Evaluation of the Effects of Varicoceles and Fertility Status on Volumetry and Shear-wave Elastography

Aim: This study aims to compare the volumetry and shear-wave elastography findings in infertile and fertile patients and evaluate the effect of presence of varicoceles on the parameters. Materials-Methods: 40 infertile and 20 fertile patients (120 testes) (mean age 29,3±6,7) between January 2018-November 2018 were included in this prospective study. All patients underwent testicular B-mode and doppler ultrasonography (US) and shear-wave elastography (SWE). Patients were sub-grouped according to fertility status and presence or absence of varicoceles. Results: Testis stiffness was significantly higher in testes without varicoceles than those with varicoceles (p=0.021). It was also higher in fertile patients than infertile patients (p=0.015). Testes volumes were higher in fertile patients and patients with varicoceles (p=0.011 and p=0.028, respectively). Conclusion: SWE is a non-invasive, cheap and reproducible technique with promising results for diagnosis and follow-up in the evaluation of infertility

Retrospectively Analysis of Clinical/Pathological and Prognostic Features of Subtypes of Breast Cancer

DergiPark: 379007tmsjAims: Breast cancer is the most common type of cancer among all women across the world, with an incidence of 25.2%. Of all the cancer cases, breast cancer comes second in line after lung cancer. By 6.4% it marks fifth place as the reason for cancer-related-deaths. Therefore new studies on breast cancer are required. We aimed to retrospectively analyze clinical, pathological and prognostic features of cases that were divided into four subgroups based on their hormone receptor and HER-2 conditions. Method: Records of GATA-Oncology Clinic patients who have been diagnosed with breast cancer within years of 2008-2014, were inspected retrospectively. Cases were divided into four subgroups based on their hormone receptor and HER-2 conditions. Missing records were primarily gathered by electronic recording system, also still-missing-information about the patients were provided via phone calls. Collected data has been evaluated with SPSS 15,0. Results: While demographics such as family history and menopausal state were not different among 4 subgroups, triple negative patients tended to have a lower body-mass index and mean age (p=009, p=0.041, respectively). Only 12 patients had advanced disease at diagnosis. A total of 168 patients received chemotherapy. Progression occurred in 41 patients (21.9%) from early phase breast cancer cases that were taken to adjuvant chemotherapy program. Family history had a significant association with recurrence in breast cancer patients (p=0.026). Menopausal state, lymphovascular invasion, lymph node state and stage were not associated with progression. Independent prognostic factors were not obtained with multivariate analysis for disease-free survival. Advanced stage breast cancer patients had a higher tendency to metastasis. Triple negative patients had more drug resistance towards systemic treatment than other subgroups (p lt;0.001). It has been found that full response to anthracycline + taxane regime was less in triple negative patients. Conclusion: In conclusion, there were some differences within our subgroups. Patients of these subgroups should be followed up and treated with different strategies. All subgroups, especially triple negative group, were in need of new effective therapy strategies

Sex Estimation From Sternal Measurements Using Multidetector Computed Tomography

We aimed to show the utility and reliability of sternal morphometric analysis for sex estimation. Sex estimation is a very important step in forensic identification. Skeletal surveys are main methods for sex estimation studies. Morphometric analysis of sternum may provide high accuracy rated data in sex discrimination. In this study, morphometric analysis of sternum was evaluated in 1mm chest computed tomography scans for sex estimation. Four hundred forty 3 subjects (202 female, 241 male, mean age: 44 +/- 8.1 [ distribution: 30-60 year old]) were included the study. Manubrium length (ML), mesosternum length (2L), Sternebra 1 (S1W), and Sternebra 3 (S3W) width were measured and also sternal index (SI) was calculated. Differences between genders were evaluated by student t-test. Predictive factors of sex were determined by discrimination analysis and receiver operating characteristic (ROC) analysis. Male sternalmeasurement values are significantly higher than females (P< 0.001) while SI is significantly low in males (P< 0.001). In discrimination analysis, MSL has high accuracy rate with 80.2% in females and 80.9% in males. MSL also has the best sensitivity (75.9%) and specificity (87.6%) values. Accuracy rates were above 80% in 3 stepwise discrimination analysis for both sexes. Stepwise 1(ML, MSL, S1W, S3W) has the highest accuracy rate in stepwise discrimination analysis with 86.1% in females and 83.8% in males. Our study showed that morphometric computed tomography analysis of sternum might provide important information for sex estimation

Demonstration of the histopathological and immunohistochemical effects of a novel hemostatic agent, ankaferd blood stopper, on vascular tissue in a rat aortic bleeding model

Background: Ankaferd Blood Stopper®(ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding.Methods: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation.Results: The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7.Conclusions: In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required. © 2010 Kandemir et al; licensee BioMed Central Ltd

Süt sığırlarında refah

Bu çalısmada, süt sıgırı yetistiriciliginde refah kavramı ve önemi, stres, hayvan saglıgı, besleme, barındırma, sürü yönetiminin refahla olan iliskileri incelenmis, AB’de ve Türkiye’de hayvan refahı uygulamalarına deginilmistir. Süt sıgırlarında önemli stres etmenlerinden biri yüksek sıcaklık ve nemdir. Bu baglamda, optimum degerlerden asırı sapmalar verim kayıplarına neden olmaktadır. Bir sürüde barındırma, gübre yönetimi, saglık koruma uygulamalarının iyi olmaması süt veriminde ortaya çıkan kayıpların miktarını artmaktadır. Ayrıca, hayvan refahının yetersiz oldugu isletmelerde sürü ömrü kısalmakta, hayvanlarda davranıs bozuklukları görülebilmektedir. Türkiye’de aile tipi isletmelerde refah kavramı ve önemi fazla bilinmezken, modern süt sıgırı isletmelerinde hayvan refahına daha fazla önem verilmeye baslanmıstır

