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Erdogan N.,Izmir Ataturk Research and Training Hospital | Altay C.,Izmir Ataturk Research and Training Hospital | Akay E.,Sakarya Research and Training Hospital | Karakas L.,Izmir Ataturk Research and Training Hospital | And 8 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2013

Magnetic resonance imaging (MRI) of the internal acoustic canal is the standard diagnostic tool for a wide range of indications in patients. This study aims to investigate the vascular variations and compression of the cranial nerves (CNs) VII and VIII at the cerebellopontine angle in patients with neuro-otologic symptoms using 3D-fast imaging employing steady-state acquisition (FIESTA) MR imaging. One hundred and eighty-seven patients (374 temporal bones) were examined on a 1.5-T MRI. In addition to conventional MR sequences, a 3D-FIESTA MR imaging was acquired. Magnetic resonance images thus obtained were evaluated with special regard to the presence of vascular contact to the CNs VII and VIII, as well as the presence of the vascular variations of the anterior inferior cerebellar artery (AICA) causing the compression of CNs. The Chi-squared test was used for statistical analysis. No statistically significant differences were found between the presence and absence of the AICA loop and/or vascular contact for the clinical symptoms of patients (P > 0.05). The cisternal and canalicular segments of CNs VII and VIII and adjacent vascular variations are well identified using 3D-FIESTA, especially by determining the relationship of the AICA variations between CNs. © 2012 Springer-Verlag.

Guven M.,Sakarya Research and Training Hospital | Turan F.,Gaziosmanpasa University | Eyibilen A.,Gaziosmanpasa University | Akbas A.,Gaziosmanpasa University | Erkorkmaz U.,Gaziosmanpasa University
European Archives of Oto-Rhino-Laryngology | Year: 2012

The aim of the study was to investigate the efficacy of 5-flourouracil/triamcinolone acetonide (5-FU/TA), carnitine and dexamethasone on wound healing in an animal model of tracheal injury. Twenty-eight rats underwent surgical injury of the tracheal mucosa and perichondrium under general anesthesia, and were randomized into four groups. Group I (the control group) received nothing after tracheal trauma. Group II received intratracheal 5 mg 5-FU/TA combined with 0.2 ml sodium hyaluronic acid once. Group III received intraperitoneal carnitine 100 mg/kg/day for 20 days. Group IV received intramuscular dexamethasone 0.1 mg/day for 20 days. After 1 month, the levels of superoxide dismutase enzyme activity (SOD) and levels of malondialdehide (MDA) and nitric oxide (NO) in serum were measured and the tracheal specimens were harvested for histopathologic examination. SOD was significantly lower in the carnitine group compared to the control group. A statistically significant decrease in MDA levels were observed in the 5-FU/TA and carnitine groups compared to the control group. NO levels were significantly lower in the 5-FU/TA group, but significantly higher in the dexamethasone group, compared to the control group. The fibrotic tissue volumes of tracheal specimens were significantly lower in both the 5-FU/TA and carnitine groups than those of the control group, but trended toward higher volumes in the dexamethasone group when compared to controls. We concluded that 5-FU/TA and carnitine diminish the occurrence of tracheal stenosis (TS) secondary to experimentally induced tracheal trauma. © 2011 Springer-Verlag.

Erol B.,Marmara University | Basci O.,Dokuz Eylul University | Topkar M.O.,Marmara University | Caypinar B.,Lutfiye Nuri Burat State Hospital | And 2 more authors.
Journal of Pediatric Orthopaedics Part B | Year: 2015

