Turkiye Yuksek Ihtisas Teaching and Research Hospital

Ankara, Turkey

Turkiye Yuksek Ihtisas Teaching and Research Hospital

Ankara, Turkey

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Okten S.,Ahu Hetman Hospital | Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Onal I.K.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Haznedaroglu I.C.,Hacettepe University
Singapore Medical Journal | Year: 2011

Variceal bleeding is one of the most important and life-threatening complications of portal hypertension. Although less common than oesophageal varices that have a lower frequency of bleeding, gastric varices tend to result in more severe and mortal bleeding. The Ankaferd Blood Stopper (ABS) has been used with varying success in recent years for the management of bleeding from skin lesions and after dental surgery, and in other clinical conditions in which conventional haemostatic measures have proved to be deficient. In serious bleeding gastric fundal varices, ABS can also act as a bridge in the absence or unavailability of definitive therapies.


Turhan N.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Ozderin Y.O.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kurt O.K.,Ataturk Chest Diseases and Chest Surgery Teaching and Research Hospital
Pathology Research and Practice | Year: 2011

The aim of this study was to determine the prevalence and histopathological characteristics of hepatic granulomas.All records of liver biopsies/resections evaluated in our pathology department between 2002 and 2009 were retrospectively reviewed. Specimens with hepatic granulomas were reexamined by a designated pathologist. Type and localization of granulomas, size of granulomas and epithelioid histiocytes, and the morphological findings of surrounding liver tissue were recorded in an attempt to establish a correlation with relevant clinical, laboratory and radiological findings.Out of 1420 liver biopsy/resected specimens evaluated at our institution during the study period, 86 cases of epithelioid cell granulomas (6.05%) were observed. Of the 86 cases, 23 were men and 63 were women. The most common underlying etiology was PBC in 38 patients, infections in 34, malignancies in five, sarcoidosis in four, and foreign bodies in three patients. One case (1.2%) of a drug-induced hepatic granuloma was encountered, while another case was deemed idiopathic (of unknown etiology). Contrary to common belief, granulomas were observed not only in early stage PBC but also in cases with stage 3 disease. Out of all the PBC cases with granulomas, 55.6% had stage 3 disease, and besides periductal granulomas, intraacinar granulomas were also seen. For sarcoidosis, intra- and peri-granulomatous fibrosis was observed in as many as 75% of cases. A large majority of granulomas (82.4%) associated with infections were of the necrotizing type.Extensive evaluation of the morphological characteristics of hepatic granulomas and surrounding liver tissue along with clinical, radiological, and other laboratory findings may help arrive at an accurate diagnosis in a majority of cases. Rather than being a final diagnosis, the presence of hepatic granulomas entails the need for further investigations towards identifying the underlying etiology, with a pathologist being at the center of the diagnostic process. © 2011 Elsevier GmbH.


Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Akdogan M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Onal I.K.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kekilli M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | And 5 more authors.
Digestive and Liver Disease | Year: 2010

Aim: The aim of this study was to retrospectively assess the haemostatic efficacy of the endoscopic topical use of Ankaferd Blood Stopper (ABS) in the setting of neoplastic GI bleeding. Methods: The records of 10 patients with neoplastic GI bleeding (7 gastric, 3 rectal) were evaluated retrospectively. Written informed consent regarding the off-label use of ABS as a means of attaining haemostasis had been obtained from all of the patients prior to the procedure. In all patients, ABS was applied topically. Rates of bleeding control and post-procedural complications were documented. Results: Haemostasis was achieved in all patients within seconds of endoscopic application of ABS, with no immediate complications. Seven patients underwent subsequent cancer surgery after a bleeding-free post-procedural period. Conclusions: ABS as a novel haemostatic agent could have a potential benefit in controlling bleeding from GI tumours. Prospective controlled studies are needed to help establish its efficacy, and perhaps offer a comparison to conventional haemostatic interventions. © 2009 Editrice Gastroenterologica Italiana S.r.l.


