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Öğe Central defect type partial ACL injury model on goat knees: The effect of infrapatellar fat pad excision(BioMed Central Ltd., 2015) Karakilic B.; Taskiran E.; Doganavsargil B.; Uzun B.; Celik S.; Kaya Bicer E.Background: The mid-substance central defect injury has been used to investigate the primary healing capacity of the anterior cruciate ligament (ACL) in a goat model. The sagittal plane stability on this model has not been confirmed, and possible effects of fat pad excision on healing have not been evaluated. We hypothesize that excising the fat pad tissue results in poorer ligament healing as assessed histologically and decreased tensile strength of the healing ligament. We further hypothesize that the creation of a central defect does not affect sagittal plane knee stability. Methods: A mid-substance central defect was created with a 4-mm arthroscopic punch in the ACLs of right knees of all the subjects through a medial mini-arthrotomy. Goats were assigned to groups based on whether the fat pad was preserved (group 1, n = 5) or excised completely (group 2, n = 5). The left knees served as controls in each goat. Histopathology of the defect area along with measurement of type I collagen in one goat from each group were performed at 10th week postoperatively. The remaining knees were evaluated biomechanically at the 12th week, by measuring anterior tibial translation (ATT) of the knee joints at 90° of flexion and testing tensile properties (ultimate tensile load (UTL), ultimate elongation (UE), stiffness (S), failure mode (FM)) of the femur-ACL-tibia complex. Results and discussion: Histopathology analysis revealed that the central defect area was fully filled macroscopically and microscopically. However, myxoid degeneration and fibrosis were observed in group 2 and increased collagen type I content was noted in group 2. There were no significant differences within and between groups in terms of ATT values (p = 0.715 and p = 0.149, respectively). There were no significance between or within groups in terms of ultimate tensile load and ultimate elongation; however, group 2 demonstrated greater stiffness than group 1 that was correlated with the fibrotic changes detected microscopically (p = 0.043). Conclusions: The central defect type injury model was confirmed to be biomechanically stable in a goat model. Resection of the fat pad was noted to negatively affect defect healing and increase ligament stiffness in the central defect injury model. © 2015 Karakilic et al.Öğe Feasibility and clinical utility of intraoperative consultation with frozen section in osseous lesions(2012) Sezak M.; Doganavsargil B.; Kececi B.; Argin M.; Sabah D.Intraoperative consultation (IOC) with frozen section (FS) allows the surgeon to make therapy decisions during the operation.However, there is relatively little information on the use of IOC in skeletal lesions. We performed a retrospective study to examine the indications for IOC and compare the histological findings of FS and permanent paraffin section (PS) results to determine its clinical benefits. Ninety-seven consecutive cases evaluated between 2008 and 2011 were retrieved from IOC archives of our Pathology Department. In 79 % of the cases, there was no prior core needle biopsy (CNB), and IOC was performed to confirm the clinical or radiological diagnosis. In 5 (5 %) cases, no definitive result could be obtained with FS, and diagnosis was deferred. The reasons for a deferred diagnosis (DD) included poor section quality in two lipomatous lesions and the sample heterogeneity in the others. When adjusted for DD, FS and PS results showed 100 % concordance in terms of discriminating "benign vs. malignant" and defining diagnostic categories as "benign non-tumoral," "benign tumoral/tumor-like, " "malignant primary tumor," "malignant metastatic tumor," or "hematopoietic malignancy." The presence of non-sclerotic osseous tissues does not have a significant adverse impact on the FS section quality and diagnosis made by FS. Thus, sections with diagnostic value can be obtained from bone lesions via FS. In this study, specific diagnoses were made in 88 % of the cases. We believe that IOC with FS can be safely performed in tertiary referral centers where there is a multidisciplinary team working in collaboration. © Springer-Verlag 2012.Öğe Long-term outcomes of colon cancer patients undergoing standardized technique operation with curative intent(International College of Surgeons, 2015) Akgun E.; Caliskan C.; Yoldas T.; Karaca C.; Karabulut B.; Doganavsargil B.; Yasar H.; Kose T.There is no defined standard surgical technique accepted worldwide for colon cancer, especially on the extent of resection and lymphadenectomy, resulting in technical variations among surgeons. Nearly all analyses employ more than one surgeon, thus giving heterogeneous results on surgical treatment. This study aims to evaluate longterm follow-up results of colon cancer patients who were operated on by a single senior colorectal surgeon using a standardized technique with curative intent, and to compare these results with the literature. A total of 269 consecutive patients who were operated on with standardized technique between January 2003 and June 2013 were enrolled in this study. Standardized technique means separation of the mesocolic fascia from the parietal plane with sharp dissection and ligation of the supplying vessels closely to their roots. Patients were assessed in terms of postoperative morbidity, mortality, disease recurrence, and survival. Operations were carried out with a 99.3% R0 resection rate and mean lymph node count of 17.7 nodes per patient. Surviving patients were followed up for a mean period of 57.8 months, and a total of 19.7% disease recurrence was recorded. Mean survival was 113.9 months. The 5-and 10-year survival rates were 78% and 75.8% for disease-free survival, 82.6% and 72.9% for overall survival, and 87.5% and 82.9% for cancer-specific survival, respectively. R1 resection and pathologic characteristics of the tumor were found to be the most important prognostic factors according to univariate and Cox regression analyses. Standardization of surgical therapy and a dedicated team are thought to make significant contributions to the improvement of prognosis.Öğe Perforated appendicitis after intravenous immunoglobulin therapy in a term neonate with haemolytic jaundice(College of Physicians and Surgeons Pakistan, 2015) Atikan B.Y.; Koroglu O.A.; Yalaz M.; Ergun O.; Dokumcu Z.; Doganavsargil B.; Akisu M.; Kultursay N.Neonatal appendicitis is a rare clinical condition that may cause high morbidity and mortality if diagnosis is delayed. There is usually an underlying disease; it can also be a localized form of necrotizing enterocolitis. Here, we present a term neonate who was treated with intravenous immunoglobulin because of severe isoimmune hemolytic jaundice. The patient developed abdominal symptoms within 10 hours of therapy, was diagnosed with acute perforated appendicitis and completely recovered after surgery.Öğe Severe colitis after administration of UFT chemotherapy for temporal bone carcinoma(2004) Akay S.; Özütemiz Ö.; Doganavsargil B.UFT (Uftoral®), a blend of uracil and Tegafur, is an antitumour agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumour tissue. As a result of increased use of high-dose 5-FU-based chemotherapy for various solid tumours, complicated drug-induced colitis is more frequently observed. Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme in the catabolism of 5-FU and its deficiency is responsible for the severe toxicities encountered in cancer patients receiving 5-FU. The authors present the case of a patient with locally advanced temporal bone carcinoma who developed haematochezia during a course of chemotherapy with UFT. Colonoscopy of the patient showed bleeding petechia-like lesions and superficial inflammatory exudate, whilst histology revealed non-specific inflammatory changes of the colon mucosa. As the haematochezia improved with supportive treatment, neutropenia complicated the clinical picture. This patient developed life-threatening UFT toxicity without an exon-14 DPD gene mutation. 2004 © Ashley Publications Ltd.
