath-Winter, Jutta; Källmark, Fredrik; Karanadze, Nino; Karcic, Huda Hajjir; Karcic, Suvad; Kontadakis, Georgious; Messmer, Elisabeth M.; Mrugacz, Malgorzata; Murphy, Conor; O'Leary, Olivia E.; Procopciuc, Vitalie; Pult, Heiko; Raus, Peter; Setälä, Niko; Stanila, Adrina; Stanila, Den Mircea; Utheim, Toor Paeske; Vehof, Jelle; Versura, Piera; Villani, Edoardo; Willcox, Mark D. P.; Wolffsohn, James S.; Zagórski, Zebigniew; Zoega, Gunnar Mar; Sullivan, David A.; Şahin, Afsun; Faculty Member; School of Medicine; 171267The mission of the Tear Film & Ocular Surface Society (TFOS) is to advance the research, literacy, and educational aspects of the scientific field of the tear film and ocular surface. Fundamental to fulfilling this mission is the TFOS Global Ambassador program. TFOS Ambassadors are dynamic and proactive experts, who help promote TFOS initiatives, such as presenting the conclusions and recommendations of the recent TFOS DEWS II™, throughout the world. They also identify unmet needs, and propose future clinical and scientific solutions, for management of ocular surface diseases in their countries. This meeting report addresses such needs and solutions for 25 European countries, as detailed in the TFOS European Ambassador meeting in Rome, Italy, in September 2019.Publication Open Access Interfascial plane blocks as shortcut alternatives for regional anesthesia and pain management for SARS-CoV-2 days: not deeper, not longer. Be safe for everyone(Elsevier, 2020) Tulgar, Serkan; Ahıskalıoğlu, Ali; Thomas, David Terence; Gürkan, Yavuz; Faculty Member; School of MedicinePublication Open Access Appropriate use of tocilizumab in COVID-19 infection(Elsevier, 2020) Keske, Şiran; Sait, Bilgin; Çimen, Cansu; Çelebi, İrfan; Palaoğlu, Erhan; N/A; Tekin, Süda; İrkören, Pelin; Kapmaz, Mahir; Ergönül, Önder; Uğur, Semra; Şentürk, Evren; Çakar, Nahit; Çağlayan, Benan Niku; Tabak, Levent; Bakır, Veli Oğuzalp; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Graduate School of Sciences and Engineering; N/A; N/A; N/A; 110398; N/A; 48359; N/A; 230719; N/A; N/AObjective: this study aimed to describe the effectiveness and optimum use of tocilizumab (TCZ) treatment by the support of clinical, laboratory and radiologic observations. Methods: all patients were followed up in the hospital with daily interleukin-6 (IL-6), C-reactive protein (CRP), ferritin, D-dimer, full blood count, and procalcitonin. Thoracic computed tomography (CT) was performed on admission, when oxygen support was necessary, and seven days after TCZ started. Disease course of the patients was grouped as severe or critical, according to their clinical, laboratory and radiologic evaluations. Results: forty-three patients were included: 70% were male; the median age was 64 years (minimum– maximum: 27–94); and six (14%) patients died. The median duration of oxygen support before the onset of TCZ was shorter among the severe patient group than the critical patient group (1 vs. 4 days, p < 0.001). Three cases of 21 (14%) who received TCZ in the ward were transferred to ICU, and none of them died. The levels of IL-6, CRP, ferritin, D-dimer, and procalcitonin were significantly lower in the severe cases group than the critical cases group (p = 0.025, p = 0.002, p = 0.008, p = 0.002, and p = 0.001, respectively). Radiological improvement was observed in severe cases on the seventh day of TCZ. Secondary bacterial infection was detected in 41% of critical cases, but none of the severe ones. Conclusion: earlier use of TCZ in COVID-19 infection was beneficial for survival, length of hospitalization and duration of oxygen support. The recommendation for administration of TCZ was based on an increase in requirement of oxygen support, progression in thoracic CT, and elevation of inflammation markers, including IL-6, CRP, ferritin, and D-dimer, and decrease in % lymphocytes.Publication Open Access Does resection of heterotopic ossification of the elbow result in satisfactory functional outcomes?