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Surgical Method for Facilitation of Aortic Valve Replacement:Intraoperative Application of External Pressure for Increasing the Transverse Axis of Aortic Annulus

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World Journal of Cardiovascular Surgery 2015年第10期5卷 108-113页

作者： sahin Bozok Mert Kestelli aykut sahin Hakan Kara Tevfik Günes Berkan Ozpak Gokhan Ilhan Serdar Bayrak Department of Cardiovascular Surgery Recep Tayyip Erdogan University Faculty of MedicineTraining and Research HospitalRizeTurkey Department of Cardiovascular Surgery Izmir Katip Celebi University Faculty of MedicineAtatürk Training and Research HospitalIzmirTurkey Department of Cardiovascular Surgery Osmangazi University Faculty of MedicineEskisehirTurkey Department of Cardiovascular Surgery Ada HospitalGiresunTurkey Department of Cardiovascular Surgery Pamukkale University Faculty of MedicineDenizliTurkey

Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.

关键词： Aortic Valve Replacement Prosthesis Mismatch Aortic Annulus

Median Nerve Somatosensory Evoked Potentials in Patients with Chiari Malformation

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World Journal of Neuroscience 2024年第1期14卷 24-32页

作者： Mustafa Harun sahin Gonul Vural Serdar Barakli Sadiye Gumusyayla Department of Neurology Ankara City Hospital Ankara Türkiye Department of Neurology Sinop Ataturk State Hospital Sinop Türkiye Department of Neurology Faculty of Medicine Ankara Yildirim Beyazit University Ankara Türkiye Department of Neurology Sungurlu State Hospital Corum Türkiye

Abnormal SEP reflects dysfunction of the medial lemniscus and posterior cervical cord. These structures are likely to be affected in Chiari malformation. Therefore, SEP abnormalities may provide valuable information in patients with CM. However, the consistency of SEP abnormality or normality with the damage is a matter of research. Knowing whether median nerve somatosensory evoked potential (SEP) is useful in revealing subclinical damage in patients with Chiari malformation is important in the treatment and follow-up plan of the disease. The aim of this study was to investigate the relationship between median nerve SEP values and the severity of cerebellar ectopia in patients with Chiari type 1 malformation. Median nerve SEP values were obtained from 30 healthy individuals and 146 individuals with Chiari malformation. The cerebellar ectopia degree and McRae line length were measured. SEP values were not significantly different between groups. The McRae line was found to be significantly shorter in the control group than in the Chiari malformation group (p = 0.031). There was no correlation between the degree of cerebellar ectopia and the length of the McRae line (r = 0.002, p = 0.979). Neither cerebellar ectopy degree nor McRae line length had a relationship with SEP values (r = -0.153, p = 0.066;r = -0.056, p = 0.500, respectively). There was no difference in cerebellar ectopy degree or SEP values between the groups with cerebellar ectopy with and without a syrinx (p = 0.899;p = 0.080, respectively). Likewise, McRae line length was not found to be related to the presence of a syrinx (p = 0.139). Median nerve SEP examination was not beneficial for diagnosing asymptomatic-oligosymptomatic Chiari malformation as a subclinical injury, whether accompanied by syringomyelia or not.

关键词： Chiari Malformation Cerebellar Ectopy Somatosensory Evoked Potential

Assessment of commonly used tests in experimental depression studies according to behavioral patterns of rodents

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Medical Review 2023年第6期3卷 526-531页

作者： Zafer sahin Department of Physiology Faculty of MedicineKaradeniz Technical UniversityTrabzon 61080Turkey

Considering the main factor that causes or triggers depression in humans is *** stress factors are applied to form depression-like symptoms in *** tests are used to analyze the nature and patterns of ***-founded modeling and versatile evaluation of tests are necessary to investigate a hypothesis that is related to *** is impossible to model or test all aspects of depression in humans by using experimental *** a result,the aims of the study should be determined specifically in depression *** correct interpretation of the tests that are suitable for these aims is indispensable for the reliability of the *** achieve this goal,the biological basis of the depression-related behaviors of animals should be well *** this review,model and test concepts related to depression are discussed and behavioral patterns of rodents are explained with several examples.

关键词： depression forced swimming test tail suspension test sucrose preference test

Practical points that gastrointestinal fellows should know in management of COVID-19

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World Journal of Clinical Cases 2022年第16期10卷 5133-5145页

作者： Tevhide sahin Cem Simsek Hatice Yasemin Balaban Department of Gastroenterology Hacettepe UniversityFaculty of MedicineAnkara 06100Turkey

Pandemics obligate providers to transform their clinical *** extensive effort has been put to find out feasible approaches for gastrointestinal diseases and also to manage coronavirus disease 2019(COVID-19)related gastrointestinal ***,hepatitis,and pancreatitis can be seen in the COVID-19 *** procedures increase the risk of contamination for medical staff and patients despite precautions,therefore indications should be tailored to balance risks vs ***,whether the immunosupression in inflammatory bowel diseases,liver transplantation,and autoimmune liver diseases increases COVID-19 related risks and how to modify immunosupression are topics of ongoing *** review aims to provide most up to date practical approaches that a gastrointestinal fellow should be aware on the problems and management of gastrointestinal and hepatobiliary diseases during the COVID-19 pandemic.

