Kayseri Training and Research Hospital

Kayseri, Turkey

Kayseri Training and Research Hospital

Kayseri, Turkey
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Senel F.,Kayseri Training and Research Hospital
Kulak burun bogaz ihtisas dergisi : KBB = Journal of ear, nose, and throat | Year: 2016

Subacute thyroiditis, which is most commonly observed after a viral infection and may heal spontaneously, is an inflammatory thyroid disease. The co-occurrence of subacute thyroiditis and papillary carcinoma is quite rare. A 58-year-old male patient who applied to our hospital with the complaints of sore throat and neck swelling was performed total thyroidectomy following physical examination, ultrasound, and laboratory analysis. In histopathological examination, many granuloma structures were observed in both lobes, and a papillary microcarcinoma focus of 2 mm in diameter was seen in the left lobe. The co-occurrence of subacute thyroiditis and papillary carcinoma was deemed worthy of presentation as it is rarely observed.

Coskun B.D.O.,Kayseri Training and Research Hospital | Ozen M.,Kayseri Training and Research Hospital
Turkish Journal of Gastroenterology | Year: 2017

Background/Aims: The critical flicker frequency (CFF) and psychometric hepatic encephalopathy score (PHES) are commonly proposed tests for detecting minimal hepatic encephalopathy (MHE); however, no studies have examined their value for detecting MHE in Turkey. Materials and Methods: A total of 70 patients with cirrhosis without overt HE, 205 controls for PHES, and 100 controls for the CFF test were included. All the patients underwent the PHES and CFF tests during the same session. Psychometric tests comprising number connection test A and B, digit symbol test, serial dotting test, and line drawing test were used. Tests were considered abnormal when test score was more than mean ± 2 standard deviations in comparison with that of the age- and education-matched controls. MHE was diagnosed when ≥2 PHES test were abnormal, and CFF was <39 Hz. Results: The prevalence of MHE among the 70 patients with cirrhosis, as measured by the CFF and PHES tests, was 41.4% (29) and 30.7% (25), respectively. The mean CFF was significantly lower in patients with cirrhosis having MHE (38.3±1.2 Hz) than in patients with cirrhosis not having MHE (42.6±2.3 Hz; p=0.001) and in controls (44.84 ± 3.7 Hz; p=0.001). With a cutoff value of <39, CFF had a sensitivity of 39%, specificity of 82%, and diagnostic accuracy of 70.6% for detecting MHE. Conclusion: The CFF test is also a useful method for detecting MHE in xxx patients with cirrhosis. However, the CFF test should be used as an adjunct to the PHES test because of its low sensitivity for detecting MHE. © Copyright 2017 by The Turkish Society of Gastroenterology.

Ergul A.B.,Kayseri Training and Research Hospital
Pediatric Emergency Care | Year: 2017

OBJECTIVES: L-Thyroxine ingestion is rarely seen in children; here, we report our experience of it. This study describes the clinical characteristics and laboratory findings of acute L-thyroxine ingestion in children. METHODS: This retrospective study enrolled patients treated for L-thyroxine ingestion at Kayseri Teaching Hospital between September 2013 and September 2016. Clinical characteristics and laboratory findings are described. Ethical approval was not obtained because the study was retrospective. RESULTS: The incidence of L-thyroxine ingestion was 0.07% to 1.2% per year. There were 14 patients. Twelve patients were asymptomatic, but 2 (14.2%) exhibited tachycardia and hypertension. Thyroid hormone levels were elevated in 3 patients (21.4%). Eleven patients did not require medical treatment (78.4%); 3 did. No serious complication or death was observed. CONCLUSIONS: Acute ingestion has a benign course. Serious complications are uncommon but may appear several hours or days after ingestion; therefore, patients with L-thyroxine ingestion should be followed closely for 2 weeks. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Yontar Y.,Kayseri Egitim Ve Arastima Hastanesi | Ozyazgan I.,Kayseri Training and Research Hospital
Plastic and Reconstructive Surgery | Year: 2017

