Izmir Ataturk Education and Research Hospital

İzmir, Turkey

Izmir Ataturk Education and Research Hospital

İzmir, Turkey
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Sefi-Yurdakul N.,Izmir Ataturk Education and Research Hospital | Koc F.,Izmir Ataturk Education and Research Hospital
International Ophthalmology | Year: 2017

Purpose: To evaluate the etiology and possible prognostic factors affecting the visual outcome in patients with indirect traumatic optic neuropathy (TON). Methods: The records of patients with indirect TON were reviewed and compared the results of treatment with high doses of corticosteroids (Group 1) and simple observation without treatment (Group 2). Results: The mean age at the time of injury was 34.7 ± 11.4 (18–58) years in Group 1 and 37.5 ± 17.7 (8–73) years in Group 2 (p = 0.513). The mean value for the first referral of the patient to the ophthalmology clinic following trauma was 2.4 ± 2.4 (1–10) days in Group 1 and 16.7 ± 13.9 (1–30) days in Group 2 (p = 0.004). The most common causes of trauma were road traffic collision (57.1 and 68%) in the Group 1 and 2, respectively (p = 0.606). The mean initial visual acuity was 0.03 ± 0.07 (0.00–0.30) in Group 1 and 0.17 ± 0.21 (0.00–0.80) decimal in Group 2 patients (p = 0.001). The mean visual acuity at the final follow-up was 0.21 ± 0.35 (0.00–1.00) and 0.46 ± 0.42 (0.00–1.00) in Group 1 and Group 2, respectively, indicating better initial and final visual acuity values in Group 2 (p = 0.022), and also a statistically significant recovery of visual acuity between initial and final values in both groups (p < 0.05). The most important determinant of the final visual acuity was initial visual acuity (p < 0.001; 95.0% CI: 0.792–2.096). Conclusions: Our study demonstrated that road traffic collision is the leading cause of indirect traumatic optic neuropathy, and the best predictor of final visual acuity outcome is the initial visual acuity. © 2017 Springer Science+Business Media B.V.

Yildirim Y.,Eastern Mediterranean University | Gunay S.,Izmir Ataturk Education and Research Hospital | Karadibak D.,Izmir University
Journal of Back and Musculoskeletal Rehabilitation | Year: 2014

Background: The purpose of this study was to identify factors associated with Low Back Pain (LBP) among employee working at a package producing industry. Methods: A sample of 111 male blue-collar workers, between the ages of 18 to 50 years old and 31 white-collar workers between the ages of 17 to 50 years old completed a questionnaire which included demographic data, educational level, participation in sports activities, activity, postural habits, smoking, work conditions lifting and bending activities during the workday strenuous arm position and questions related with low back pain (LBP). The isometric strength of back muscles were measured using a dynamometer. RESULT: The prevalence of LBP during the past 12 months was 55.9% for blue-collar workers and 51.6% for white-collar workers. The chi-square and t-test analysis showed statistically significant relations between LBP and smoking, number of years spent working in the last job, lifting activities between the ages of 30-34 years old. The incorrect standing and sitting posture of the blue-collar workers and the sitting posture with bending forward on the table of the white-collar workers were significantly related with LBP (p< 0.05). Conclusions: Our results identified the risk factors of LBP in a package producing company. The protective approaches aiming to avoid the risk factors could decrease the low back pain prevalence that increases each year passed worked at the company. © 2014 - IOS Press and the authors. All rights reserved.

Salva E.,Marmara University | Salva E.,Vocational Health School | Kabasakal L.,Marmara University | Eren F.,Marmara University | And 3 more authors.
Nucleic Acid Therapeutics | Year: 2012

Vascular endothelial growth factor (VEGF) is the important angiogenic factor associated with tumor growth and metastasis in a wide variety of solid tumors. The aim of this study is to investigate the tumor suppressive effect of chitosan/small interfering RNA (siRNA)-VEGF nanoplexes in the rat breast cancer model. Chitosan/siRNA nanoplexes (siVEGF-A, siVEGFR-1, siVEGFR-2) and NRP-1 were prepared in a 15 to1 ratio and injected (intratumorally) into the breast-tumor-bearing Sprague-Dawley rats. Tumor volumes were measured during 21 days. To investigate the effect of chitosan/siRNA nanoplexes on VEGF expression in tumors, VEGF was analyzed with immunohistochemistry and western blotting. The mRNA levels of VEGF in tumor samples were determined with real-time PCR (RT-PCR). After siRNA treatment, a marked reduction in tumor volumes was measured in complex-injected rats (97%). Free siRNA injection showed lower tumor inhibition. Reduction of VEGF protein was also shown with western blotting and immunohistochemistry. Similar results were obtained with RT-PCR also. These results indicate that the chitosan/siRNA targeting to VEGF nanoplexes have a remarkably suppressive effect on VEGF expression and tumor volume in breast cancer model of rats. © 2012 Mary Ann Liebert, Inc.

