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International Journal of Clinical Medicine 2016年第9期7卷 566-576页

作者： Banu Bilezikçi Seyfettin Ilgan Serdar Özbaş Savaş Koçak Departments of Pathology Guven Hospital Ankara Turkey Departments of Nuclear Medicine Guven Hospital Ankara Turkey Departments of Endocrine Surgery Guven Hospital Ankara Turkey

Background: Central lymph node dissection (CLND) for papillary thyroid carcinoma (PTC) allows correct pathologic staging of lymph nodes and planning of postoperative management. The purpose of this study was to determine the number of the lymph nodes in the CLND and the relationship to presence of chronic lymphocytic thyroiditis (CLT) and thymic tissue (TT). Methods: Total thyroidectomy and CLND materials from 153 patients with PTC were included in this study. Two histopathologic features (presence of CLT and TT) were evaluated for their value in adequacy of CLND. Results: Histopathologic examination revealed CLT and TT in CLND materials in 70 (46%) and 63 (41%) patients, respectively. Total number of lymph nodes in CLND materials was significantly higher in CLT (+) and TT (+) groups (p Conclusions: Our study demonstrates that presence of CLT in thyroid gland has been associated with higher number of central lymph nodes mainly due to increased number of benign hyperplastic lymph nodes. It may be possible to conclude that upper limit of lymph nodes for satisfactory CLND would be higher to correctly evaluate central lymph node status in existing staging systems if specimens have CLT. Results of this study also show that the presence of TT in surgical materials may represent the adequacy of CLND.

关键词： Thyroid Papillary Carcinoma Central Lymph Node Dissection Thyroiditis Thymus

Evaluation of ischemic lesions after carotid artery stenting with diffusion-weighted imaging

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World Journal of Clinical Cases 2020年第10期8卷 1859-1870页

作者： Murat Beyhan Berat Acu Erkan Gokce Mehmet Murat Firat Department of Radiology Tokat Gaziosmanpasa University Faculty of MedicineTokat 60100Turkey Department of Radiology Eskisehir Osmangazi University Faculty of MedicineEskisehir 26480Turkey Department of Radiology Guven HospitalAnkara 06540Turkey

BACKGROUND Almost 90%of cerebral thromboembolism cases are caused by *** atherosclerosis is often observed at the carotid bifurcation and is responsible for 20%-30%of all stroke *** course of atherosclerotic carotid artery stenosis varies depending on the grade of stenosis and characteristics of the *** artery stenting(CAS)can be used as a less invasive method in patients with symptomatic and asymptomatic high-grade carotid artery ***-weighted imaging(DWI)is an effective method for detection of silent or symptomatic acute ischemic lesions that may arise due to CAS or carotid *** number and volume of new ischemic lesions are determined using *** To evaluate the number and volume of ischemic lesions and their cerebral parenchymal and vascular distribution after CAS using *** Forty-seven male(73.4%)and seventeen female(26.6%)patients(total,n=64)aged 42-84 years(mean 67.96±8.03 years)diagnosed with carotid stenosis between October 2006 and July 2012 were included in this retrospective *** of the cases(18.8%)were asymptomatic,while fifty-two(81.2%)were *** area where the stenosis was highest was measured,and the stenosis rate was determined using the North American Symptomatic Carotid Endarterectomy Trial *** of the cases was evaluated by two radiologists experienced in neuroradiology(*** more than 15 years of experience,*** more than 10 years of experience).Routine DWI examinations were carried out by a 1.5 T MR device 1 h before and after the *** the ischemic lesions that developed in the first hour and in the follow-up period of 5-24 h were assumed to be due to CAS,all lesions within the first 24 h were considered as new *** In the present study,39 new ischemic lesions were detected in 20 *** average number of new lesions after all CAS operations was *** were mostly located in the occipital lobes,followed by

关键词： Carotid artery stenosis Carotid artery stenting Diffusion-weighted imaging Ischemia Stroke

Staging of hepatocellular carcinoma

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Hepatoma Research 2018年第9期4卷 93-110页

作者： Sedat Karademir Department of General Surgery Section of HPB Surgery and Organ TransplantationAnkara Guven HospitalAnkara 06540Turkey

Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths in the world. In contrast to other cancers, survival of patients with HCC is determined by the extent of the tumor in addition to underlying liver disease and its functional reserve. From risk factors to management, HCC reveals a considerable geographic and institutional variation throughout the world. Although many staging and/or scoring systems have been proposed, each prognostic system has several benefits and limitations on its own. Therefore, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. In this review, currently available staging systems for assessing the prognosis of HCC, their uses, limitations, and future prospects are revisited.

