Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences

Permanent URI for this collectionhttps://gcris3.etu.edu.tr/handle/20.500.11851/707

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Acute Clouding of a Trifocal Intraocular Lens During Implantation: a Case Report
(Elsevier Inc., 2022) Özülken, Kemal; Gokce S.E.; Tekin K.
Purpose: In this paper, we present a case of acute clouding of a trifocal intraocular lens (IOL) that resolved spontaneously by the day after surgery. Observations: A 68-year-old woman with a nuclear cataract in the right eye was scheduled for cataract surgery with +21.00 diopter trifocal IOL (AT LISA tri 839MP, Carl Zeiss Meditec AG, Germany) implantation. Phacoemulsification was uneventful until the implantation of the IOL. Although the IOL was initially transparent, we observed acute clouding of the IOL optic immediately upon implantation into the eye, and the IOL remained cloudy at the end of the surgery. On the day after surgery, we observed that the clouding was completely resolved. Conclusions and Importance: We think that the sudden temperature change of the IOL upon implantation into the anterior chamber may have caused acute clouding. If a similar situation is encountered, clinicians should avoid explantation or replacement of the Zeiss AT LISA trifocal IOL, as the clouding resolves spontaneously. © 2022
Additive Effect of Topical Nepafenac on Mydriasis in Patients With Diabetes Mellitus
(Eye and Contact Lens Association (ECLA), 2020-08) Kızıltoprak, Hasan; Koç, Mustafa; Yetkin, Esat; Tekin, Kemal; İnanç, Merve; Özülken, Kemal
OBJECTIVES: To evaluate the additive effect of topical nepafenac on pupil diameter (PD) in patients with diabetes mellitus (DM) and cataract. METHODS: This prospective comparative study included the patients having cataract surgery with and without DM. Two consecutive PD measurements were taken using an automatic quantitative pupillometry system (MonPack One, Metrovision). A baseline measurement was taken, then one drop of nepafenac % 0.1 (Nevanac; Alcon, Fort Worth, TX) was instilled only to the eye that will be operated on (study eye). Cyclopentolate 1.0% (Sikloplejin; Abdi İbrahim, İstanbul, Turkey) was instilled to both eyes (study eye/fellow eye) 5 minutes later. The second measurement was taken at 1 hour after this application. RESULTS: The DM group consisted of 43 patients, and the control group consisted of 39 participants. The baseline PDs of both eyes were similar in the DM group (P=0.070) and the control group (P=0.345). The change in pupil size from baseline to mydriasis was statistically significantly greater in the study eyes (2.69±0.53) than fellow eyes (2.54±0.61) in the DM group (P=0.009), but there was no statistically significant difference in the control group (2.94±0.63 vs. 2.86±0.58). When the groups were compared, the PD changes were similar in the study eyes between groups (P=0.065), while the PD changes in the fellow eyes were lower in the DM group (P=0.017). CONCLUSIONS: Nepafenac has been shown additive effect on pupil dilation in diabetic patients before cataract surgery.
Citation - WoS: 13
Citation - Scopus: 15
Adherence To Glaucoma Medication, Illness Perceptions, and Beliefs About Glaucoma: Attitudinal Perspectives Among Turkish Population
(Sage Publications Ltd, 2021) Güven, Soner; Koylu, Mehmet Talay; Mumcuoğlu, Tarkan
Purpose: To evaluate the topical glaucoma eye drops adherence prevalence and its association with beliefs and illness perceptions about glaucoma in Turkey. We also aimed to explore the factors linked to patients' total, voluntary, and involuntary non-adherence to medication in different patient attitudes. Material and Methods: A prospective study with cross-sectional design which included a total of 317 glaucoma patients who completed questionnaires. We assessed the adherence to medication, illness perceptions, and the beliefs about the glaucoma treatment by the "Reported Adherence to Medication scale," "the Brief Illness Perception Questionnaire," and "the Beliefs about Medicine-Specific Questionnaire," respectively. According to the RAM scale, voluntary and involuntary non-adherence scores were also distinguished. Different adherence categories in RAM scale were compared with perception and belief measures. Patient attitudes were assessed from the BMQ. We also performed attitudinal type comparisons with different adherence groups. Results: The full adherence prevelance to glaucoma medication was 40%. The proportion of voluntary and involuntary non-adherence was 26% and 57%, respectively. The adherence groups were similar in terms of belief measures but statistically different according to illness perceptions (consequences (p = 0.002), timeline (p = 0.008), personal control (p = 0.001), identity (p = 0.019), concerns (p = 0.003)), and attitude types (ambivalent (p = 0.030) and accepting (p = 0.029)). Conclusion: New strategies are required to improve patient adherence to glaucoma medication in Turkey. The beliefs about the glaucoma treatment and illness perceptions are also needed to be enhanced.
