Kayseri Research and Education Hospital

Kayseri, Turkey

Kayseri Research and Education Hospital

Kayseri, Turkey

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Sunman H.,Beyazit Training and Research Hospital | Yorgun H.,Hacettepe University | Canpolat U.,Turkiye Yuksek Ihtisas Hospital | Kunak A.U.,Kayseri Research and Education Hospital | And 8 more authors.
International Journal of Cardiovascular Imaging | Year: 2013

We aim to evaluate the prognostic value of dual-source 64-slice multidetector computed tomography (MDCT) in patients with coronary stents. The study included 173 patients [mean age 59.9 ± 10.1 years, 76.7 % male] with previous stent implantation who underwent MDCT for evaluation of CAD and stent patency. Coronary imaging was performed via dual-source MDCT scanner. Stented vessel segment was evaluated as patent without neointimal hyperplasia (NIH), nonobstructive NIH (>50 % luminal narrowing), or obstructive NIH (<50 % luminal narrowing). Patients were evaluated for major cardiovascular events (MACEs) to demonstrate association between stent patency and clinical outcome. MACEs that were originating from non-stented segments were excluded. A total of 213 coronary stents were evaluated in our study. During mean of 21.2 ± 13.6 months' follow-up, 25 patients experienced MACEs [1 (4.0 %) cardiac death, 5 (20.0 %) nonfatal MI, and 19 (76.0 %) unstable angina pectoris requiring hospitalization and target vessel revascularization] associated with stented segment of coronary arteries. One hundred of 105 patients (95.2 %) with a patent stent without NIH detected by MDCT had no cardiac event associated with stented segments during mean 2 years' follow-up period. These data indicate that patients with a patent stent without NIH as determined by MDCT have a good prognosis as opposed to an increased rate of events among patients with either nonobstructive or obstructive NIH as determined with MDCT, supporting MDCT as a reliable tool to evaluate patients after coronary stenting.


Kiraz A.,Kayseri Research and Education Hospital | Avci D.,Erciyes University | Tasdemir A.,Kayseri Research and Education Hospital | Unal T.D.,Kayseri Research and Education Hospital | And 5 more authors.
International Journal of Radiation Biology | Year: 2016

Purpose: To evaluate cytogenetic damage of radiotherapy (RT) and chemoradiotherapy (CRT) in long-term head and neck cancer survivors. Materials and methods: This study included 20 patients treated with RT (10 patients) or CRT (10 patients) for head and neck cancer. Nine healthy volunteers were included as control subjects. Cytochalasin B-blocked micronucleus (CBMN) assay was used to evaluate cytogenetic damage. To evaluate micronucleus (MN) by CBMN, the venous blood samples were drawn median 68 months (range 60–239 months) after the completion of treatment (RT or CRT) for head and neck cancer. Results: Nuclear division index (NDI) and number of MN in mononuclear and binuclear lymphocytes were significantly higher in patients with head and neck cancer than in control subjects [1.19 (1.08–1.47) vs. 1.07 (1.04–1.14), p < 0.001; 11.0 (2.0–22.0) vs. 1.0 (0–3.0), p < 0.001 and 15.0 (5.0–45.0) vs. 9.0 (2.0–15.0), p = 0.020, respectively]. NDI and number of MN in mononuclear lymphocytes were significantly lower in control subjects compared patients received CRT and those received only RT, but there was no significant difference between patients received CRT and those received only RT. Number of MN in binuclear lymphocytes was significantly lower in control subjects compared to patients received CRT, but there was no significant difference between control subjects and those received only RT. Also there was no significant difference between patients received CRT and those received only RT in terms of number of MN in binuclear lymphocytes. Conclusions: MN frequency of mononuclear and binuclear lymphocytes in medical follow-up of patients with head and neck cancer after RT could be important in evaluating cytogenetic damage of RT. However, further investigations are needed to provide quantitative correlations between MN yields and the clinical features in post-radiotherapy period. © 2016 Informa UK Limited, trading as Taylor & Francis Group.


