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Şişli, Turkey

Oreroglu A.R.,Okmeydani Research and Training Hospital | Dogan T.,American Hospital | Akan M.,Okmeydani Research and Training Hospital
Aesthetic Surgery Journal | Year: 2012

Background: A complete subperichondrial and subperiosteal dissection technique during rhinoplasty may minimize soft tissue disruption, resulting in less scar tissue formation and preservation of ligamentous structures. Objectives: The authors describe their results with subperichondrial dissection of the nasal framework and manipulation of the preserved nasal ligaments. Methods: The charts of 228 consecutive patients who underwent rhinoplasty with complete subperichondrial dissection via an open or closed approach between May 2008 and April 2011 with the senior author (BÇ) were retrospectively reviewed. Intraoperatively, the scroll ligament and Pitanguy's midline ligament were repaired to stabilize the internal valve and tip position, respectively. Results: Patients in this series (182 women, 46 men) ranged in age from 18 to 54 years (mean, 24.3 years). A total of 203 procedures were primary rhinoplasties; 14 were secondary, and 11 were revisions. The open approach was used in 92 patients, whereas a closed dome delivery was used in the remaining 136 patients. Follow-up ranged from 9 months to 3 years. A complete subperichondrial dissection technique resulted in relatively limited edema and more rapid patient recovery compared with the authors' previous experience with the sub-superficial musculoaponeurotic system (SMAS) approach. Repeat elevation in the subperichondrial plane was easier and less traumatic in revision cases compared with secondary rhinoplasty cases. Conclusions: Subperichondrial dissection of the nasal framework allows reshaping and redraping of the nasal tip and controlled manipulation and repair of ligaments without disturbing the overlying soft tissue. © 2012 The American Society for Aesthetic Plastic Surgery, Inc.

Tokmak H.,American Hospital | Demir N.,Istanbul University | Demirkol M.O.,Koc University
Vascular Health and Risk Management | Year: 2014

Cardiac angiosarcomas are a rare form of malignancy. The majority of cases arise from the right atrium as mural masses. These tumors have extremely aggressive behavior, with early clinical symptoms that vary depending on location, size, and extent of the tumor. Most of these patients have a very short survival time. Surgical therapy is considered the best choice of therapy approach in cardiac angiosarcoma patients with nonmetastatic disease, even though the disease is rarely cured. Advanced diagnostic techniques facilitate accurate, noninvasive assessments of cardiac sarcomas. We report a case of a 62-year-old man with cardiac angiosarcoma who had multiple distant metastases that were revealed by [18F]fuorodeoxyglucose positron emission tomography-computed tomography imaging. © 2014 Tokmak et al.

Tokmak H.,American Hospital | Ergonul O.,Koc University | Demirkol O.,Koc University | Cetiner M.,Koc University | Ferhanoglu B.,Koc University
International Journal of Infectious Diseases | Year: 2014

Objectives: Fever of unknown origin (FUO) remains one of the most compelling diagnostic issues in medicine. We aimed to evaluate the potential clinical contribution of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in the identification of the underlying cause of FUO. Methods: Fifty consecutive patients (27 men and 23 women; age range 16-88 years) with FUO based on the revised definition criteria were included in the study. A diagnostic protocol including biochemistry, histopathology, and microbiological tests was performed and the patients were followed up. FDG-PET was performed in 25 of the 50 patients (12 males and 13 females; age range 16-88 years) in order to determine the etiology of the patient's fever. PET-CT images were obtained with the Gemini Philips TF 18F-FDG-PET/CT camera after a 60-min 'standard uptake' period following an injection of a mean 330 MBq (range 290-370 MBq) intravenous 18F-FDG. Results: A total of 21 patients were available for analysis of the diagnostic contribution of PET/CT (two patients were undiagnosed and two had non-contributory PET/CT findings). 18F-FDG-PET/CT was able to precisely detect the cause of fever in 60% of the cases (n=15). The accuracy, sensitivity, and specificity of this imaging modality were 90.5%, 93.8%, and 80%, respectively. Among the cases with a true-positive 18F-FDG-PET/CT finding (i.e., 15 cases), the identified underlying causes of FUO included localized infection (n=7), non-infective inflammatory process (n=5), and malignancy (n=3). Conclusions: Further studies to confirm the high diagnostic yield of 18F-FDG-PET/CT observed in the present study would lend support to the inclusion of this imaging modality in the initial diagnostic work-up of patients with suspected FUO. © 2013 The Authors.

Suzer T.,American Hospital
Turkish Neurosurgery | Year: 2014

Lumbar spine instability develops as a result of a gradual degenerative process. Segmental instability causes chronic low back pain and decreases the quality of life of the patient. The deformity that develops secondary to lumbar instability is seen as coronal and sagittal imbalance. The diagnosis is made with the radiological and clinical findings. Surgery and stabilization is necessary for those patients when conservative treatment modalities fail.

Kul-Panza E.,Camlica Erdem Hospital | Berker N.,American Hospital
Minerva Medica | Year: 2010

Aim. The aim of this study was to investigate the effect of intra-articular hyaluronic acid (HA) injection on pain and function in knee osteoarthritis (OA). Methods. Fourty-eight patients with knee OA were included in this study. The patients were randomized into two groups: one group received HA injections (average molecular weight [MW] 1.5 million Da), and the other group received placebo containing 0.9% saline. Three injections of HA or placebo were given at weeks 1, 2 and 3. The evaluation instruments were: Visual Analog Scale (VAS); Likert Scale; Lequesne ndex; the Western Ontario and McMaster Universities (WOMAC) Index for Osteoarthritis pain, stiffness, and function, and WOMAC pain subgroups (pain on walking, climbing stairs, at night, on sitting and lying down, on standing); the number of analgesics taken; changes in knee flexion angle; and patient satisfaction. Assessment was performed at weeks 1, 3, 5, and 14 after the first injection. Results. Significant improvement for almost all parameters was noted in both groups (P <0.05). There was no statistically significant difference between change in outcome after HA or placebo treatment (P>0.05), except for WOMAC pain subscore on walking at final assessment (week 14) which showed greater improvement in the HA-treated group (35-2% versus 9.1%; P=0-01). Conclusion. HA treatment was effective in the management of knee OA and improved knee pain and functional outcome, but there was no statistically significant difference in functional and symptom improvement with respect to saline (placebo) injection.

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