Citation - WoS: 5
Citation - Scopus: 6
Alterations in the Choroidal Thickness and Retinal Vascular Caliber in Keratoconus
(Springer, 2023) Aksoy Aydemir, Gozde; Ozkoyuncu Kocabas, Dilara; Aydemir, Emre; Bayat, Alper Halil; Cinar, Serife Sule; Karadag, Ayse Sevgi
Purpose To compare the choroidal thickness (CT) and retinal vascular caliber in the differentiation of patients who have keratoconus (KC) from those of astigmatic and normal patients. Methods This was a prospective, cross-sectional study. A total of 72 patients who had KC, 70 who had astigmatism, and 83 healthy control subjects were enrolled in this study. All the patients were examined using the Sirius topography system and spectral domain optical coherence tomography with enhanced depth imaging. Using the digital fundus photographs, the retinal vascular calibers were calculated. The measurements were also analyzed between the KC stages according to the Amsler-Krumeich classification. Results The CT measurements were significantly higher in the KC group, when compared with the other 2 groups, in each location (P < 0.05). No statistically significant difference was observed with regards to the central retinal artery equivalent (CRAE) values (P = 0.959), while significant differences were noted in the central retinal vein equivalent (CRVE) among the groups (P = 0.011). Significant increases were noted in the CT as the stage of KC progressed, except at temporal 3000 mu m (P = 0.603). No statistically significant difference was observed with regards to the CRAE among the stages (P = 0.901). However, the CRVE changes increased remarkably as the stages advanced (P < 0.001). Conclusion The patients who had KC seemed to have a thicker CT and higher CRVE values than the healthy individuals, and these differences were progressively increased as the stages of KC advanced. Reflecting the vascular effects of inflammation, the high CRVE supported theories based on the inflammatory component of KC.
Anesthesia Management for Craniosynostosis Surgery
(Anestezi Dergisi, 2022) Özlü, O.
Craniosynostosis is premature fusion of one or more cranial sutures. In isolated craniosynostosis, surgical procedures are applied to ensure normal brain development and normal cognitive functions, to correct cosmetic deformities in order to prevent psychosocial negative consequences. The fact that they are mostly infants, combined with significant blood loss in the perioperative period, makes these cases challenging for the anesthetist. Ensuring airway safety, coping with metabolic complications related to blood transfusions and infusion of electrolyte fluids, preventing hypothermia, postoperative pain management, treatment of nausea and vomiting are the main subjects of anesthesia management. Excellent results can be obtained with proper preoperative planning, monitoring and timely blood and fluid infusion. © 2022 Anestezi Dergisi. All rights reserved.
