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Kayseri, Turkey

Mutlu H.,Kayseri Training and Research Hospital | Ozdogan M.,Akdeniz University | Colak T.,Akdeniz University | Akca Z.,Mersin State Hospital | Buyukcelik A.,Kayseri Acibadem Hospital
UHOD - Uluslararasi Hematoloji-Onkoloji Dergisi | Year: 2013

In Turkish patients with breast cancer variations of prognostic factors were examined according to the menopausal status. In addition, molecular variations were investigated according to the menopausal status. A total of 1449 patients was enrolled from Akdeniz University Hospital of Medical School and Kayseri Education and Research Hospital. The patients were divided into three groups as menopausal status (pre, peri and postmenopausal) and into four groups according to molecular types (luminal A,luminal B, HER2 like and Unclassified-Basal like). Patients were retrospectively recorded in the SPSS software. There was significant difference in the estrogen and cerbB2 hormon receptor positivity between premenopausal and postmenopausal groups (p=0.003 and 0.032). Estrogen receptor ratio was higher in postmenopausal group, and CerbB2 receptor ratio was higher in premenopausal group. Luminal A molecular subtype was the dominant subgroup. Compared to the other two groups, in premenopausal group, the ratio of HER 2 Like and Unclassified-Basal like molecular type were higher and the ratio of the luminal types were lower. Luminal A was the dominant subgroup in Turkish patients with breast cancer. Rate of molecular types was determined to be varied with menopausal status. This variations were compatible with the poor prognosis premenopausal patients with breast cancer.

Cihan Y.B.,Kayseri Education and Research Hospital | Ozturk A.,Erciyes University | Mutlu H.,Kayseri Acibadem Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: It has been demonstrated that neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR) ratios are associated with prognosis in cancer patients. The aim of this study was to investigate whether pretreatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, basophil and eosinophil counts, LDH level, NLR and PLR are associated with prognosis in patients with malignant pleural mesothelioma (MPM). Materials and Methods: We retrospectively reviewed files of 50 patients who were managed with a diagnosis of MPM between 2005 and 2010. Demographic and clinical characteristics, treatments, response to treatment and prognostic factors were evaluated, along with relationships between pretreatment blood parameters and prognosis. Results: Overall, 38 men and 12 women were included to the study. Mean age was 61.5±9.4 years (range: 39-83 years). There was advanced disease in 86% (n=43) and the histological type was epithelial mesothelioma in the majority (82%). Of the cases, 17 (34%) received radiotherapy, while 42 cases underwent first-and second-line chemotherapy, with cisplatin plus pemetrexed as the most commonly used regimen. In the assessment after therapy, it was found that there was complete response in 4 cases (8%), partial response in 10 cases (20%), stable disease in 17 cases (34%) and progression in 19 cases (38%). Median follow-up was 10 months (range: 10 day-30 months). Median overall survival was found to be 20.7 months while median progression-free survival as 10 months. In univariate and multivariate analyses, it was found that factors significantly affecting overall survival included stage (p=0.030), response to treatment (p=0.026) and monocyte count (p=0.004), while factors affecting disease-free survival included NLR (p=0.018), response to treatment (p=0.001), and PLR score (p=0.003). Conclusions: Overall and disease-free survival was found to be better in cases with a WBC count<8.000, platelet count<300,000, and low NLR and PLR scores in malignant pleural mesothelioma.

