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Yener O.,Goztepe Training and Research Hospital
Prague medical report

Carcinoid tumors are rare, slow-growing neuroendocrine neoplasms that are often indolent and may not become clinically apparent until there is a metastatic spread or evidence of carcinoid syndrome. A 44-year-old man presented to our clinic department with a history of previous left colon cancer operation, chronic crampy left lower quadrant pain, mass and severe anemia. A MR scan was obtained which demonstrated a calcified mesenteric mass 12×8×10 cm diameter with surrounding left colon mesenteric infiltration. The liver was normal. A case of ischaemic ileal necrosis is reported. It was associated with elastic vascular sclerosis produced by mesenteric metastases of an ileal carcinoid tumor. It is postulated that intestinal ischaemia may be of more importance in the production of abdominal pain by carcinoid tumors than has been generally accepted, and that it is the result of functional and structural changes in and around the mesenteric blood vessels, caused by substances secreted by the carcinoid tumor. Source

Buyukozturk S.,Istanbul University | Gelincik A.,Istanbul University | Demirturk M.,Istanbul University | Kocaturk E.,Goztepe Training and Research Hospital | And 2 more authors.
Journal of Dermatology

Treatment of chronic urticaria consists of antihistamines as the first-line treatment. For more severe symptoms, combinations can be necessary as well as dose augmentations. The recent guidelines suggest the possibility of using omalizumab in resistant cases, but this therapy is still investigational. We treated two patients with idiopathic recurrent angioedema and 12 patients with chronic spontaneous urticaria (CSU) with omalizumab, who had not benefited from the recommended first-line, second-line and third-line treatments. To evaluate the efficacy of the omalizumab treatment, urticaria activity scores (UAS) and chronic urticaria quality of life (CU-Q2oL) scores were measured at baseline, and at the end of the first and sixth month of the therapy. The dosage and intervals of omalizumab therapy were determined according to the rules suggested for severe asthma treatment. CU-Q2oL scores and UAS displayed significant improvements in all 14 patients. None of the patients reported any adverse effect during the treatment until the submission of this data. Our results show that omalizumab apparently improves CU-Q2oL as well as UAS in treatment-resistant CSU in a real life setting. © 2012 Japanese Dermatological Association. Source

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

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. Source

Cerit C.,Haydarpasa Numune Training and Research Hospital | Filizer A.,Goztepe Training and Research Hospital | Tural U.,Kocaeli University | Tufan A.E.,Abant Izzet Baysal University
Comprehensive Psychiatry

Objective: Extant literature indicates that bipolar disorder (BD) is associated with significant poor psychosocial functioning. However, the relationship between functioning and demographic and clinical variables is unclear. The aim of this study is to investigate the predictors of functioning such as demographic and clinical variables, social support, self-perceived stigma, and insight in remitted patients with BD. Methods: Eighty patients with a diagnosis of BD, complete remission according to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were included in the final assessment. Bipolar Disorder Functioning Questionnaire, Beck Depression Inventory, Young Mania Rating Scale, Internalized Stigma of Mental Illness Scale, Multidimensional Scale of Perceived Social Support, and Schedule for Assessing the Three Components of Insight were used. Student t test, Pearson correlation analyses, and linear regression analyses were used to assess the pathways effecting on functioning. Results: The 3 predictors of functioning were severity of depression, perceived social support, and internalized stigmatization. Severity of depression is considered the strongest predictor, whereas internalized stigmatization has a core role in predicting functioning. Clinical variables such as years of education and number of hospitalization probably have indirect effects on functioning. Conclusion: Interventions that oppose stigmatization and consideration of mild depressive symptoms will positively affect functioning in remitted patients with BD. © 2012 Elsevier Inc. Source

Seyhan M.,Acibadem Kadikoy Hospital | Unay K.,Goztepe Training and Research Hospital | Sener N.,Acibadem University
Acta Orthopaedica et Traumatologica Turcica

Objective: The aim of this study was to compare the outcomes of three reduction methods used during intramedullary nailing of the subtrochanteric femur fractures. Methods: This study included 45 patients with subtrochanteric femur fractures who were treated with intramedullary nailing. Twenty-two patients underwent clamp-assisted reduction, 11 reduction with cable cerclage, and 12 with blocking screws. Reduction techniques were compared with respect to the early postoperative alignment, one year postoperative alignment, time to full weight-bearing, time to union, Harris hip score at one year, operation and fluoroscopy times, blood transfusion amount, complications, and additional interventions. Results: The clamp-assisted reduction group had a statistically high mean time to full weight-bearing (p=0.038) and a low mean Harris hip score at one year (p=0.002). The blocking screw group's operation times and fluoroscopy times were statistically long. There was no statistically significant difference between the clamp-assisted reduction and cable cerclage groups in terms of operation times and fluoroscopy times. On the other hand, there were statistically significant differences between the clamp-assisted reduction and blocking screw groups (p=0.0001 and p=0.0001, respectively) and between the cable cerclage and blocking screw groups (p=0.037 p=0.0001, respectively) in terms of operation times and fluoroscopy times. There was no statistically significant difference between the clamp-assisted reduction, cable cerclage and the blocking screw groups in terms of early postoperative alignment, one year postoperative alignment, time to union, complications or additional interventions. Conclusion: Clamp-assisted reduction leads to a longer time to weight-bearing and a poorer functional status at one year. Operation time and fluoroscopy time were longest in the blocking screw group. © 2012 Turkish Association of Orthopaedics and Traumatology. Source

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