Gulhane Military Medical Academy Haydarpasa Training Hospital

İstanbul, Turkey

Gulhane Military Medical Academy Haydarpasa Training Hospital

İstanbul, Turkey
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PubMed | Dr Siyami Ersek Thoracic And Cardiovascular Surgery Center Training And Research Hospital, Gulhane Military Medical Academy Haydarpasa Training Hospital and Van Army District Hospital
Type: Journal Article | Journal: Arquivos brasileiros de cardiologia | Year: 2016

Epicardial fat is an upper body visceral fat depot that may play a significant role in the development of adverse metabolic and cardiovascular risk profiles. There is a significant direct relationship between the amount of epicardial fat and general body adiposity (body mass index, BMI), but data regarding subcutaneous adiposity is limited.We conducted a study to determine the association between neck circumference and epicardial fat thickness in healthy young male individuals, and assess their individual correlations with general body adiposity and cardiometabolic risk factors.One hundred consecutive male patients aged 18 years or older with no known major medical conditions were included in the study. All participants underwent detailed physical examination including measurement of blood pressure, weight, height, waist/hip ratio, and neck circumference. Blood was collected to determine fasting glucose and lipid parameters. A standard echocardiographic examination was performed with additional epicardial fat thickness determination.Among 100 study participants, neck circumference correlated significantly with weight, waist circumference, BMI, blood glucose, serum total cholesterol, low-density (LDL)-cholesterol, and triglycerides levels. No significant correlation was found between neck circumference and high-density lipoprotein (HDL)-cholesterol levels. Neck circumference correlated moderately and positively with echocardiographic epicardial fat thickness.Among patients with low cardiometabolic risk, increased neck circumference was associated with increased epicardial fat thickness.A gordura epicrdica um depsito de gordura visceral na parte superior do organismo que pode desempenhar um papel importante no desenvolvimento de perfis cardiovasculares e metablicos adversos. H uma relao direta significativa entre a quantidade de gordura epicrdica e a adiposidade corporal geral (ndice de massa corporal, IMC), mas dados sobre a adiposidade subcutnea so limitados.Realizamos um estudo para determinar a associao entre a circunferncia do pescoo e a espessura da gordura epicrdica em jovens saudveis do sexo masculino, alm de avaliar as suas correlaes individuais com a adiposidade corporal geral e fatores de risco cardiometablicos.Cem pacientes consecutivos do sexo masculino com idade igual ou superior a 18 anos e sem nenhuma condio mdica importante e conhecida foram includos no estudo. Todos os participantes foram submetidos a um exame fsico detalhado que incluiu medida da presso arterial, peso, altura, razo cintura/quadril e circunferncia do pescoo. Sangue foi coletado para determinao da glicemia de jejum e parmetros lipdicos. Um exame ecocardiogrfico padro foi realizado com determinao adicional da espessura da gordura epicrdica.Entre os 100 participantes do estudo, a circunferncia do pescoo mostrou correlao significativa com o peso, circunferncia de cintura, IMC, glicemia e nveis sricos de colesterol total, lipoprotena de baixa densidade (LDL-colesterol) e triglicerdeos. No foi observada correlao significativa entre a circunferncia do pescoo e nveis de colesterol de alta densidade (HDL-colesterol). A circunferncia do pescoo correlacionou moderadamente e positivamente com a espessura da gordura epicrdica ecocardiografia.Entre pacientes com baixo risco cardiometablico, o aumento da circunferncia do pescoo foi associado a um aumento da espessura da gordura epicrdica.


PubMed | Beytepe Military Hospital, Gulhane Military Medical Academy Haydarpasa Training Hospital and Ordu University
Type: Journal Article | Journal: Turkish journal of urology | Year: 2016