Citation - WoS: 11
Citation - Scopus: 5
Assessment of Corneal Endothelial Cell Morphology and Anterior Segment Parameters in Covid-19
(Sage Publications Ltd, 2022) Oren, Burak; Özkoyuncu Kocabaş, Dilara
Background: The ocular manifestations of the 2019 novel coronavirus disease (COVID-19) vary from acute follicular, pseudomembranous, and hemorrhagic conjunctivitis to keratoconjunctivitis with subepithelial infiltrates and dendritic lesions. Similar to other respiratory viruses, such as adenoviruses, it is thought that COVID-19 may impact the cornea. However, its impact on the cornea and anterior segment parameters are currently poorly understood. Objective: This study aims to assess the corneal endothelial cell morphology and anterior segment parameters in patients who have recovered from COVID-19. Methods: In this cross-sectional study, the COVID-19 group comprised 34 patients who had been diagnosed with and recovered from COVID-19, while the control group comprised age- and sex-matched individuals without any systemic or ocular diseases. The endothelial cell density (ECD), coefficient of variation (CV) of cell area, hexagonal cell percentage (HEX), anterior chamber depth (ACD), central corneal thickness (CCT), horizontal anterior chamber diameter (HACD), iridocorneal angle (ICA), horizontal visible iris diameter (HVID), pupillary diameter (PD), and keratometry values (K1 and K2) were analyzed for each participant. The differences in each of these between the groups were analyzed using either an independent samples t test or a Mann-Whitney U test based on the normality of the data. Results: Regarding corneal endothelial cell morphology, the ECDs for the COVID-19 and control groups were 2278.50 +/- 186.78 cells/mm(2) and 2420.15 +/- 222.25 cells/mm(2), respectively (p = 0.002). A significant increase was noted in CV values in the COVID-19 group compared with the control group (p <0.001). The HEX values for the COVID-19 and control groups were 56.26 +/- 5.75 and 61.50 +/- 3.63, respectively (p < 0.001). Regarding the anterior segment parameters, no significant differences were observed between the groups (p> 0.05). Conclusions: It was hypothesized that individuals who had recovered from COVID-19 would demonstrate a reduction in their endothelial functional preserves. A decrease in ECD and HEX and an increase in CV were observed in the individuals during their early post-recovery period from COVID-19.
Citation - WoS: 2
Citation - Scopus: 2
Assessment of Tear Meniscus Dimensions Using Anterior Segment Optical Coherence Tomography in Vitamin D Deficiency in a Pediatric Population
(Georg Thieme Verlag Kg, 2023) Ören, Burak; Erboğa, Çağlar; Kocaay, Funda; Öztürk, Yücel; Bilak, Şemsettin; Özkoyuncu Kocabaş, Dilara; Ballı, Hacı
Background To investigate of the effect of vitamin D (Vit-D) deficiency on the tear film in children and compare it with that of healthy subjects.Methods This prospective and cross-sectional study comprised 75 eyes of children who had Vit-D deficiency (Group 1) and 85 eyes of age- and gender-matched healthy children (Group 2). The tear-film break-up time (TF-BUT) and Schirmer test values, as well as the Ocular Surface Disease Index (OSDI) scores, were recorded for the participants in all groups. Measurement of the tear meniscus area (TMA) and tear meniscus height (TMH) was performed 2 times in the same day via the use of anterior segment-optical coherence tomography (AS-OCT).Results The mean age of the participants in Group 1 was 12.42 +/- 3.40 years, while in Group 2, it was 12.59 +/- 2.32 years (p = 0.758). Group 1 comprised 43 females and 32 males, while Group 2 comprised 44 females and 41 males (p = 0.250). The mean TMH, TMA, and Schirmer test values were found to be significantly lower in children with Vit-D deficiency (Group 1) than in healthy children (Group 2), with p < 0.05 for all the values. It was concluded that there was no significant difference in the values for the mean TF-BUT and OSDI scores (p = 0.029 and p = 0.596, respectively).Conclusion The children with Vit-D deficiency exhibited lower TMH, TMA, and Schirmer test values. The alterations that were observed in these parameters were more prominent in the participants who had lower Vit-D levels.
Citation - WoS: 33
Citation - Scopus: 33
Associations Between Risk Factors and Developmental Dysplasia of the Hip and Ultrasonographic Hip Type: a Retrospective Case Control Study
(2019) Ömeroğlu, H.; Akceylan, A.; Köse, N.
Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened.
