Comparison of short-term results of open and laparoscopic surgery in gastric cancer at a new regional hospital: A single surgeon experience

Aim: To compare the short-term results of open and laparoscopic gastrectomy in gastric cancer surgery. Material and Method: From 15 May 2018 to 28 June 2021, patients who underwent open and laparoscopic gastrectomy for gastric cancer by a single surgeon between were retrospectively analyzed from a prospectively maintained database. Patients were compared in terms of early intraoperative and postoperative outcomes. Both surgical methods were compared in terms of early intraoperative and postoperative outcomes. Results: A total of 34 patients (open n=23, laparoscopic n=11) were included in the study. While the mean number of lymph nodes was similar between the groups, more metastatic lymph nodes and more advanced disease were detected in the open group (p=0.007, p=0.002, respectively). According to tumor location, patients who underwent laparoscopic gastrectomy were more distally located (p=0.01). The mean operative time was shorter in the open group (171.5 min and 206 min, p=0.006, respectively), while the estimated blood loss was less in the laparoscopic group (158.2 mL vs 186.7 mL, p=0.003). Four patients (17.4%) in the open group and two patients (18%) in the laparoscopic group had at least Clavien-Dindo grade III complications (p=0.96). Earlier gas output was seen in the laparoscopic group (p=0.002), while other postoperative outcomes were similar between the groups. Mean follow-up time was longer in the open group (13.4 months and 7.6 months, respectively, p=0.004). Conclusion: Until sufficient experience is reached in laparoscopic gastrectomy, choosing earlier stage and distally located tumors is a safe method with postoperative results similar to open gastrectomy

Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers

https://deepblue.lib.umich.edu/bitstream/2027.42/138963/1/12987_2017_Article_71.pd

The outcome of conservative treatment of adult distal radius fractures compared with the other wrist: Radiological and functional evaluation