Background: The authors present the results of an experimental study in which four different techniques were used for the correction of concave rabbit auricular cartilage. Methods: Sixteen New Zealand adult male rabbits were used in the study. Butyl cyanoacrylate-aided cartilage graft fixation and butyl cyanoacrylate-aided bone graft fixation and scoring technique, alone or combined with butyl cyanoacrylate application, were performed to correct the concavity of rabbit auricular cartilage. Results: Angle measurements showed that all four techniques were efficient for correction of the cartilage concavities. However, the mean postsacrifice angles of the graft fixation groups were significantly higher than those of the other study groups, reflecting the fact that graft fixation with butyl cyanoacrylate application was more efficient for preserving the final cartilage shape. Furthermore, in the ninth month, graft fixation groups had the lowest chondrocyte densities, the highest degree of inflammation, the highest degree of foreign body reaction, and the highest butyl cyanoacrylate density. Conclusions: Fibrosis or chondrocyte proliferation on scoring incision lines is not an associated feature of this technique. When the incision depths were standardized, the scoring technique provided efficacy similar to that of the scoring incisions combined with butyl cyanoacrylate application for correction of the cartilage concavity. The scoring incision plus butyl cyanoacrylate group showed less toxicity than the graft fixation groups because of rapid removal of toxic breakdown products. Graft fixation techniques were superior to other corrective procedures with regard to preservation of the final cartilage shape. Although they resulted in greater toxicity, the cartilage correction was not affected unfavorably. Copyright © 2017 by the American Society of Plastic Surgeons.

Yasar M.,Kayseri Training and Research Hospital
The journal of international advanced otology | Year: 2016

OBJECTIVE: Our aim was to investigate the curative role of topical Hypericum perforatum (HP) in a rat model of tympanic membrane perforation in a histopathological manner.MATERIALS AND METHODS: This study was conducted on 30 female Sprague-Dawley rats. An HP extract was prepared as a suspension in pure olive oil. In all rats, the right and left tympanic membranes were perforated by a fine puncture under a microscope. Rats were randomly assigned to three groups. The HP extract was given as drops on a daily basis in Group 1, while olive oil alone was given on a daily basis in Group 2. In Group 3, the rats were allowed spontaneous recovery without any intervention. Three rats from each group were sacrificed on days 7, 14, and 21. Temporal bullae were removed for histopathological examination to evaluate fibroblast proliferation, leukocyte infiltration, neovascularization, and subepithelial thickness and to compare these among the groups.RESULTS: In histopathological examination of the rats from each group on days 7, 14, and 21, there were significant differences in leukocyte infiltration, fibroblast proliferation, and subepithelial thickness. No significant difference was observed in neovascularization among the groups.CONCLUSION: Compared with the spontaneous recovery group, HP was found to be more effective in a wound-healing model of the tympanic membrane. HP may be applied in clinical practice if it is shown to be safe with regard to ototoxicity.

Bayram A.,Kayseri Training and Research Hospital
Journal of Craniofacial Surgery | Year: 2017

ABSTRACT: The authors describe a case of gunshot injury in a 26-year-old male patient with an unusual bullet trajectory. The bullet had an entry hole just near the right lateral alar cartilage of the nose, and the trajectory descended through the left side of the neck by route of the hard palate, soft palate, and posterior pharyngeal wall, respectively. Surgical removal of the bullet was achieved with neck exploration. Gunshot injuries of the head and neck necessitate a thorough clinical and radiological evaluation due to the possibility of an unusual bullet trajectory. © 2017 by Mutaz B. Habal, MD.

Sagit M.,Kayseri Training and Research Hospital
The Journal of laryngology and otology | Year: 2011

To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss. A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality. Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.

Yontar Y.,Kayseri Training and Research Hospital
Journal of Burn Care and Research | Year: 2016

Early tangential excision of the burn wound is essential for removal of necrotic tissue and promotion of burn wound healing process. However, the depth of the burn wound is not easily assessed during the tangential excision performed by hand-held dermatomes, and it may be possible to excise unburned vital dermis unnecessarily, which aids in primary epithelization of the burn wound by adnexal structures. We herein present early clinical results of steel wool-aided dermabrasion in patients with deep partial-thickness burns. This is a retrospective case study of 23 consecutive hospitalized patients with deep partial-thickness burns. All of the steel wool-aided dermabrasions were performed under general anesthesia within 48 hours after injury. Patients were excluded from the study if the admission was not within 24 hours after injury, and if the burn wound was entirely superficial partial- or full-thickness. Thirteen male and 10 female patients with a mean age of 26.2 ± 17.1 years were enrolled in the study. During the follow-up period, all of the patients had burn wounds primary epithelized on postburn day 15.1 ± 1.8, without any complications. None of the patients exhibited a mortal course, and redebridement or skin grafting of the previously dermabraded deep partial-thickness burn wounds were not required in any of the patients. Steel wool-aided dermabrasion is an easy, cost-effective, and reliable technique for the treatment of deep partial-thickness burns, which provides complete removal of necrotic tissue, preserves the vital dermis, reduces the requirement for skin grafting, and decreases length of hospital stay. © 2016 The American Burn Association

