Bursa Sevket Yilmaz Training and Research Hospital

Yıldırım, Turkey

Bursa Sevket Yilmaz Training and Research Hospital

Yıldırım, Turkey
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Turgut A.,Bursa Sevket Yilmaz Training and Research Hospital | Kayali C.,Izmir Bozyaka Training and Research Hospitay | Agus H.,Izmir Tepecik Training and Research Hospital
Eklem Hastaliklari ve Cerrahisi | Year: 2012

Objectives: In this study, we aimed to evaluate changes in frontal plane (anatomical axis) and sagittal plane (tibial slope, patellar height) parameters following closed-wedge high tibial osteotomy (HTO) and possible correlations between them. Patients and methods: Between June 2003 and May 2007, 15 knees of the 13 female patients (mean age 52.6 years; range 45 to 64 years) who were followed on a regular basis in our outpatient clinic and underwent closed-wedge HTO were included. The mean follow-up was 49 months (range 29-75 months). Radiologic analysis was performed using pre- and postoperative anatomical axis, tibial slope, and patellar height measurements [Caton index (CI) and Insall-Salvati index (ISI)]. The findings were analyzed by using Wilcoxon matched pairs test and Pearson's correlation test. Results: Preoperative varus deformity was 6.3°±2.7°, while it was measured as 7.2°±2.5° valgus in the last visit (p=0.0004). The pre- and postoperative CI were 0.97±0.1 and 0.96±0.1, respectively (p=0.85). The ISI decreased from 1.23±0.15 to 1.14±0.15 (p=0.012). Patella baja was observed in only one patient (ISI=0.77). Preoperatively tibial slope was 6.5°±2.4°, while it was measured as 0.06°±3.4° in the last visit (p=0.0001). There was no correlation between frontal plane angle change and tibial slope, also between patellar height and tibial slope. Conclusion: Closed-wedge HTO does not result in significant changes in patellar height. The risk of patella baja can be decreased through minimal dissection around patellar tendon. However, closed-wedge HTO reduces tibial slope significantly. Optimal resection from posterior tibia is necessary to prevent this condition. A possible loss of tibial slope should be considered in the further reconstructive procedures.


Dilli D.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Aydin B.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Fettah N.D.,Dr Sami Ulus Maternity and Children Research and Training Hospital | Ozyazici E.,Dr Sami Ulus Maternity and Children Research and Training Hospital | And 8 more authors.
Journal of Pediatrics | Year: 2015

Objective To test the efficacy of probiotic and prebiotic, alone or combined (synbiotic), on the prevention of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants. Study design A prospective, randomized, controlled trial was conducted at 5 neonatal intensive care units in Turkey. VLBW infants (n = 400) were assigned to a control group and 3 study groups that were given probiotic (Bifidobacterium lactis), prebiotic (inulin), or synbiotic (Bifidobacterium lactis plus inulin) added to breastmilk or formula for a maximum of 8 weeks before discharge or death. The primary outcome was NEC (Bell stage 2). Results The rate of NEC was lower in probiotic (2.0%) and synbiotic (4.0%) groups compared with prebiotic (12.0%) and placebo (18.0%) groups (P <.001). The times to reach full enteral feeding were faster (P <.001), the rates of clinical nosocomial sepsis were lower (P =.004), stays in the neonatal intensive care unit were shorter, (P =.002), and mortality rates were lower (P =.003) for infants receiving probiotics, prebiotics, or synbiotic than controls. The use of antenatal steroid (OR 0.5, 95% CI 0.3-0.9) and postnatal probiotic (alone or in synbiotic) (OR 0.5, 95% CI 0.2-0.8) decreased the risk of NEC, and maternal antibiotic exposure increased this risk (OR 1.9, 95% CI 1.1-3.6). Conclusions In VLBW infants, probiotic (Bifidobacterium lactis) and synbiotic (Bifidobacterium lactis plus inulin) but not prebiotic (inulin) alone decrease NEC. © 2015 Elsevier Inc.