YÖK Tez No: 531236Amaç: Bu çalışmada erişkin hastalarda kapalı redüksiyon ve uzun kol alçı ile tedavi edilen radius distal uç kırıklarının, karşı taraf el bileği ile karşılaştırılarak; radyolojik ve fonksiyonel sonuçları değerlendirildi. Gereç ve Yöntem: Kliniğimizde Ocak 2010-Aralık 2010 tarihleri arasında 77 hastaya(33'ü erkek 44'ü kadın, ortalama yaş 49.69) konservatif tedavi uygulandı. Kırıklar prospektif olarak incelendi ve AO ve Frykman sınıflama sistemine göre sınıflandırıldı. Son kontrollerinde radyolojik-anatomik sonuçlar, Stewart'ın geliştirdiği skorlama metodu; fonksiyonel sonuçlar ise Stewart II tarafından modifiye edilmiş puanlandırma sistemi ve Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH) sorgulama yöntemleriyle değerlendirildi. Hastaların ortalama takip süresi 8 aydı. Sonuçlar: Çalışmamızda 16'sı erkek, 24' ü kadın toplam 40 (%51.9) hastanın sağ el bileğinde, 16'sı erkek,21'i kadın toplam 37 (%48.1 ) hastanın sol el bileğinde kırık mevcuttu. 18 hasta evde düşme,32 hasta ev dışı düz zeminde düşme,5 hasta spor yaralanması,8 hasta trafik kazası,12 hasta yüksekten düşme ve 2 hasta direkt travma sonrası başvurmuştur. Frykman sınıflamasına göre 46 olgu tip I-II kırık, AO sınıflamasına göre 59 olguda 23.A2.1- 23.A2.2 kırık tespit edildi. Stewart radyolojik–anatomik skorlama sistemine göre, 77 hastanın toplam 57' sinde (%74.0) mükemmel, 17' sinde (%22.1) iyi, 3' ünde (%3.9) orta sonuç elde edildi. Kötü sonuç alınan hasta bulunmamaktaydı. Stewart II göre fonksiyonel sonuçları değerlendirdiğimizde, 57 hastada (%74.0) mükemmel, 8 hastada (%10.4) iyi, 12 hastada da (%15.6) orta sonuç alındığı, kötü sonuç olmadığı saptandı. DASH subjektif sorgulama ortalama puanı 6.37 olarak bulundu. Komplikasyon oranımız %12.98(10/77) 2(%2.59) hastada median sinirde hafif derecede tuzaklanma, 4(%5.19) hastada ulna stiloidinde kaynamama, 1(%1.3) hastada distal radioulnar eklemde hassasiyet,3(%3.89) hastada distal radioulnar eklemde hassasiyet ve median sinirde hafif derecede tuzaklanma tespit edildi. Çıkarımlar: Distal radius kırıkları tedavisinde kapalı redüksiyon ve alçılı tespit halen etkin ve son derece ucuz bir tedavi yöntemi olarak görülmektedir. Yaşlı ve aktif olmayan hastalarda, operasyon için risk oluşturan medikal problemi olanlarda seçilmesi gereken tedavi şeklidir. ANAHTAR KELİMELER, erişkin, radius distal, kapalı redüksiyon, alçı, prospektifBackground: This study was designed to evaluate anatomical and functional results of closed reduction-long arm cast treatment for distal radius fractures and compared other healty wrist in the adults. Methods: 77 patients (44 female, 33 male, mean age: 49.69 years)were treated conservatively in our clinic between January 2010 and December 2010.The fractures were classified according to AO and Frykman classification system and investigated prospectively. At last visit, anatomical and functional results were assessed using the Stewart I-II criteria and Q-DASH (Quick-Disability of Arm, Shoulder and Hand) questionnaire, respectively. The mean follow-up of patients was 8 months. Results: İn our study,40(%51.9) patients(16 male,24 female)had right wrist fracture,37(%48.1) patients had left wrist fracture. The causes of the fractures were 18 patients fall in house,32 patients fall in out of house,5 patients sports injury,8 patients car accident,12 patients falling down from height,2 patients direct trauma. According to Frykman classification 46 patients were type I-II fracture, according to AO classification 59 patients were type 23.A2.1- 23.A2.2 fracture. According to Stewart anatomical criteria, the result were excellent in 57(%74.0),good in 17(%22.1),fair in 3(%3.9). No poor result. According to Stewart II functional criteria, the result were excellent in 57(%74.0), good in 8(%10.4),fair in 12(%15.6). No poor result. The mean DASH score was 6.37.The overall complication rate was %12.98(10/77). Carpal tunnel syndrome was observed in 2(%2.59) patients, ulna styloid nonunion in 4(%5.19)patients, tenderness of distal radioulnar joint in 1(%1.3) patient and Carpal tunnel syndrome and, tenderness of distal radioulnar joint in3(%3.89) patients. Conclusions: Closed reduction and cast immobilization is an effective and in expensive treatment method in distal radial fractures. We prefer this method for old and inactive patients and for the patients that have risk for surgery. KEY WORDS, adult, radius distal, closed reduction, cast, prospectiv

