Acibadem Hospital

İstanbul, Turkey

Acibadem Hospital

İstanbul, Turkey
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Yucel B.,AcIbadem Hospital | Usta T.A.,Bagcilar Training and Research Hospital | Kaya E.,Bagcilar Training and Research Hospital | Turgut H.,Bakirkoy Sadi Konuk Training and Research Hospital | Ates U.,Haseki Training and Research Hospital
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2014

Objective We assess follicular reserve changes by follicle count in torsion-detorsion rat model. Study design 30 albino rats were randomly divided into 3 groups: sham group (SG), detorsion after 24-hour torsion group (24hTG) and detorsion after 72-hour torsion group (72hTG). Ovaries were torsioned and fixed. They were untwisted 24 and 72 h later. Oophorectomies were performed at 14th day after detorsion. Tissue damage scoring and follicle counts were evaluated microscopically. Results Tissue damage scores (TDSs) were higher in 72hTG and 24hTG compared to SG. In addition, as we increase torsion duration, TDSs also increased. There was no statistically significant difference in follicle numbers (primordial, primary, secondary and tertiary). Conclusion Duration of torsion and intensity of ovarian damage do not affect follicular reserve in a rat model. Regardless of their macroscopic appearance, ovaries maintain their follicle reserves after torsion. Thus, surgeons should be reassured and encouraged to untwist torsioned ovaries rather than removing them. © 2014 Elsevier Ireland Ltd.

Cihan Y.B.,Kayseri Education and Research Hospital | Arslan A.,Kayseri Education and Research Hospital | Cetindag M.F.,Acibadem Hospital | Mutlu H.,Ankara Education and Research Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2014

Aim: To determine prognostic value of blood parameters on overall and progression-free survival in cases received adjuvant radiotherapy and chemotherapy with diagnosis of stage I-III breast cancer. Materials and Methods: We retrospectively reviewed files of 350 patients with non-metastatic breast cancer who were treated in the Radiation Oncology Department of Kayseri Teaching Hospital between 2005 and 2010. Pretreatment white blood cell (WBC), neutrophil, monocyte, basophil and eosinophil counts, and the neutrophil/lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were recorded. The relationship between clinicopathological findings and blood parameters was assessed. Results: Overall, 344 women and 6 men were recruited. Median age was 55.3±0.3 years (range: 22-86). Of the cases, 243 (61.4%) received radiotherapy while 329 (94.3%), received chemotherapy and 215 (61.4%) received hormone therapy. Mean overall survival (OS) and progression-free survival (PFS) was 84.4 and 78.8 months, respectively. During follow-up, 48 patients died due to either disease-related or non-related causes. Local recurrence was detected in 14 cases, while distant metastasis was noted in 45 cases. In univariate analysis, age, pathology, perinodal invasion were significantly associated with overall survival, whereas gender, stage and hormone therapy were significantly associated with progression-free survival. In multivariate analysis, histopathological diagnosis (OR: 0.3; 95%: 0.1-0.7; p=0.006) and perinodal invasion (OR: 0.1; 95% CI: 0.1-1.3; p=0.026) were significantly associated with overall survival, whereas tumor stage (OR: 2.1; 95% CI: 0.0-0.7; p=0.014) and hormone therapy (OR: 2.1; 95%: 1.2-3.8; p=0.010) were significantly associated with progression-free survival. Conclusions: It was found that serum inflammatory markers including WBC, neutrophil, lymphocyte and monocyte counts, and NLR and PLR had no effect on prognosis in patients with breast cancer who underwent surgery and received adjuvant radiotherapy and chemotherapy.

