Ataturk Research and Training Hospital

İzmir, Turkey

Ataturk Research and Training Hospital

İzmir, Turkey
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The purpose of our study was to evaluate the role of oxidative stress and lipid peroxidation in acute mesenteric ischemia. Thirty male Wistar albino rats weighing 240-260 g were randomized into control (no operation), sham (operation without ischemia), and ischemia groups. To induce ischemia, the superior mesenteric artery was sutured. Total antioxidant and oxidant capacity and lipid peroxidase activity were measured in blood samples collected at 0 min, 60 min, and 240 min, and the pathology of ileum segments resected at 240 min was evaluated. Total oxidant status did not differ among the groups. Total antioxidant status increased significantly with time in the ischemia group compared to the control and sham groups (P < 0.001). Although basal arylesterase activity was lower in the ischemia group than controls (P < 0.05), post-ischemia values were similar among the groups. Similarly, basal and stimulated paraoxonase activity in blood samples did not differ among the groups. In conclusion, oxidative stress and lipid peroxidation have no significant role in the pathophysiology of acute mesenteric ischemia.

Afsar F.S.,Dr Behcet Uz Childrens Hospital | Afsar F.S.,Ataturk Research and Training Hospital
Cutaneous and Ocular Toxicology | Year: 2011

Purpose: The aim of this study was to determine the real spectrum of skin diseases in Turkish children and how they were managed. Methods: Data on a total of 6000 consecutive patients aged 0-18 years attending the pediatric dermatology clinic were analyzed for diagnosis, disease group, diagnostic pattern, treatment modality, and referral and hospitalization frequency. Results: Allergic skin diseases (49.9%) were the leading group of dermatoses, which were followed by infectious diseases (20.5%), and disorders of skin appendages (10.2%). Atopic dermatitis was the most common dermatose, which was followed by papular urticaria and unclassified eczema. Most of the patients (92.0%) had diagnosis on clinical basis, whereas skin biopsy was performed in 3.7% and laboratory investigation in 4.4% of the patients. The hospitalization rate was 0.3%, and Henoch-Schönlein purpura was the most frequent dermatose for which hospitalization was required. Local treatment was prescribed in 56.0% of the patients, local treatment and systemic treatment together in 26.4%, and systemic treatment in 6.2%. Viral warts followed by viral exanthems caused by enteroviruses and acquired melanocytic nevi were the most frequently referred skin problems. Further investigation and treatment for systemic or related diseases was the most common reason for referrals (2.1%), and pediatrics was the department to which most of the referrals were made (1.8%). Conclusion: This study provided important data on the spectrum of skin diseases encountered in the pediatric age groups and general approach to patients in a pediatric dermatology clinic in Turkey. © 2011 Informa Healthcare USA, Inc.

Kosar M.,Sakarya Hospital | Kurt A.,Diskapi Research and Training Hospital | Keskin S.,University of Konya | Keskin Z.,Konya Research and Training Hospital | Arslan H.,Ataturk Research and Training Hospital
Acta Radiologica | Year: 2014

Background: Among patients with increased bronchial artery diameter there is a significant association between hemoptysis and bronchiectasis score. The higher score of bronchiectasis, the higher risk of hemoptysis development. Purpose: To investigate the association of stages of bronchiectasis based on a computed tomography (CT) grading system, with bronchial artery diameter and hemoptysis in patients with bronchiectasis. Material and Methods: Patients with lung pathologies other than bronchiectasis, which may cause hemoptysis, were excluded from the study. One hundred and forty-five patients who underwent contrast-enhanced thorax CT by a 64-detector CT for various indications, and who were diagnosed with bronchiectasis, were evaluated retrospectively. CT examinations were carried out by two radiologists with 9 and 4 years of experience with chest radiology, respectively. The diameters of the right and left bronchial arteries were measured 1 cm from the aortic origin and perpendicular to the vessel axis. Cases were assessed based on the Bhalla CT scoring system. The hemoptysis history of every patient was taken. Results: The diameters of the right and left bronchial arteries were significantly greater in patients with scores of 2 and 3 bronchiectasis than in patients with a score of 1. This was significantly greater in patients with a score of 3 than in patients with a score of 2 (P<0.05). In patients with a score of 1, the right bronchial artery diameter was significantly greater than that of the left bronchial artery (P<0.05). Right bronchial artery diameters were significantly greater than left bronchial artery diameters in score 3 patients (P<0.05). A significant association was observed between hemoptysis and bronchiectasis in patients with increased bronchial artery diameter (P<0.05). Conclusion: In patients with bronchiectasis, as the stage of bronchiectasis increases, the bronchial artery diameters and the risk of hemoptysis increase. We think that in patients who are diagnosed with bronchiectasis via multidetector CT (MDCT), based on scoring with bronchial artery diameters, the risk of hemoptysis can be estimated, and early management plans can be implemented. © The Foundation Acta Radiologica 2013.