关键词： COVID-19 Gastrointestinal diseases Practical points Endoscopy Gastrointestinal fellows

Frequency of celiac disease and distribution of HLA-DQ2/DQ8 haplotypes among siblings of children with celiac disease

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World Journal of Clinical Pediatrics 2022年第4期11卷 351-359页

作者： Yasin sahin Serdar Mermer Department of Pediatric Gastroenterology Mersin Training and Research HospitalMersin 33240MersinTurkey Department of Medical Genetics Mersin Training and Research HospitalMersin 33240MersinTurkey

BACKGROUND Celiac disease(CD)is a multifactorial disease,but genetic factors play a major role in its *** has been known that human leucocyte antigen(HLA)-DQ2/DQ8 haplotypes are one of the most important predisposing genetic *** risk of developing CD in first-degree relatives and especially siblings of celiac patients is quite high because of having the same HLA *** To evaluate the frequency of CD and the distribution of the HLA-DQ2/DQ8 haplotypes in siblings of celiac *** Patients with biopsy-proven CD and their siblings were included in the study;those who did not have HLA genotyping were excluded from the *** siblings were on a gluten-containing *** HLA genotyping,tissue transglutaminase antibody IgA antibody test,and total IgA test were performed in all *** A total of 57 celiac patients and their 112 siblings were included in the *** mean age of celiac patients and siblings were 10.30±3.87 years and 9.90±6.11 years,***-DQ2/DQ8 alleles were detected in 98.2%of patients with CD and 90.2%of siblings of celiac ***-DQ genotypes were present in all siblings diagnosed with *** transglutaminase antibody IgA test was found to be positive in 16 *** was diagnosed in 12 siblings(10.7%)by intestinal *** The prevalence of CD was found to be 10.7%in siblings of celiac patients in our ***-third of the siblings diagnosed with CD were *** detected HLA-DQ alleles in 98.2%of celiac patients and 100%in siblings diagnosed with *** addition,1 of the 2 siblings was diagnosed with CD 1 year later and the other 4 years ***,we suggest that siblings of celiac patients should be followed up with clinical findings as well as HLA analysis and serological *** the risk of developing CD is much higher in asymptomatic siblings,we recommend that siblings should be screened for CD even if they are asymptomatic.

关键词： Celiac disease Frequency Genetic HLA haplotypes Intestinal biopsy Siblings

Retinal neurodegeneration in metabolic syndrome:a spectral optical coherence tomography study

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International Journal of Ophthalmology(English edition) 2023年第2期16卷 224-232页

作者： Evrim Polat Ekrem Celik Mesut Togac Afsun sahin Department of Ophthalmology Tekirdag City HospitalTekirdag 59100Turkey Department of Ophthalmology Tekirdag Namik Kemal UniversityFaculty of MedicineTekirdag 59100Turkey Department of Ophthalmology Koc University Medical SchoolIstanbul 34010Turkey Research Center for Translational Medicine Koc UniversityIstanbul 34450Turkey

AIM:To evaluate the effects of metabolic syndrome(Met S)on retinal neurodegeneration by optical coherence tomography(OCT).METHODS:Patients diagnosed as Met S were compared with the age and sex-matched healthy control group(CG).Waist circumference measurements,fasting serological biochemical tests,and systemic blood pressures of all participants were *** Met S group was divided into 3 subgroups according to the number of Met S components:hypertension,diabetes mellitus,dyslipidemia(low-,high-density lipoprotein,hypertriglyceridemia),and visceral obesity findings;3-component Met S3,4-component Met S4,and all-component Met *** patients underwent complete eye examination and spectral OCT retinal ***:Totally 58 eyes of 58 patients were included in the Met S group and 63 eyes of 63 age and sex-matched healthy subjects were included in *** S group was composed of 22 subjects in Met S3,21 subjects in Met S4,and 15 subjects in the Met S5 *** foveal thickness(Met S,218.7±23.1μm vs CG,228.8±21.9μm,P=0.015),mean inferior(Met S,283.4±17.0μm vs CG,288.7±38.4μm,P=0.002),superior(Met S,287.0±18.5μm vs CG 297.3±17.1μm,P=0.001),nasal(Met S 287.3±16.7μm vs CG 297.9±13.9μm,P=0.000)and temporal(274.5±17.6μm vs CG 285.6±13.6μm,P=0.000)thickness in the 3 mm Early Treatment of Diabetic Retinopathy Study(ETDRS)circle was significantly lower in the Met S *** was no statistically significant difference in the mean inferior,superior,nasal,and temporal thickness of 6 mm ETDRS circle,total macular volume,peripapillary and macular retinal nerve fiber layer,macular ganglion cell layer with inner plexiform layer,and ganglion cell *** statistically significant difference was found in these values between the Met S3,Met S4,and the Met S5 ***:A significant reduction in central macular region thickness in Met S is detected and macular thickness is more susceptible to Met S induced neurodegeneration than peripapillary retinal nerve fiber

