EDITORIAL | |
1. | Editorial Bekir Durmus Page IX |
RESEARCH ARTICLE | |
2. | Preoperative evaluation of liver volume in living donor liver transplantation Adil Baskiran, Aysegul Sagir Kahraman, Ipek Balikci Cicek, Tolga Sahin, Burak Isik, Sezai Yilmaz PMID: 29607424 PMCID: PMC5864700 doi: 10.14744/nci.2017.14227 Pages 1 - 5 INTRODUCTION: The aim of the present study was to retrospectively evaluate the difference between the preoperative estimated volume and the actual intraoperative graft volume determined in donor right hepatectomies and to evaluate the possible effect of age, gender, and body mass index on the difference. METHODS: A total of 225 donor hepatectomies performed at the center between 2016 and 2017 were evaluated for the study. Left hepatectomies and left lateral segmentectomies were excluded from the analysis. As a result, 174 donor right hepatectomies were included in the study. Volumetric analysis was performed with dynamic hepatic computed tomography (CT), including non-contrast analysis, followed by non-ionic, contrast-enhanced arterial, portal, and hepatic-phase, thin-slice scanning. Volumetric analysis was performed based on the CT images using automatic volume calculating software. RESULTS: The mean preoperatively estimated graft volume was 800±112 g and the mean intraoperatively measured actual graft volume was 750±131 g. There was a statistically significant difference (p=0.003). Age and body mass index had a significant impact on the discrepancy between the predicted and actual graft volume, while gender did not. DISCUSSION AND CONCLUSION: A thorough preoperative evaluation of the donor graft volume should be performed in order to prevent donor morbidity and mortality, as well as small-for-size and large-for-size phenomena in the implanted grafts. Physicians working in the field of transplantation should be aware of the fact that a difference of 10% between the predicted and the actual graft volume is usually encountered. |
3. | Investigation of genotoxicity risk and DNA repair capacity in breast cancer patients using anastrozole Tugce Yesil Devecioglu, Fatih Aydogan, Gulden Zehra Omurtag, Nuran Senel Bese, Semra Sardas PMID: 29607425 PMCID: PMC5864710 doi: 10.14744/nci.2017.55822 Pages 6 - 13 INTRODUCTION: Breast cancer is the most common cancer in women worldwide and the incidence increases in postmenopausal women. Anastrozole is a non-steroidal (type II), third-generation aromatase inhibitor (AI) that is used in the treatment of postmenopausal estrogen-related breast cancer. Several studies have been conducted to assess the efficacy, safety, and superiority of AIs to tamoxifen; however, a literature search did not reveal a study that investigated the genotoxic potential of AIs. The aim of this study was to investigate the possible DNA damage risk profile and individual DNA repair capacity of patients using anastrozole with the modified alkaline comet assay in order to contribute to public health and health economics. METHODS: Women diagnosed with breast cancer after menopause comprised the study group. Six patients who had taken anastrozole for at least 6 months were retrospectively enrolled, and 12 patients who had not yet received treatment were prospectively enrolled as a control group. Peripheral blood lymphocytes were used to measure oxidized DNA damage using formamidopyrimidine DNA-glycosylase (FPG) and endonuclease III (endo III) in a modified comet assay. Individual DNA repair capacity was evaluated with the comet assay after a hydrogen peroxide (H202) challenge to examine the difference in DNA damage susceptibility. RESULTS: Analysis of DNA damage, oxidative base damage, susceptibility to DNA damage, and repair capacity revealed no significant difference between the control group and the patients taking anastrozole (p>0.05). Susceptibility to H2O2 damage was observed to increase with age (p<0.05). DISCUSSION AND CONCLUSION: According to the results obtained in this study, anastrozole did not contribute to oxidative DNA damage. An H2O2 challenge with the comet assay is useful to evaluate circumstances of increased vulnerability to damage, such as aging and cancer. |
