Araştırma Çıktıları
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Item Analysis of Cavernous Malformations: Experience with 18 Cases(TURKISH NEUROSURGICAL SOC, 2019-01-01) Haciyakupoglu, Ersin; Yilmaz, Dervis Mansuri; Kinali, Burak; Akbas, Tugana; Haciyakupoglu, SebahattinAIM: To analyze the results of stereotactic radiosurgery (SRS) or surgical treatment of 18 cases with cavernous malformation and report 2 cases with unusual localization and size. MATERIAL and METHODS: We present 11 and 8 patients who underwent surgery and SRS between 2010 and 2018 respectively. The operated group comprised six men and five women (mean age, 33.6 years). SRS was performed in five men and three women (mean age, 33.3 years). All patients were diagnosed and followed-up with magnetic resonance imaging. Stereotactic navigation was not used for lesion localization. The lesion, including the area with hemosiderin, was easily excised using microsurgical approach. RESULTS: Except for recurrent headache, all symptoms of patients who underwent surgery resolved rapidly. Hemorrhage developed in two of our patients after SRS. One of them refused to undergo surgery and recovered completely with steroid therapy, whereas the other underwent surgery after detection of cavernous malformation at the posterior fossa, with a dimension of 26.8x26.2 mm and occluding the fourth ventricle. CONCLUSION: In patients without significant preoperative morbidity risk, surgical excision is the gold standard of treatment. SRS is performed in surgically inaccessible, deeply located, multiple cavernous malformations in the brain stem and eloquent area. Of note, giant aneurysm is defined as an aneurysm with a diameter of at least 25 mmItem Bilateral recurrent external obturator muscle hematoma: An unusual cause of pelvic pain in hemophilia(SPANDIDOS PUBL LTD, 2016-01-01) Arpaci, Taner; Sasmaz, Ilgen; Akbas, Tugana; Eken, Alper; Ozgur, Anil; Antmen, BulentFollowing joint hemorrhages, intramuscular hemorrhages are the second most prevalent bleeding pattern in hemophiliac patients. Hematomas of the iliopsoas muscle are a well-known complication of hemophiliaItem Recurrent chronic subdural hematoma: Report of 13 cases(DE GRUYTER POLAND SP ZOO, 2018-01-01) Haciyakupoglu, Ersin; Yilmaz, Dervis Mansuri; Kinali, Burak; Arpaci, Taner; Akbas, Tugana; Haciyakupoglu, SebahattinChronic subdural hematoma is a frequent type of hemorrhage, which terminates with mortality if not diagnosed and treated early. The aim of this clinical study is to evaluate the patients with unilateral and bilateral recurrent chronic subdural hematoma. The study group consisted of 13 cases with unilateral and bilateral recurrent chronic subdural hematomas who underwent aggressive wide craniotomy, duraectomy, inner and outer membranectomy, dural border coagulation, incision through cortical vein trace and hang up of dural edge, between 2009 - 2016. All of our patients were diagnosed by preoperative Magnetic Resonance Imaging. We evaluated the age, gender, complaints and neurologic signs, localization and thickness of the hematoma. We can estimate that wide craniotomy, duraectomy and membranectomy is a good option in preventing recurrent chronic subdural hematoma and complications.Item Primary pericardial extragastrointestinal stromal tumor: A case report and literature review(SPANDIDOS PUBL LTD, 2015-01-01) Arpaci, Taner; Tokat, Fatma; Arpaci, Rabia Bozdogan; Akbas, Tugana; Ugurluer, Gamze; Yavuz, SinanGastrointestinal stromal tumors (GISTs) are the most prevalent mesenchymal tumors of the gastrointestinal tract. GISTs are considered to originate from the interstitial cells of Cajal, the pacemakers of the peristaltic activity of the gastrointestinal tract. More than 95\% of GISTs express KIT protein and discovered on GIST-1. GISTs may also be encountered in locations outside the gastrointestinal tract, in which case they are referred to as extra-GISTs (EGISTs) and often behave more aggressively. This is the case report of a primary pericardial EGIST in a 53-year-old male patient, confirmed by immunohistochemistry. To the best of our knowledge, this is the third case of EGIST diagnosed above the diaphragm, without being associated with the esophageal wall. Two cases of primary EGIST arising from the pleura were reported previously. In addition, this is the first reported case of an EGIST originating from the pericardium.Item Safety, efficacy and outcomes of the new GreenLight XPS 180W laser system compared to the GreenLight HPS 120W system for the treatment of benign prostatic hyperplasia in a prospective nonrandomized single-centre study(CANADIAN UROLOGICAL ASSOCIATION, 2015-01-01) Eken, Alper; Soyupak, Bulent; Acil, Meltem; Arpaci, Taner; Akbas, TuganaIntroduction: We compare and evaluate the safety, efficacy, and short-term outcomes of the new GreenLight XPS 180W (GL-XPS) laser system with