Koc F.,Izmir Ataturk Education and Research Hospital | Erten Y.,Izmir Ataturk Education and Research Hospital | Yurdakul N.S.,Izmir Ataturk Education and Research Hospital
British Journal of Ophthalmology | Year: 2013

Background: To report the effect of restoration of binocular functions in adult strabismus on the health-related quality of life (HRQOL). Methods: 61 adults undergoing strabismus surgery completed Adult Strabismus-20 (AS-20) and Amblyopia and Strabismus (A&SQ) HRQOL questionnaires preoperatively and postoperatively. Patients were grouped according to their responses to binocular tests as binocular vision positive (BVP) and binocular vision negative (BVN) groups. Changes in AS-20 and A&SQ scores of the overall group and the subgroups were evaluated. Results: Motor success was 90%, and 43% of the cohort showed measurable level stereopsis and central fusion on the Worth four-dot test or on the synoptophore. HRQOL scores (composite, psychosocial and functional) of the cohort measured by AS-20 and A&SQ showed significant improvement after surgery (AS-20: 42,40,45 vs 85,86,84, AS&Q: 46,52,38 vs 76,75,78, p<0.05 for all comparisons). But the BVP (n-26) group was not found superior to the BVN (n-35) group both functionally and psychosocially ( p>0.05). Only after the exclusion of the amblyopic patients, functional superiority of the BVP group (n-20) over the BVN group (n-20) was disclosed (AS-20: 45 vs 31, A&SQ: 28 vs 16, p<0.05), while the composite and psychosocial subscale score improvements were not different (AS-20: 44,40 vs 34,38, A&SQ: 30,38 vs 20,37, p>0.05 for all comparisons). Conclusions: The restoration of binocular vision is possible in adults with a long-term history of strabismus and both AS-20 and A&SQ questionnaires are sensitive to detect additive effect of binocular vision on functional aspects of the quality of life. To increase this sensitivity, questionnaires can be modified to include items inquiring tasks that require fine stereopsis.

Koc F.,Izmir Ataturk Education and Research Hospital | Sefi-Yurdakul N.,Izmir Ataturk Education and Research Hospital
Eye (Basingstoke) | Year: 2016

The purpose of this study was to determine the predictors of stereoacuity outcome in visually mature subjects with exotropia following surgical correction. Visually mature subjects who were surgically aligned and had been tested for stereoacuity in the postoperative period were studied retrospectively. Subjects were grouped with respect to their responses to Titmus or TNO stereotests. Characteristics such as amblyopia, anisometropia, and characteristics of the exodeviation such as time of onset, duration, intermittency, presence of an A or V pattern, distance-near disparity, coexisting vertical deviation, and inferior oblique overaction, were compared between the groups. One hundred and four visually mature subjects with exotropia met the inclusion criteria. Stereoacuity was achieved in 77% of the study group and only 9% of these could achieve fine stereoacuity. Negative stereoacuity was more frequently associated with larger deviation angles, higher anisometropia, inferior oblique overaction, pattern strabismus, coexisting vertical strabismus, and distance-near disparity, but not at a statistically significant level. The optimal cutoff for strabismus duration was 20 years for a positive stereoacuity outcome. Any-level visual acuity difference was found to decrease the chance for positive stereoacuity significantly. The odds ratios for the stereoacuity positivity were 4.05 for strabismus duration <20 years, 7.9 for strabismus onset >1 year of age, 3.79 for weaker eye visual acuity >20/25 and 9.85 for intermittency of strabismus. Intermittence of exotropia was the strongest predictor for positive stereoacuity. Exotropia onset after 1 year of age, absence of any-level visual acuity difference, and strabismus duration <20 years were the other predictors with decreasing power. © 2016 Macmillan Publishers Limited All rights.