Karaman A.,Kayseri Acibadem Hospital
Journal of Laryngology and Otology | Year: 2016

Objective: To investigate whether cochlear involvement is an extraintestinal manifestation in patients with ulcerative colitis. Method: Forty-four ulcerative colitis patients and 44 age-matched healthy subjects were included in the study. Pure tone and speech audiometry, and distortion product otoacoustic emission tests were performed on all participants. The audiometric test results were compared between groups and their relationship with disease activity was investigated. Results: Pure tone threshold averages were significantly higher in ulcerative colitis patients compared to controls (p < 0.05). Speech discrimination scores were significantly lower in ulcerative colitis patients compared to controls (p < 0.05). Distortion product otoacoustic emission amplitude values were significantly lower for all of the tested frequencies (except for 6000 Hz in the right ear) in ulcerative colitis patients compared to controls (p < 0.05). No relationship was detected between audiometric test results and disease activity (p > 0.05). Conclusion: Even though hearing thresholds may be within normal limits, decreased distortion product otoacoustic emission amplitude values indicate a cochlear involvement in ulcerative colitis patients. Copyright © JLO (1984) Limited 2015.

Aksoy H.,Kayseri Military Hospital | Aksoy U.,Kayseri Memorial Hospital | Yucel B.,Kayseri Acibadem Hospital | Ozyurt S.S.,Kayseri Traininig and Research Hospital | And 4 more authors.
Journal of the Turkish German Gynecology Association | Year: 2015

Objective: We aimed to compare the effect of general and spinal anesthesia on maternal blood loss in elective cesarean section (CS). Material and Methods: This was a prospective randomized study and included 418 healthy pregnant women with a term uncomplicated singleton pregnancy between 37 and 41 weeks of gestation. The study participants were randomly divided into two groups: the general anesthesia group and spinal anesthesia group. CSs were all performed using the same surgical technique, and within the groups, the same anesthetic procedures were used (either general or spinal). The primary outcome for this study was operative blood loss. Hemoglobin and hematocrit concentrations were compared between the two groups. Results: The preoperative hemoglobin and hematocrit levels were similar in the both groups (p=0.08 and p=0.239, respectively). Significantly lower operative blood loss was achieved using spinal anesthesia versus general anesthesia during elective CS. The differences between preoperative and postoperative blood values for both the study groups were statistically significant (p<0.001). Conclusion: This study demonstrates that spinal anesthesia is associated with a lower risk of operative blood loss than general anesthesia in low risk patients undergoing elective CS. © 2015 by the Turkish-German Gynecological Education and Research Foundation.

Aksoy H.,Kayseri Military Hospital | Aydin T.,Kayseri Acibadem Hospital | Ozdamar O.,Kayseri Military Hospital | Karadag O.I.,Kayseri Acibadem Hospital | Aksoy U.,Kayseri Memorial Hospital
Journal of Medical Case Reports | Year: 2015

Introduction: Uterine leiomyomas are the most common benign neoplasms of the female reproductive tract. Myomectomy is the preferred surgical treatment in reproductive-aged women who desire to retain their fertility. The use of a laparoscopic approach for large myomas is still controversial, although there are several compelling reasons for its use. The laparoscopic removal of giant uterine myomas is rare, and only a few cases have been published in the literature. Case presentation: We report the case of a 33-year-old white woman who was referred to our clinic with progressive abdominal distension. An ultrasonic examination revealed a markedly enlarged uterus containing a 17 cm uterine myoma. Laparoscopic myomectomy was selected as the treatment option. The laparoscopy confirmed the 17 cm fundal intramural myoma. The myoma was totally enucleated and removed without disturbing her endometrial cavity. The myometrial defect was repaired with a continuous suture using the V-loc suture in two layers. The entire myoma was removed using a tissue morcellator. The total weight of the myoma removed was 2005g, and the operation lasted for 140 minutes. Her postoperative course was unremarkable. Conclusions: Laparoscopic myomectomy offers many advantages compared with abdominal myomectomy. Although the use of a laparoscopic approach to treat very large myomas is controversial and technically demanding, we successfully performed a laparoscopic myomectomy in a patient with a giant myoma. This case confirms the efficiency, reliability, and safety of a minimally invasive surgical approach to treating a giant uterine myoma. Laparoscopic myomectomy can be performed by experienced surgeons regardless of the size of the myoma. © 2015 Aksoy et al.

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