Arslan D.,Erzurum Research and Education Hospital | Tural D.,Akdeniz University | Koca T.,Erzurum Research and Education Hospital | Tastekin D.,Istanbul University | And 15 more authors.
Journal of B.U.ON. | Year: 2015

Purpose: Relatively few studies have focused on T4N2 (stage HIB) locally advanced non-small cell lung cancer (NSCLC). In this study, we tried to identify prognostic factors for patients with clinical stage T4N2 NSCLC. Methods: We retrospectively identified 223 patients, of which 168 met the inclusion criteria. Patients treated with curative intent using concurrent chemoradiotherapy (CRT) with or without adjuvant chemotherapy, or concurrent CRT after induction chemotherapy, were included in this study. Relevant patient, treatment, and disease factors were evaluated for their prognostic significance in both univariate and multivariate analyses using the Cox proportional hazards model. Results: The median progression-free survival (PFS) was 13 months (95% confidence interval [CI], 10.6-15.4). The median overall survival (OS) was 20 months (95% CI, 16.8-23.1), and 71, 40.3 and 28.2% of the patients survived for 1,2 and 3 years after diagnosis, respectively. Multivariate analysis showed Eastern Cooperative Oncology Group (ECOG) performance status (PS) was independent predictor of PFS (hazard ratio [HR], 0.24; 95% CI, 0.13-0.43; p=0.001), and OS [HR, 0.48; 95% CI, 0.26-0.87; p=0.015). Absence of multifocal T4 tumors was also associated with a significantly longer OS (HR, 046; 95% CI, 0.31-0.7; p=0.001). There was no statistically significant difference in OS and PFS between treatment modalities. Conclusion: PFS and OS were significantly shorter in patients with poor ECOG PS. OS was also significantly shorter in patients with multifocal T4 tumors. There were no differences between the two therapeutic approaches with respect to outcome.


PubMed | Erciyes University and Kayseri Research and Education Hospital
Type: Journal Article | Journal: International journal of radiation biology | Year: 2016

To evaluate cytogenetic damage of radiotherapy (RT) and chemoradiotherapy (CRT) in long-term head and neck cancer survivors.This study included 20 patients treated with RT (10 patients) or CRT (10 patients) for head and neck cancer. Nine healthy volunteers were included as control subjects. Cytochalasin B-blocked micronucleus (CBMN) assay was used to evaluate cytogenetic damage. To evaluate micronucleus (MN) by CBMN, the venous blood samples were drawn median 68 months (range 60-239 months) after the completion of treatment (RT or CRT) for head and neck cancer.Nuclear division index (NDI) and number of MN in mononuclear and binuclear lymphocytes were significantly higher in patients with head and neck cancer than in control subjects [1.19 (1.08-1.47) vs. 1.07 (1.04-1.14), p<0.001; 11.0 (2.0-22.0) vs. 1.0 (0-3.0), p<0.001 and 15.0 (5.0-45.0) vs. 9.0 (2.0-15.0), p=0.020, respectively]. NDI and number of MN in mononuclear lymphocytes were significantly lower in control subjects compared patients received CRT and those received only RT, but there was no significant difference between patients received CRT and those received only RT. Number of MN in binuclear lymphocytes was significantly lower in control subjects compared to patients received CRT, but there was no significant difference between control subjects and those received only RT. Also there was no significant difference between patients received CRT and those received only RT in terms of number of MN in binuclear lymphocytes.MN frequency of mononuclear and binuclear lymphocytes in medical follow-up of patients with head and neck cancer after RT could be important in evaluating cytogenetic damage of RT. However, further investigations are needed to provide quantitative correlations between MN yields and the clinical features in post-radiotherapy period.