Api M.,Zeynep Kamil Women and Children Diseases Training and Research Hospital | Boza A.,Goztepe Training and Research Hospital | Gorgen H.,Acibadem Hospital | Api O.,Yeditepe University
Journal of Minimally Invasive Gynecology | Year: 2015

Several obstetric complications due to inappropriately healed cesarean scar such as placenta accreta, scar dehiscence, and ectopic scar pregnancy are increasingly reported along with rising cesarean rates. Furthermore, many gynecologic conditions, including abnormal uterine bleeding, pelvic pain and infertility, are imputed to deficient cesarean scar healing. Hysteroscopy is the most commonly reported approach for the revision of cesarean scar defects (CSDs). Nevertheless, existing evidence is inadequate to conclude that either hysteroscopy or laparoscopy is effective or superior to each other. Although several management options have been suggested recently, the laparoscopic approach has not been thoroughly scrutinized. We present a case and reviewed the data related to the laparoscopic repair of CSDs and compared the hysteroscopic and laparoscopic management options based on the data from previously published articles. As a result of our analyses, the laparoscopic approach increases uterine wall thickness when compared with the hysteroscopic approach, and both surgical techniques seem to be effective for the resolution of gynecologic symptoms. Hysteroscopic treatment most likely corrects the scar defect but does not strengthen the uterine wall; thus, the potential risk of dehiscence or rupture in subsequent pregnancies does not seem to be improved. Because large uterine defects are known risk factors for scar dehiscence, the repair of the defect to reinforce the myometrial endurance seems to be an appropriate method of treatment. © 2015 AAGL.

Kilicdag H.,Acibadem Hospital | Daglioglu K.,Cukurova University | Erdogan S.,Cukurova University | Guzel A.,Numune Education and Research and Hospital | And 3 more authors.
Early Human Development | Year: 2013

Background: Hypoxic-ischemic brain injury (HIBI) is a common cause of neonatal mortality and morbidity. The use of levetiracetam (LEV), as a potential neuroprotective in brain ischemia, receives an increasingly high attention, and it could have a crucial role in the regulation of epileptogenesis and neuroprotection. Potential effects of LEV on neuronal apoptosis in HIBI have not previously been reported in literature. Objectives: The aim of this study is to evaluate the possible effects of LEV on neuronal apoptosis in neonatal rat model of HIBI. Methods: Seven-day-old Wistar rat pups were subjected to right common carotid artery ligation and hypoxia (92% nitrogen and 8% oxygen) for 2. h. The pups were treated with LEV or saline after hypoxia. In sham group rats, neither ligation, nor hypoxia was performed. Neuronal apoptosis was evaluated by the terminal deoxynucleotidyl-transferase- mediated dUTP nick-end labeling (TUNEL) methods. Results: The counts of apoptotic cells in both hippocampus and cerebral cortex were significantly higher in the saline treatment group than in the sham group. The counts of apoptotic cells in both hippocampus and cerebral cortex were similar to those in the sham group and in the LEV treatment group. The number of apoptotic cells decreased significantly in the LEV-treated group compared with the saline group. Conclusions: These results show that LEV administration after hypoxia reduces neuronal apoptosis. Thus, we propose that LEV, as an effective antiepileptic and antiapoptotic drug, may be a viable choice for the control of seizure activity in neonates with HIBI. © 2012 Elsevier Ltd.

Turkyilmaz K.,Recep Tayyip Erdoğan University | Turkyilmaz A.K.,Recep Tayyip Erdoğan University | Kurt E.E.,Acibadem Hospital | Kurt A.,Maya Eye Clinic | Oner V.,Recep Tayyip Erdoğan University
Cornea | Year: 2013

Purpose: To evaluate dry eye in patients with fibromyalgia (FM). Methods: Fifty-three FM patients and 53 age and sex well-matched controls were included in this study. Visual analog scale (VAS), number of tender points, FM impact questionnaire (FIQ), Beck depression scale (BDS), Ocular Surface Disease Index (OSDI), the tear break-up time (TBUT), Schirmer test, and tear osmolarity (TO) were assessed. Results: The OSDI, TBUT, Schirmer test, and TO scores of the FM and control groups were significantly different (P< 0.05). The OSDI, TBUT, Schirmer test, and TO were higher in FM with high FIQ, and TBUT and TO were higher in FM with high BDS. In FM patients, Schirmer test was correlated with the VAS (r = -0.429, P = 0.001), BDS (r = -0.277, P = 0.044), and FIQ (r = -0.382, P = 0.005), and the TBUT was correlated with the VAS (r = -0.537, P < 0.001), BDS (r = -0.350, P = 0.010), and FIQ (r = -0.456, P = 0.001). In addition, TO was significantly correlated with the VAS (r = 0.681, P < 0.001), BDS (r = 0.661, P < 0.001), and FIQ (r = 0.842, P < 0.001). However, no significant correlation existed between the OSDI and the VAS, BDS, or FIQ. Conclusions: We have revealed an association between FM disease activity and dry eye severity. The consideration of this relation will be useful in the treatment of FM with deteriorated clinical status. Copyright © 2013 by Lippincott Williams & Wilkins.