Citation - Scopus: 1
Asymmetric Z-Plasty for Telephone Deformity in Prominent Ear Correction
(Lippincott Williams & Wilkins, 2014) Uysal, Afşin; Uysal, Çağrı A.; Çöloğlu, Harun; Borman, Hüseyin
There have been plenty of surgical techniques for the correction of prominent ears. "Telephone deformity" or "reverse telephone ear" has been described as the undesired result of the inappropriate correction of the prominent ear, mainly the deficient correction of the lobule. We have performed an asymmetric Z-plasty to the lobule to overcome this deformity not only by excision of the excess skin but also by transposition of the soft tissue. Between 2005 and 2011, the technique currently described was performed in 19 patients. Preoperative, intraoperative, and postoperative standardized photographs were taken, and measurements were done on postoperative first week, first month, and first year. The measurements include ear height at 3 different horizontal planes as follows: (1) the most cranial point of the ear, (2) the middle point of the ear, and (3) the most caudal point of the ear. The angle between the vertical plane of the head and the ear was measured at these previously defined 3 points. These measurements were used for indication and preoperative planning. There were statistically significant differences between preoperative and postoperative values (P < 0.05). The postoperative first year results indicated the effectiveness of this alternative technique for the long-term maintenance of the position of the lobule.
Citation - WoS: 27
Citation - Scopus: 32
Basic Principles of Fracture Treatment in Children
(2018) Ömeroğlu, Hakan
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.
Beta-Catenin or Pax 2. Which One Is More Useful in Endometrial Cancer?
(Bayrakol Medical Publisher, 2021) Kahraman, Devrim
Aim : Pax 2 is a nuclear transcription factor. It is essential for the embryonic development of Mullerian organs and is suppressed through at later stages of embryonic development, but is reactivated during carcinogenesis. Beta-catenin is a protein that is translocated from membrane to cytoplasm and nucleus in WNT activation as a signaling pathway. Endometrioid carcinoma is associated with beta-catenin mutations. This study aimed to evaluate PAX2 and Beta-catenin expressions in benign and precancerous endometrial hyperplasias. Material and Methods: The study was performed on 40 endometrial curettage materials, including benign endometrial hyperplasia (n: 20), precancerous endometrial hyperplasia (n: 10), and endometrioid carcinoma (n: 20) as study groups. For immunohistochemical evaluation, one representative paraffin block for each case was selected. Results: Pax 2 nuclear staining was detected in all endometrial tissues. The mean percentage was % 70 in benign hyperplasia and % 90 in precancerous endometrial hyperplasia and endometrioid carcinoma. Beta-catenin membranous-cytoplasmic staining was detected in only precancerous endometrial hyperplasia with a percentage of % 80 and endometrioid carcinoma with a percentage of % 90. Discussion: Pax 2 is expressed in benign endometrial hyperplastic, precancerous endometrial hyperplasia and carcinoma, but beta catenin is expressed in only precancerous endometrial hyperplasia and carcinoma. These findings suggest that both the WNT signaling pathway and PAX 2 transcription factor may contribute to the development of endometrial cancer.
Citation - WoS: 1
Citation - Scopus: 2
Black Aorta in a Patient With Alkaptonuric Ochronosis
(Turkish Soc Cardiology, 2012) Tosya, Alper; Coşkun, Pınar Köksal; Uymaz, Barış; Tarcan, Onurcan; Aybek, Tayfun
[No abstract available]
Citation - WoS: 6
Citation - Scopus: 9
Botulinum Toxin Type a Injection Increases Range of Motion in Hip, Knee and Ankle Joint Contractures of Children With Cerebral Palsy
(TURKISH JOINT DISEASES FOUNDATION, 2019) Aktaş, Erdem; Ömeroğlu, Hakan
Objectives: This study aims to evaluate the clinical outcomes of children with spastic type cerebral palsy (CP) treated with botulinum toxin type A (BoNT-A) injection for lower limb contracture and the influence of age, gender, functional level and degree of initial contracture on treatment outcomes. Patients and methods: Clinical records at pre-BoNT-A injection and post-BoNT-A injections of 153 sessions of a total of 118 consecutive children (67 boys, 51 girls; mean age 5.9 +/- 2.6 years; range, 2.5-16 years) were retrospectively evaluated. Degrees of pre- and post-injection contracture were evaluated. Post-injection supplemental casting for 10 days was recorded in all cases. Less than 20 degrees of hip flexion contracture, more than 30 degrees of hip abduction, a negative prone Ely test, less than 50 degrees of popliteal angle and at least 5 degrees of ankle dorsiflexion values at post-injection were accepted as sufficient clinical improvement. Results: Sufficient post-injection range of motion (ROM) was observed in 80% of cases with hip flexion contracture, in 45% of cases with hip adduction contracture, in 84% of cases with knee flexion contracture and in 77% of cases with ankle equinus contracture. Prone Ely test that was positive in 60% of cases with knee extension contracture was negative at post-injection. Improvement in contractures were prominent in children with lesser degree initial contractures. Conclusion: Botulinum toxin type A injection increases ROM in hip, knee and ankle joint contractures in CP. Although age, gender and functional level may influence the clinical outcomes, pre-treatment level of contracture is the main determinant in improvement in ROM at post-injection.