Murat S.N.,Etlik Ihtisas Research and Education Hospital | Duran M.,Kayseri Research and Education Hospital | Kalay N.,Erciyes University | Gunebakmaz O.,Kastamonu City Hospital | And 10 more authors.
Angiology | Year: 2013

Platelets play a central role in the pathophysiology of coronary artery disease (CAD). Increased mean platelet volume (MPV) is an indicator of platelet function and associated with poor clinical outcome in patients with acute coronary syndrome (ACS). We evaluated the relationship between MPV and severity of CAD in patients with ACS. A total of 395 patients with ACS were included. Severity of CAD was assessed with the Gensini and Syntax scores. High levels of MPV were associated with the Gensini and Syntax scores, number of diseased vessels (>50%), number of critical lesions (>50% and >70%), and noncritical lesions. After multivariate analysis, high levels of MPV were independent predictors of multivessel CAD together with age. In patients with ACS, high MPV levels were associated with severity of CAD. It is possible that MPV can be a helpful marker in patients with CAD for the severity of coronary atherosclerosis. © The Author(s) 2013.


Altntas A.G.,Ulucanlar Eye Research and Education Hospital | Arifoglu H.B.,Kayseri Research and Education Hospital | Koklu S.G.,Ulucanlar Eye Research and Education Hospital
Turk Oftalmoloiji Dergisi | Year: 2015

Objectives: To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome (DRS) with significant upshoot or downshoot. Materials and Methods: A total of 12 patients including 10 patients with Type I DRS and 2 with Type III DRS underwent modified Y-splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intraoperative adjustable suture technique. Preoperatively 3 patients had esotropia (ET), 6 had exotropia (XT), and 3 patients had orthotropia. The mean preoperative deviation was 19.3 prism diopters (PD) (range, 18-20 PD) in ET patients and 19.2 PD (range, 16-20 PD) in XT patients. Results: Postoperatively, all patients had significant correction in horizontal deviation and aligned within 4 PD of orthotropia, and no patients exhibited abnormal head posture. Co-contraction and globe retraction were markedly reduced and abnormal ocular vertical movement disappeared or significantly decreased in all cases. No patients experienced recurrence of ocular motility disorders in the mean 26-month (range, 13-66 months) follow-up period. Conclusion: Modified Y-splitting surgery combined with co-contracting horizontal muscle recession technique seems to be a safe and effective treatment in DRS. © 2015, Turkish Ophthalmology Society. All rights reserved.


Duran M.,Kayseri Research and Education Hospital | Gunebakmaz O.,Harran University | Uysal O.K.,Kayseri Research and Education Hospital | Ocak A.,Erciyes University | And 5 more authors.
Journal of Cardiology | Year: 2013

Objective: Elevated mean platelet volume (MPV) has been proposed as a risk factor for coronary artery disease (CAD) and is associated with poor clinical outcome in acute coronary syndrome (ACS). We aimed to evaluate the association of MPV with presence of coronary collateral vessel (CCV) in patients with ACS. Methods: A total of 417 patients with ACS were included in the study. All patients underwent coronary angiography on the first day after admission and patients with a greater than or equal to 80% obstruction in at least one epicardial coronary artery were included in the study. The CCVs are graded according to the Rentrop scoring system and a Rentrop grade 0 was accepted as no CCV development (Group 1), Rentrop Grade 1-2-3 were accepted as presence of CCV development (Group 2). Results: The median of MPV was 9.1. ±. 1.4. fl. Mean age was 60. ±. 12 year. Group 1 consisted of 233 (55.9%) patients and Group 2 consisted of 184 (44.1%) patients. Presence of CCV was significantly associated with high levels of MPV (. p=. 0.005). Presence of CCV was also associated with presence of diabetes and systolic blood pressure. Conclusion: High MPV on admission was associated with presence of CCV in patients with ACS. © 2013 Japanese College of Cardiology.


Altintas A.G.,Kayseri Research and Education Hospital | Arifoglu H.B.,Kayseri Research and Education Hospital | Koklu S.G.,Kayseri Research and Education Hospital | Sonmez K.,Kayseri Research and Education Hospital
Turkish Journal of Medical Sciences | Year: 2014