Aydin N.,Uskudar State Hospital | Aydin N.,Acibadem Hospital | Kocaoglu B.,Acibadem Hospital | Guven O.,Acibadem Hospital
Journal of Shoulder and Elbow Surgery | Year: 2010

Hypothesis: Double-row rotator cuff repair leads to superior cuff integrity and clinical results compared with single-row repair. Materials and methods: The study enrolled 68 patients with a full-thickness rotator cuff tear who were divided into 2 groups of 34 patients according to repair technique. The patients were followed-up for at least 2 years. The results were evaluated by Constant score. Discussion: Despite the biomechanical studies and cadaver studies that proved the superiority of double-row fixation over single-row fixation, our clinical results show no difference in functional outcome between the two methods. It is evident that double-row repair is more technically demanding, expensive, and time-consuming than single-row repair, without providing a significant improvement in clinical results. Results: Comparison between groups did not show significant differences. At the final follow-up, the Constant score was 82.2 in the single-row group and 78.8 in the double-row group. Functional outcome was improved in both groups after surgery, but the difference between the 2 groups was not significant. Conclusions: At long-term follow-up, arthroscopic rotator cuff repair with the double-row technique showed no significant difference in clinical outcome compared with single-row repair in small to medium tears. © 2010 Journal of Shoulder and Elbow Surgery Board of Trustees.

Tastemir-Korkmaz D.,Adiyaman University | Demirhan O.,Cukurova University | Kuleci S.,Cukurova University | Hasturk S.,AcIbadem Hospital
Pathology and Oncology Research | Year: 2013

Death receptor 4 (DR4) gene is a candidate tumor supressor gene that has a role in apoptotic pathway. It was reported in literature that polymorphisms in DR4 gene lead to susceptibility to many cancers. In accordance with this information, we aimed to investigate the association between G422A, C626G, A683C and A1322G polymorphisms in DR4 gene and lung cancer. We selected 60 patients with lung cancer (LC) and 30 healthy, sex and age matched volunteers randomly. Four polymorhisms, G422A, C626G, A683C and A1322G, in DR4 gene were analyzed with Polymerase Change Reaction (PCR) - Restriction Fragment Lenght Polymorphism (RFLP) and Amplification Refractory Mutation System (ARMS) techniques in both groups. Our results showed that there are no statistically significances between the patients and controls in terms of the G422A, C626G, A683C and A1322G polymorphisms in DR4 gene (p > 0,05). Our findings showed no role of DR4 gene polymorhisms in susceptibility to LC and provide a plausible explanation for DR4 genetic heterogeneity in LC susceptibility. © 2013 Arányi Lajos Foundation.

Baskol G.,Erciyes University | Korkmaz S.,Acibadem Hospital | Erdem F.,Erciyes University | Caniklioglu A.,Erciyes University | And 2 more authors.
Sleep Medicine | Year: 2012

Objectives: We aimed to determine the importance of oxidative stress in the pathogenesis of restless legs syndrome (RLS) by quantification of advanced oxidation protein products and total thiol levels (as markers of oxidative protein damage), nitric oxide levels (as an antioxidant and endothelial function), and malondialdehyde levels (as a marker of lipid peroxidation) in patients with RLS. Design and methods: A total of 22 patients with primary RLS were enrolled in the study and 20 age-and-gender-matched healthy subjects were enrolled as a control group. Serum nitric oxide, malondialdehyde, thiol levels, and plasma advanced oxidation protein products levels were determined by spectrophotometric methods. Results: Serum nitric oxide and thiol levels were lower in the patient group than in controls (. p=. 0.007 and . p=. 0.017, respectively). Plasma advanced oxidation protein products levels and serum malondialdehyde levels were found to be higher in patients with RLS than in controls (. p=. 0.017 and . p=. 0.008, respectively). Serum malondialdehyde level was found to be positively correlated with plasma advanced oxidation protein products levels (. p=. 0.039). Serum thiol level was found to be negatively correlated with plasma advanced oxidation protein products levels (. p=. 0.030). Conclusions: Increased advanced oxidation protein products, malondialdehyde levels, and decreased thiol and nitric oxide levels, may suggest that patients with RLS are under oxidative stress. Although both lipid peroxidation and protein oxidation may have a role in atherosclerosis in RLS, those factors may be related to the pathogenesis of RLS. © 2012 Elsevier B.V.