Korkut E.,Ankara University | Bektas M.,Ankara University | Oztas E.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | And 2 more authors.
European Journal of Internal Medicine | Year: 2010

Background and aims: Celiac disease shares several symptoms which constitute some of the ROME criteria used for the diagnosis of irritable bowel syndrome (IBS), and as such many patients with underlying Celiac disease may be mistakenly diagnosed as having IBS. The aim of the present study was to determine the prevalence of Celiac disease in patients with IBS fulfilling ROME III criteria. Materials and methods: Patients who fulfilled ROME III criteria for irritable bowel syndrome were screened for Celiac disease using the Biocard TM Celiac Disease Stick test, and patients who tested positive had their serum samples analyzed for antigliadin IgA and IgG, and anti-tissue transglutaminase IgA antibodies. Patients with detectable antibody levels underwent endoscopic duodenal biopsy to confirm a diagnosis of Celiac disease. Results: Two of 100 patients who were diagnosed as having irritable bowel syndrome as per the Roma III criteria were found to have elevated levels of serum antigliadin IgA and IgG, and anti-tissue transglutaminase IgA antibodies, with histological evidence of Celiac disease on examination of duodenal biopsy. Both patients were started on a gluten-free diet, showing significant improvement in their symptoms on follow-up. Conclusions: Celiac disease is a common finding among patients labeled as IBS. Celiac disease must be considered in differential diagnosis of IBS especially in the therapy refractory group. © 2010 European Federation of Internal Medicine.


Canbay S.,Oncology Training and Research Hospital | Turhan N.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Bozkurt M.,Ankara University | Arda K.,Oncology Training and Research Hospital | Caglar S.,Ankara University
Turkish Neurosurgery | Year: 2013

Aim:The purpose of the present study is to analyze the expression of matrix metalloproteinase-3 (MMP-3), magnetic resonance imaging (MRI) grading and histopathological alterations of the intervertebral disc (IVD) for correlations with each other and with the age, gender and low back pain duration of the patients who had undergone operations for lumbar disc herniation (LDH). Material and Methods: Forty-two patients were admitted to our clinic with signs of LDH and underwent surgery for LDH at 48 IVD levels. In all cases, specimens for histological and immunohistochemical analyses were removed from the IVD space. Lumbar IVD degeneration on MRI of the 48 IVDs from which surgical specimens had been obtained was classified into five grades using the Pfirrmann classification. Results: In the degenerated IVD, the expression of MMP-3, MRI grading and histopathological alterations of the IVD displayed significant correlation. Increased age is closely related with aforementioned alterations. There was no correlation between MMP-3 expression and age, gender and duration of the pain. Conclusion: For evaluating and treating IVD degeneration, MRI is a good and non-invasive diagnostic tool to determine the severity of degeneration. MMP-3 may be a therapeutic target of the degenerated IVD.


PubMed | Turkiye Yuksek Ihtisas Teaching and Research Hospital and Ankara University
Type: Journal Article | Journal: Archives of Iranian medicine | Year: 2016

Neuroendocrine tumors (NETs) are rare tumors, but the incidence is increasing with new diagnostics. A 37-year-old man was admitted to our hospital for an incidental 17-mm nodule in the tail of the pancreas. PET/CT shows indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-dotatate. NET was suspected and laparoscopic distal pancreatectomy was performed. Pathologic examination revealed an accessory spleen with a heterotopic location. To the best of our knowledge, this is the first intrapancreatic accessory spleen (IPAS) case in which the positive 68-Ga-dotatate uptake reported in the literature. Our case showed that IPAS is one of the reasons of false positive involvement of 68-Ga-dotatate PET/CT. When PET/CT shows an indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-dotatate, surgeons should keep IPAS in their mind for differential diagnosis to avoid false treatment.


Beyazit Y.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kekilli M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Goker H.,Hacettepe University | Haznedaroglu I.C.,Hacettepe University
Alternative Medicine Review | Year: 2010

Ankaferd Blood Stopper (ABS), a unique traditional herbal mixture, has been used topically to stop bleeding for centuries in Anatolia. ABS is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. Through its effects on the endothelium, blood cells, angiogenesis, cellular proliferation, vascular dynamics, and cell mediators, ABS is now becoming an official alternative hemostatic medicine for intractable bleedings that are resistant to conventional anti-hemorrhagic measures in Turkey. Furthermore, ABS seems to have a considerable therapeutic benefit, because of its anti-infective, antineoplastic, and wound healing properties, to restore and maintain tissue homeostasis in a variety of diseases. Copyright © 2010 Alternative Medicine Review, LLC. All Rights Reserved.