Reduction and arthrodesis with sublaminar spiral silk in atlantoaxial joint instability

Kotil, Kadir (Arel Author)Amaç: Bu yazıda atlantoaksiyel eklem instabilitesinde sublaminar telleme yerine kalın sarmal ipek kullanılarak yapılan C1-C2 artrodez tekniğinin klinik ve radyolojik sonuçlarının değerlendirilmesi amaçlandı. Çalışma planı: Atlantoaksiyel instabilitesi bulunan ve redüksiyonları yapıldıktan sonra sublaminar sarmal ipekle C1-C2 füzyonu gerçekleştirilen 16 hasta (10 kadın, 6 erkek; ortalama yaş: 43.4, ortalama takip süresi: 34 ay) retrospektif olarak incelendi. Açık redüksiyondan sonra tel yerine sarmal ipekle iki taraflı laminaları bağlanan ve sonrasında otogreftle artrodezi yapılan bu olguların, redüksiyon oranları, vidaların pozisyonları ve füzyon değerleri bilgisayarlı tomografiyle değerlendirildi. Bulgular: Cerrahi öncesi ortalama atlantodental açıklık (ADA) değeri 8 (dağılım: 6-11) mm, cerrahi sonrasında ise ortalama 2.1 (dağılım: 0.5-2.5) mm olarak ölçüldü. Dural veya spinal kord yaralanmasına bağlı bir komplikasyon gözlenmedi. Tüm olgularda redüksiyonun tam olduğu görüldü. Sadece bir olguda füzyon oluşmadı (%6.25). Olguların cerrahi sonrası fleksiyonda ortalama 10 mm olan ADA değeri, ekstansiyonda 1 mm olarak ölçüldü. Tomografik ince kesitlerde C1-C2 arasında bir olgu hariç greft ayrışmasına ait bulguya rastlanmadı. İki adet vidada (%4) malpozisyon belirlendi. Çıkarımlar: Sublaminar sarmal ipek tekniği güvenli anatomik redüksiyon sağlaması, ucuz ve basit bir yöntem olması, ekstra implant gerektirmemesi, gevşememesi, nörolojik hasar yaratmaması ve radyolojik kirlilik oluşturmaması nedeniyle sublaminar tellemeye alternatif bir cerrahi uygulamadır

The Type of Anesthesia Technique Does Not Have an Impact on 30-Day Mortality in Geriatric Patients Undergoing Lower Extremity Amputation

This study aimed to determine the appropriate anesthetic technique for patients who underwent amputation due to peripheral vascular disease. The anesthetic technique to be applied during lower extremity amputations in geriatric patients with limited functional capacity may be important in terms of clinical outcomes and mortality rates. Patients aged older than 65 years who had undergone major lower extremity amputation were retrospectively evaluated. The patients were divided into 2 groups: regional anesthesia (RA) and general anesthesia (GA). Demographic characteristics, comorbidities, medications used, anesthesia technique, the durations of anesthesia and surgery, need for blood transfusion, 30-day mortality, postoperative cardiac and pulmonary complication rates were recorded from the medical records of the patients. Among the 441 patients, 244 had received RA, while 197 had received GA. The average length of stay in the hospital was longer in the GA group (P = 0.001). The use of antiplatelet drugs (P = 0.001) and the number of transfusions were higher (P = 0.045) in the GA group. No significant difference was found between the groups in terms of mortality and postoperative cardiac or pulmonary complication rates. We determined that the anesthesia technique does not have an effect on 30-day mortality and complication rates. The regional anesthesia technique may be preferred in geriatric patients who will undergo major lower extremity amputation because of the shorter hospital stay and theoretical advantages. However, considering the general functional status of patients, the importance of patient-based evaluation should not be forgotten

Current Status of Open Surgical Treatment Protocols for Subacromial Impingement Syndrome Associated with Rotator Tear

Objective: The aim of this study was to evaluate the recent treatment protocols for Neer stage III subacromial impingement syndrome with open anterior acromioplasty and rotator cuff repair. Material and Methods: Twenty-two patients (8 males, 14 females; mean age: 52.9±10.2) who were diagnosed with a rotator cuff tear based on clinical and radiological findings between 2009 and 2010 participated in the study.. We used the open surgical decompression technique which was previously described by Neer. The ruptured tendon ends were isolated and were fixed to the bones with appropriate suture anchors and transosseoz sutures. Preoperative, postoperative and the final follow-up Constant and UCLA shoulder scores were evaluated. Results: The mean preoperative Constant score was 34.4±6.6 and UCLA score was 13.8±3.3. The mean postoperative Constant score was 73±7.6 and UCLA score was 31.7±3.3. Significant improvement was observed in postoperative shoulder scores (p<0.01) and postoperative shoulder range of motion in all patients (p<0.01). Conclusion: Currently, clinical and functional results of open and arthroscopic subacromial rotator cuff decompression are similar. However, many surgeons prefer the open method and achieve successful results. (The Me di cal Bul le tin of Ha se ki 2012; 50: 59-63