To evaluate the clinical and histopathological results of adult unilateral cryptorchidism patients.Data from adult unilateral cryptorchidism patients that underwent orchiectomy in our clinic between between January 2004 and March 2013 were retrospectively evaluated. Patients were divided into three groups as intra-abdominal, inguinal canal and superficial inguinal region according to the location of the undescended testes. Patients were also grouped according to their testicular volume (<4 cc, 4.1-12 cc, and >12 cc). Histopathology results of orchiectomy specimens were classified as follows: 1. Sertoli cells only, testicular atrophy and vanished testis (anorchia) 2. Hypospermatogenesis, and 3. Maturation arrest. Patients were grouped as normospermia, azoospermia and oligo/astheno/teratospermia groups according to semen analysis results. Correlations between testicular localization, testicular size, semen analysis and pathology results were evaluated. Incidental tumor detection rates were also calculated.Two hundred and forty-four adult unilateral cryptorchidism patients underwent orchiectomy in our clinic. There was no a significant relationship between location of the testis and testicular pathology results (p=0.707). Most common semen analysis results was normospermia in patients with high testicular volume group however azoospermia and oligoasthenospermia observed commonly in patients with low testicular volume group. There was a significant relationship between testicular volume and semen analysis results (p=0.023). No significant relationship was observed between semen analysis and pathological results (p=0.929). After an evaluation of all factors with possible effects on the semen analysis results, only testicular volume (p=0.036) was found to have a significant impact. Only one case (0.4%) was incidentally diagnosed seminoma after a review of 233 patients with available histopathological results on record.Adult unilateral cryptorchidism has a minimal effect on male fertility or even this effect can be overlooked. Low detection rates of incidental germ cell tumors also make an orchiectomy decision questionable in such cases.


PubMed | Anittepe Military Dispensary, Kasimpasa Military Hospital, Gulhane Military Medical Academy Haydarpasa Training Hospital, Girne Military Hospital and Diyarbakir Military Hospital
Type: | Journal: Journal of ophthalmology | Year: 2016

Aim. To compare the surgical outcomes of surgery with and without bicanalicular silicon tube intubation for the treatment of patients who have primary uncomplicated nasolacrimal duct obstruction. Methods. This retrospective study is comprised of 113 patients with uncomplicated primary nasolacrimal duct obstruction. There were 2 groups in the study: Group 1 (n = 58) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation and Group 2 (n = 55) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery without bicanalicular silicon tube intubation. The follow-up period was 18.42 2.8 months for Group 1 and 18.8 2.1 months for Group 2. Results. Success was defined by irrigation of the lacrimal system without regurgitation and by the absence of epiphora. Success rates were 84.4% for Group 1 and 63.6% for Group 2 (P = 0.011). Statistically a significant difference was found between the two groups. Conclusion. The results of the study showed that transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation was more successful than the other method of surgery. Consequently, the application of silicone tube intubation in transcanalicular diode laser dacryocystorhinostomy surgery is recommended.


Altundag A.,Istanbul Surgery Hospital | Salihoglu M.,Gulhane Military Medical Academy Haydarpasa Training Hospital | Cayonu M.,Amasya University | Tekeli H.,Gulhane Military Medical Academy Haydarpasa Training Hospital Haydarpasa Training Hospital
International Journal of Pediatric Otorhinolaryngology | Year: 2014

Objective: The aim of this study was to investigate the changes of both ortho- and retronasal olfactory function in children who underwent adenotonsillectomy (AT) operation due to infectious and/or obstructive adenotonsillar disease. Material and methods: A total of 25 children with adenotonsillar disease are included in the study; the children were followed for 6 months in the conducted clinics and underwent AT operation. An age- and sex-matched control group was constituted with 25 healthy children free of adenotonsillar disease. Adenoid and tonsillar hypertrophy was graded according to the subjective size scales. Each subject's orthonasal and retronasal olfactory functions were assessed using odor identification test and retronasal olfactory testing. These tests were performed once, at the beginning of the study, for the control group and performed twice, at the beginning of the study and the third month follow-up, for the disease group. Parents of children in the adenotonsillar disease group filled out a visual analog scale to evaluate the children's appetite at the same time with olfactory testing. Results: The current investigation produced four major findings: (1) both ortho- and retronasal olfactory abilities of participants were improving following AT operation, (2) adenoid hypertrophy had a significant negative effect on both ortho- and retronasal olfaction, whereas tonsil hypertrophy had significant negative effect only on the retronasal olfactory score, (3) retronasal olfaction was found to be more affected by the adenoid size than the orthonasal, as shown with correlation analysis, and (4) the increase in appetite of children after AT operation had been specified by parents. Conclusions: Children with adenotonsillar disease have increased olfaction abilities, namely ortho- and retronasal olfactory function following AT operation. In addition, retronasal olfactory function, an important component of flavor, seems to be more affected than orthonasal function. These results also explain the increased appetite of operated children. © 2014 Elsevier Ireland Ltd.


