Karabey M.S. | Yirmibeşoğlu Erkal E. | Yolcu A. | Bakkal, Bekir Hakan | Ay Ö. | Aksu M.G. | Sarper E.B.

Article | 2017 | Turkish Journal of Medical Sciences47 ( 2 ) , pp.412 - 416

Background/aim: This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). Materials and methods: The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone. Results: Follow-up ranged from 1 to 44 months. Loc . . .al control was not achieved in 10 out of 11 patients who had received RT with palliative intent. Systemic failure was observed in eight patients at 5 to 16 months. Fifteen patients died due to disease-related causes at 1 to 22 months. At 2 years, overall survival was 33% and disease-free survival was 19%. A surgical resection with curative intent predicted improved local failure-free survival and improved disease-free survival. Conclusion: Since local recurrence is still the leading cause of failure following postoperative RT and the outcome following palliative RT is far from satisfactory, the indications, the target volume, and the doses for RT should be reconsidered. © TÜBİTAK Daha fazlası Daha az

Bektaş, Sibel | Bahadır, Burak | Doğan Gün, Banu | Kertiş, Gürkan | Özdamar, Şükrü Oğuz

Article | 2009 | Turkish Journal of Medical Sciences39 ( 3 ) , pp.381 - 387

Aim: The aim of this study was to assess the size and shape characteristics of prostatic adenocarcinoma cell nuclei using a computer-assisted analysis system, and to compare the results with the Gleason score. Materials and Methods: Morphometric nuclear parameters, such as roundness factor, form ellipse, area, length, and perimeter, were evaluated based on specimen slides of 130 prostatic adenocarcinoma cases (77% needle biopsies and 23% prostatectomy specimens) using a computerized image analysis system. Correlation analysis between Gleason score and morphometric results was performed. Results: The Gleason score was correlated with . . . mean nuclear area (r = 0.516, P = 0.01), mean nuclear length (r = 0.298, P = 0.01), and mean nuclear perimeter (r = 0.303, P = 0.01) for all specimens. In the needle biopsy group the Gleason score was correlated with mean nuclear area (r = 0.522, P = 0.01), mean nuclear length (r = 0.398, P = 0.01), and mean nuclear perimeter (r = 0.432, P = 0.01), whereas in the prostatectomy group the Gleason score was correlated only with mean nuclear area (? = 0.619, P = 0.01) and mean nuclear roundness factor (? = -0.425, P = 0.05). Conclusions: Nuclear size and shape factors, especially mean nuclear area, were concordant with the Gleason score. Nuclear size and shape assessment may aid in the evaluation of the pathological status of prostatic adenocarcinoma. © TÜBİTAK Daha fazlası Daha az

Yurtlu, Bülent Serhan | Hancı, Volkan | Ege, Ahmet | Bostankolu, Selime Evrim | Ayoğlu, Hilal | Özkoçak Turan, Işıl

Article | 2012 | Turkish Journal of Medical Sciences42 ( 1 ) , pp.55 - 62

Aim: To evaluate the effect of tramadol addition to levobupivacaine in axillary plexus blockade in a prospective, randomized double-blind study. Materials and methods: A total of 60 patients scheduled to undergo hand and forearm surgery under axillary plexus blockade were randomly divided into 2 groups. Group L received 36 mL of racemic 0.5% levobupivacaine with 2 mL of saline, whereas Group LT received 2 mL (100 mg) of tramadol instead of saline. After routine monitorization, axillary block was performed with a multistimulation technique using a nerve stimulator. Motor (finger, wrist, and elbow movements) and sensory (pinprick sens . . .ation for the cutaneous supply) block characteristics for radial, median, ulnar, and musculocutaneous nerves were determined every 5 min. Postoperative motor and sensory block duration, analgesic consumption, and numeric rating scale (NRS) scores were also recorded. Results: In each group, 2 patients had block failures. The data for the remaining 56 patients were analyzed. There were no significant differences between the study groups according to motor and sensory block characteristics of 4 nerves, block durations, analgesic consumption, and NRS scores. Conclusion: The addition of 100 mg of tramadol to 0.5% levobupivacaine for axillary brachial plexus blockade neither improved the intraoperative block quality nor prolonged the duration of postoperative analgesia. © TÜBITAK Daha fazlası Daha az

Gonca E. | Barut F. | Şahin D.

Article | 2018 | Turkish Journal of Medical Sciences48 ( 6 ) , pp.1293 - 1301

Background/aim: Epileptic seizure leads to sudden unexpected death in epilepsy (SUDEP) among affected patients. The causes of SUDEP are still unclear. The aim of this study was to research the effect of epilepsy on myocardial injury and arrhythmias during experimentally induced acute myocardial ischemia. Materials and methods: Wistar albino rats were divided into four groups: sham, pentylentetrazole (PTZ) + sham, ischemia, and PTZ + ischemia groups. PTZ (65 mg/kg, ip) was given 2 h before ischemia. Seizure scoring was conducted by evaluating the PTZ-induced behavioral changes in the rats. The left main coronary artery was ligated in . . . anesthetized rats for 30 min. The incidence and the number of ventricular arrhythmias were determined. Histopathological scoring was performed for tissue injury by using a microscope. Results: Seizure scores were not different among the groups (P > 0.05). The incidence and number of ventricular tachycardia (VT) episodes were significantly higher in the PTZ + ischemia group than in the ischemia group (P ? 0.05). More prominent myocardial damage was observed in the PTZ + ischemia group than in the other groups (histopathological scores: PTZ + ischemia; 2.5 ± 0.5 versus ischemia; 1.2 ± 0.4, P ? 0.05). Conclusion: PTZ-induced seizure in rats increased myocardial injury and the incidence and number of VT episodes in myocardial ischemia. These results reveal that seizure in epilepsy patients may increase ventricular arrhythmia and myocardial injury during heart attack. © TÜBİTAK Daha fazlası Daha az