关键词： metabolic syndrome retinal neurodegeneration hypertension diabetes mellitus dyslipidemia optical coherence tomography

Impact of COVID-19 pandemic on clinicopathological features of transplant recipients with hepatocellular carcinoma:A case-control study

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World Journal of Clinical Cases 2022年第15期10卷 4785-4798页

作者： Sami Akbulut Tevfik Tolga sahin Volkan Ince Sezai Yilmaz Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic had a significant impact on the management of all *** diseases such as cancer have a higher risk of COVID-19-related *** this fact,any delay or alteration in treatment of cancer may have fatal *** carcinoma(HCC)is an aggressive liver cancer that requires multimodality treatment to improve *** To evaluate the impact of COVID-19 on the management of patients with HCC by determining changes in demographic,clinical and histopathological *** Demographic,clinical and pathological variables of patients with HCC who had undergone liver transplantation between March 2020 and June 2021(Pandemic group,n=48)were retrospectively compared with that of the patients with HCC transplanted between November 2018 and March 2020(Pre-pandemic group,n=61).RESULTS The median age of the patients in the study was 56(interquartile range=15).Ninety-seven patients(89%)were male and 12 were female(11%).The most common etiology of liver disease was hepatitis B virus(n=52,47.7%).According to our results,there was a 21.3% drop in the number of patients transplanted for *** was no difference in the demographic,clinical and pathological characteristics of the patients except blood alkaline phosphatase levels(P=0.029),lymphovascular invasion(P=0.019)and type of the liver graft that was transplanted(P=0.017).CONCLUSION It is important to develop a surveillance strategy for liver transplant *** liver transplantation for HCC is justified and safe provided that strict surveillance protocols are applied.

关键词： COVID-19 pandemic Liver transplantation Hepatocellular carcinoma Biological behavior

Liver transplantation for hepatocellular carcinoma:Historical evolution of transplantation criteria

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World Journal of Clinical Cases 2022年第29期10卷 10413-10427页

作者： Volkan Ince Tevfik Tolga sahin Sami Akbulut Sezai Yilmaz Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey Biostatistics and Medical Informatics Inonu University Faculty of MedicineMalatya 44280Turkey

Liver transplantation(LT) for hepatocellular carcinoma is still a hot topic,and the main factor that is associated with the success of treatment is to determine the patients who will benefit from *** criteria have been defined 25 years ago and still is being used for patient selection for ***,in living donor LT,the Milan criteria is being *** criteria for patient selection do not only consider morphologic characteristics such as tumor size and number of tumor nodules but also biologic markers that show tumor aggressiveness is also being *** the present review article,we have summarized all the criteria and scoring systems regarding LT for hepatocellular *** criteria have 5-year overall survival rates that were comparable to the Milan Criteria and ranged between 60%-85%.On the other hand,it was seen that the recurrence rates had increased as the Milan criteria were exceeded;the 5-year recurrence rates ranged between 4.9% to 39.9%.Treatment of hepatocellular carcinoma needs a multidisciplinary *** selection criteria are yet to be *** same is true for treatment *** goal will be achieved by a harmonic interplay between basic science researchers and clinicians.

关键词： Liver transplantation Hepatocellular carcinoma Milan criteria Expanded Malatya criteria

The value of prognostic markers for pediatric trauma patients

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World Journal of Emergency Medicine 2023年第6期14卷 448-453页

作者： Cansu Durak Ebru Guney sahin Yasar Yusuf Can Alican Sarisaltik Kubra Boydag Guvenc Department of Pediatric Intensive Care Sancaktepe Sehit Prof.Dr.IlhanVarank Training and Research HospitalHealth Science UniversityIstanbul 34785Turkiye Republic of Turkiye Ministry of Health Cayirova District Health DirectorateKocaeli 41420Turkiye

BACKGROUND: Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units(PICUs). In this study, we aim to evaluate our experience with children admitted and followed up with the diagnosis of trauma at our ***: We evaluated the retrospective data of 77 pediatric trauma patients who were admitted to the PICU at Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital from August 2020 to December 2022. The demographic data, clinical parameters and laboratory results were recorded. The primary outcome was the mortality in PICU. The performances of markers in predicting mortality were evaluated with receiver operating characteristic(ROC) ***: The median age of the patients was 70(33–157) months, and the median duration of hospitalization in the PICU was 6(2–11) d. Of the 77 patients, 9 died due to trauma(11,1%). Among the clinical parameters, Pediatric Risk of Mortality III(PRISM III) Score, inotrope requirement, extracorporeal treatment requirement, and mechanical ventilator requirement were significantly higher in non-survivors than in survivors. Among the laboratory parameters, procalcitonin(PCT), lactate/albumin ratio(LAR), neutrophil/lymphocyte ratio(NLR), and transfusion requirement were significantly higher in non-survivors than in ***: In pediatric trauma patients, baseline PCT, LAR, and NLR values can be used to identify patients at risk for mortality.

关键词： Critical care Pediatric Lactate Procalcitonin Trauma