Biological reconstruction is a useful option for reconstruction following bone sarcoma resection in children. The mid-term functional and radiological outcomes of biological reconstructions after resection of bone sarcomas in children are presented in this study. Eighteen patients [average age 12.5 years (range 4-22 years)] with primary sarcomas of long bones underwent wide surgical resection and biological reconstruction. The bone defects were managed by intercalary (n=14), osteoarticular (n=3) reconstructions and arthrodesis (n=1) with a vascularized fibular graft (VFG). VFG was combined with a massive allograft in seven lower extremity reconstructions. The average follow-up was 45.7 months (range 25-78 months). Graft union and graft hypertrophy was observed in 17 (94.4%) of 18 patients at 12 months. The VFG-allograft osteointegration rate was 100% at 24 months. The average final follow-up Musculoskeletal Tumor Society (MSTS) scores for lower and upper extremity reconstructions were 79.7% (range 66.6-90%) and 80.9% (range 53.3-100%), respectively. Four (22.2%) complications, including nonunion (n=1), implant failure (n=1), infection (n=1) and skin necrosis (n=1), required reoperation. The disease relapsed in three (16.6%) patients. Defect size and VFG length did not correlate with MSTS scores and radiological parameters (P>0.05). Biological reconstruction with VFG can provide permanent stability and progressively increasing functional and radiological results. © 2015 Wolters Kluwer Health, Inc.

Background: Blood gas analyzer (BGA) electrolyte measurements are frequently used in emergency departments (EDs) pending biochemistry laboratory autoanalyzer (BLA) results. There is lack of data in the literature in terms of agreement of these 2 measurement methods of sodium. We aimed to comprehensively evaluate the agreement in hyponatremia, eunatremia, and hypernatremia groups. Methods: Retrospectively, adult subjects who presented to ED of a tertiary care teaching hospital and had simultaneous BGA and BLA results were included in the study. Blood pairs were grouped into hyponatremia, eunatremia, and hypernatremia according to BLA results. Agreement of sodium measurements between the methods were evaluated by Bland-Altman plots and Passing and Bablok regression analysis. Results: A total of 2557 blood pairs (1326 males [51.8%]) were included. Median age of the patients was 66 years (18-103). The numbers of patients with hyponatremia, eunatremia, and hypernatremia were 487 (19%), 1943 (76%), and 127 (5%), respectively. The minimum and maximum serum sodium levels measured by biochemistry analyzer were 106 and 171 mmol/L, respectively. The Pearson linear correlation coefficient between BGA and BLA for sodium measurements were 0.574, 0.358, and 0.562 in hyponatremia, eunatremia, and hypernatremia groups, respectively. The absolute mean difference for the 3 groups was greater than 4 mmol/L. Biochemistry laboratory autoanalyzer tended to measure serum sodium higher than BGA in all sodium groups. Passing and Bablok regression analysis showed significant differences between the 2 methods in all sodium groups. Conclusion: This is the first comprehensive evaluation of agreement between BGA and BLA in distinct sodium groups. Significant differences should be taken into account when these patients are managed in the ED. © 2016 Elsevier Inc.

Karkucak M.,Sakarya Research and Training Hospital | Ursavas A.,Uludag University | Ocakoglu G.,Uludag University | Gorukmez O.,Uludag University | And 3 more authors.
Turkiye Klinikleri Journal of Medical Sciences | Year: 2012

Objective: Tumor necrosis factor-alpha (TNF-alpha) is an important indicator of inflammation. Recent studies have demonstrated a relationship between inflammation and obstructive sleep apnea syndrome (OSAS). The aim of this study was to investigate the association between TNF-alpha G308A and C857T gene polymorphisms and OSAS in Turkish patients. Material and Methods: Sixty-nine patients who were diagnosed with OSAS and 42 control subjects were included in the study. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect TNF-alpha G308A and C857T gene polymorphisms. The level of significance for statistical analysis was set at p<0.05. Results: The distribution of genotypes was not significantly different between subjects with a definite diagnosis of OSAS and the control group (p> 0.05). However, the mean body mass index of the OSAS group was significantly different from that of the control group (p<0.05). Conclusion: To our knowledge, this study is the first to analyze the relationship between OSAS and TNF-alpha G308A and C857T gene polymorphisms in Turkish patients. Our results do not support an association between OSAS and TNF-alpha G308A and C857T gene polymorphisms. © 2012 by Türkiye Klinikleri.

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