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Öğe Characteristics of pediatric multiple sclerosis: The Turkish pediatric multiple sclerosis database(W.B. Saunders Ltd, 2017) Yılmaz Ü.; Anlar B.; Gücüyener K.; Yaramış A.; Cansu A.; Ünalp A.; Aksoy A.; Bayram A.K.; Kartal A.; Tosun A.; Serdaroğlu A.; Konuşkan B.; Sarıoğlu B.; Yüzbaşı B.K.; Kılıç B.; Taşkın B.D.; Bulut C.; Yılmaz C.; Yarar C.; Okuyaz Ç.; Gençsel Ç.; Yüksel D.; Arslan E.A.; Gürkaş E.; Faruk incecik; Serdaroğlu G.; Deda G.; Gürbüz G.; Gümüş H.; Acer H.; Tekgül H.; Çaksen H.; Per H.; Erol İ.; Çarman K.B.; Canpolat M.; Özkan M.; Direk M.Ç.; Kutluk M.G.; Arslan M.; Sönmez F.M.; Dündar N.O.; Koçak O.; Aydın Ö.F.; Toptaş Ö.; Duman Ö.; Hergüner Ö.; Bozkurt Ö.; Arıcan P.; Yılmaz S.; Gökben S.; Işıkay S.; Kumandaş S.; Edizer S.; Kurul S.H.; Saygı S.; Teber S.; Güngör S.; Altunbaşak Ş.; Haspolat Ş.; Sezer T.; Yılmaz T.S.; Yiş U.; Öztoprak Ü.; Aydoğmuş Ü.; Topçu Y.; Öztürk Z.; Karalök Z.S.Objective To document the clinical and paraclinical features of pediatric multiple sclerosis (MS) in Turkey. Methods Data of MS patients with onset before age 18 years (n = 193) were collected from 27 pediatric neurology centers throughout Turkey. Earlier-onset (<12 years) and later-onset (?12 years) groups were compared. Results There were 123 (63.7%) girls and 70 (36.3%) boys aged 4–17 years, median 14 years at disease onset. Family history of MS was 6.5%. The first presentation was polysymptomatic in 55.4% of patients, with brainstem syndromes (50.3%), sensory disturbances (44%), motor symptoms (33.2%), and optic neuritis (26.4%) as common initial manifestations. Nineteen children had facial paralysis and 10 had epileptic seizures at first attack; 21 (11%) were initially diagnosed with acute disseminated encephalomyelitis (ADEM). Oligoclonal bands were identified in 68% of patients. Magnetic resonance imaging revealed periventricular (96%), cortical/juxtacortical (64.2%), brainstem (63%), cerebellum (51.4%), and spinal cord (67%) involvement. Visual evoked potentials (VEP) were abnormal in 52%; serum 25-hydroxyvitamin D levels were low in 68.5% of patients. The earlier-onset group had a higher rate of infection/vaccination preceding initial attack, initial diagnosis of ADEM, longer interval between first 2 attacks, and more disability accumulating in the first 3 years of the disease. Conclusion Brainstem and cerebellum are common sites of clinical and radiological involvement in pediatric-onset MS. VEP abnormalities are frequent even in patients without history of optic neuropathy. Vitamin D status does not appear to affect the course in early disease. MS beginning before 12 years of age has certain characteristics in history and course. © 2017 European Paediatric Neurology SocietyÖğe Evolution in abdominal trauma: Ege University experience [Abdominal travmada de?işim süreci: Ege Üniversitesi deneyimi](2005) Makay Ö.; Firat Ö.; Gürcü B.; Sezer T.; Içöz G.Purpose: Since the last two decades there has been an evolution in the diagnosis and management of trauma. A shift has also been seen in the etiological pattern of trauma. In this study, we evaluated the reflection of changes in abdominal trauma on our patients. Materials and methods: A total of 601 adult penetrating and blunt trauma patients admitted to our clinic between July 1994 - September 2005 were evaluated and compared retrospectively between two different time intervals (Period I = July 1994 - December 1999 and Period II = January 2000 - September 2005). Results: Eighty-three percent of the patients studied were male while 17% were female. The mean age was 33.4 ± 12 years. There were 50.7% injuries due to blunt and 49.3% due to penetrating trauma. The main cause of penetrating trauma was stabbing (31.4%), while road accident was the main cause of blunt trauma (42%). Penetrating injury increased from 41.5% to 56% (p<0.05), while blunt trauma rates decreased from 58% to 44% (p<0.05). When comparing DPL rates between two different time intervals it was observed that the indication of DPL decreased significantly in period II from 31.3% to 10.6% (p<0.05). Nonoperative management, which was started in period II, was carried out in 65124.7%) patients. Diagnostic laparoscopy was used in 11 (7.9%) of the 153 patients in period II. Conclusion: Abdominal trauma is in evolution with respect to the developmental technology and changing algorithms. It is logical that this change will effect surgical education and practice.Öğe Large mucinous neoplasm of the appendix mimicking adnexal mass in a postmenopausal woman(Elsevier Ltd, 2014) Akman L.; Hursitoglu B.S.; Hortu I.; Sezer T.; Oztekin K.; Avsargil B.D.INTRODUCTION: Appendiceal tumors are rare, late-diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery. PRESENTATION OF CASE: We report a case of 81-year-old postmenopausal woman presented with abdominal pain. A magnetic resonance imaging revealed right adnexal mass. Laparotomy was performed and detected a 12 cm × 9 cm mucinous tumoral mass arising in the appendix. An appendectomy and a right hemicolectomy with ileo-transverse anastomosis were performed. Histopathological examination was revealed appendiceal mucinous neoplasm with low malignancy potential. DISCUSSION: Gastrointestinal tumors such as appendiceal tumors can mimicking adnexal mass. Therefore, appendiceal tumor kept in mind in a patient with diagnosed adnexal mass, especially patient had non-specific clinical symptoms, laboratory and radiologic findings. CONCLUSION: Gastrointestinal tumors such as appendiceal tumors kept in mind in a patient with diagnosed adnexal mass. © 2014, Elsevier Ltd. All rights reserved.Öğe Our 'Ligation of Intersphincteric Fistula Tract' experience for complex anorectal fistulas: Is it a preferable method?(Southeastern Surgical Congress, 2014) Yoldas T.; Karaca C.; Unalp O.; Ekmekcigil E.; Uguz A.; Sezer T.; Caliskan C.; Akgun E.; Korkut M.[No abstract available]Öğe Perioperative management of Sneddon syndrome during thyroidectomy(2008) Ulukaya S.; Makay O.; Icoz G.; Demir F.; Sezer T.The perioperative management of an adult woman with Sneddon syndrome is presented. This syndrome is characterized by vasculopathy, hypercoagulable state, ischemic cerebral events, livedo reticularis, heart valve disease, and renal insufficiency. During surgery in these patients, the balance between bleeding and thrombosis requires rapid diagnostic information for therapeutic decisions. Thrombelastographic analysis may be a valuable tool to use in monitoring these patients. © 2008 Elsevier Inc. All rights reserved.