The Investigation Of An Air Breathing Rocket Engine Powered Vehicle

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2003Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2003Bu tez çalışması kapsamında, örnek bir taşıtın havayla çalışan bir roket motoruyla tahriği incelenmiştir. Roket motorundan elde edilecek tepki kuvvetinin bu taşıtın belli bir sabit hızında, üzerine etki eden seyir dirençlerini dengeleyen kuvvet olduğu düşünülmektedir. Bu bakımdan taşıtın öngörülen hareketi esnasındaki seyir dirençlerinin hesaplanmasıyla, roket motorundan alınması hedeflenen tepki kuvveti bulunmuştur. Bu hesabın değişik hız değerleri için yapılmasından sonra, elde edilen tepki kuvvetlerini makul miktarda yakıcı ve yakıt debisiyle sağlayan sistemdeki lüle, yanma odası ve püskürtme sisteminin tasarımı yapılmıştır. Yapılan bu tasarım birçok faktöre bağlı olarak değiştiğinden, tanımlanan roket motoru karakteristik parametreleri yardımıyla, değişen işletme koşullarının tasarlanılan sisteme ne gibi etkiler yaptığı araştırılmıştır. Bu çalışmada yanma odası basınçları ile yakıcı ve yakıt olarak kullanılan hava ve kerozen arasındaki yanma reaksiyonunda karışım oranını tanımlayan hava fazlalık katsayıları değiştirilerek elde edilmesi hedeflenen tepki kuvvetine göre tasarımı yapılan roket motorundaki lüle boğaz ve çıkış kesit alanları, yanma odası uzunluğu ve gerekli yakıcı ve yakıt debisi gibi büyüklüklerin bu değişimlerden ne şekilde etkilendiği incelenmiştir. Çalışmanın son bölümünde ise yapılan tasarıma uygun bir püskürtme sisteminin geliştirilmesi amaçlanmıştır. Hava ile kerozenin yanma reaksiyonları ve yanma odasına giriş hızları dikkate alınmak suretiyle, taşıt hızlarına göre hesaplanan tepki kuvvetini sağlayan yakıcı ve yakıt debisini, tasarımı yapılan roket motoruna sevk edecek püskürtme sistemi büyüklükleri hesaplanmıştır. Ayrıca bu büyüklüklerin değişen koşullardan ne şekilde etkilendiği oluşturulan tablo ve grafikler yardımıyla belirtilmiştir.In this study, the propulsion of an air breathing rocket engine powered vehicle is investigated. The thrust for this rocket engine is assumed to be the force which can overcome the total resistance forces acting on this vehicle for a chosen constant speed. So, the calculation of the total resistance forces acting on the vehicle, under the conditions of constant speed and normal road conditions, leads us to determine the thrust of the rocket engine. After finding the necessary thrust for the constant speed of vehicle, rocket nozzle, combustion chamber and injection system designs are made to obtain that thrust. As the design of the rocket engine for obtaining desirable thrust relies on various factors, it is convenient to make use of characteristic parameters to examine the changes occurred in our design resulting from these factors. In this study the changes in the nozzle throat and exit areas, combustion chamber lenghts and necessary mass flow rate values used in the air breathing engine, are investigated by changing the combustion chamber pressures and air excess ratios which define the mixture ratio of the propellant. In the last chapter of this study, it is intended to design an appropriate injection system for the air breathing rocket engine. By considering the speeds of air and kerosene in the combustion chamber and the mechanism of combustion reaction, injection system dimensions are calculated. The changes of injection system characteristic parameters versus design conditions are shown in the graphics plotted in this study.Yüksek LisansM.Sc

Kalça Kırığı Nedeniyle Cerrahi Tedavi Uygulanan 65 Yaş Üstü Hastaların Bir Yıllık Mortalite Oranları