Yurdakul N.S.,Izmir Ataturk Education and Research Hospital | Ugurlu S.,Izmir Ataturk Education and Research Hospital
Journal of Pediatric Ophthalmology and Strabismus | Year: 2013

Purpose: To evaluate the possible risk factors in patients with consecutive exotropia following esotropia surgery. Methods: Medical records of patients who had comitant esotropia surgery between June 1999 and April 2011 were reviewed. Those who developed consecutive exotropia composed the exotropia group; patients matched for age and duration of follow-up who did not develop consecutive exotropia composed the no exotropia group. The charts of the patients were reviewed and possible risk factors for development of consecutive exotropia were investigated. Results: The average ages of 47 patients in the exotropia group and 54 patients in the no exotropia group were 10.8 ± 8.7 years (range: 1 to 41 years) and 8.5 ± 6.3 years (range: 1 to 30 years), respectively (P = .292). Amblyopia was detected in 31 (66%) and 12 (22.2%) patients in the exotropia and no exotropia groups, respectively (P = .004). Anisometropia was observed in 20 patients (42.6%) in the exotropia group and 5 patients (9.3%) in the no exotropia group (P = .003). Preoperative average esodeviation values were 42.5 ± 8.3 prism diopters (PD) (range: 25 to 60 PD) in the exotropia group and 42 ± 9.4 PD (range: 20 to 65 PD) in the no exotropia group (P = .673). Postoperative deviations were 32.8 ± 23 PD exotropia (range: 10 to 90 PD exotropia) in the exotropia group and 4.4 ± 4.2 PD esotropia (range: 0 to 10 PD esotropia) in the no exotropia group (P = .000). Asymmetric surgery had been performed in 61.7% of the exotropia group (n = 29) and 9.3% of the no exotropia group (n = 5) (P = .000). Limitation of adduction was detected in 14 patients (29.8%) in the exotropia group; none was noted in the no exotropia group (P = .000). The mean interval between the initial surgery and the onset of consecutive exotropia was 11.1 ± 15.1 months (range: 0 to 126 months). Conclusions: Anisometropia, amblyopia, asymmetric surgery, and postoperative adduction deficit were associated with the development of consecutive exotropia. Longterm follow-up should be considered because consecutive exotropia can develop after months or years. © SLACK Incorporated.

Sefi-Yurdakul N.,Izmir Ataturk Education and Research Hospital | Tugcu B.,Istanbul University
Strabismus | Year: 2016

Purpose: To evaluate the incidence of strabismus in children initially diagnosed with pseudostrabismus and to identify risk factors for the development of strabismus. Methods: The medical records of patients who were diagnosed with pseudostrabismus at initial examinations in outpatient clinic were reviewed retrospectively. Follow-up examinations were made at the strabismus department. Age at first examination, gender, family and developmental history, ophthalmic and orthoptic findings including orbit, and eyelid pathologies were investigated. Results: Sixty-five patients with the diagnosis of pseudostrabismus were identified; 2 patients (3.1%) had pseudoexotropia, and 63 patients (96.9%) had pseudoesotropia. The mean age at the initial exam was 29.26±26.68 months (range; 4–120 months). Epicanthal skin folds (n=35), flat broad nasal bridge (n=17), blepharophimosis syndrome (n=1), hypertelorism (n=1), telecanthus (n=1), and multiple pathologies (n=10) were the reasons for pseudostrabismus. Six patients (9.2%) had clinically significant hypermetropia. Anisometropia and amblyopia were detected in 1 (1.5%) and 3 patients (4.6%), respectively, at the initial examination. The mean follow-up period was 25.2±23.28 months (range; 1–154 months). During the follow-up period, true strabismus was detected in 8 cases (12%); of these, 5 cases had non-refractive esotropia, 2 cases had refractive accommodative esotropia, and 1 case had exotropia. Binocular single vision was not developed following amblyopia therapy and refractive correction in esotropic cases. Binocular single vision and best corrected visual acuity were statistically significant risk factors for the development of strabismus (P=0.001). Conclusion: The pseudostrabismic children with subnormal binocular single vision or low visual acuity require follow-up for the risk of development of true strabismus. © 2016 Taylor & Francis.