Salman A.E.,Etlik Research and Training Hospital | Yetisir F.,Etlik Research and Training Hospital | Aksoy M.,Ataturk Research and Training Hospital | Tokac M.,Etlik Research and Training Hospital | And 2 more authors.
Hernia | Year: 2014

Aim: Definitive abdominal closure may not be possible for several days or weeks after laparotomy in damage-control surgery, abdominal compartment syndrome and intraabdominal sepsis, until the patient has stabilized. Vacuum-assisted closure (VAC therapy®, KCI, San Antonio, TX, USA) and abdominal re-approximation anchor system (ABRA, Canica, Almonte, Ontario, Canada) are novel techniques in delayed closure of open abdomen. Our aim is to present the use of these strategies in the management of 7 patients with open abdomen. Methods: Between August 2010 and December 2011, 7 patients with severe peritonitis were stabilized by laparotomy and treated with either ABRA system or ABRA system in conjunction with VAC dressing. VAC dressing applied to 4 patients initially and followed by ABRA. ABRA was applied alone to remaining 3 patients. Demographic data and patient characteristics, timing of VAC dressing and ABRA system were recorded. ICU and hospital stay and development of incisional hernia were also recorded. Stage of open abdomen, width of abdominal defect, extent to damage to fascia, and pressure sores were staged. Results: The mean duration with VAC dressing before ABRA application was 18 days. The mean duration of ABRA application was 53 days. The average width of the abdominal defect was 18 cm. The average length of defect was 20.8 cm. Delayed primary abdominal closure was accomplished in 6 patients without further surgery. Incisional hernia with a small abdominal defect developed in 2 patients. Conclusion: Abdominal re-approximation anchor system and VAC dressing can be used separately or in conjunction with each other for closure of delayed open abdomen successfully. © 2012 Springer-Verlag France.

Dumlu E.G.,Ataturk Research and Training Hospital | Abbasolu O.,Hacettepe University | Hamalolu E.,Hacettepe University
Chirurgia (Romania) | Year: 2014

Background: Traditional treatment for liver hemangiomas is surgery. Currently, it is controversial whether hemangioma surgeries are sufficiently beneficial for the patients. In this study, we evaluated the effectiveness of surgery in patients with liver hemangiomas. Methods: Forty-two patients who underwent surgical operations for hepatic hemangiomas were retrospectively evaluated and interviewed. Results: Study population included 36 female and 6 male patients whose ages ranged between 26 and 65 years (mean age, 47.8±8.7 years). Their mean duration of hospitalization was 6 days (range, 3-59 days). The median time since surgery was 50 months (range 0-120 months). There was a statistically significant decrease in numerical rating and adjective rating pain scale scores (p<0.05). Postoperatively, pain did not cease in 10 patients (peptic ulcers requiring medical treatment in four patients, cholelithiasis in four patients, and nephrolithiasis in two patients). Conclusion: Patients with cavernous hemangiomas of the liver who require surgical treatment have significant benefits in terms of pain relief following surgery. The lack of pain relief after the surgery in some patients may be related to concomitant medical problems other than the hemangioma. Copyright© Celsius.

Celebisoy M.,Ataturk Research and Training Hospital | Celebisoy N.,Ege University | Bayam E.,Ege University | Kose T.,Ege University
Journal of Neurology, Neurosurgery and Psychiatry | Year: 2011

Objective: To assess the temporal course of homonymous visual-field defects due to occipital lobe infarction, by using automated perimetry. Methods: 32 patients with ischaemic infarction of the occipital lobe were studied prospectively, using a Humphrey Visual Field Analyser II. The visual field of each eye was divided into central, paracentral and peripheral zones. The mean visual sensitivity of each zone was calculated and used for the statistical analysis. The results of the initial examination, performed within 2 weeks of stroke, were compared with the results of the sixth-month control. The lesions were assigned to the localisations, optic radiation, striate cortex, occipital pole and occipital convexity, by MRI. Results: A statistically significant improvement was noted, especially for the lower quadrants. Lesions of the occipital pole and convexity were not significantly associated with visual-field recovery. However, involvement of the striate cortex and extensive lesions involving all the areas studied was significantly associated with poor prognosis. Conclusions: Homonymous visual-field defects in our patients improved within 6 months. Restoration of the lower quadrants and especially the peripheral zones was noted. Incomplete damage to the striate cortex, which has a varying pattern of vascular supply, could explain this finding. Magnification factor theory, which is the increment of the receptive-field size of striate cortex cells with visual-field eccentricity, may explain the more significant improvement in the peripheral zones.

Demirkln Biler E.,Ataturk Research and Training Hospital | Uretmen O.,Ege University | Kose S.,Ege University
Journal of AAPOS | Year: 2010

Purpose: To compare the effects of partial or full hyperopic optical correction on refractive development in children with accommodative esotropia. Methods: Children with accommodative esotropia and hyperopia >3 D were enrolled in this prospective, nonrandomized study. All children underwent an ophthalmologic examination, including refraction, keratometry, and axial length. Subjects were divided into either full- or partial-correction groups according to their tolerance of the full hyperopic correction. Routine follow-up examinations were performed for at least 3 years. The main outcome measure was cycloplegic spherical equivalent at the end of the study period. Results: A total of 120 children were enrolled. The mean cycloplegic spherical equivalent, corneal radius, and axial length were significantly (p < 0.05) different between the first and last visits in both groups. However, when all the mesurements were adjusted for the age difference between groups, only the difference in axial length between the first and last visits was statistically significant (p < 0.05). Partial or full optical correction in age-adjusted cohorts with accommodative esotropia did not result in a significant change in refraction, keratometry, or axial length between the first and last visits. Conclusions: Partial or full optical correction of hyperopia had similar effects on refractive development of the eye in children with accommodative esotropia. Treatment of acccommodative esotropia in children older than age 5 did not appear to impair refractive development. Copyright © 2010 by the American Association for Pediatric Ophthalmology and Strabismus.