关键词： Hepatocellular cancer staging and scoring systems risk factors survival

Portopulmonary hypertension in liver transplant candidates

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World Journal of Gastroenterology 2016年第6期22卷 2024-2029页

作者： Serife Savas Bozbas Huseyin Bozbas Department of Pulmonary Disease Baskent University Faculty of Medicine06490 AnkaraTurkey Cardiology Clinic Guven Hospital06540 AnkaraTurkey

Pulmonary vascular disorders including portopulmonary hypertension(PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure(PAP) and liver transplant surgery, survival of patients with Po PHT and advanced liver disease is significantly improved. Because of the prognostic significance of Po PHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild Po PHT can safely undergo liver transplant surgery. In cases of moderate to severe Po PHT, right heart catheterization(RHC) should be performed. In patients with moderate to severe Po PHT on RHC(mean PAP 35-45 mm Hg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri- and post-operative periods as needed.

关键词： portopulmonary hypertension pulmonaryarterial hypertension liver disease liver transplantation portal hypertension

Epstein Barr Virus Infection Induced Suspected Acute Myocarditis in COVID-19 Pandemic

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World Journal of Cardiovascular Diseases 2022年第8期12卷 419-425页

作者： Ersin Saricam Nalan Can Gulay Kilic Yasemin Saglam Fatih Karaahmet Erdogan Ilkay Medicana International Ankara hospital Atilim University Cardiology Clinic Ankara Turkey Medicana International Ankara hospital Nuclear Medicine Ankara Turkey Medicana International Ankara hospital Department of Infectious Disease Ankara Turkey guven hospital Cardiology Clinic Ankara Turkey Medicana International Ankara hospital Gastroenterology and Hepatology Ankara Turkey Medicana International Ankara hospital Cardiology Clinic Ankara Turkey

Background: Epstein Barr Virus infection (EBV) could be associated with cardiovascular disease, including myocarditis. We informed a case of EBV infection presenting initially as myocarditis, followed 5 days later by the typical symptoms of infectious mononucleosis. Case Presentation: A 19-year-old man with persistent retrosternal chest pain was admitted to the emergency department. On physical examination, the patient had sub-febrile fever (37.2°C) and palpable cervical lymphadenopathy, with no hepatosplenomegaly. Initial ECG has repolarization abnormalities in leads II, aVF and III. Laboratory testing revealed elevated cardiac enzymes and liver enzymes (high sensitive troponin I levels 3000 ng/mL, aspartate transaminase 158 U/L, alanine transaminase 100 U/L). Blood white cells were 10,500 μL, platelet level were low 98,000 (thrombocytopenia), and lenfo-monocytosis in complete blood count. We hospitalized the patients the intensive coronary unit (ICU) because of high troponin levels. We recognized hypokinesia of the posterolateral wall of the left ventricle with mild impaired systolic function and increased perimyocardial brightness by echocardiography. Antibody serology tests showed that the anti-EBV capsid antigen IgM (EBV-VCA) was positive, EBV-VCA) IgG was negative. Other etiologies were excluded. Therefore, the patient was referred to cardiac positron emission tomography due to technic problems of magnetic resonance imaging device. We documented in positron emission tomography imaging that increased 18F-FDG uptake on posterior and posterolateral walls of left ventricle (indicating a large jeopardized area). We diagnosed suspected diagnosis of myocarditis without associated pericarditis. We monitored the patient and gave beta blocker, and aldosterone antagonists. Complications in the intensive care unit not occurred. We discharged patients after one week. After three weeks, we re-evaluated the patient. We not observed wall segment motion abnormality

关键词： Epstein Barr Virus Myocarditis 18F-FDG PET/CT

Combination of allopurinol and hyperbaric oxygen therapy:A new treatment in experimental acute necrotizing pancreatitis?

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World Journal of Gastroenterology 2007年第46期13卷 6203-6207页

作者： Bilgin Comert Ahmet Turan Isik Sezai Aydin Ergun Bozoglu Bulent Unal Salih Deveci Nuket Mas Esref Cinar Mehmet Refik Mas Division of Intensive Care Departments of Internal MedicineGulhane School of MedicineAnkara 06018Turkey Division of Geriatric Medicine Department of Internal MedicineGulhane School of MedicineAnkara 06018Turkey Department of Surgery Guven HospitalA.AyranciAnkara 06018Turkey Department of Surgery Numune Training HospitalSihhiyeAnkara 06018Turkey Department of Pathology Gulhane School of MedicineAnkara 06018Turkey Department of Anatomy Medical FacultyBaskent UniversityAnkara 06018Turkey Department of Infection Disease Gulhane School of MedicineAnkara 06018Turkey Department of Internal Medicine Gulhane School of MedicineAnkara 06018Turkey

