Modifiye bilobe alın flebi ile nazal rekonstrüksiyon

Supratroklear arterden beslenen ve yapı olarak burun cildiyle uyum gösteren paramedian alın flepleri, nazal rekonstrüksiyon amacıyla uzun yıllardır başarıyla kullanılmaktadır. Ancak, bu flebin alın çizgilerine dik olarak orta hattan kaldırılması belirgin bir skara neden olabilmektedir. Alın çizgilerine paralel olarak laterale uzanan bir flep ise, aynı tarafta kaşın asimetrik olarak kalkmasıyla sonuçlanır. Bu yazıda “modifiye bilobe alın flebi tekniği” olarak adlandırılan bir flep tekniğini göstermeyi amaçladık. Bu teknikte flep sapı bir tarafın supratroklear arterinden beslenir ve lezyonun karşı tarafında alın çizgilerine paralel insizyonla kaldırılır. Flebin kaldırıldığı sahada kaşın asimetrik olarak kalkmasını engellemek amacıyla, karşı frontal bölgeden ilk kaldırılan flebin yarısı kalınlığında bir başka flep ilk kaldırılan flebin yerine rotasyonel olarak çevrilir. Bu tekniğin temel amacı, alın çizgilerinin kamuflaj etkisini kullanmak; temel yöntemi ise, bilobe flep tekniğidir. Alnın gerilmesi ve kaşların iki taraflı kalkması ise bu tekniğin sekonder kazançlarıdır.Paramedian forehead flaps, which are supplied by supratrochlear artery and have structural compatibility with nasal skin, have been successfully used for nasal reconstruction for many years. However, removing this flap from midline as perpendicular to natural lines of forehead may lead to marked scar. A flap extending to lateral in parallel to natural lines of forehead results in ipsilateral elevation of eyebrow. In this article, we aimed to demonstrate a flap technique called as “modified bilobed forehead flap technique”. In this technique, pedicle of the flap is supplied by supratrochlear artery at one side and the flap is removed at the contralateral side of the lesion using parallel incision to natural lines of forehead. Another flap with a half thickness of the original flap is removed from contralateral frontal region and interpolated to the site where the original flap is removed to prevent the asymmetrical elevation of eyebrow ipsilateral to flap removal. The aim of this technique is to utilize masking effect of natural lines of forehead, while the basic method is bilobed flap technique. Secondary benefits of this technique include forehead lifting and bilateral eyebrow lifting

Masseter adalesinden köken alan intramuskuler kavernöz hemanjiyom

Tüm hemanjiyomların %1’ini oluşturan intramuskuler hemanjiyomalar nadir görülen benign tümörlerdir. Sıklıkla gövde ve ekstremitelerde görülebilmektedir. Masseter ve trapezius kaslarından köken alabilen bu oluşumlar baş ve boyun bölgesinde nadir izlenmektedir. Hastalar genellikle parotis ve yüz bölgesinde zamanla büyüyen ağrısız kitleden şikayet eder. Lokalizasyonundan dolayı intramuskuler hemanjiyomaların %90’ında klinik olarak yanlışlıkla parotis kitlesi tanısı konulabilir. Bu kitlelerin tanısında görüntüleme yöntemleri önemli yer tutar.Intramuscular hemangiomas are rarely seen benign tumors, constituting %1 of all hemangiomas. They mostly occur in the trunk and extremities. They are uncommon in the head and neck region and arising most frequently from masseter and trapezius muscle. The patients usually complain about progressive and painless swelling in facial-parotid region. Due to its location, 90% of all intramuscular hemangiomas are misdiagnosed and often clinically mistaken as a parotid swelling. Radiologic images play important role for diagnosis of these hemangiomas