the former generation GreenLight HPS 120W (GL-HPS) system for the treatment of benign prostatic hyperplasia (BPH) in a prospective nonrandomized single-centre study. Methods: From May 2012 to June 2013, 161 consecutive patients with lower urinary tract symptoms secondary to BPH were included: 88 patients were treated with the GL-HPS system and 73 were treated with the GL-XPS system. The perioperative variables International Prostate Symptom Score (IPSS), quality of life (QOL), and maximum flow rate (Qmax) were recorded at baseline, at one month and 6 months. Serum prostate-specific antigen (PSA) was assessed at baseline. Results: The mean age was 70.2 years in the GL-HPS group and 68.6 years in the GL-XPS group. Prostate volumes were 62.3 mL and 61.3 mL, respectively. Both groups showed significant postoperative improvement in the IPSS, QOL, Qmax variables compared to baseline levels. There were no significant differences in improvement in IPSS and QOL between groups. However, both operating and catheterization times were shorter in patients in the GL-XPS group. The overall postoperative complication rate was similar in both groups. Conclusion: Both GreenLight systems provide safe, effective tissue vaporization with significant clinical relief of BPH obstruction. The GL-XPS system appears more favourable with regard to reduced operating and hospitalization time, suggesting more cost-effective and efficient tissue removal.Item Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation(AVES, 2017-01-01) Arpaci, Taner; Ugurluer, Gamze; Ispir, Emine Burcin; Eken, Alper; Akbas, Tugana; Serin, MeltemObjective: The aim of this study was to determine whether significant fiducial marker migration occurs between the periods of prostatic marker insertion and computed tomography (CT) performed for radiotherapy planning and if a waiting period is necessary. Material and methods: Thirty-nine patients with prostate adenocarcinoma underwent fiducial marker insertion before radiotherapy between June 2013 and December 2015. Three markers were inserted by one radiologist under the guidance of transrectal ultrasonography. All patients underwent CT three hours after insertion to confirm the number and position of fiducial markers. Radiotherapy planning CT was performed on an average of 11 days (range 7-20) after insertion. CT images were imported into treatment planning system to analyze the position of fiducial markers. Point-based marker match algorithm was used to find the distance of marker migration. The mean and maximum distances between each fiducial markers were calculated. Results: The mean distance of migration was 1.029+/-0.42 mm (range 0.23-1.93 mm) and the maximum distance was 1.361+/-0.59 mm (range 0.25-2.74 mm). The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, prostate specific antigen level and Gleason score. Conclusion: According to our results significant fiducial marker migration did not occur during the interval between insertion and treatment planning CT. It should be taken into consideration that performing simulation on the same day as marker insertion might prevent increased cost and delayed radiation therapy by saving the patients from extra visits to the clinic.Item Clinical and radiological features of COVID-19 infection in pediatric hematology-oncology and transplant patients(CUKUROVA UNIV, FAC MEDICINE, 2022-01-01) Aygunes, Utku; Karagun, Barbaros Sahin; Sasmaz, Hatice Ilgen; Akbas, Tugana; Antmen, BulentPurpose: The goal of this study is to explain the characteristics of COVID-19 in this demographic, as well as the impact it had on pediatric cancer care during the pandemic. Materials and Methods: Fifteen COVID-19 patients diagnosed were studied retrospectively. Clinical, laboratory and radiological data were collected in relation to 15 patients under the age of 18 who tested positive for SarsCoV-2. Results: Of the 12117 pediatric hemato-oncological patients tested for COVID-19, 1125 patients showed symptoms, and 14 tested positive. The majority of cases suffered minor illnesses. A total of ten children required inpatient care, five needed oxygen support, and four required mechanical ventilation and later died. It was noted that the duration of real-time polymerase chain reaction (RT-PCR) positivity was prolonged in patients receiving intensive chemotherapy and/or immunosuppressive therapy. Patients' chemotherapy was delayed in all 15 (100\%) Sars-CoV-2-positive patients. Although changes visible on chest computed tomography (CT) imaging of children were mainly milder than in adults, radiological findings were more severe in patients who received relatively intensive cancer treatment. Conclusion: Children who have been treated for cancer or who have undergone a hematopoietic stem cell transplantation (HSCT) may be at greater risk of severe COVID-19 and should be under constant observation.