AIM： To investigate the individual and combined effects of allopurinol and hyperbaric oxygen （HBO） therapy on biochemical and histopathological changes, oxidative stress, and bacterial translocation （BT） in the experimental rat acute pancreatitis （AP）. METHODS： Eighty-five Sprague-Dawley rats were included in the study. Fifteen of the eighty-five rats were used as controls （sham, Group I ）. AP was induced via intraductal taurocholate infusion in the remaining seventy rats. Rats that survived to induction of acute necrotizing pancreatitis were randomized into four groups. Group H received saline, Group m allopurinol, Group IV allopurinol plus HBO and Group v HBO alone. Serum amylase levels, oxidative stress parameters, BT and histopathologic scores were determined. RESULTS： Serum amylase levels were lower in Groups Ⅲ, Ⅳ and v compared to Group H （974 ± 110, 384 ± 40, 851 ＋ 56, and 1664 Ⅳ 234 U/L, respectively, P 〈 0.05, for all）. Combining the two treatment optionsrevealed significantly lower median [25-75 percentiles] histopathological scores when compared to individual administrations （13 [12.5-15] in allopurinol group, 9.5 [7-11.75] in HBO group, and 6 [4.5-7.5] in combined group, P 〈 0.01）. Oxidative stress markers were significantly better in all treatment groups compared to the controls. Bacterial translocation into the pancreas and mesenteric lymph nodes was lower in Groups m, iV and v compared to Group H （54%, 23%, 50% vs 100% for translocation to pancreas, and 62%, 46%, 58% vs 100% for translocation to mesenteric lymph nodes, respectively, P 〈 0.05 for all）. CONCLUSION： The present study confirms the benefit of HBO and allopurinol treatment when administered separately in experimental rat AP. Combination of these treatment options appears to prevent progression of pancreatic injury parameters more effectively.

关键词： Experimental pancreatitis AIIopurinol Hyperbaric oxygen

Bilateral papilledema in a child with osteogenesis imperfecta

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Eye and Vision 2016年第1期3卷 197-201页

作者： Selam Yekta Sendul Cemile Ucgul Atilgan Semra Tiryaki Dilek guven Department of Ophthalmology Sisli Hamidiye Etfal Training and Research HospitalEtfal Street34280 IstanbulSisliTurkey Department of Ophthalmology Ulucanlar Eye Training and Research HospitalUlucanlar street06030 AnkaraAltindagTurkey

Background:To present a female child patient with osteogenesis imperfecta who had bilateral *** presentation:A twelve-year-old girl with osteogenesis imperfecta was referred to our *** best corrected visual acuity of the patient was 5/10(corrected with+3.50 for right eye,+5.00 for left eye)with a standard Snellen scale at a distance of a 6 *** chamber,iris and lens examination of both of her eyes were *** her fundus examination,bilateral stage 2 papilledema and the wrinkles in papillomacular area were *** coherence tomography images revealed the macular pucker and thickening in the retinal nerve fibre layers of both *** tomography images revealed that there were ossifications in the optic chiasma and occlusion in all periorbital sinus ***:Osteogenesis imperfecta is a rare,autosomal dominant connective tissue disorder characterised by bone fractures,deafness and blue *** would like to draw attention to the clinical course of our patient with computed tomography,optical coherence tomography and visual field findings.

关键词： Optical coherence tomography Osteogenesis imperfecta Papilledema Visual field defect

Pediatric dysphagia overview:best practice recommendation study by multidisciplinary experts

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World Journal of Pediatrics 2022年第11期18卷 715-724页