Afsar I.,Ataturk Research and Training Hospital | Afsar F.S.,Ataturk Research and Training Hospital
Indian Journal of Pathology and Microbiology | Year: 2016

Background and Aim: Cutaneous tuberculosis (CTB) is still difficult to diagnose due to its varied clinical presentation and limitations of diagnostic methods. The aim of this study was to evaluate the results of diagnostic laboratory tests available for CTB. Materials and Methods: Twenty-six skin biopsy specimens belonging to clinically suspected cases of CTB were studied retrospectively. The specimens were divided into two portions, one part processed for histopathological evaluation and the other was used for microscopy and inoculation for the isolation of mycobacteria. Polymerase chain reaction (PCR) technique was applied to 14 of 26 specimens to detect Mycobacterium tuberculosis complex (MTBC) DNA. Results: Of the 26 biopsy specimens, 11 were confirmed as CTB by identification of MTBC in culture and/or histopathologic affirmation. Of these, four were lupus vulgaris, four were TB verrucosa cutis, one was scrofuloderma, one was primary inoculation TB, and one was periorifical CTB. Culture for mycobacteria was positive for five (45.45%) specimens, while histopathologic affirmation was obtained in ten (90.90%) specimens. Acid-fast Bacilli were not demonstrated in any of the specimens on microscopic examination. The PCR was found to be applied to six of the 11 specimens diagnosed as CTB and was positive in two specimens (33.3%), which were positive for growth in culture and histopathological correlation. Conclusion: The recovery rate of MTBC from biopsy specimens was found to be satisfactory for CTB with histopathological correlation, but the combination of culture with a rapid method, PCR, may improve the diagnostic rate. © 2016 Indian Journal of Pathology and Microbiology | Publishedby Wolters Kluwer - Medknow.

Secil Y.,Ataturk Research and Training Hospital | Ciftci Y.,Ataturk Research and Training Hospital | Tokucoglu F.,Ataturk Research and Training Hospital | Beckmann Y.,Ataturk Research and Training Hospital
Journal of Stroke and Cerebrovascular Diseases | Year: 2014

Background: Acetylsalicylic acid (ASA) and warfarin are used to prevent ischemic cerebrovascular events. They have serious complications including intracranial hemorrhages (ICHs). Warfarin-related intracerebral hemorrhage (ich) incidence is.2%-5% in population that accounts for 10%-12% of all ichs. In this article, we investigated the profile of ASA and warfarin-related spontaneous ICHs in comparison with ICHs without any drug use (WADU) with their clinical, radiological, and biochemical properties. Methods: In all, 486 patients aged 18-101 years with spontaneous ICHs were included. Patients constituted 4 separate groups: users of warfarin, ASA, ASA + warfarin, and WADU. Clinical, neurological, etiological, and radiological data of these patients were compared. Results: There were 32 patients in warfarin, 58 patients in ASA, and 7 in warfarin + ASA group. Most of the patients were in no drug group (389 patients). The most frequent type of hemorrhage was supratentorial intraparenchymal hemorrhage. The most common accompanying disease was hypertension. The number of female patients was statistically significant in the warfarin group. Glasgow Coma Scale (GCS), accompanying diseases, opening of the hematoma to the ventricle, localization of the hemorrhage, age of the patient, and activated partial thromboplastin time level are all related to the outcome of patients. Warfarin users had worst mortality rate. Conclusions: Use of warfarin, low GCS score, opening to ventricle, older age, accompanying diabetes, and/or hypertension were worse prognostic factors. It is possible that patients with these unfavorable prognostic factors cannot survive. © 2014 by National Stroke Association.

Afsar I.,Ataturk Research and Training Hospital | Sener A.G.,Ataturk Research and Training Hospital
Infectious Diseases in Clinical Practice | Year: 2015

Millions of patients in the world are being increasingly exposed to sepsis every year, and the rate of sepsis mortality remains high. If effective antibiotic therapy is started early, morbidity and mortality levels decrease in infections. Many previous studies indicated that the prohormone procalcitonin (PCT) is an excellent marker for sepsis and its related conditions. Procalcitonin is synthesized by a large number of tissues and organs in response to the invasion by pathogenic microorganisms and the use of PCT as a marker to improve the diagnosis of bacterial infections and guide antibiotic therapy. Procalcitonin also correlates with the extent and severity of infection, and it can be used for a prognostic marker. The aim of this review was to discuss whether serum PCT levels could be a diagnostic and/or prognostic marker in sepsis. © 2014 Wolters Kluwer Health, Inc. All rights reserved.

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