Benderli Cihan Y.,Kayseri Training and Research Hospital
Kulak burun boǧaz ihtisas dergisi : KBB = Journal of ear, nose, and throat | Year: 2011

This study aims to investigate whether propolis has a protective role in oral mucosal damage induced by radiotherapy applied to head-neck region, using quantitative, biochemical and histopathological approaches. Forty eight Wistar-Albino adult female rats at eight weeks of age and weighing 213±27 grams were included in this study and randomly divided into six groups: Group 1: control, group 2: only irradiated rats, group 3: irradiated rats with propolis administration at 50 mg/kg/day, group 4: irradiated rats with propolis administration at 100 mg/kg/day, group 5: only propolis administration at 50 mg/kg/day, group 6: only propolis administration at 100 mg/kg/day. The first dose of propolis was administered before 30 minutes irradiation and the other doses after irradiation once daily for seven days by topical application. Radiotherapy was applied to the total cranium by single fraction at a dose of 18 Gy. The mucositis degrees and body weights of the animals were measured throughout the experiment. On the 7th day of study, blood samples were taken from the rats under ketamine anesthesia and then the rats were sacrificed and tongue tissues samples were taken. Complete blood count and biochemical and antioxidant activities were analysed in the blood samples. The tongue samples were microscopically examined. Radiotherapy group had a decrease in body weight and neutrophil count, and an increase in oral mucositis as compared with the control group (p<0.001). Moreover, an increase in plasma malondialdehyde concentrations (p<0.001) and significant decreases in catalase and superoxide dismutase activities (p<0.001) were observed in irradiation-alone group when compared to the control group. Propolis administered irradiated rat groups showed a dose-dependent normalization in quantitative, biochemical and histopathological parameters when compared with the irradiation-alone group. The results showed that propolis is effective in reducing the severity of oral mucositis induced by head-and-neck irradiation.

Celikbilek A.,Kayseri Training and Research Hospital | Ismailogullari S.,Erciyes University | Zararsiz G.,Erciyes University
Journal of Clinical Laboratory Analysis | Year: 2014

Background: Inflammation plays a role in the pathogenesis of carotid atherosclerosis. Although previous data demonstrated an association between inflammatory biomarkers and stroke, there is no publication reporting the relation of neutrophil to lymphocyte (N/L) ratio with ischemic stroke. We aimed to analyze the predictive ability of N/L ratio in acute ischemic cerebrovascular disease. Methods: A total of 190 patients including 70 patients with first-ever atherothrombotic acute ischemic stroke (AAIS), 50 patients with transient ischemic attack, and 70 healthy subjects were enrolled in this study. We analyzed the values of white blood cell (WBC), N/L ratio, C-reactive protein (CRP), gamma-glutamyltransferase (GGT), homocysteine (HCY), mean platelet volume (MPV) in patients with ischemic group and compared those with control individuals. Results: WBC, CRP, HCY, N/L ratio were found to increase significantly in AAIS patients than the controls (P < 0.001). With respect to mortality, there were no significant differences between the values of CRP, GGT, HCY, and MPV in patients with AAIS. However, WBC and N/L ratio values were found to increase significantly in dead patients (P = 0.024 and P = 0.029, respectively). A comparison of receiver operating characteristic curves among WBC, CRP, GGT, HCY, MPV, and N/L ratio variables was made. No significant differences were obtained between area under curve values (P > 0.05). A cut-off value of 4.1 for N/L ratio was detected in predicting mortality with a sensitivity of 66.7% and a specificity of 74.1% (κ = 0.299, P = 0.006). Conclusions: These findings support the role of N/L ratio as a simple inexpensive and readily available marker of prognosis in acute ischemic stroke. © 2013 Wiley Periodicals, Inc.

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