Amaç: Yaşlı hastalarda sık gözlenen kalça kırıkları ciddi morbidite, maluliyet ve hatta artmış mortalite ile yakındanilişkilidir. Bu çalışmada kalça kırığı sebebiyle cerrahi tedavi uygulanan hastaların, cerrahiden sonraki ilk bir yıldagözlenen mortalite oranı ve buna etki eden faktörlerin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Kliniğimizde Ekim 2014-Şubat 2018 tarihleri arasında izole intertrokanterik femur ya da femurboyun kırıkları nedeniyle cerrahi tedavi uygulanan 65 yaş üzeri 164 hasta geriye dönük olarak incelendi. Arşiv kayıtlarıüzerinden hastalara ait yaş, cinsiyet, kırık tipi, yatış-cerrahi arası zaman, cerrahi-taburculuk arası zaman ve kırık içinuygulanan implant tipi gibi gerekli bilgilere ulaşıldı. Ayrıca hastalara telefon ile ulaşılarak vefat tarihleri (vefat ettiiseler) öğrenildi. Hastalar; cerrahi sonrasındaki ilk bir yıl içinde vefat edenler ve yaşayanlar olarak iki gruba ayrıldı vemortaliteye etki eden faktörler açısından karşılaştırmalı analizler yapıldı.Bulgular: Çalışmaya kriterlere uygun 138 hasta dahil edildi. Cerrahi sonrası ilk 1 yıldaki ölüm oranı %21,73 olarakbulundu. Vefat edenler grubunun yaş ortalaması (85,97±7,49) yaşayanlar grubundan (79,02±8,92) istatistiksel olarakanlamlı derecede yüksek bulundu (p=0,0001). Vefat edenler grubundaki kadın hasta oranı yaşayanlar grubundanistatistiksel olarak anlamlı derecede yüksek bulundu (p=0,037). Vefat edenler ve yaşayanlar grupları arasında kırık tipive uygulanan implant türü açısından anlamlı derecede farklılık gözlenmedi (p=0,881 ve p=0,101). Vefat edenlergrubunun yatış-cerrahi arası süre ile cerrahi-taburculuk arası süre ortalamaları yaşayanlar grubundan istatistiksel olarakanlamlı derecede yüksek bulundu (p=0,034 ve p=0,0001).Sonuç: Bu çalışmada cerrahi sonrası ilk bir yıldaki mortalite oranı %21,73 olarak bulundu ve mortaliteye etki eden enönemli faktörlerin ileri yaş ile artmış yatış-cerrahi ve cerrahi-taburculuk arası süre olduğu tespit edildi.Aim: Fractures of the hip are frequently seen in the elderly patients and closely related to severe morbidity, disability, and even increased mortality. The aim of this study was to evaluate the first year mortality rate and the factors affecting this in the patients with surgically treated hip fractures. Material and Methods: In this retrospective study, 164 patients aged over 65 years who had undergone surgery in our clinics for isolated intertrochanteric femur or femoral neck fractures between October 2014 and February 2018 were evaluated. The necessary information such as age, gender, type of fracture and applied implant, the times between hospitalization/surgery and surgery/discharge were obtained from the archive records. In addition, the patients were contacted by phone and the death times (if they died) were learned. Patients were divided into two groups as who died in the first year after surgery and survived; and then factors affecting the mortality were analyzed comparatively. Results: This study included 138 patients who meet eligibility criteria. One year mortality rate after surgery was 21.73%. The mean age of the death group (85.97±7.49) was statistically significantly higher than the survival group (79.02±8.92) (p=0.0001). The ratio of the female patients in the death group was found to be statistically significantly higher than the survival group (p=0.037). There were not any statistically significant difference between the death and survival groups in terms of fracture and applied implant types (p=0.881 and p=0.101). The mean times between hospitalization/surgery and surgery/discharge were statistically significantly higher in the death group (p=0.034 and p=0.0001). Conclusion: In this study, the mortality rate in the first year after surgery was found to be 21.73% and the most important factors affecting this rate were determined as advanced age and increased times between hospitalization/surgery and surgery/discharge

A rare localized giant cell tumor of the tendon sheath originating from the ligamentum mucosum: A case report

WOS: 000521139200025PubMed: 32160509Giant cell tumor of the tendon sheath (GCTTS) occurs most often in the hand and rarely in the feet, and as an extremely uncommon presentation in the knee joint. Case reports involving GCTTS in the knee joint generally describe it originating from the nearby anterior cruciate ligament, posterior cruciatc ligament, patellar tendon, and medial plica. To the best of our knowledge, there are no previously reported case reports involving GCTTS originating in the ligamentum mucosum. In this article, we describe a 27-year-old male patient who was admitted to the orthopedic emergency room with a painful locked knee. He had severe pain that was worse with activity and a decreased range of motion. Magnetic resonance imaging (MRI) indicated massive swelling and a wellcircumscribed lobulated intraarticular mass at the distal one third of the ligamentum mucosum. The mass was removed successfully with arthroscopic-assisted mini-open excision, and histological analysis subsequently diagnosed it as a localized type of GCSTT. The patient remained asymptomatic and a follow-up MRI two years after surgery did not show any recurrence of the lesion

Kronik plantar fasiit tedavisinde üç farklı tedavi yönteminin kıyaslanması: Kortikosteroid enjeksiyonu, ekstrakorporeal şok dalga tedavisi ve radyofrekans sinir ablasyonu

Aim: In this study, it was aimed to compare the clinical and functional outcomes of three popular conservative treatment options in the treatment of chronic plantar fasciitis (PF): corticosteroid injection (CSI), extracorporeal shock wave therapy (ESWT) and radiofrequency nerve ablation (RFNA). Material and Methods: Patients with chronic PF refractory to other conservative treatment methods were included in this retrospective study. From January 2017 to February 2019, all the patients with the diagnosis of chronic PF who were treated with conservative treatment modalities were evaluated. Forty eight patients who met our eligibility criteria and treated either with CSI, ESWT or RFNA methods were included in the study. Clinical and functional assessments of the patients were done by American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and Visual Analogue Scale (VAS) just before the treatment, at 6th and at 12th weeks of the last session. Results: There was a statistically significant difference in terms of VAS scores between the groups both for before treatment and for 6th week (both p<0.001), but there was not a statistically significant difference between the groups in terms of VAS scores at 12th week (p=0.436). Also, there was not a statistically significant difference between the three groups in terms of AOFAS scores before treatment, 6th and 12th week assessments (p=0.076, p=0.081, p=0.478 respectively). Conclusion: Although the three treatment modalities showed significant improvements in the chronic PF treatment, no differences were found among effectiveness of them at the final follow-up period. © 2019, Duzce University Medical School. All rights reserved