Akcay L.,Dr Lutfi Kirdar Kartal Training and Research Hospital | Eser I.,Acibadem Hospital | Kaplan A.T.,Dr Lutfi Kirdar Kartal Training and Research Hospital | Taskiran-Comez A.,Canakkale Onsekiz Mart University | Dogan O.K.,Dr Lutfi Kirdar Kartal Training and Research Hospital
Clinical and Experimental Ophthalmology | Year: 2012

Background: To evaluate the efficacy and tolerance of two different foldable anterior chamber phakic intraocular lenses for high myopia. Design: A prospective interventional case series at the Eye Clinic, Kartal Training and Research Hospital, Istanbul, Turkey. Participants: Sixty-two eyes of 31 patients received iris-claw lens (group 1) (Artiflex AC 401, Ophtec), and 43 eyes of 22 patients received angle-supported lens (group 2) (I-Care, Corneal). Methods: The mean preoperative spherical equivalents for group 1 and group 2 were -12.13D and -18.95D, respectively. Endothelial cell density was measured at day 1 and at 1, 3, 6, 12 and 18months for follow ups. Main Outcome Measures: Percentage change in endothelial cell density and improvement in visual acuity. Results: At the 18-months follow up, uncorrected visual acuity improved to logMAR 0.37±0.23 from 1.60±0.10 in group 1, and logMAR 0.47±0.14 from 0.70±0.20 in group 2; best spectacle corrected visual acuity improved to logMAR 0.23±0.22 from logMAR 0.36±0.14) in group 1, and logMAR 0.29±0.18 from logMAR 0.50±0.20) in group 2 (P<0.001, in both groups). Mean decreased endothelial cell density was 241 cells/mm 2 (8.61%) and 223 cells/mm 2 (8.42%) at 18months follow up in group 1 and 2, respectively (P=0.17) but significant in comparison to preoperative values for both groups (P<0.001). Conclusions: Although both iris-claw and angle-supported lenses offer good refractive outcomes significant endothelial cell density was observed at 18months follow up. © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Pour P.M.,University of Nebraska Medical Center | Saruc M.,Acibadem Hospital
Journal of the Pancreas | Year: 2011

Context The association between islet cells and neural elements, the so-called "neuro-insular complex", has been known for centuries. Objective We examined the expression of beta-III tubulin, in normal pancreases from organ donors, surgical specimens of chronic pancreatitis, surgical specimens of duct al type carcinoma, isolated and purified islets of a 57-year-old male and the pancreases of adult Syrian golden hamsters by immunohis to chemistry using a monoclonal antibody to beta-tubulin. Results In the normal pancreas of humans and hamsters, beta-III tubulin was expressed in alpha- and beta-cells, but not in PP cells, neural fibers and gangliae. Occasionally, intra-and peri-insular neural elements were also found. In chronic pancreatit is and pancreatic cancer samples, the number of beta-cells and the immuno reactivity of the beta-III tubulin antibody in islet cells were decreased in most cases. In cultured human islets, devoid of neural elements, no correlation was found between the expression of beta-III tubulin and is let cell hormones. Conclusion Beta-III tubulin is only expressed in the islets derived from the dorsal pancreas and in neural elements. In chronic pancreatitis and pancreatic cancer swelling of intra- and peri-insular nerves occurs, possibly in response to the loss of beta-cells. The secretion of insulin and the expression of beta-tubulin seem to be regulated by nerves.

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