4. | Effect of nerve monitoring on complications of thyroid surgery Suleyman Demiryas, Turgut Donmez, Erdinc Cekic PMID: 29607426 PMCID: PMC5864701 doi: 10.14744/nci.2017.93764 Pages 14 - 19 INTRODUCTION: The most frequent and critical complications of thyroid surgery are recurrent laryngeal nerve palsy and hypocalcemia. In first years of the 21st century, intraoperative neuromonitoring (IONM) was introduced as a new technique to avoid the recurrent laryngeal nerve (RLN) injury. However, the role and the benefits of IONM are still controversial. In this study, we aimed to compare the postoperative complication rates during thyroid surgery with IONM usage (Group 1) and conventional direct visual technique without IONM usage (Group 2). METHODS: We conducted retrospective review of all patients undergoing thyroid surgery in Lütfiye Nuri Burat State Hospital General Surgery Department between 2014 and 2016 years. Patients have been classified in to two groups: Group 1 and 2. RESULTS: Overall, 191 patients were included in the study; Group 1 comprised 79 patients and Group 2 comprised 112 patients. Unilateral RLN paralysis was observed in 7 patients in Group 1 (8.9%) and 15 patients in Group 2 (13.4%) without any significant difference between the groups (p=0.368). Hypocalcemia was encountered in 5 patients (6.3%) in Group 1 and 18 patients (16.1%) in Group 2; this difference was statistically significant (p=0.045). Other complications (such as hematoma and suture reaction) were not significantly different. Operation time was found to be significantly shorter in Group 1 (Mean time, 93.08 min) than in Group 2 (116.54 min) (p=0.03). DISCUSSION AND CONCLUSION: Proven effect of IONM on RLN paralysis is still controversial. However, easy identification of RLN, which gives more confidence to surgeon, and shorter operation time may be factors to lower hypocalcemia rates. |
5. | Urban legend or real fact: Coronary artery size varies with demographics Mustafa Adem Tatlisu, Murat Sargin, Adnan Kaya, Ahmet Ilker Tekkesin, Zekeriya Nurkalem, Serap Aykut Aka PMID: 29607427 PMCID: PMC5864702 doi: 10.14744/nci.2017.07269 Pages 20 - 24 INTRODUCTION: This study aimed to determine the relationship between the diameter of coronary artery stents and age, gender, diabetes mellitus (DM), left ventricular ejection fraction (LVEF), renal dysfunction, and the clinical presentation of myocardial ischemia in the cohort of patients with implanted stents in coronary arteries with severe stenotic lesions. METHODS: This study included 2256 patients (mean age, 59.3±10.9 years; men, 62%) who underwent percutaneous coronary intervention (PCI). The clinical status of the patients at presentation was subcategorized as follows: ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina pectoris, and stable angina pectoris. The diameters, without any type or brand differentiation, were divided into two groups as follows: Group I, which included 2.5- and 2.75-mm-diameter stents, and Group II, which included ≥3-mm-diameter stents. RESULTS: The type of procedure, including primary PCI, early invasive strategy, and elective stenting, was not found to be a significant factor affecting the diameter of coronary artery stents. Univariate and multivariate analyses revealed a relationship between the diameter of coronary artery stents and age, gender, DM, and LVEF. DISCUSSION AND CONCLUSION: This study demonstrated that the diameter of coronary artery stents was independently associated with gender, age, a history of DM, and moderate-to-severe systolic left ventricular dysfunction. |
6. | Investigation of the attitudes of university students to discrimination of the elderly Derya Cinar, Ayfer Karadakovan, Sibel Karaca Sivrikaya PMID: 29607428 PMCID: PMC5864703 doi: 10.14744/nci.2017.10437 Pages 25 - 30 INTRODUCTION: This study was conducted to determine the attitudes of university students studying in different fields toward discrimination of the elderly. METHODS: This descriptive study was conducted with students who were still studying in the 2015-2016 period. A sample size of 416 students was determined by the stratified sampling method, and students were selected by simple random sampling. Data were collected using an identifying information form and an Age Discrimination Attitude Scale (ADAS) by face-to-face interview. Statistical analysis was performed using the program SPSS 20.0. RESULTS: The mean total ADAS score of students was 67.7±6.0. The total ADAS scores and the scores of male students on limiting the life of the elderly was significantly higher than those of female students (p<0.05). DISCUSSION AND CONCLUSION: It was determined that university students studying in different fields have a positive attitude toward the elderly. Action must be taken to remove discrimination of the elderly, and policies must be developed to increase social sensitivity. |
