Araştırma Makaleleri

Permanent URI for this collectionhttps://hdl.handle.net/11443/392

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Usual and Unusual Pathologies of Appendicitis: A Retrospective Analysis of 385 Patients
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Yardımcı, Veysi Hakan; Uras, Cihan
ABSTRACT Purpose: Appendectomy is the most common abdominal surgery performed worldwide. In this report, we evaluated the results of pathological examinations of acute appendicitis specimens. Methods: We performed a retrospective analysis of patients operated on for acute appendicitis at our surgical department from 2009 to 2017. Data on age, gender, and pathological diagnostic parameters were analyzed. Results: A total of 385 patients (168 women [43.6%] and 217 men [56.4%]), were classified into acute appendicitis (Group 1), normal appendix (Group 2), and unusual pathological findings (Group 3) groups. The patients undergoing appendectomy were mostly in the 21–30 (n = 136, 35.3%) and 31–40 years (n = 118, 30.6%) age groups. The negative appendectomy rate was 4.4% in Group 2, and the proportion of women (70.6%) was significantly higher in that group than the other groups (p <0.05). In total, 24 (6.2%) patients had unexpected findings. Among the appendix tumors (n = 12 [3.1%]) in our series, low-grade mucinous neoplasm (n = 6, 1.6%) was the most common, followed by a well differentiated neuroendocrine tumor (n = 3, 0.8%). Conclusion: Although unusual pathological findings are rare during appendectomy, all appendectomy specimens should be sent for routine histopathological examination. The abnormal incidental findings of 24 cases in this series had a significant impact on management. Patients with rare abnormalities should be treated according to the results of their pathological reports.
Transcriptomics Analysis of Nrf2 Regulators in Cancer Resistant and Long-Lived Naked Mole-Rats
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Bozaykut Eker, Perinur
ABSTRACT Purpose: Naked mole-rats (NMR, Heterocephalus glaber) have extreme resistance to cancer although they are known as the longest-living rodent with their 30-year maximum lifespan. Therefore, NMRs have rapidly emerged as a natural model for biomedical research. Studies have shown that NMRs can better tolerate stress due to mechanisms, such as upregulation of the Nrf2 pathway. Another mechanism proposed to contribute to their protection from stress involves stem cells. Therefore, in this study, we aimed to identify the regulation of Nrf2 signaling in NMR fibroblasts and induced pluripotent stem cells (iPSCs). Methods: The transcriptomics data of NMR and laboratory mice (Mus musculus) were used in the study. Particularly, the genes that are accepted as Nrf2 activators (Dpp3, Sqstm1, Palb2, Amer1, Mapk14, Trp53) and inhibitors (Keap1, Siah1, Btrc) were comparatively analyzed in fibroblasts and iPSCs of both species. Results: Our data demonstrated differentially expressed gene expressions between different cell types. Among target Nrf2 activators, Palb2 RNA expression was found to be increased significantly (p<0.0001) in NMR fibroblasts when compared to mouse fibroblasts. In addition, the expression of Palb2 was even more increased in NMR iPSCs when compared to NMR fibroblasts (p<0.0001). Conclusion: It was shown, for the first time, Palb2 could be partially responsible for the activation of Nrf2 pathway. These results contribute to literature on the stress resistance of the NMRs and its relationship with their superior features of aging and cancer.