Anterior approach in otoplasty

Kepçe kulak deformitesi, dış kulağın otozomal dominant geçişli bir anomalisidir. Nüfusun yaklaşık %5’ini etkilemektedir. En fazla iki anatomik nedenle ortaya çıkar; birincisi antiheliksin az gelişmişliği, ikincisi ise konkal çukurun aşırı gelişmesidir. Bu durum okul çağındaki çocuklarda psikolojik açıdan önemli sorunlara neden olabilmektedir. Kepçe kulak deformitesi olan bireylerde birden çok anatomik sorun, bir arada ya da ayrı ayrı bulunabilir. Bu sorunlara yönelik çeşitli cerrahi yöntemler geliştirilmiştir. Otoplastide günümüze kadar 200’den fazla cerrahi tekniği bildirilmiştir. Bu teknikler çoğunlukla antiheliks oluşturmasına ve konkal çukurun ya da lobülün biçimlendirilmesine odaklıdır Konkal yapılara daha kolay ve direkt yaklaşım sunan anteriyor otoplasti tekniği tartışılmıştır. Bu teknikte, gerektiğinde direkt görüş altında yarımay şeklinde bir kıkırdak eksizyonu ve subdermal çekme sütürleri ile antihelikal kıvrımın oluşturulması tartışılmıştır. Dolayısıyla, tekniğimiz, konkal çukur kıvrımının yeni seviyesinin elde edilmesine olanak vermiştir.Prominent ear deformity is an autosomal dominant inherited anomaly of the external ear. It's found to be affecting approximately 5% of the population. It most frequently results from two reasons, one being the poor developmental of the antihelix and the other being the overdevelopment of the conchal bowl. This condition can cause psychological problems in school-age children. One or more anatomical problems of prominent ear may be existing in the individuals. Several surgical methods were developed for these problems. More than 200 surgical techniques have been described up to date in otoplasty. These techniques are mostly focused on creating antihelix or on shaping the conchal bowl or the lobule.
 Anterior otoplasty that provides an easier and direct approach was discussed. In this technique, formation of the anti-helical fold by excision of a crescent shaped cartilage, if required, and by using subdermal pull sutures under direct visualization were discussed. Thus our technique enabled obtaining the new level of the choncal bowl ridge

Evaluation of the tonsillectomy and adenotonsillectomy implemented patients with respect to indications, complications, postoperative consequences, and anticipation-outcome relations