7. | Sleep quality and anxiety level in employees Ayse Gusen Teker, Nimet Emel Luleci PMID: 29607429 PMCID: PMC5864704 doi: 10.14744/nci.2017.58855 Pages 31 - 36 INTRODUCTION: The aim of this study was to measure the sleep quality and anxiety level of a group of employees, as well as determine the relationship between sleep quality and anxiety and other factors. METHODS: A total of 130 of 185 employees at a university campus were enrolled in this cross-sectional study. A descriptive questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Anxiety Inventory were the data collection instruments. In addition to univariate analysis, the relationship between the 2 scales was examined with Spearman correlation analysis. RESULTS: Of the participants, 38.9% had poor sleep quality. Gender, income level, presence of a chronic disease, regular medication use, and relationship with family and the social environment were found to affect both sleep quality and anxiety. A decrease in sleep quality was associated with an increase in the level of anxiety. DISCUSSION AND CONCLUSION: Poor sleep quality and a high anxiety level are common in this country, as in the rest of the world. Socioeconomic interventions and psychosocial support to improve the status of individuals with risk factors, such as chronic disease, will reduce anxiety and improve sleep quality and overall psychosocial health. Further prospective studies should be conducted with different groups of participants and with larger samples to expand knowledge of the relationship between sleep quality and anxiety. |
8. | Immunomodulator effect of topical zinc oxide application in tuberculin skin test Cagatay Nuhoglu, Evrim Hepkaya, Zehra Esra Onal, Narin Akici, Tamay Gurbuz, Vildan Atasayan, Omer Ceran PMID: 29607430 PMCID: PMC5864705 doi: 10.14744/nci.2017.88896 Pages 37 - 40 INTRODUCTION: We aimed to evaluate the sensitivity of tuberculin skintest (purified protein derivative-PPD) by topical zinc application on test site to improve diagnostic reliability. METHODS: We performed this study in 100 children aged 6–14 years, and plasma zinc levels were analyzed after 10–12 hours fasting. After PPD,we applied 40% zinc oxide cream on one forearm and placebo on the other forearm. PPD indurations were measured 72 hours later. RESULTS: In this study, 26% of the children showed increases in PPD induration following local zinc applications. There was no correlation between indurations size and serum zinc levels. DISCUSSION AND CONCLUSION: We concluded that topical zinc cream application can enhance sensitivity of tuberculin reactivityin the diagnosis of tuberculosis. |
9. | Evaluation of patients with gastric polyps Sehmus Olmez, Suleyman Sayar, Bunyamin Saritas, Ayla Yildiz Savas, Ufuk Avcioglu, Ilyas Tenlik, Ersan Ozaslan, Hasan Tankut Koseoglu, Emin Altiparmak PMID: 29607431 PMCID: PMC5864706 doi: 10.14744/nci.2017.50480 Pages 41 - 46 INTRODUCTION: The incidence of gastric polyps (GPs) greatly differs according to study populations and was found to be 0.33%–6.7% in various studies. The majority of GPs are composed of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Although APs have a high risk of malignant potential, sporadic FGPs have no malignant potential. Conversely, HPs have a low risk of malignant potential. It is not sufficient to perform a biopsy to identify the polyp type and the presence of dysplasia; thus, some polyps may require multiple biopsies or total excision. METHODS: This retrospective study included patients with GPs or polypoid lesions found on esophagogastroscopy with polyp or malignant histology on biopsy at Ankara Numune Training and Research Hospital Endoscopy Unit between 2005 and 2011. RESULTS: In a series of 56.300 upper endoscopies, 192 patients (0.34%) were found to have GPs. Among the patients, 51 (26.6%) were men and 151 (73.4%) were women. The average age of the patients was 61.9±13.3 (14–90) years. The frequency of HPs, APs, and FGPs were 88%, 2.6%, and 1.6%, respectively. The size of the polyps was ≤1 cm in 137 (70%) patients. One polyp was determined in 141 (73.4%) patients. The most common localizations of polyps were the antrum and corpus. Endoscopic snare polypectomy was performed in 64 patients. One bleeding episode was observed, which required endoscopic treatment after ESP. DISCUSSION AND CONCLUSION: In our study, the GP frequency was low (0.34%), whereas the frequency of HP maybe high due to the high frequency of Helicobacter pylori (HPy) infection in our country. The frequency of FGP is probably low due to the high frequency of HPy infection and the short-term use of proton-pump inhibitors. |