Endonasal Dacryocystorhinostomy; the learning curve and our experience
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Emre, İsmet Emrah; Çelebi, Ali Rıza Cenk Çelebi
ABSTRACT Aim: It was aimed to give an insight on the learning curve adopted by an ophthalmic surgeon while performing endonasal dacryocystorhinostomy under the supervision of an otolaryngologist with the results experienced during this survey. Materials and Methods: In this retrospective study, consecutive cases with endonasal dacryocystorhinostomy (DCR) surgery were performed by a single ophthalmic surgeon while a second otolaryngologist was overlooking the procedures. A total of 29 surgeries were performed on 23 patients. Patients that were diagnosed with complete nasolacrimal duct obstruction were then evaluated and proceeded to the surgery. The intraoperative video was recorded in all surgical cases and recording time was noted for each case. All of the complications that occurred during or at the postoperative stages were noted. Results: The mean age of the 23 patients was 55.25±18.6 years (15 y-80 y), of which 20 cases (87%) were female. The left side was involved in 69% (20/29) of cases. At the final follow-up of the mean of 12,4 months, the anatomical and functional success was achieved in 89% (26/29) cases. The mean time spent in the operating theatre was 84±17.2 minutes (range, 40–110 min). It was found that the only 3 failed surgeries were in the first 5 surgeries performed with no surgical failure in the remaining 24 eyes. Conclusions: Endonasal dacryocystorhinostomy is a safe, effective and cosmetically pleasing surgery for the treatment of nasolacrimal duct obstruction. Although it has a somewhat longer learning curve than some surgeries, once handling of the endoscope has been mastered and familiarity with the surgical field is improved, the duration of the surgery will decrease significantly. We believe multidisciplinary coordination plays an important role in decreasing potential complication rates and also in perfecting the technique.
Effectiveness of Simulation-Based Cooperative Learning Method in Electrocardiography Education
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Uslu, Yasemin; Kocatepe, Vildan; Ünver, Vesile; Karabacak, Ükke
ABSTRACT Objective: The study was conducted to evaluate the effectiveness of basic electrocardiography education designed in accordance with the simulation-based cooperative learning method. Methods: This is a single group, quasi-experimental study. A two-day electrocardiography (ECG) education program was designed for the nursing internship (4th year) program (n=125). Data were gathered with pre-posttest, Students’ Satisfaction and Self-Confidence Scale, Simulation Design Scale and Educational Practices Questionnaire. Results: The knowledge pretest score and the knowledge posttest score averages of the students were 40.36±20.24 and 75.39±11.46 respectively, with a significant difference (p=.001; t=-14.78). The mean score for satisfaction with current learning was 4.77±.42 and the mean score for self-confidence was 4.51±.54. The mean total score for Simulation Design Scale was 4.44±.67 and the mean total score for Educational Practices Questionnaire was 4.66±.56. Conclusion: After simulation-based cooperative learning method, knowledge and skills of the students improved also had high self-confidence and satisfaction with learning.
Risk Factors Associated with Dysfunction of Permanent Tunneled Cuffed Hemodialysis Catheters; Single Center Experience
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Yıldız, Işıl
ABSTRACT Purpose: Permanent tunneled cuffed catheters are frequently preferred for hemodialysis in patients with chronic renal failure (CRF), but the factors associated with the dysfunction of these catheters are not well known. Our goal is to investigate these risk factors. Materials and Methods: All cases with a diagnosis of CRF and a permanent tunneled cuffed catheter inserted into the central vein for the first time in our radiology clinic between 2014 and 2019 and who developed catheter dysfunction were included in the study. Demographic and clinical data of the cases were obtained from file records. The relationship between the causes of catheter dysfunction and the presence of diabetes and hypertension was investigated. Results: Of the total 123 cases, 78 (63.4%) were male, 45 (36.6%) were female, the median age was 55 (28-78). Twenty-nine (23.6%) of the cases had thrombosis, 72 (58.5%) had venous stenosis and 22 (17.9%) had catheter dysfunction due to fibrin sheath. Dysfunction groups were compared with each other in terms of age, gender, duration of operation of the catheter, CRF etiology, comorbid diseases, the vein where the catheter was placed and the use of anticoagulants. The most important cause of catheter dysfunction in the early period was thrombosis (p = 0.003). When the causes of dysfunction were examined, the most common causes of dysfunction were venous stenosis in patients with hypertension, thrombosis in patients with diabetes as a concomitant disease without diabetes in the etiology of CRF, and thrombosis in patients with diabetes in CRF etiology (p <0.001). In addition, it was found that catheter dysfunction due to thrombosis developed less in patients using anticoagulants (p <0.001). There was no statistically significant difference between the groups in terms of other parameters (p> 0.05). Conclusion: The use of low-dose anticoagulants plays a protective role against thrombosis. The use of low-dose anticoagulants in patients without contraindications, especially in diabetic patients, may reduce especially early catheter dysfunction.