Cayonu M.,Amasya University | Salihoglu M.,Gulhane Military Medical Academy Haydarpasa Training Hospital | Altundag A.,Istanbul Surgery Hospital | Tekeli H.,Gulhane Military Medical Academy Haydarpasa Training Hospital | Kayabasoglu G.,Sakarya University
European Archives of Oto-Rhino-Laryngology | Year: 2014

Tonsillar hypertrophy is common in children, but it can also be present in adults. Enlarged tonsils, a significant anatomical barrier, may affect the flow of odor molecules from the oral cavity to the nasal passages, which has not yet been studied. Thus, we aimed to investigate the mass effect of palatine tonsillar hypertrophy on retronasal olfaction. This study was carried out in 146 subjects, with a mean age of 22.1 ± 2.2 years, ranging 20-29 years. An oropharyngeal examination of the participants was completed, and tonsillar hypertrophy was graded according to the subjective tonsil size scale. The participants were divided into four groups according to their tonsil size grading; then, each subject's orthonasal olfactory and retronasal olfactory functions were assessed using "Sniffin' Sticks" and retronasal olfactory testing. There were no differences observed between the groups in terms of age, gender, cigarette smoking, or alcohol consumption. In addition, there was no difference between the groups in terms of "Sniffin' Sticks" subtests and TDI scores. It was determined that the retronasal olfactory scores of the participants with grade 4 tonsil size were significantly lower than the retronasal olfactory scores of the participants with grade 1 tonsil size. The current investigation demonstrates that grade 4 tonsillar hypertrophy has significant negative effects on the retronasal route of olfactory sensing, when compared with grade 1 tonsillar hypertrophy. © Springer-Verlag Berlin Heidelberg 2013.


PubMed | Kanuni Sultan Suleyman Training Hospital, Nisa Hospital, Gulhane Military Medical Academy Haydarpasa Training Hospital and Fatih University
Type: Journal Article | Journal: Archives of orthopaedic and trauma surgery | Year: 2016

When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees.Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel.Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78 and 46.80 (p<0.01). With respect to TT patients, ACL graft angle was 58.87 and 70.04 on sagittal and frontal planes in operated knees versus 47.38 and 61.82 in healthy knees (p<0.001). ACL graft angle was significantly different between the groups on both sagittal and frontal planes (p<0.001). Sagittal graft insertion tibia midpoint distance ratio was 0.51 and 0.48% in the operated and healthy knees of AM group (p<0.001) and 0.51 and 0.48% in TT group (p<0.001). Sagittal tibial tunnel midpoint distance ratio did not differ from sagittal graft insertion tibia midpoint distance of healthy knees in either group. Femoral tunnel clock position was better in AM [right knee 10:19 oclock-face position (3104); left knee 1:40 (503)] compared with TT group [right knee 10:48 (3245); left knee 1:04 (324)]. With respect to the sagittal plane, the anterior-posterior position of femoral tunnel was better in AM patients. Lysholm scores and range of motion of operated knees in the AM and TT groups showed no significant difference (p>0.05).Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane.


Akarsu S.,Gulhane Military Medical Academy Haydarpasa Training Hospital
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc | Year: 2013

Chronic fatigue syndrome (CFS) is a chronic disease with social components that ensue secondary to the incapacity of the person to fulfill work, social and family responsibilities. Currently, there is no consensus regarding its treatment. The aim of this study was to determine the efficacy of hyperbaric oxygen (HBO2) therapy in CFS. Sixteen patients included in the study were diagnosed with CFS according to the Fukuda criteria. Patients received 15 treatment sessions of HBO2 therapy over a period of three consecutive weeks (five days per week). The outcome measures (visual analog fatigue scale (VAFS). Fatigue Severity Scale (FSS) and Fatigue Quality of Life Score (FQLS) were assessed before the treatment and after completion of the 15 sessions. HBO2 therapy was well tolerated, with no complications. After treatment, patients' scores were found to have improved with respect to VAFS, FSS and FQLS (all p<0.005). We ,may infer that HBO2 therapy decreases the severity of symptoms and increases the life quality of CFS patients. It may be a new treatment modality for the management of CFS. However, further studies with larger sample sizes and control groups are definitely awaited.