Kurt M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Onal I.K.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Akdogan M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Kekilli M.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | And 4 more authors.
Canadian Journal of Gastroenterology | Year: 2010

OBJECTIVE: To assess the hemostatic efficacy of the Ankaferd Blood Stopper (ABS, Ankaferd Health Products Ltd, Turkey) hemostatic agent for controlling gastrointestinal bleeding associated with various benign lesions refractory to conventional antihemorrhagic measures. METHODS: The records of all patients who underwent upper and lower endoscopy procedures at the Turkiye Yuksek Ihtisas Teaching and Research Hospital (Ankara, Turkey) between April 2008 and June 2009 were reviewed. Patients in whom ABS was used as a primary or adjuvant hemostatic agent were included in the study. Rates of bleeding control and postprocedural complications were documented. RESULTS: Hemostasis with no immediate complications was achieved in all patients within seconds of endoscopic application of ABS. CONCLUSIONS: ABS may have a role as a primary treatment or as an adjuvant to conventional modalities used to control gastrointestinal bleeding. Prospective controlled studies are needed to help establish its efficacy and, perhaps, offer a comparison with conventional hemostatic interventions. ©2010 Pulsus Group Inc. All rights reserved.


Turhan N.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Ozguler Z.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Cagli K.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Golbasi Z.,Turkiye Yuksek Ihtisas Teaching and Research Hospital
Cardiovascular Pathology | Year: 2011

Primary cardiac tumors are very rare, and a vast majority of such malignant tumors are sarcomas. Associated symptoms are usually vague and nonspecific resulting in a late diagnosis and poorer prognosis. Most cardiac sarcomas have been reported in autopsy series. Although echocardiography may help make a diagnosis of a cardiac sarcoma, histopathological confirmation is quintessential. Presented here are two cases of patients who underwent successful surgery for the removal of a cardiac tumor, along with echocardiographic, cytological, and histopathological findings as well as a compact literature review. In both patients, the masses were on the surface of the mitral valve, and intraoperative evaluation of frozen sections and imprint cytology were indicative of a "probably malignant" mesenchymal tumor prompting more extensive surgical resection. Immunohistochemical staining of the resected material in both cases was only positive for vimentin, leading to a diagnosis of undifferentiated sarcoma. One of the patients died 3 months after surgery, while the other who received adjuvant chemotherapy was still alive after 4 months. Surgery remains the most definite treatment for cardiac sarcomas. The use of intraoperative frozen section and imprint cytology plays an important role in the decision to extend surgical resection. © 2011 Elsevier Inc. All rights reserved.


Turhan N.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Aydog G.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Ozin Y.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | Cicek B.,Turkiye Yuksek Ihtisas Teaching and Research Hospital | And 2 more authors.
Diagnostic Cytopathology | Year: 2011

The objective was to assess EUS-FNA for diagnosing intramural upper GI tract lesions. The subjects were 50 patients (21M/29F) with upper GI submucosal lesions who underwent EUS-FNA at a referral center for GI system over a 12-month period. All cases were followed for 1 year after initial EUS-FNA. Cytologic diagnoses were categorized as benign, malignant, suspicious for malignancy, mesenchymal tumor, endocrine tumor, or nondiagnostic. All tumors were assessed for various cytomorphologic features. The accuracy of the initial FNA diagnoses was evaluated for each patient who also underwent subsequent histopathological examination of a core biopsy and/or surgical biopsy/resection material of the same lesion. According to the site of the lesions; while 84% of all esophageal lesions were diagnosed as mesenchymal; 67% of all gastric lesions were mesenchymal. The sole lesion was nonmesenchymal (benign cyst) in duodenum. The sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA for diagnosing submucosal mesenchymal tumors of the upper GI tract were 82.9, 73.3, 87.9, 64.7, and 80%, respectively. The corresponding values for nonmesenchymal lesions were 100, 85.7, 80, 100, and 90.9%. Our experience confirms that EUS-FNA is an extremely valuable tool for diagnosing submucosal lesions of the upper GI, and is particularly useful in cases where endoscopic forceps biopsy does not lead to diagnosis. Optimal results can be yielded by a close working relationship between the gastroenterologist and pathologist. Copyright © 2010 Wiley-Liss, Inc.

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