Sensitive Detection of Molecular Targets in Cancer by Minisequencing
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2021-12-01) Yüksel, Şirin K.; Akyerli, Cemaliye B.
ABSTRACT Purpose: Molecular alterations leading to specific mutations are essential for tumor development and survival. Accurate analysis of these molecular targets is important for diagnosis, early detection, forecasting of prognosis and aiding in the treatment of different cancer types. Therefore, for sensitive analysis of molecular markers, we aimed to optimize and use minisequencing protocols besides Sanger sequencing. Methods and Materials: Sanger sequencing and minisequencing were performed for IDH1 R132, IDH2 R140/R172 and TERT promoter C228/C250 mutations using genomic DNA isolated from glioma samples. Minisequencing reactions were performed with detection primers using SnaPshot Multiplex Ready Reaction Mix and run on an automated capillary electrophoresis. Multiplex peaks were analyzed with GeneMapper Software. Results: In the multiplex minisequencing analyses, peaks corresponding to wild type alleles and different mutations were detected. The presence of the peaks next to the wild type peaks points to the presence of variations in that location and the nature of the mutation can be identified according to the color. Conclusions: Identification of molecular markers in cancer is very important. Minisequencing is a reliable method for the detection of molecular targets.
Comparison of Laparascopic and Open Adrenalectomy
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2022-01-01) Dülgeroğlu, Onur; Sayın Gür, Emine Özlem; Durak, Evren; Tatar, Fatma; Akgül, Özgün; Kızıloğlu, İlker; Bilgiç, Tayfun; Kumkumoğlu, Yusuf; Hacıyanlı, Mehmet
ABSTRACT Purpose: Laparoscopic adrenalectomy, which was performed successfully for the first time in 1992, has become the preferred method in adrenal surgery especially in adrenal diseases. In this study, our aim is to compare the demographic and operative data of laparoscopic and open adrenalectomies performed in the general surgery clinic of our hospital. Methods: The records of the patients who were operated in hospital due to a surrenal mass between August 2006 and December 2012 have been retrospectively assessed. Demographic characteristics of the patients, such as age, sex, the size and location of tumors were included. Surgical indications were classified in terms of their radiologic and biochemical investigations. Type of the surgery (lateral transperitoneal laparoscopic or open approach), the incision used in these surgeries (midline, subcoastal and paramedian), the length of operation, the length of hospital stay, postoperative complications and the final pathology results were all examined. Results: During the afformentioned period, adrenalectomy was performed in 106 patients. Eighty of these patients (%75,4) were operated by open and 26 of them (%24,6) by lateral transperitoneal laparoscopic surgery. Subcostal incision was used 61 of 80 patients (% 82,4), whereas 17 patients (% 22,9) were operated by midline incision and 2(% 2,7) were by paramedian incision. No mortality was encountered. Operation time was statistically significantly shorter in the open group (p<0,0166). Duration of hospital stay was statistically significantly longer in open group (p<0,0083). Hospital stay time was statistically significantly longer in midline incision group (p<0,0083). Except for the weight of masses, statistically significant difference was not found between two groups (laparascopic and open surgery) in demographic and operative features (age,gender,side,pathological diagnose,size of mass) releated to postoperative complications. Conclusion: In carefully selected group of patients laparoscopic adrenalectomy offered lesser postoperative hospital stay than the open adrenalectomy. The longer operative time can be decreased when more experience is gained in laparascopic adrenalectomy. Laparoscopic adrenalectomy should be preferred in adrenal disease as the gold standard in centers with completed learning curve.