Polat E.,Kartal Kosuyolu High Specialty Training and Research Hospital | Duman U.,Kartal Kosuyolu High Specialty Training and Research Hospital | Duman M.,Bursa Sevket Yilmaz Training and Research Hospital | Atici A.E.,Kartal Kosuyolu High Specialty Training and Research Hospital | And 4 more authors.
Current Oncology | Year: 2014

Background: Since the first introduction of tumour markers, their usefulness for diagnosis has been a challenging question. The aim of the present prospective study was to investigate, in colorectal cancer patients, the relationship between preoperative tumour marker concentrations and various clinical variables. Methods: The study prospectively enrolled 131 consecutive patients with a confirmed diagnosis of colorectal carcinoma and 131 age- and sex-matched control subjects with no malignancy. The relationships of the tumour markers carcinoembryonic antigen (cea) and carbohydrate antigen (ca) 19-9 with disease stage, tumour differentiation (grade), mucus production, liver function tests, T stage, N stage, M stage were investigated. Results: Serum concentrations of cea were significantly higher in the patient group than in the control group (p = 0.001); they were also significantly higher in stage iii (p = 0.018) and iv disease (p = 0.001) than in stage i. Serum concentrations of cea were significantly elevated in the presence of spread to lymph nodes (p = 0.005) in the patient group. Levels of both tumour markers were significantly elevated in the presence of distant metastasis in the patient group (p = 0.005 for cea; p = 0.004 for ca 19-9). Conclusions: Preoperative levels of cea and ca 19-9 might provide an estimate of lymph node invasion and distant metastasis in colorectal cancer patients. © 2014 Multimed Inc.


Akduman D.,Bursa Sevket Yilmaz Training and Research Hospital | Yanilmaz M.,Fatih University | Haksever M.,Bursa Sevket Yilmaz Training and Research Hospital | Doner F.,Medical Park Bursa Hospital | Sayar Z.,Bursa Sevket Yilmaz Training and Research Hospital
Rhinology | Year: 2013

Statement of problem: Surgery for nasal obstruction is performed to give a subjective benefit. We aimed to evaluate the surgical management of the nasal obstruction in the patient's perception. Methods of study: The study was performed prospectively with 134 patients over the age of 18. They were allotted to three groups according to the level of nasal obstruction by clinical examination. The G1 group had only a deviated nasal septum (DNS), G2 had DNS and hypertrophy of inferior turbinates, and G3 had nasal valve problems in conjunction with DNS. All the patients had surgery focused on obstructive pathologies. The study was conducted using three different scoring systems to determine the patients' evaluation of the surgical procedures. Results: The study included more man than woman, with a mean age around 28 (wide range). Twenty six patients were in G1, 73 patients in G2 and 35 patients in G3. Total and general Glasgow Benefit Inventory (GBI) scores for each group showed improvement postoperatively. There was a significant dierence between the groups for general GBI score, and Post-hoc test showed that the improvement of G1 was greater than of G3. The influence of the surgery on physical health, psycho-social function and social interaction scores for each group showed no changes postoperatively. There was a significant improvement in all Nasal Obstruction Septoplasty Effectiveness (NOSE) scores and Likert Scale scores for each group. The improvement of G1 and G2 were greater than G3 on the Likert Scale. Conclusion: Surgical management targeted to the region of obstruction improves symptoms and benefit in the patient's perception.


Ozyurtlu M.,Bursa Sevket Yilmaz Training and Research Hospital | Altinkaya S.,Uludag University | Baltu Y.,Uludag University | Ozgenel G.Y.,Uludag University
Ulusal Travma ve Acil Cerrahi Dergisi | Year: 2014

Background: The aim of this study was to demonstrate a new, easy and safe technique, which has not been defined in the literature previously, that enables the gradual primary closure of fasciotomy wounds using barbed sutures. Methods: The technique was performed on five patients who presented with fasciotomy wounds on both upper and lower extremities, varying in size, observed after compartment syndrome due to different causes. The average width of the defects for which primary closure was planned was 8.8 cm. Following the fasciotomy incision, absorbable barbed sutures were inserted through the dermal tissue around the wound similar to that of a subcuticular closure, but left loose, after which closed dressing was applied. During the clinical follow-up, with the decrease in tissue edema and tightness around the wound, the barbed suture was tightened at bedside every 48-72 hours. Results: At the end of this gradual closure, all the fasciotomy defects were primarily closed within an average of 8.6 days. All the patients had complete and uncomplicated primary closure with the exception of one with high-voltage electrical burn injury, who developed necrosis in the distal part of the defect, and was treated by secondary healing. Conclusion: The gradual fasciotomy closure technique with barbed suture seems to be an easy, rapid and effective method. © 2014 TJTES.