Background/aim: To elucidate the early surgical advantages of a 23-gauge trocar combined with a one-directional valve system in transconjunctival pars plana vitrectomies. Materials and methods: Early surgical results of 432 eyes of 432 patients (190 female and 242 male) who underwent 23-gauge (23G) transconjunctival sutureless vitrectomies (TSV) were evaluated. Sixty-three patients out of 432 underwent a second operation, 29 of them underwent silicone oil extraction, and 34 had phacoemulsification surgery with the help of vitreous infusion. If any sign of leakage was observed after the withdrawal of the cannulae, a suture was applied at the conjunctiva-scleral opening site. Results: A total of 21 (4.8%) patients in the first operation and 7 (11.1%) cases in the second operation needed suture in at least 1 sclerotomy site. No one had intraoperative hypotony. On postoperative day 1, 37 initial surgery patients and 3 second TSV patients had hypotony; all of them resolved spontaneously 1 week after surgery. No one developed choroidal effusions or detachment. Intraocular pressure spikes more than 22 mmHg in day 1 occurred in 18 eyes after initial TSV; 6 of them had gas and 4 eyes had silicone tamponade. Conclusion: 23G TSV is an effective and safe procedure for both first vitreoretinal surgery and second intraocular surgeries in eyes that had TSV previously. © TÜBİTAK.


Altekin R.E.,Akdeniz University | Yanikoglu A.,Akdeniz University | Baktir A.O.,Kayseri Research and Education Hospital | Karakas M.S.,Akdeniz University | And 5 more authors.
International Journal of Cardiovascular Imaging | Year: 2012

In this study, our aim was to evaluate the LV (left ventricle) subclinical myocardial dysfunction using the two-dimensional speckle tracking echocardiography (2D-STE) method on obstructive sleep apnea (OSA) patients with preserved left ventricular ejection fraction (LVEF) and without any confounding disease that may result myocardial dysfunction. Twenty-one healthy individuals and 58 OSA patients were enrolled in the study. The patients were categorized into mild, moderate and severe OSA groups according to the apnea-hypopnea index (AHI). Conventional- and tissue Doppler echocardiography imagings were performed in all the individuals besides the 2D-STE. The longitudinal strain (S) and systolic strain rate (SRS) values decreased as the severity of disease increased from moderate towards severe OSA. The circumferential S and SRS values were observed to be lower in the severe OSA patients. Despite the increase in the radial S and SRS in moderate and mild OSA patients, these measurements decreased in those with severe OSA. Although the longitudinal, circumferential and radial early diastolic strain rates (SRE) decreased as the severity of disease increased form moderate to severe, the late diastolic strain rates (SRA) were observed to increase. In the early stages of OSA, longitudinal systolic LV dysfunction is detected in addition to the diastolic dysfunction. The circumferential mechanics of the LV deteriorate in the later stages of the OSA. Despite a compensatory increase in the radial LV function in the early stages of OSA, in later stages, the LV radial function also deteriorates. The assessment of the myocardial functions using the STE method in patients with OSA with preserved LVEF has the potential to detect the subclinical LV dysfunction and might provide useful information for risk stratification. © Springer Science+Business Media, B.V. 2012.


PubMed | Kayseri Research and Education Hospital and Ulucanlar Eye Research and Education Hospital
Type: Journal Article | Journal: Turkish journal of ophthalmology | Year: 2016

To present the outcomes of modified lateral rectus Y-splitting combined with either unilateral or bilateral horizontal rectus recession in Duane Retraction Syndrome (DRS) with significant upshoot or downshoot.A total of 12 patients including 10 patients with Type I DRS and 2 with Type III DRS underwent modified Y-splitting surgery. Amount of additional recessions varied with the degree of preoperative deviation by intraoperative adjustable suture technique. Preoperatively 3 patients had esotropia (ET), 6 had exotropia (XT), and 3 patients had orthotropia. The mean preoperative deviation was 19.3 prism diopters (PD) (range, 18-20 PD) in ET patients and 19.2 PD (range, 16-20 PD) in XT patients.Postoperatively, all patients had significant correction in horizontal deviation and aligned within 4 PD of orthotropia, and no patients exhibited abnormal head posture. Co-contraction and globe retraction were markedly reduced and abnormal ocular vertical movement disappeared or significantly decreased in all cases. No patients experienced recurrence of ocular motility disorders in the mean 26-month (range, 13-66 months) follow-up period.Modified Y-splitting surgery combined with co-contracting horizontal muscle recession technique seems to be a safe and effective treatment in DRS.

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