作者： Ebru Umay Sibel Eyigor Esra Giray Evrim Karadag Saygi Bulent Karadag Nihal Durmus Kocaaslan Deniz Yuksel Arzu Meltem Demir Engin Tutar Canan Tikiz Eda Gurcay Zeliha Unlu Pelin Celik Ece Unlu Akyuz guven Mengu Serkan Bengisu Sibel Alicura Necati Unver Nida Yekteusaklari Cuma Uz Merve Cikili Uytuni Fatih Bagcier Elif Tarihci Mazlum Serdar Akaltun Iclal Ayranci Sucakli Damla Cankurtaran Zeynep Aykin Resa Aydin Fatma Nazli Department of Physical Medicine and Rehabilitation Ankara University of Health Sciences TurkeyAnkara Diskapi Yildirim Beyazit Training and Research HospitalIstanbulTurkey Department of Physical Medicine and Rehabilitation Ege UniversityIzmirTurkey Department of Physical Medicine and Rehabilitation Fatih Sultan Mehmet Training and Research HospitalIstanbulTurkey Department of Physical Medicine and Rehabilitation Marmara UniversityIstanbulTurkey Department of Pediatric Pulmonology Marmara UniversityIstanbulTurkey Department of Plastic Reconstructive and Aesthetic SurgeryMarmara UniversityIstanbulTurkey Department of Pediatric Neurology University of Health SciencesAnkara Dr Sami Ulus MaternityChildren's Health and Diseases Training and Research HospitalAnkaraTurkey Department of Pediatric Gastroenterology Ankara City HospitalAnkaraTurkey Department of Pediatric Gastroenterology Marmara UniversityAnkaraTurkey Department of Physical Medicine and Rehabilitation Celal Bayar UniversityManisaTurkey University of Health Sciences Turkey Gaziler Physical Medicine and Rehabilitation Training and Research HospitalAnkaraTurkey Department of Developmental Pediatric Ankara City HospitalAnkaraTurkey Department of Western Languages and Literatures Ankara Haci Bayram Veli UniversityEnglish Language and Literature DivisionAnkaraTurkey Department of Speech and Language Therapy Uskudar UniversityIstanbulTurkey Department of Otolaryngology Head and Neck SurgeryUniversity of Health SciencesAnkara Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey Department of Otolaryngology Head and Neck SurgeryMarmara UniversityIstanbulTurkey Department of Child and Adolescent Psychiatry Ankara UniversityAnkaraTurkey Department of Physical Medicine and Rehabilitation Istanbul Basaksehir Cam and Sakura City HospitalIstanbulTurkey Department of Physical Medicine and Rehabilitation Istanbul UniversityIstanbulTurkey Department of Physical Medicine and Rehabilitation Gaziantep UniversityGazian

Background Currently,there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia(PD).This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world,from the perspective of experienced multidisciplinary *** This recommendation paper was generated by a multidisciplinary team,using the seven-step process and a three-round modified Delphi survey via ***,ten open-ended questions were created,and then detailed recommendations including management,diagnosis,treatment,and follow-up were created with the answers from these *** recommendation item was voted on by the experts as overall consensus(strong recommendation),approaching consensus(weak recommendation)and divergent consensus(not recommended).Results In the 1st Delphi round,a questionnaire of 414 items was prepared based on the experts’responses to ten open-ended *** the 2nd Delphi round,59.2%of these items were accepted as *** the 3rd Delphi round,62.6%of 246 items were accepted for inclusion in the *** final version recommendations consisted of 154 *** This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD,and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.

关键词： Diagnosis Dysphagia Pediatric Recommendation Rehabilitation

EEG （Electroencephalography） Abnormality in First Episode Mania： Is It Trait or State？

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Psychology Research 2013年第10期3卷 563-570页

作者： Sermin Kesebir Sertac guven Elif Tathdil Yaylacl Ozgur Bilgin Topcuoglu Merih Altlntas Erenkoy Mental and Neurological Disease Training and Research hospital istanbul Turkey

Antioxidant Supplement Improves the Pregnancy Rate in Patients Undergoing in Vitro Fertilization for Unexplained Infertility

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Open Journal of Obstetrics and Gynecology 2019年第1期9卷 1-9页

作者： Ayse Z.Ozdemir Bulent Ayas Davut guven Abdulkadir Bakay Pervin Karl? Ondokuz Mayis University IVF Center Ondokuz Mayis University HospitalSamsunTurkey Department of Obstetrics and Gynaecology Ondokuz Mayis University HospitalSamsunTurkey Amasya University Department of Obstetrics and GynecologyAmasyaTurkey

Objective: This is a retrospective study to evaluate the effect of using the antioxidants containing coenzyme Q10 (CoQ10) and omega-3 in patients undergoing in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) for unexplained infertility. Materials Methods: A total of 299 patients undergoing IVF-ICSI for unexplained infertility at the IVF center of Ondokuz Mayis University were studied. The subject group consisted of 135 patients who used OMEPA Q10 (Co Q10 100 mg, omega-3 600 mg, eicosapentaenoic acid 300 mg, docosahexaenoic acid 230 mg) for two months before ovarian stimulation. A group of 164 patients who did not use the supplement were evaluated as the control group. Results: The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p 0.05). The pregnancy rates of patients in the two groups were 32.9% and 49.6% respectively. The pregnancy rate of patients using antioxidants was statistically higher than that of those who did not use the supplement (p 0.05) seemed not enough. Conclusion: We concluded that using antioxidants that contain Co Q10 and omega-3 in patients undergoing IVF-ICSI for unexplained infertility increased the clinical pregnancy rate. We recommend using antioxidants that contain Co Q10 and omega-3 in infertile patients.

关键词： CoQ10 Omega-3 Antioxidant Unexplained Infertility In Vitro Fertilization