Carotid Endarterctomy Surgery Results, a Yozgat Based Study
(2021) Er, Zafer Cengiz; Atılgan, Kıvanç; Zekey, Fethi Sada
Objectives: We aimed to present the examination of the results of patients who underwent carotid endarterctomy due to carotid artery stenosis and to compare our experience with the literature. Methods: Thirty five patients who underwent carotid endarterctomy at Bozok University hospital between January 2013 and March 2020 were included in the study. Etiology, concomitant diseases, anesthesia type, surgery and postoperative complications were evaluated retrospectively. Results: The mean age of the patients was 68±4.2. Of the patients, 27 were male and eight were female respectively. Right carotid endarterectomy was performed in 19 (54.28%) patients and left carotid endarterectomy in 16 (45.71%) patients. Thirty patients underwent surgery with general anesthesia and five patients underwent regional anesthesia. No mortality was observed. The records of complications were as follows; transient ischemic attacks in four patients (11.42%), difficulty in swallowing in two patients (5.71%), wound infection that improved with medical treatment in one patient (2.85%) and hematoma in three patients (8.57%) respectively in postoperative early period. Conclusion: Carotid endarterctomy is a surgery that can be performed with low mortality and morbidity when following the principles coming from the past and present.
A Case of Cavernous Hemangioma in the Right Ventricular Outflow Tract
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Bulut, Asiye Şafak; Aybek, Tayfun; Tarcan, Onurcan; Günaydın, Gülser
Primary cardiac tumors are very rare and myxomas constitute most of them. Hemangiomas are even rarer. As most of cardiac hemangiomas are asymptomatic, they are generally incidentally detected in postmortem examination or imaging studies. Echocardiography is the preferred imaging modality for the clinical diagnosis in symptomatic patients, while the definitive diagnosis is based on histopathological examination. Treatment is surgical excision of the tumor. As there is a risk of recurrence for incompletely resected tumors, particularly, postoperative follow-up is necessary. In this article, we report a rare cardiac cavernous hemangioma case with remarkable features including symptomatic profile of the patient, localization of the tumor in the right ventricular outflow tract and its macroscopic appearance mimicking myxoma. The patient is followed uneventfully.
Citation - WoS: 1
Citation - Scopus: 2
A Case Report of a Unique Aorto-Bifemoral Graft Infection and Its Treatment
(Oxford University Press, 2020) Uslu, H.Y.; Kurt, H.
In this study, we report a unique case of aorto-bifemoral graft infection, which developed in a 47-year-old male patient after endovascular aortic aneurysmal repair (EVAR) and extra anatomic axillo-femoral bypass. The patient had previously been treated by EVAR for an infrarenal abdominal aortic aneurysm. Earlier, the EVAR was blocked by a thrombosis and treated with an extra-anatomic axillo femoral bypass, which then became occluded. The patient was then treated with an aorto-bifemoral bypass using a Dacron Y graft. A few months later, he was referred to our cardiovascular center with high body temperature, weight loss, inability to stand and walk, and very serious sepsis. A computed abdominal tomography scan revealed that a part of the graft proximal to the bifurcation had totally eroded into the proximal jejunum. We treated this patient with multiple surgeries, antibiotic administrations and hypochlorous acid irrigation without graft excision, which carries a high morbidity and mortality risks. © 2020 Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved.