Bektaş, Sibel | Barut, Figen | Bahadır, Burak | Gün, Banu Doğan | Kandemir, Orak Nilüfer | Karadayı, Nimet | Özdamar, Şükrü Oğuz

Article | 2009 | Turkish Journal of Medical Sciences39 ( 2 ) , pp.185 - 189

Amaç: Bu çalışmada, renal hücreli karsinomda Fuhrman nükleer derece sisteminin gözlemci içi ve gözlemciler arasındaki tekrarlanabilirliğini değerlendirmek amaçlanmıştır. Metot: 46 renal hücreli karsinom olgusuna ait histolojik kesitler, iki patolog tarafından Fuhrman sistemine göre yeniden skorlanmıştır. Patologlar arasında gözlemci içi ve gözlemciler arasındaki tekrarlanabilirlik kappa istatistiği ile değerlendirilmiştir. Bulgular: Birinci patoloğun ilk değerlendirmesinde; derece 1: dört (% 8,7), derece 2: otuz (% 65,2), derece 3: on bir (% 23,9) ve derece 4: bir (% 2,2) olguda belirlenmiştir. Aynı patoloğun ikinci değerlendirmesin . . .de; derece 1: sekiz (% 17,4), derece 2: yirmi üç (% 50), derece 3: on dört (% 30,4) ve derece 4: bir (% 2,2) olguda saptanmıştır. Fuhrman sisteminin gözlemci içi tekrarlanabilirliği güçlü düzeyde bulunmuştur (? = 0,66). İkinci patoloğun Fuhrman derecelendirmesinde; derece 1: on bir (% 23,9), derece 2: yirmi yedi (% 58,7), derece 3: yedi (% 15,2) ve derece 4: bir (% 2,2) olguda belirlenmiştir. Fuhrman sisteminin gözlemciler arasındaki tekrarlanabilirliği ise orta düzeyde bulunmuştur (? = 0,42). Sonuç: Fuhrman derecenin gözlemci içi güçlü tekrarlanabilirliğine rağmen, gözlemciler arasında orta düzeydeki tekrarlanabilirliği ve derece 3’teki düşük uyum göz önünde tutulmalıdır. Background: The aim of this study was to evaluate intraobserver and interobserver reproducibility of Fuhrman nuclear grading of renal cell carcinoma. Methods: Pathology slides from 46 cases of renal cell carcinoma were rescored by 2 pathologists according to the Fuhrman system. Both intraobserver and interobserver reproducibility were assessed using kappa statistics. Results: The initial Fuhrman grade was grade 1 in 4 of the cases (8.7%), grade 2 in 30 (65.2%), grade 3 in 11 (23.9%), and grade 4 in 1 (2.2%). After reviewing the slides by the same pathologist, grades were reassigned as follows: grade 1 in 8 cases (17.4%), grade 2 in 23 (50%), grade 3 in 14 (30.4%), and grade 4 in 1 (2.2%). Intraobserver reproducibility of the Fuhrman system was substantial (κ = 0.66). Fuhrman grading by the second pathologist was grade 1 in 11 cases (23.9%), grade 2 in 27 (58.7%), grade 3 in 7 (15.2%), and grade 4 in 1 (2.2%). Interobserver reproducibility of the Fuhrman system was moderate (κ = 0.42). Conclusions: Despite substantial intraobserver reproducibility of Fuhrman grading, moderate interobserver reproducibility and low agreement for grade 3 should be a consideration Daha fazlası Daha az

Bektaş S. | Barut F. | Bahadir B. | Dogan G.Ü.N.B. | Kandemir N.O. | Karadayi N. | Özdamar Ş.O.

Article | 2009 | Turkish Journal of Medical Sciences39 ( 2 ) , pp.185 - 189

Background: The aim of this study was to evaluate intraobserver and interobserver reproducibility of Fuhrman nuclear grading of renal cell carcinoma. Methods: Pathology slides from 46 cases of renal cell carcinoma were rescored by 2 pathologists according to the Fuhrman system. Both intraobserver and interobserver reproducibility were assessed using kappa statistics. Results: The initial Fuhrman grade was grade 1 in 4 of the cases (8.7%), grade 2 in 30 (65.2%), grade 3 in 11 (23.9%), and grade 4 in 1 (2.2%). After reviewing the slides by the same pathologist, grades were reassigned as follows: grade 1 in 8 cases (17.4%), grade 2 in . . .23 (50%), grade 3 in 14 (30.4%), and grade 4 in 1 (2.2%). Intraobserver reproducibility of the Fuhrman system was substantial (k = 0.66). Fuhrman grading by the second pathologist was grade 1 in 11 cases (23.9%), grade 2 in 27 (58.7%), grade 3 in 7 (15.2%), and grade 4 in 1 (2.2%). Interobserver reproducibility of the Fuhrman system was moderate (k = 0.42). Conclusions: Despite substantial intraobserver reproducibility of Fuhrman grading, moderate interobserver reproducibility and low agreement for grade 3 should be a consideration Daha fazlası Daha az