(Galenos Yayınevi, 2019) Kapıcıoğlu, Mehmet; Sağlam, Yavuz; Ersen, Ali; Atalar, Ata, Can; Durmaz, Hayati; N/A; Demirhan, Mehmet; Faculty Member; School of Medicine; 9882Objective: heterotopic ossification (HO) is a common cause of elbow stiffness following surgical treatment of elbow trauma. In this study, our aim was to evaluate the mid-term functional outcomes of open surgical procedures for HO. Methods: in this retrospective study approved by the institutional review board (IRB), all patients who were diagnosed as having stiff elbow due to HO and underwent surgical resection at a single institution from 2006 to 2013 were included. Intrinsic (inside the joint) pathologies were excluded. Range of motion (ROM) in sagittal and coronal planes, complications, functional scores such as Quick Disabilities of the Arm, Shoulder and Hand Score (Q-DASH), and Mayo Elbow Performance Score (MEPS) were evaluated before and after surgery. Results: there were 19 patients (16 males, 3 females) with a mean age of 38.6 (range 15-69) years. At an average follow-up of 36 +/- 8 months, the mean flexion-extension arc was improved from 27.4 degrees to 99.2 degrees (p<0.001) and mean supination-pronation arc was improved from 48.9 degrees to 102.3 degrees (p<0.001). The mean Q-DASH score was decreased from 68.2 to 17.1 (p<0.001) and mean MEPS was improved from 37.5 to 85.6 (p<0.001). Conclusion: excision of heterotopic bone and releasing contracted tissues around elbow can provide a substantial increase in range of motion and improvement in clinical scores.Publication Open Access Views of Turkish people on oocyte and sperm donation(Çukurova Üniversitesi, 2019) Şenol, Derya Kaya; Yılmaz, Sema Dereli; Bal, Meltem Demirgöz; Beji, Nezihe Kızılkaya; Çalışkan, Seval; N/A; Urman, Cumhur Bülent; Faculty Member; School of Medicine; 12147Purpose: the aim of the study is to determine the views of the Turkish people on oocyte/sperm donation. Materials and methods: following informed consent, a questionnaire was given to women and their spouses who presented to obstetrics and gynecology outpatient clinics of a university hospital. The data collection form consists of 35 questions about the demographics of the participants and their thoughts about oocyte/sperm donation. A total of 428 women, including 323 women and 105 men, agreed to participate in the sampling study. Results: sixty-four-point three percent of the women and 71.4% of males found use of donated oocytes/sperms in infertile couples unacceptable. Sixty-three-point one percent of the participants said that both couples receiving, and those donating oocytes/sperms should get counseling. Twenty-one point-five percent of the participants approved of infertile couples' receiving oocytes/sperms donated by their relatives (e.g. sister) and friends and 31,8% agreed about getting them from strangers. Eighty-eight-point seven percent of the primary school graduates, 73.4% of the university graduates and postgraduates, 76.7% of the employed participants, 86.2% of the participants with an income lower than their expenses and 85.1% of the participants with live children reported to unaccept donated sperms if their spouses had a problem preventing them from having a child. Conclusion: more than half of the participants declared that it was not appropriate to have children through infertile-donated oocyte/sperm. / Amaç: bu çalışmanın amacı, Türk halkının oosit / sperm bağışı hakkındaki görüşlerini belirlemektir. Gereç ve Yöntem: tanımlayıcı kesitsel tipteki bu çalışma bir üniversite hastanesinin kadın hastalıkları ve doğum polikliniğine, kadınlar ve eşlerine veri toplama formu uygulanarak yürütüldü. Veri toplama formu katılımcıların demografik özelliklerine ve oosit/sperm bağışı hakkındaki düşüncelerine ilişkin 35 sorudan oluşmaktadır. Örnekleme çalışmaya katılmayı kabul eden 323'ü kadın, 105'i erkek toplam 428 kişi dahil edildi. Bulgular: kadınların %64.3’ü, erkeklerin %71.4’ü infertile çiftlerde bağışlanmış oosit/sperm kullanımını uygun bulmadığını belirtti. Katılımcıların %63.0’ü, oositler/sperm bağışçılarının ve bağışı kabul edenlerin danışmanlık alması gerektiğini söyledi. Uygun bulan kişilerin %21.5’i akraba (örneğin kızkardeşi) ve arkadaş tarafından yapılan oosit/sperm bağışını uygun bulurken, %31.8'i yabancılardan almayı uygun bulmaktadır. İlkokul mezunlarının %88.7’si, üniversite ve üzeri düzeyde mezunların %73.4'ü, çalışanların %76.7'si, gelirleri giderlerinden daha düşük olanların%86.2'si ve yaşayan çocuğu olanların %77,1'i eşlerinde çocuk sahibi olmayı engelleyen bir problem varlığında bağışlanan oosit/sperm yoluyla çocuk sahibi olmayı kabul etmeyeceklerini belirttiler. Sonuç: katılımcıların yarıdan fazlası, infertilitede bağışlanmış oosit/sperm yoluyla çocuk sahibi olmasını uygun bulmadığını beyan etmiştir.