Choroidal Vascular Index in Patients With Attention-deficit/Hyperactivity Disorder and Methylphenidate
(Slack Inc, 2022) Kızıltoprak, Hasan; Özkoyuncu Kocabaş, Dilara; Aksoy Aydemir, Gözde; Kalınlı, Emine Merve; Aydemir, Emre; Ören, Burak
Purpose:To investigate choroidal vascularity in children with attention-deficit/hyperactivity disorder (ADHD) who were not receiving therapy, children with ADHD who were regularly taking methylphenidate (MPH), and healthy controls.Methods: The study included three groups: patients with newly diagnosed ADHD without treatment, patients diagnosed as having ADHD who were already being treated with oral MPH, and controls. Both choroidal vascularity index (CVI) and choroidal thickness were measured using an enhanced-depth imaging mode of spectral-domain optical coherence tomography (EDIOCT) (Spectralis; Heidelberg Engineering GmbH).Results: There was a significant difference in CVI and stromal area between groups. Post-hoc univariate analysis showed that CVI was significantly lower in patients with ADHD treated with MPH compared with the other groups (P < .001, for each); however, there was no difference between the treatment-free ADHD group and controls (P = .305). In contrast, stromal area was significantly higher in patients with ADHD treated with MPH than the other groups (P < .001, for each group). The correlation of CVI with MPH treatment duration in patients with ADHD treated with MPH showed a significant, moderate negative correlation (P = .01, r = - 0.66).Conclusions: CVI is reduced in patients with ADHD treated with MPH, and the decrease in CVI becomes significant with increasing duration of MPH treatment. This result reflects an indirect effect of MPH treatment on choroidal vascular structures.[J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.]
Citation - WoS: 1
Citation - Scopus: 1
Choroidal Vascularity Index and Choroidal Thickness Assessment in Vitiligo
(Taylor & Francis Ltd, 2024) Oren, Burak; Kiziltoprak, Hasan; Duzayak, Serkan; Kocabas, Dilara Ozkoyuncu
Background: To evaluate structural changes in the choroid by measuring choroidal thickness and vascularity index using optical coherence tomography in patients with vitiligo and comparing them to healthy subjects. Methods: This study included 168 participants: 84 with vitiligo (30 females, 54 males) and 84 controls (36 females, 48 males). Choroidal thickness and vascularity index were measured using the enhanced depth imaging mode in spectral-domain optical coherence tomography. The choroidal thickness was measured at the following five points; subfoveal (SF), 500 mu m (NCT1) and 1000 mu m (NCT2) nasal to the fovea; and 500 mu m (TCT1) and 1000 mu m (TCT2) temporal to the fovea. The choroidal vascularity index was calculated using the ImageJ software. Results: SF (p < 0.001), NCT1 (p < 0.001), NCT2 (p = 0.021), TCT1 (p = 0.001), and TCT2 (p < 0.006) choroidal thicknesses were significantly smaller in the vitiligo group than in the control group. Total choroidal (p < 0.001) and stromal (p < 0.001) areas were significantly smaller in the vitiligo group than in the control group. Choroidal vascularity indices were significantly higher in the vitiligo group than in the control group (p < 0.001). However, luminal areas did not differ significantly between groups (p = 0.935). Conclusion: Patients with vitiligo should be regularly monitored for choroidal alterations and, if necessary, referred to an ophthalmologist.