Spastik Serebral Palsili Hastalarda Uygulanan Perkütan ve Açık Hamstring Uzatmanın Klinik Kıyaslaması

Objective: Knee flexion contracture due to increased hamstring muscle spasticity is the most commonly seen knee deformity in patients with cerebral palsy (CP) and hamstring lengthening is a useful technique for this problem. The purpose of this study is to evaluate the clinical outcomes of open (OHL) vs. percutaneous hamstring lengthening (PHL) surgery. Method: This retrospective study was performed on medical files of spastic cerebral palsy patients who underwent open or closed hamstring lenghtening surgery because of knee flexion contracture between the years 2014 and 2018. All surgical procedures were carried out under general anesthesia and the patients’ preoperative and postoperative popliteal angles (PA) were recorded. In OHL, one midline incision was used to lengthen the medial and lateral hamstrings. In PHL, both the medial and lateral hamstrings were lengthened percutaneously by a no. 15 blade. Results: Twenty-six knees of 17 patients were included in the study. Mean age of the patients was 10.6 (6-17) years. Nine patients with 14 knees were included in OHL and 8 patients with 12 knees in PHL group. Mean preoperative popliteal angle (PA) was 45° (±6.03) and decreased to 24° (±4.37) after the OHL procedure (p=0.0001). Mean preoperative PA was 49.75° (±6.7) and decreased to 26° (±7.12) after the PHL procedure (p=0.0001). There was no statistically significant difference in terms of the mean differences between the preoperative and postoperative PA in OHL and PHL groups (p=0.215). Conclusion: The findings of this study have shown that the relatively simple and minimal invasive PHL technique can be considered a viable option in selected patient groups for hamstring lengthening. © Istanbul Medeniyet University Faculty of Medicine

Unexpected extremity injury in orthopaedic emergency service

PubMed ID: 30755433[No abstract available

Improved Clinical Outcomes After Arthroscopic Microfracture in Isolated Medial Talar Osteochondral Lesions with a Single Injection of High Molecular Weight Hyaluronic Acid

WOS: 000493402900020Objective: To investigate the effectiveness of a single intra-articular injection of high molecular weight hyaluronic acid (HMW-HA) for treating isolated medial osteochondral lesions (OCLs) of the talus following arthroscopic microfracture. Methods: A total of 39 patients, treated between 2014-2017 for medial OCLs of the talus, were enrolled in the study. Patients were split into two groups: group 1, consisting of 18 patients who received a single injection of 4 ml of HMW-HA (22 mg/ml) injection following microfracture; and group 2, consisting of 21 patients who underwent microfracture but did not receive an injection. Clinical results were assessed at baseline, 6 months, and at a final follow-up using a visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS). Results: The mean AOFAS score increased in groups 1 and 2, from 45.61 +/- 14.71 to 95.11 +/- 5.02 (p=0.0001) and 41.81 +/- 13.83 to 90.29 +/- 7.43 (p=0.0001), respectively. Similarly, the average VAS score decreased in groups 1 and 2 from 8.72 +/- 1.23 to 2.11 +/- 1.45 (p=0.0001) and 9.05 +/- 0.80 to 3.67 +/- 2.22 (p=0.0001), respectively. In addition, the average AOFAS score in group 1 was higher than in group 2 (p=0.025) at the final follow-up, and the average VAS score in group 1 was lower than that of group 2 (p=0.0001, p=0.015, respectively) at 6 months postoperatively and the final follow-up. Conclusions: Although both treatments for isolated medial OCL of the talus were associated with successful results, single-dose HMW-HA injection following arthroscopic microfracture was significantly more effective