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Celik S.E.,Beyoglu State Hospital | Celik S.,Okmeydani Research and Training Hospital | Goksu K.,Centermed Neuroradiology Center | Kara A.,Beyoglu State Hospital | Ince I.,Centermed Neuroradiology Center
Journal of Spinal Disorders and Techniques | Year: 2010

Study Design: The 2 groups of patients with severe lumbar spinal stenosis were prospectively compared as a case control study. Objectives: This prospective case control study sought to evaluate bilateral microdecompressive laminatomy (MDL) for treatment of severe lumbar spinal stenosis. Summary of Background Data: Total laminectomy is a general consensus on the therapy of severe spinal stenosis. The authors tried to investigate a new minimal invasive approach. Methods: Patients were randomly divided into 2 groups. In first group, 34 patients underwent total laminectomy (TL) for severe lumbar spinal stenosis. In the second group, 37 patients with the same diagnosis underwent bilateral MDL. The groups were compared for disability, walking distance, degree of postoperative back and leg pain, perioperative complications, and postoperative instability. Radiographic analyses were performed at regular intervals to demonstrate satisfactory decompression. Results: Mean follow-up was 5 years. Postoperative computerized tomography and magnetic resonance imaging demonstrated adequate decompressions in both groups. The walking distance, pain control, and disability scores were slightly higher among patients in the MDL group, although these results did not achieve statistical significance. Perioperative complications and postoperative instability were significantly higher in the TL group (P<0.05). Conclusions: Compared with classic approaches, bilateral MDL provides adequate and safe decompression in lumbar spinal stenosis. It significantly reduces clinical symptoms and disability. However, TL shows higher perioperative complications and postoperative instability. To the best of our knowledge, this is the first study to define a bilateral MDL approach to treat the stenotic lumbar spine without a herniated disc. © 2010 by Lippincott Williams & Wilkins. Source

Evliyaoglu F.,Okmeydani Research and Training Hospital | Karadag R.,Yuzuncu Yil University | Burakgazi A.Z.,Virginia Polytechnic Institute and State University
Muscle and Nerve | Year: 2012

Ocular movements and coordination require complex and integrated functions of somatic and autonomic nervous systems. Neurological disorders affecting these nervous systems may cause ocular dysfunction involving extraocular muscles and pupils. In this article, the prevalence, clinical presentations, and management of ocular neuropathy related to certain peripheral neuropathies, including diabetic neuropathy, Guillain-Barré syndrome (GBS), chronic inflammatory neuropathies, human immunodeficiency virus (HIV)-associated neuropathy, and hereditary neuropathies, are examined in detail. © 2012 Wiley Periodicals, Inc. Source

Veyseller B.,Bezmialem Foundation University | Ozucer B.,Bezmialem Foundation University | Degirmenci N.,Bezmialem Foundation University | Gurbuz D.,Okmeydani Research and Training Hospital | And 4 more authors.
Auris Nasus Larynx | Year: 2014

Objective: Radiotherapy is the primary method of treatment for nasopharyngeal cancer (NPC) and many side effects were reported in patients receiving radiation to this area. This study was conducted to evaluate the long-term effects of radiotherapy following NPC on olfactory bulb (OB) volume and olfactory function. Methods: Twenty-four patients with NPC who received radiotherapy at least 12 months ago were recruited. Fourteen healthy subjects with similar demographical characteristics were recruited as the healthy control group. All volunteers were subjected to a nasoendoscopical examination, and abnormalities that could potentially cause olfactory dysfunction were the exclusion criteria from the study. An experienced radiologist segmented the MRI coronal, axial and sagittal slices manually for three-dimensional OB volume measurement in a blinded manner. Olfactory function was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) test, and average score (0: worst, 7: best) was calculated as the total CCCRC olfactory score. Results: The mean CCCRC score was 5.5±1.1 for the nasopharyngeal cancer patients, whereas the mean score of healthy control group was 6.4±0.4. There was a significant difference in the olfactory scores (p=0.003). The mean OB volume in the NPC group was 46.7 ± 12.1 mm3. Among the patients with NPC, the cisplatin receiving group had a mean OB volume of 47.2 mm3, whereas the cisplatin+docetaxel receiving group had a mean OB volume of 46.5mm3, and they were similar. The MRI measurement of the healthy control group was 58.6 ± 13.8mm3. The OB volumes of the healthy control group were significantly higher (p<0.05). Conclusion: Radiotherapy following nasopharyngeal cancer results in a diminished OB volume and deteriorated olfactory function. Chemosensory olfactory dysfunction might be a contributing factor to lack of appetite, cancer cachexia and consequent lowered quality of life in NPC patients. © 2014 Elsevier Ireland Ltd. Source

Guney S.,Sisli Etfal Research and Training Hospital | Ozakin E.,Okmeydani Research and Training Hospital
European Journal of Gynaecological Oncology | Year: 2010

Ovarian metastases from renal cell carcinoma (RCC) are very rare, with only 23 cases reported in the literature. We report a case of 54-year-old women who developed bilateral ovarian metastasis 39 months after diagnosis of clear cell carcinoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was carried out. Subsequently she was treated with sunitinib and her disease stabilized. She is still alive four years after diagnosis of the renal primary, and disease has stabilized on sunitinib. We conclude that, although rare, the possibility of metastatic RCC should be considered in the differential diagnosis of clear cell tumors of the ovary. Due to therapeutic and prognostic implications, it is very important to differentiate if the tumor is a primary ovarian tumor or a metastasis from a renal cell carcinoma. Early diagnosis of this rare metastatic tumor results in prompt treatment and prolonged patient survival. Source

Gerceker Turk B.,Ege University | Taskin B.,Istanbul Bagcilar Research and Training Hospital | Karaca N.,Okmeydani Research and Training Hospital | Ozden Sezgin A.,Ege University | Aytimur D.,Ege University
Acta Dermatovenerologica Croatica | Year: 2013

Tinea incognita is a dermatophyte infection with atypical clinical features modified by the improper use of corticosteroids or calcineurin inhibitors. The aim of this study was to analyze clinical and microbiological features of patients with tinea incognita. A total of 6326 patients referred to mycology laboratory between January 2008 and January 2011 for mycological examination with a diagnosis of tinea incognita were reviewed retrospectively. Twenty-one patients, 13 (61.9%) women and 8 (38.1%) men, mean age 42.2±36.8, were included in the study. Of them, lesions were localized in 15 (71.4%) patients and widespread in six (28.6%) patients. The mean duration of the disease was 9.5 (range 1-120) months. All patients had a history of treatment with steroids. Before admission, most of them had been misdiagnosed as eczema or psoriasis. Microscopic examination revealed hyphae and spores in most of the cases (n=17, 80.95%). Mycological cultures were positive in 19 (90.5%) patients. The most frequently isolated dermatophyte was Trichophyton rubrum (n=14, 66.7%). This case series revealed Trichophyton rubrum as the most frequent agent of tinea incognita. To the best of our knowledge, this is the largest case series from Turkey describing clinical features and mycological agents of tinea incognita. Source

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