Tutuncu L.,Gulhane Military Medical Academy Haydarpasa Training Hospital
Ginekologia polska | Year: 2012

The aim of this retrospective study is to determine whether increasing the stimulation dose of rFSH in unexpected poor responders is associated with better IVF outcome or not. A total of forty eligible women who fulfilled our definition of poor responders (< or = 3 follicles, < 4 oocytes or E2 levels < or = 500 pg/ml on day of hCG administration) and who did not achieve an ongoing pregnancy in the first cycle and who returned for a second higher rFSH dose IVF cycle with a long-agonist protocol were included to the study. The first-low dose cycles and the second-high dose cycles were compared to each other. Each patient functioned as her own control. Main outcome measures of the study were daily and total dose of rFSH, duration of stimulation, number of follicles, number of oocytes retrieved, number of embryos and E2 level on day of hCG injection. The first-low dose cycles and the second-high dose cycles were comparable regarding patient characteristics. There were no significant differences in duration of stimulation, number of follicles, number of oocytes retrieved, number of embryos and E2 level on day of hCG injection between the first-low and second-high dose cycles. Daily and total dose of rFSH were significantly higher in the second-high dose cycles. Fewer cycles were cancelled during the second higher gonadotrophin dose after first unexpected poor response. Increasing the starting dose of gonadotrophin after an unexpected poor response in the first IVF cycle is not an effective approach. It may increase the oocyte retrieval rates and embryo transfer rates, but will not add any significant improvement in the number of oocytes retrieved and the number of transferable embryos. The only important benefit of increasing the dose was the low cancellation rate.


Acar A.,Gulhane Military Medical Academy Haydarpasa Training Hospital
Burns : journal of the International Society for Burn Injuries | Year: 2011

In this experimental animal study, the effects of three different topical antimicrobial dressings on Candida albicans contaminated full-thickness burn in rats were analyzed. In total 32 adult Wistar rats (body weight 200-220 g) were used. Silver-coated dressing (Acticoat™®), chlorhexidine acetate 0.5% (Bactigrass®) and Mycostatine (Nystatin®) were compared to assess the antifungal effect of a once-daily application on experimental rat 15% full-skin thickness burn wound seeded 24h earlier with a 10(8) CFU/mL standard strain of C. albicans ATCC 90028. All the animals were sacrificed at post burn day 7. The quantitative counts of seeded organism in burn eschar and subjacent muscle were determined, in addition to the cultures of left ventricle blood and lung biopsies. While there were significant differences between Acticoat™® group (4 ± 10 × 10(4)) and control group (5 ± 6 × 10(6)), and between Nystatin group (4 ± 4 × 10(4)) and control group (P=0.01, P=0.01), there were no significant differences between chlorhexidine acetate 0.5% group (2 ± 3 × 10(4)) and control group (P=0.7) respectively. Acticoat™® and Nystatin were sufficient to prevent to C. albicans from invading to the muscle and from causing systemic infection. The animal data suggest that nystatin is the most effective agents in the treatment of C. albicans-contaminated burn wounds, and Acticoat™® is a choice of treatment on fungal burn wound infection with antibacterial effect and the particular advantage of limiting the frequency of replacement of the dressing. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.


PubMed | Gulhane Military Medical Academy Haydarpasa Training Hospital and Gulhane Military Medical Academy
Type: | Journal: Head & neck | Year: 2016

Tumor necrosis factor-related associated-inducing ligand (TRAIL) is a death ligand currently under clinical trials for laryngeal carcinoma.Paraffin-embedded tissues from 40 patients with laryngeal carcinoma and 20 patients with benign laryngeal pathologies were retrospectively analyzed using immunohistochemistry in terms of distribution and intensity, and for final analysis of immunoreactivity of receptors, H-score was used. The study group was assessed in terms of localization, lymph node staging, tumor stage, overall survival, disease-free survival, locoregional control, perineural invasion, and vascular invasion.The H-score of decoy-R2 (DcR2) staining were increased significantly in tumor tissue (p=.04). A significantly greater increase in terms of H-score of DR5 receptor staining (p=.06) was detected in tumor tissue.TRAIL-mediated gene therapy may not be effective. Indeed, the findings may indicate treatment resistance. TRAIL and TRAIL receptor levels were not associated with prognosis 2015 Wiley Periodicals, Inc. Head Neck 38: E535-E541, 2016.

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