10. | Gallbladder perforation during elective laparoscopic cholecystectomy: Incidence, risk factors, and outcomes Yunus Emre Altuntas, Mustafa Oncel, Mustafa Haksal, Metin Kement, Ersin Gundogdu, Nihat Aksakal, Fazli Cem Gezen PMID: 29607432 PMCID: PMC5864707 doi: 10.14744/nci.2017.88155 Pages 47 - 53 INTRODUCTION: This study aimed to reveal the risk factors and outcomes of gallbladder perforation (GP) during laparoscopic cholecystectomy. METHODS: Videotapes of all patients who underwent an elective cholecystectomy at our department were retrospectively analyzed, and the patients were divided into two groups based on the presence of GP. The possible risk factors and early outcomes were analyzed. RESULTS: In total, 664 patients [524 (78.9%) females, 49.7±13.4 years of age] were observed, and GP occurred in 240 (36.1%) patients, mostly while dissecting the gallbladder from its bed (n=197, 82.1%). GP was not recorded in the operation notes in 177 (73.8%) cases. Among the studied parameters, there was no significant risk factor for GP, except preoperatively elevated alanine transaminase level (p=0.005), but the sensitivity and specificity of this measure in predicting GP were 14.2% and 7.4%, respectively. The two groups had similar outcomes, but the operation time (35.4±17.5 vs 41.4±18.7 min, p=0.000) and incidence of drain use (25% vs 45.8%, p=0.000) increased in the GP group. DISCUSSION AND CONCLUSION: The present study reveals that GP occurs in 36.1% of patients who undergo laparoscopic elective cholecystectomy, but it may not be recorded in most cases. We did not find any reliable risk factor that increases the possibility of GP. GP causes an increase in the operation time and incidence of drain use; however, the other outcomes were found to be similar in patients with GP and those without. |
11. | Effect of trabeculectomy on ocular higher-order aberrations in patients with open angle glaucoma Ali Mahdavi Fard, Rana Daei Sorkhabi, Kamal Nasiri, Arezou Tajlil PMID: 29607433 PMCID: PMC5864708 doi: 10.14744/nci.2017.80958 Pages 54 - 57 INTRODUCTION: The aim of this study was to evaluate the effect of trabeculectomy on ocular higher-order aberrations following surgery in a group of patients with open angle glaucoma. METHODS: In this prospective study, patients with primary open angle glaucoma underwent wavefront aberrometry before trabeculectomy with mitomycin-C. Coma-like, spherical-like, and total ocular higher-order aberrations were measured as root mean square values. The measurements were repeated 1 month and 3 months after the procedure. RESULTS: A total of 20 eyes from 20 patients were examined. There was a significant decrease in intraocular pressure following surgery at 1 month and 3 months postoperatively. However, there was no statistically significant change in the spherical equivalent of the eyes. One month after surgery, a significant change in coma-like, spherical-like, and total higher-order aberrations of the eyes was observed. However, the repeated measurements performed 3 months after procedure revealed no significant difference compared to the baseline values. DISCUSSION AND CONCLUSION: Ocular higher-order aberrations increased 1 month following trabeculectomy surgery. However, this effect seems to be transient, as the values returned to the preoperative measurement 3 months after the procedure. |
ORIGINAL IMAGES | |
12. | Gaucher disease in an adult: A rare cause of hepatosplenomegaly in adults Volkan Karakus, Yelda Dere, Ozcan Dere, Fahri Sahin, Nazan Ozsan PMID: 29607434 PMCID: PMC5864709 doi: 10.14744/nci.2017.01336 Pages 58 - 59 Abstract | |
CASE REPORT | |
13. | Renal clear cell sarcoma presenting as a spontaneous renal hematoma: A rare presentation Zeynep Canan Ozdemir, Burcu Ayvaci, Yeter Duzenli Kar, Mehmet Oguzman, Mehmet Surhan Arda, Mustafa Fuat Acikalin, Ozcan Bor PMID: 29607435 PMCID: PMC5864711 doi: 10.14744/nci.2017.75537 Pages 60 - 63 Clear cell sarcoma of the kidney (CCSK) is an uncommon renal neoplasm of childhood. It represents between 2% and 9% of all pediatric renal tumors, and generally arises before the age of 5 years. It often mimics other pediatric renal tumors. Presently described is the case of a 7-year-old girl who presented with complaints of vomiting and abdominal pain. Abdominal ultrasonography revealed a right renal mass, and the patient developed a renal hematoma a few hours after admission. The patient underwent a nephroureterectomy with a provisional diagnosis of Wilms tumor; however, histopathological examination of a specimen revealed CCSK. CCSK is similar to Wilms tumor in terms of the typical age of appearance and clinical and histopathological features, but the treatment method and prognosis are different. Therefore, the differential diagnosis is very important. This case was presented to draw attention to a rare presentation of clear cell sarcoma. CCSK should be kept in mind in the differential diagnosis of a renal mass. |