Akduman D.,Bursa Sevket Yilmaz Training and Research Hospital | Haksever M.,Bursa Sevket Yilmaz Training and Research Hospital | Yanilmaz M.,Fatih University
European Archives of Oto-Rhino-Laryngology | Year: 2014

We aim to define a cartilage reshaping and repositioning technique for caudal septal dislocations, with the logic of adapting the smoother tissues to the stiffer structures. The study was designed retrospectively with the patient charts and photographic analysis. Thirty-six patients who had septal surgery in a septoplasty or an open approach septorhinoplasty operation and meet the inclusion criteria were evaluated for the study. Postoperative success of the technique was based on preoperative and postoperative photographic analysis by two independent otorhinolaryngologists. The estimators classified 33 cases as near complete, 3 cases as improved but persisting caudal septal deviation, and any cases with no change. The improvement of the degree of reconstruction was near complete about 87 % in septoplasty and 95 % in septorhinoplasty groups, and 92 % for all patients. In this study, we present a caudal septal repositioning maneuver which achieves a stable anchorage between postero-caudal septal cartilage and nasal spine. Septal cartilage is notched and fixed to nasal spine with two simple independent sutures as lock and key model. We define this maneuver as riding spine technique. It is an anatomic re-orientation between the septum and nasal spine for caudal septal deviations and subluxations. © Springer-Verlag Berlin Heidelberg 2013.


Haksever M.,Bursa Sevket Yilmaz Training and Research Hospital | Akduman D.,Bursa Sevket Yilmaz Training and Research Hospital | Aslan S.,Bursa Sevket Yilmaz Training and Research Hospital | Solmaz F.,Bursa Sevket Yilmaz Training and Research Hospital | Ozmen S.,Bursa Sevket Yilmaz Training and Research Hospital
Clinical and Experimental Otorhinolaryngology | Year: 2015

Objectives. Pharyngocutaneous fistula is a serious complication after total laryngectomy, and there are some risk factors stated in the literature. The surgical suture techniques are not studied so much. The aim of this study is to evaluate the effectiveness of ‘modified continuous mucosal Connell suture’ on the incidence of pharyngocutaneous fistula after total laryngectomy. Methods. This is a retrospective case series study based at a tertiary center with 31 patients who underwent total laryngectomy between July 2011 and December 2013. Pharyngocutaneous fistula formation after total laryngectomy was evaluated with the patients who underwent modified continuous mucosal Connell suture for pharyngeal repair. Results. Pharyngocutaneous fistula was observed in only one patient (3.2%) who had a history of previous radiotherapy, and it was spontaneously healed within 6 days by conservative treatment. Conclusion. We defined a new suture technique for the pharyngeal repair after total laryngectomy. This technique is a simple modification of continuous mucosal Connell suture. We named it as zipper suture. It is effective in the prevention of pharyngocutaneous fistula for pharyngeal reconstruction after total laryngectomy. © 2015 by Korean Society of Otorhinolaryngology-Head and Neck Surgery.