Amaç: Bu çalışmanın amacı, tonsillektomi ve adenotonsillektomi yapılan çocuk hastaların erken ve geç dönem postoperatif sonuçları ile ailelerinin ameliyat sonrası düşüncelerini araştırmak; bulguları hedef – sonuç ilişkisinde değerlendirmektir. Hastalar ve Metod: Çalışmaya Eylül 2008 ile Ekim 2011 tarihleri arasında kliniğimizde tonsillektomi ve adenotonsillektomi yapılan 34'ü erkek(%52.3), 31'i kız(%47.7) olmak üzere 65 çocuk hasta dahil edildi. Hastaların preoperatif yaş ortalaması 7.09±2.30 (min. 4, maks. 13) idi. 11 tanesi (%16.9) kronik/hipertrofik tonsillit, geri kalan 54 tanesi (%83.1) ise adenoid vejetasyon ile birlikte kronik/hipertrofik tonsillit tanısı bulunan çocuklar arasından rastgele seçilerek oluşturuldu. Kontrol amaçlı çağırılan tüm hastaların anamnezleri ve postoperatif şikayetleri anne/babalarından alındı. Çoktan seçmeli ve/veya ucu açık 19 kalem soruyu cevaplamaları istendi. Cevapların ardından hastaların muayeneleri yapılarak son klinik bulguları not edildi. Bulgular: Postoperatif takip süresi ortalama 15.18±7.4 ay(min. 1 – maks. 36) idi. Ameliyatın bizim hastanemizde yapılması için verilen kararda en etkili faktör %55.4 ile fakülte olması iken, bu ameliyata karar verinceye kadar başvurulan KBB uzmanı sayısının ortalama 2.55±1.87 (min. 1 – maks. 10) olduğu öğrenildi. Ameliyatın etkinliği 10 üzerinden ortalama 8.55±1.39 (min. 4 – maks. 10) olarak tespit edildi. Tedavi sonrası hastaların 19'u (%29.2) aynı şikayetlerin devam ettiğini, 36'sı (%55.4) şikayetlerinin tamemen geçtiğini ve 10'u (%15.4) eskisine nazaran daha iyi olduğunu bildirdi. Cerrahi öncesi yaşıtlarına göre gelişme geriliği bulunan 39 hastanın(%60), postoperatif 24'ünde (%61.5) farkedilir bir gelişme olduğu söylendi. 4(%6.2) hasta tekrar başa dönebilseydik bu operasyonu yaptırmazdım yanıtını verdi. Çocukların, 25(%38.5)'inin okul öncesi olduğu, 1(%1.5)'inin özel eğitim öğrencisi olduğu, 19(%29.2)'unun cerrahi sonrası derslerindeki başarının ailenin farkedeceği düzeyde arttığı, 20(%30.8) çocuğun ise ders başarı düzeyinin aynı kaldığı saptandı. Hastaları erken postoperatif dönemde en fazla rahatsız eden semptomlar arasında ilk sırada ağrı(%35), ikinci sırada yutma güçlüğü(%32) ve üçüncü sırada iştahsızlık gelmekteydi(%15). Hastaların yaşları ile iyileşme süreleri arasında ve yapılan cerrahi ile iyileşme süreleri arasında anlamlı bir ilişki tespit edilemedi. Cinsiyete, yaşa ve tanıya bağlı olarak dağılım yapıldığında iyileşme süresi, komplikasyon gelişimi gibi diğer değişkenlerde de anlamlı bir fark bulunamadı. Sonuç: Sonuç olarak preoperatif değerlendirmelerde daha dikkatli olunması, sistemik hastalıklar yönünden detaylı sorgulanması, hasta ve ebeveynlerinin cerrahiden tam olarak ne beklediklerinin bilinmesi ve cerrahi kararın buna göre verilmesi gerektiği anlaşılmıştır. Seçilmiş hastalarda yapılacak adenotonsillektominin daha memnun edici sonuçlar verdiği görülmüştür.Purpose: The purpose of this study is to reveal both the early and late postoperative results of tonsillectomy and adenotonsillectomy which are performed on pediatric patients. It is also intended to disclose the feelings and thoughts of parents or guardians of the patients. Then, ultimate purpose is to evaluate the findings with regards to intent - result relation. Patients and Methods: Sixty-five pediatric patients with a ratio of 34 male (52.3%) and 31 female (47.7%) participated. All the participants have had either tonsillectomy or adenotonsillectomy operation in our clinic sometime from September, 2008 to October, 2011. The mean age of the patients was found as 7.09±2.30 (min. 4 - max. 13) preoperatively. All the patients were randomly chosen. Considering the patients' diagnosis; 11 (16.9%) of the total patients had chronic/hypertrophic tonsillitis, and remaining 54 (83.1%) patients had cronic/hypertrophic tonsillitis with adenoid vegetation. Anamnesis of all the patients who were called for follow-up were taken from the parents. The parents were asked to complete a survey which consists of 19 multiple choice or/and open ended questions. After survey, patients were examined and latest clinical findings were noted. Results: Average length of postoperative follow-up was 15.18±7.7 months (min. 1 – max. 36). Our clinic being an university research institution was the most influential factor (55.4%) for those who had chosen this clinic for the operations. Findings indicated that; before making final decision on having the operation, patients had been consulted by an avarage of 2.55±1.87 (min 1- max. 10) specialist doctors. Affectiveness of the operations was found as 8.55±1.39 (min. 4 – max. 10) out of 10 point. Nine-teen (29.2%) patients have complained about ongoing problems; 36 (55.4%) of them have not had any complaint; and remaining 10 (15.4%) patients have reported being relatively better. According to the reports, although 39 (60%) of the patients preoperatively had growth defficiency in comparasion to their peers; postoperative reports have been claimed a noticable progress for 24 (61.5%) of growth defficiency suffering patients. On the other hand, 4 (6.2%) patients have reported regret of having the surgery. Twenty-five (38.5%) of the patients were preschool children and 1 (1.5%) was receiving special education. In addition to this, school success of 19 (29.2%) children has increased in an observable level; however, the success level has remained the same for remaining 20 (30.8%) children. The most frequently reported early postoperative semptoms were pain (35%), disphagy (32%), and lack of appetite (15%). No statistically significant relation found between both age – recovery time and type of operation – recovery time. In the cases of grouping patients according to gender, age, or diagnosis; no statistically significant results were found between recovery time, development of complications, and other variables. Conclusion: As conclusion, before making a decision on whether performing an operation, followings need to be considered: More careful preoperative evaluations should be done, detailed investigation regarding patients' systemic diseases need to be done, expectations of patients should be precisely defined. It is observed that adenotonsillectomies performed on picked patients result in higher satisfaction

Ecofriendly solventless synthesis and reduction reaction of some triazole compounds and evaluation of their antimicrobial activity

Ozil, Musa/0000-0002-1980-1364WOS: 000322302800013A number of triazole-3-one compounds have been synthesized, and reduction of the carbonyl group in the molecule has been carried out to give a corresponding hydroxyl group that possesses asymmetric carbon atom in good yields and short reaction times. It is ecofriendly because it is produced by straightforward microwave irradiation in the absence of solvent. All newly synthesized compounds were also screened for their antimicrobial activities. the antimicrobial activity study revealed that 2d, 2i, 3c, and 3g-j showed good activity against a variety of microorganisms. Supplemental materials are available for this article. Go to the publisher's online edition of Synthetic Communications (R) to view the free supplemental file.Scientific and Technical Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [108T221]Financial support from the Scientific and Technical Research Council of Turkey (TUBITAK) through Project 108T221 is gratefully acknowledged