Sefi-Yurdakul N.,Izmir Ataturk Education and Research Hospital
International Journal of Ophthalmology | Year: 2015

Aim: To evaluate the visual findings as primary manifestations in patients with intracranial tumors. Methods: The medical charts of the patients with intracranial tumors who initially admitted to the Neuro-ophthalmology and Strabismus Department with ocular complaints between August 1999 and December 2012 were reviewed retrospectively. The detailed clinical history and the findings of neuro-ophthalmologic examination were recorded. Ocular symptoms and signs, the types and locations of intracranial tumors, and the duration of symptoms before the diagnosis were evaluated. Results: The mean age of 11 women (61.1%) and 7 men (38.9%) was 42.2±11.0 (range 20-66y) at the time of intracranial tumor diagnosis. Initial symptoms were transient visual obscurations, visual loss or visual field defect in 16 cases (88.9%), and diplopia in 2 cases (11.1%). Neuro-ophthalmologic examination revealed normal optic discs in both eyes of 6 patients (33.3%), paleness, atrophy or edema of optic disc in 12 patients (66.7%), and sixth cranial nerve palsy in 2 patients (11.1%). Visual acuity ranged between normal vision and loss of light perception. Cranial imaging demonstrated craniopharyngioma (n=1), plasmacytoma (n=1), meningioma (n=6; olfactory groove and tuberculum sellae, pontocerebellar angle, anterior cranial fossa, frontal vertex, suprasellar region), and pituitary macroadenoma (n=10). The mean duration between the onset of visual disturbances and the diagnosis of intracranial tumor was 9.8±18mo (range 3d-6y). Conclusion: The ophthalmologist is frequently the first physician to encounter a patient with clinical manifestations of intracranial tumors that may cause neurological and ocular complications. Neuro-ophthalmologic findings should be carefully evaluated to avoid a delay in the diagnosis of intracranial tumors. © 2015, International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.

Ozkan N.,Marmara University | Salva E.,Marmara University | Cakalagaoglu F.,Izmir Ataturk Education and Research Hospital | Tuzuner B.,Marmara University
Biotechnic and Histochemistry | Year: 2012

Formalin has long been the standard fixative for clinical routines worldwide. After the Formaldehyde Standard became law in the US in 1987, as a result of increasing concerns about the potential carcinogenicity of formaldehyde, attempts have been made to find safer alternatives. Alcoholic formalin is a useful fixative, because in addition to fixation, dehydration also is begun. For centuries, honey has been known to be an antibacterial agent with the potential to preserve compounds without harmful effects on its users. We compared the effects of honey fixation with other routine fixatives using conventional histochemical and immunohistochemical staining methods. Our results demonstrated that tissues fixed in either honey or alcoholic formalin and 10% neutral buffered formalin (NBF) have similar histomorphology. Honey fixation showed minor histomorphological differences among the various tissues; however, it did not influence affect correct diagnostic conclusions. Our results suggested that honey can be used as a safe alternative to formalin in histopathology. © 2012 The Biological Stain Commission.

Yurekli I.,Izmir Ataturk Education and Research Hospital
Medical science monitor basic research | Year: 2013

The aim of this study was to investigate the protective effects of methylprednisolone (Pn), which is a potent anti-inflammatory agent, and pheniramine maleate (Ph), which is an antihistaminic with some anti-inflammatory effects, on reperfusion injury in brain developing after ischemia of the left lower extremity of rats. Twenty-eight randomly selected male Sprague-Dawley rats were divided into 4 groups: Group 1 was the control group, Group 2 was the sham group (I/R), Rats in Group 3 were subjected to I/R and given Ph, and rats in Group 4 were subjected to I/R and given Pn. A tourniquet was applied at the level of left groin region of subjects in the I/R group after induction of anesthesia. One h of ischemia was performed with no drug administration. In the Ph group, half of a total dose of 10 mg/kg Ph was administered intraperitoneally before ischemia and the remaining half before reperfusion. In the Pn group, subjects received a single dose of 50 mg/kg Pn intraperitoneally at the 30th min of ischemia. Brains of all subjects were removed after 24 h for examination. Malondialdehyde (MDA) levels of the prefrontal cortex were significantly lower in the Ph group than in the I/R group (p<0.05). Superoxide dismutase (SOD) and glutathione peroxidase (GPx) enzyme activities were found to be significantly higher in the Ph group than in the I/R group (p<0.05). Histological examination demonstrated that Ph had protective effects against I/R injury developing in the brain tissue. Ph has a protective effect against ischemia/reperfusion injury created experimentally in rat brains.

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