Akdur N.C.,Bursa Sevket Yilmaz Training and Research Hospital | Donmez M.,Ankara Training and Research Hospital | Gozel S.,Ankara Training and Research Hospital | Ustun H.,Kafkas University | Hucumenoglu S.,Ankara Training and Research Hospital
Diagnostic Pathology | Year: 2013

Background: Intravascular papillary endothelial hyperplasia (IPEH) is a benign intravascular process with features mimicking other benign and malignant vascular proliferations. IPEH lesions predominate in the head-neck region and the extremities. The characteristic histomorphological feature of IPEH is a papillary structure covered with hyperplastic endothelial cells within the vascular lumen. It is critical that this clinically benign lesion should not be mistaken for well-differentiated vascular tumors. In addition to the characteristic histological features, other useful diagnostic features included the intra-luminal location of the lesion, an intimate association with the organizing thrombus, the absence of necrosis, cellular pleomorphism, and mitotic activity. In addition, immunohistochemistry may indicate the vascular origin and proliferative index. In this study, we evaluated histomorphological and immunohistochemical findings (CD31, CD34, FVIII, type IV collagen, SMA, MSA, CD105, and Ki-67 staining) of ten IPEH cases.Methods: Ten IPEH cases were re-examined for a panel of histomorphological and immunohistochemical features. CD31, CD34, FVIII, Type IV collagen, SMA and MSA antibodies utilized for immunohistochemical analysis. The histomorphological and immunohistochemical findings were evaluated by two independent pathologists using light microscopy.Results: All ten cases involved intraluminal lesions with characteristic features of IPEH. All ten cases (100%) were stained positive for CD31 and CD34. The degree of staining with FVIII, type IV collagen, SMA, and MSA was variable.Conclusion: In this series of specimens, CD31 and CD34 were the most sensitive markers indicating the vascular origin of the lesion. Staining for the other vascular markers (FVIII, type IV collagen, SMA and MSA) was variable. Different maturation degrees of lesions may account for the variation in immunohistochemical staining. Few previous investigations evaluated a wide range of antigen panels in IPEH sections. In our opinion, the evaluation of immune markers in a larger sample set will reveal new features in the maturity and developmental pathogenesis of vascular lesions and angiogenesis. IPEH is a benign lesion, which must be differentiated from malignant tumors such as angiosarcoma and Kaposi's sarcoma. Improved definition of IPEH lesions using immunohistochemical markers may enhance the ability to differentiate between various vascular lesions.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1381849312101856. © 2013 Akdur et al.; licensee BioMed Central Ltd.


PubMed | Bursa Sevket Yilmaz Training and Research Hospital
Type: Journal Article | Journal: APSP journal of case reports | Year: 2016

Intestinal neuronal dysplasia (IND) type B is characterized by malformation of parasympathetic plexus and manifests at more than 6 month of age with progressive severe constipation. We report a case of IND type B presented with bowel dilatation on antenatal scan and neonatal intestinal obstruction which is unusual with this type of IND.


Haksever M.,Bursa Sevket Yilmaz Training and Research Hospital | Ozmen S.,Bursa Sevket Yilmaz Training and Research Hospital | Akduman D.,Bursa Sevket Yilmaz Training and Research Hospital | Solmaz F.,Bursa Sevket Yilmaz Training and Research Hospital
European Archives of Oto-Rhino-Laryngology | Year: 2014

The objective of this study is to compare the topical administration of bupivacaine hydrochloride, saline and bupivacaine hydrochloride infiltration on post-tonsillectomy pain in children. Sixty children undergoing tonsillectomy were enrolled in the study. Patients were randomized into three groups using sealed envelopes. Group 1 (n = 20) received topical 0.5 % bupivacaine hydrochloride, group 2 (n = 20) received topical 0.9 % NaCl (saline), and group 3 (n = 20) received 0.5 % bupivacaine hydrochloride infiltrated around each tonsil. Pain was evaluated using McGrath's face scale. Pain scores in topical bupivacaine hydrochloride group was significantly lesser than the topical saline group at 5th, 13th, 17th and 21st hours, until the 6th day (p < 0.017). Moreover, pain scores of topical bupivacaine hydrochloride group was superior to bupivacaine hydrochloride infiltration group at 5th, 13th, 17th hours and 2nd, 3rd, 4th and 5th day (p < 0.017). There were significantly lesser morbidities in topical bupivacaine hydrochloride than saline group in 1st and 4th day (p < 0.017). Topical administration of bupivacaine hydrochloride proved to provide more efficient pain control than bupivacaine hydrochloride infiltration. © 2014 Springer-Verlag.

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