Acetate bridged dinuclear Cu(II) complexes with ferrocene based benzimidazol ligands: Synthesis, spectroscopy, electrochemistry, DFT calculations and catecholase activity

emirik, mustafa/0000-0001-9489-9093; KARAOGLU, Kaan/0000-0003-3265-8328; KARAOGLU, Kaan/0000-0003-3265-8328WOS: 000376546500015Two new benzimidazole ligands, 1-[(E)-ferrocenylmethylidenehydrazino]-2-{5,6-dichloro-2-[(o-chloro-phenyl)methyl]-1,3-diaza-1H-inden-1-yl}-1-ethanone (1) and 1-[(E)-ferrocenylmethylidenehydrazino]-2-{2-[p-(trifluoromethyl)phenyl]-1,3-diaza-1H-inden-1-yl}-1-ethanone (2), and their copper(II) complexes (1a, 2a) have been prepared and characterized by IR, UVVis, NMR, TG/DTA and MALDI-TOF mass spectrometry. DFT-based molecular orbital energy calculations and the electrochemical behavior of the compounds have been also studied to explain the redox potentials of the compounds. the catecholase-mimetic activities of the complexes have been investigated by monitoring the formation of 3,5-di-tert-butyl-benzoquinone from 3,5-di-tert-butylcatechol. the catalytic activity of 1a is slightly lower than that of 2a, and the correlation between catalytic activity and electrochemical behaviors of the compounds has been established. (C) 2016 Elsevier Ltd. All rights reserved.Research Fund of Recep Tayyip Erdogan University (Rize/Turkey)Recep Tayyip Erdogan University [2011.102.02.1]This work was supported by the Research Fund of Recep Tayyip Erdogan University, Project No: 2011.102.02.1 (Rize/Turkey). the numerical calculations reported in this paper were performed at TUBITAK ULAKBIM, High Performance and Grid Computing Center (TRUBA Resources)

Is advanced age a hesitation for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer?

WOS: 000452413200012Purpose: The purpose of this study was to assess the feasibility and safety of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in elderly patients with peritoneal carcinomatosis of colorectal cancer. Methods: Patients who underwent curative complete CRS and HIPEC for peritoneal carcinomatosis of colorectal cancer with minimum follow-up of 24 months were included in the analysis. Charlson comorbidity index and ECOG performance status were used to evaluate preoperative condition. Patients were tiered into two groups according to age (= 65 years). Postoperative morbidity, mortality, recurrence, and overall survival were compared between groups. Results: One-hundred patients were meeting the inclusion criteria. Median age was 56 years (ranging, 20-86). The origin of peritoneal carcinomatosis (PC) was colon in 77 and rectum in 23 patients. There were 31 patients in the elderly group. Mean hospital stay was 17 +/- 11.8 and 16.8 +/- 14.3 days in young and elderly groups (p=0.937). In young patients, postoperative morbidity was seen in 26 (37.6%) patients versus 9 (29%) patients in elderly group (p=0.272). Mortality was higher in elderly group (n=4, 12.9%) than in the younger group (n=5, 7.2%), but the difference was not statistically significant (p=0.287). Median follow-up was 25 months (ranging, 2-112). Local and/or distant recurrence occurred in 30 (43.4%) patients in the young group and 9 (29%) patients in elderly group (p=0.169). Two-years disease-free survival was similar: 67.1% in the young and 74% in the elderly groups (p=0.713). Conclusions: CRS and HIPEC offer comparable oncologic outcome in meticulously selected medically-fit elderly patients without increased postoperative morbidity and mortality

Microwave-assisted synthesis of some novel benzimidazole derivatives containing imine function and evaluation of their antimicrobial activity

Ozil, Musa/0000-0002-1980-1364WOS: 0003402772000144-Bromo-o-phenylenediamine and ethylimido-p-bromophenylacetate, 1, were subjected to microwave irradiation to synthesize benzimidazole derivative, compound 2. Ester derivative, 3, and hydrazide derivative, 4, of compound 2 were also synthesized, respectively. Finally, compound 4 was treated with 11 different aromatic aldehydes to obtain benzimidazole derivatives containing imine function. All reactions were carried out with microwave irradiation and conventional heating, and results were compared. Some of the newly synthesized compounds showed moderate antimicrobial activity against some tested organisms.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [108T356]This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK, project no: 108T356