14. | Autoimmune hemolytic anemia associated with infliximab infusion in ulcerative colitis Fazia A. Mir, Alhareth Al Juboori, Jack D. Bragg, Veysel Tahan PMID: 29607436 PMCID: PMC5864712 doi: 10.14744/nci.2017.77045 Pages 64 - 66 Infliximab is a monoclonal antibody that antagonizes the activity of tumor necrosis factor alpha to induce and maintain remission in patients with inflammatory bowel disease. Adverse effects associated with Infliximab infusions include infusion reactions, risk of infections, development of hematological malignancies, and pancytopenia. Autoimmune hemolytic anemia has rarely been reported in ulcerative colitis. Herein we report a case of drug-induced hemolytic anemia after infliximab infusion for treating ulcerative colitis. |
15. | Diagnosing between papillary carcinoma and reactive papillary changes in an infarcted thyroid nodule after fine needle aspiration and accompanied by a synchronous brain stem astrocytoma Ceren Canbey Goret, Nuri Emrah Goret, Omer Faruk Ozkan, Muammer Karaayvaz PMID: 29607437 PMCID: PMC5864713 doi: 10.14744/nci.2017.27147 Pages 67 - 71 A 22-year-old patient underwent fine needle aspiration of a nodule at the outer center of the right lobe of the thyroid, and it was reported to be Bethesda system category IV, Hurthle cell follicular neoplasia. The patient, who persented to Onsekiz Mart University Research and Application Hospital, underwent surgery. During right total thyroidectomy, an almost totally infarcted nodule and papillary structures around these infarcted areas were detected. Herein, we report on diagnostic challenges faced in confirming whether the infarcted nodule was a case of reactive papillary changes or an underdiagnosed papillary carcinoma and how the challenges were overcome using immunohistochemistry analysis and molecular genetic testing. In addition, we examined the case along with a literature review because an accompanying synchronous brain stem astrocytoma was detected in the patient after thyroidectomy. |
16. | Reconstructive surgery of true aneurysm of the radial artery: A case report Sevinc Bayer Erdogan, Serdar Akansel, Nehir Tandogar Selcuk, Serap Aykut Aka PMID: 29607438 PMCID: PMC5864714 doi: 10.14744/nci.2017.98700 Pages 72 - 74 True radial artery aneurysms are uncommon pathologies and have an organic cause, unlike trauma-induced false aneurysms. A 52-year-old man presented with a pulsatile mass at the anatomical snuff box area of his left hand. The aneurysm was repaired with reconstructive procedure. Although many posttraumatic and iatrogenic cases of false aneurysm of the radial artery have been reported; there are a few reported cases of a true idiopathic aneurysm. A case of reconstructive surgery for true idiopathic radial artery aneurysm is reported in this paper. |
17. | Penetrating injury caused by a long iron bar: A case report Seyithan Ozaydin, Aykan Gulleroglu, Birgul Karaaslan, Suleyman Celebi, Cemile Besik, Melike Korkmaz Toker, Serdar Sander PMID: 29607439 PMCID: PMC5864715 doi: 10.14744/nci.2017.75508 Pages 75 - 78 Foreign bodies which strike the body with their long edges can cause severe problems. From the transfer of the patient to the removal of the foreign body, and from surgery to the follow-up, it is required to work as a team in a well-organized manner. Herein, we present our experience including the transfer, initial assessment by the emergency team, examination, and treatment plan of a pediatric case who had a 12-meter long construction iron traversing from the right side of the anus to the loin, while sliding through the snow-covered street and had to wait on the snow, until the fire department arrived and cut the construction iron. |
INVITED REVIEW | |
18. | Fecal microbiota transplantation and its potential therapeutic uses in gastrointestinal disorders Ryan D. Heath, Courtney Cockerell, Ravinder Mankoo, Jamal A. Ibdah, Veysel Tahan PMID: 29607440 PMCID: PMC5864716 doi: 10.14744/nci.2017.10692 Pages 79 - 88 Typical human gut flora has been well characterized in previous studies and has been noted to have significant differences when compared with the typical microbiome of various disease states involving the gastrointestinal tract. Such diseases include Clostridium difficile colitis, inflammatory bowel disease, functional bowel syndromes, and various states of liver disease. A growing number of studies have investigated the use of a fecal microbiota transplant as a potential therapy for these disease states. |