The Clinical and Histological Analysis of 140 Cases of Ameloblastoma: an Emphasis To Histological Variants
(Türkiye Klinikleri (Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.), 2020) Dereci, Ömür; Kahraman, Devrim; Koşar, Yasin Çağlar; Karagece, Ülker Yalçın; Günhan, Ömer
Objektive: The objective of this study is to evaluate the clinical and demographic features of ameloblastoma cases of a pathology center with a detailed examination of the histopathological properties of the subtypes and variants. Material and Methods: The clinical and radiological data and histologic slides of ameloblastoma cases diagnosed and treated between 2005 and 2017 were retrieved from the archives. Histopathological features of previously diagnosed cases were re-evaluated and re-classification of all cases was performed in accordance with the World Health Organization (WHO) classification of odontogenic tumors. The significance of the relationship between radiological appearance (multiocularity/unilocularity) and final histological diagnosis (solid/unicystic) was evaluated with statistical analysis. Results: There were a total of a hundred and forty cases of ameloblastoma. A hundred and twenty (85.7%) cases were diagnosed as solid type. Sixteen (11.4%) cases were diagnosed as unilocular ameloblastoma. Three cases showed admixed histopathological characteristics. There was a significant relationship between radiological appearance and histological diagnosis (p=0.005). All recurrent luminal unicystic ameloblastomas were re-diagnosed as mural subtype in the histopathological examination. Conclusion: The presence of rare variants should be diagnosed correctly with a thorough histopathological examination to contribute to the prognosis. The radiographic appearance of the tumor is correlated with the histological subtype. In the examination of recurrent unicystic cases, the surgical specimen should be entirely inspected to indicate mural ameloblastic invasions.
Clinical Behavior of Appendiceal Mucinous Neoplasia: 9 Years of Experience
(2022) Demirbaş, Sezai; Ozer, M. Tahir; Dogan, Semra; Tulunay, Gökhan; Kaymak, Sahin
Appendiceal mucocele is known a mucinous neoplasia of the appendix. It’s etiology is not clear. For last 30 years it’s incidence has increased to 2,8 cases/million person from 0,6 cases per million. Even if different classification has been made over the years, WHO and AJCC classifications are frequently used. Objective: The aim of this study was to find the pathologically performing the discrimination between LAMN and HAMN in the extracted specimen and how much the scattering mucin influenced the surgery and patients’ follow-up. Material and Methods: Patients and Centers: In two different hospitals between 2012-2020, the patients admitted to the emergency department and diagnosed as acute abdomen were evaluated retrospectively. All patients were accepted in the emergency clinic and operated then followed in the general surgical clinic. The appendiceal mucocele diagnosis was based on perioperative observation of mucinous distention or mucin dissemination. After obtaining specimens, the type of the mucinous neoplasm of appendix diagnosis and assessment was made by histopathological investigation. Results: Appendix mucocele was detected in 19 of 2974 patients included in the study. Two additional patients had advanced pseudomyxoma peritonei (PMP) after previous appendectomy. 11 of the patients (52.4%) were female. The mean age was 63.8 years. The appendix was evaluated preoperatively as enlarged in fourteen patients. In 1 patient, this condition was belonging to the ovary. Adeno cancer in one patient and PMP in 2 patients were clinically detected. Histopathologically, the appendix size was 37.1x71.9 mm. Sixteen of the patients were reported as LAMN, 2 as HAMN, 1 as adenocarcinoma and 2 as PMP. The leukocyte, carcinoembryonic antigen (CEA) and CA 19-9 levels of the patients were found to be significantly higher than normal. The patients were followed up for an average of 30.2 months. Early postoperative complications were seen in 5 patients. Complications evaluated late were seen in 8 patients. Recurrence was detected in one of the patients during the follow-up. The average survival rate was 36.7 months, although it was slightly higher in women. While the effect of leukocytosis, CEA, CA 19-9 on mortality was not significant, but tumor size was (p<0.05). This study has a few limitations. These are the small number of patients, the retrospective evaluation of the patients, and the relatively short follow-up time. Conclusion: In this study, we found mucocele more frequently than seen in the literature. Histopathologically, low grade mucinous neoplasia (LAMN) was often encountered. Mucocele with acellular mucin scattering were also seen in approximately 20% of the patients. After simple appendectomy, no recurrence was observed during the follow-up. The leukocyte count, tumor markers, and tumor size were evaluated in terms of their effects on postoperative morbidity and mortality. The tumor size had a negative effect on survival only. Finally, the simple appendectomy operation was considered suitable for the treatment.

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