Can Breast Asymmetry Following the Treatment of Juvenile Idiopathic Scoliosis with Growing Rod Be Prevented? : A Preliminary Analysis

Atici, Yunus,Polat, Baris,Erdogan, Sinan,Gurpinar, Tahsin,Demiroz, Serdar The Korean Neurosurgical Society 2020 Journal of Korean neurosurgical society Vol.63 No.2

Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

On Some Lacunary Generalized Difference Sequence Spaces of Invariant Means De ned by a Sequence of Modulus Function

Atici, Gulcan,Bektas, Cigdem Asma Department of Mathematics 2011 Kyungpook mathematical journal Vol.51 No.4

The aim of this paper is to introduce and study the sequence spaces [w, ${\theta}$, F, p, q]$_{\infty}({\Delta}_{\upsilon}^m)$, [w, ${\theta}$, F, p, q]$_1({\Delta}_{\upsilon}^m)$ and [w, ${\theta}$, F, p, q]$_0({\Delta}_{\upsilon}^m)$, which arise from the notions of generalized difference sequence space, lacunary convergence, invariant mean and a sequence of Moduli $F=(f_k)$. We establish some inclusion relations between these spaces under some conditions.

A New Radiological Sign for Severe Angular Kyphosis: “The Baltalimani Sign”

Yunus Atici,Osman Emre Aycan,Muhammed Mert,Deniz Kargin,Akif Albayrak,Mehmet Bulent Balioglu 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.6

Study Design: Retrospective diagnostic study. Purpose: To define a new radiological sign, “Baltalimani sign,” in severe angular kyphosis (SAK) and to report its relationship with the risk of neurological deficits and deformity severity. Overview of Literature: Baltalimani sign was previously undefined in the literature. Methods: We propose Baltalimani sign as the axial orientation of the vertebrae that are located above or below the apex of angular kyphosis on anteroposterior radiographs. Patients with SAK of various etiologies with kyphotic angles ≥90° were selected and evaluated for the presence of Baltalimani sign. Demographic data of the patients including age, gender, etiology, neurological status, local kyphosis angles, and the location of the kyphosis apex were recorded. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of Baltalimani sign for the risk of the neurological deficits were evaluated by the IBM SPSS ver. 20.0. A p -values of <0.05 were considered statistically significant. Cohen’s kappa was used for analysis of interrater agreement. Results: The mean local kyphosis angle in all patients was 124.2° (range, 90°–169°), and 15 of 40 (37.5%) patients had neurological deficits. Baltalimani sign was seen in 13 of 15 patients with neurological deficits (p =0.001). Baltalimani sign showed a sensitivity and specificity PPV and NPV of 61.9%, 86.7%, 89.5%, and 68.8% for the risk of the neurological deficits in SAK patients, respectively. Cohen’s kappa value was moderate (κ=0.506). Conclusions: The detection of Baltalimani sign in SAK may indicate severity of deformity and the risk of neurological deficits.

The Surgical Overcorrection of Lenke Type 1 Deformities with Selective Fusion Segments: What Happens to the Coronal Balance ?

Yunus Atici,Sinan Erdogan,Yunus Emre Akman,Murat Mert,Engin Carkci,Tolga Tuzuner 대한척추신경외과학회 2016 Neurospine Vol.13 No.3

Purpose: The aim of our study is to determine the alterations on coronal balance after overcorrection of Lenke type 1 curve, retrospectively. Methods: Datas of 34 patients (29 female, 5 male patients; mean age, 16.3±3.3 years; range, 13-24 years) surgically treated for scoliosis between 2004 and 2010 were reviewed, retrospectively. The adolescent idiopathic scoliosis patients with Lenke type 1 curve treated with only posterior pedicle screw and postoperative thoracic curves less than 10° by Cobb method on frontal plane were enrolled in this study. Mean follow-up period was 52.5±29.7 months. Results: The mean amount of the preoperative thoracic curves was measured as 41.2°±6.1° (range, 30°-56°). The mean amount of the early postoperative thoracic curves was measured as 6.5°±1.8° (range, 3°-9°). The mean amount of the thoracic curves was measured as 8.5°±4.6° (range, 3°-22°) during the last follow-up (p=0.01). The mean preoperative coronal balance was measured as 8.5mm(range, 1-30mm). The mean early postoperative coronal balance was measured as 3.5mm(range, 0-36 mm). The mean coronal balance was measured as 5.5mm(range, 0-38mm) during the last follow-up (p>0.05). Conclusion: We suggest that Lenke type 1B and 1C should be carefully evaluated and the fusion levels should be accurately selected in order to maintain the correction of coronal balance. We suggest that selective fusion with overcorrection in Lenke type 1A are applied to curves that can be corrected lumbar curve at the preoperative bending radiograph and curves that not have coronal decompensation and >10° distal junctional kyphosis, preoperatively.

Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis

Erdogan, Sinan,Polat, Baris,Atici, Yunus,Ozyalvac, Osman Nuri,Ozturk, Cagatay The Korean Neurosurgical Society 2019 Journal of Korean neurosurgical society Vol.62 No.5

Objective : Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). Methods : Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. Results : Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. Conclusion : There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

On Some New Generalized Di erence Statistically Convergen Sequence Spaces De ned by a Sequence of Orlicz Function

Bekt, Cigdem Asma,Atici, Gulcan Department of Mathematics 2010 Kyungpook mathematical journal Vol.50 No.3

In this paper we introduce the new generalized difference sequence space $\ell_\infty$($\Delta_v^n$, M,p,q,s), $\bar{c}$($\Delta_v^n$,M,p,q,s), $\bar{c_0}$($\Delta_v^n$,M,p,q,s), m($\Delta_v^n$,M,p,q,s) and $m_0$($\Delta_v^n$,M,p,q,s) defined over a seminormed sequence space (X,q). We study some of it properties, like completeness, solidity, symmetricity etc. We obtain some relations between these spaces as well as prove some inclusion result.

Is Tranexamic Acid an Effective Prevention in the Formation of Epidural Fibrosis? Histological Evaluation in the Rats

Esra Circi,Yunus Atici,Alican Baris,Ahmet Senel,Cem Leblebici,Saltuk Bugra Tekin,Yusuf Ozturkmen 대한신경외과학회 2023 Journal of Korean neurosurgical society Vol.66 No.5

Objective : The present study aimed to determine the topical and systemic efficacy of tranexamic acid (TXA) on epidural fibrosis in a rat laminectomy model. Methods : Thirty-two 12-month-old adult Sprague-Dawley rats were used in this study. Each rat underwent bilateral laminectomy at the L1 and L2 vertebral levels. Rats were divided into four groups : in group I (control group, n=8), a laminectomy was performed and saline solution was applied into the surgical space. In group II (topical group, n=8), laminectomy was performed and 30 mg/ kg TXA was applied to the surgical site before skin closure. In group III (systemic group, n=8), 30 mg/kg TXA was administered intravenously via the tail vein in the same session as the surgical procedure. In group IV (topical and systemic group, n=8), TXA was administered 30 mg/kg both topical and intravenous. The rats were sacrificed at 4 weeks postoperatively. Masson’s trichrome and hematoxylin and eosin were used to assess acute inflammatory cells, chronic inflammatory cells, vascular proliferation, and epidural fibrosis. Results : Epidural fibrosis, acute inflammation, chronic inflammation, and sum histologic score value were significantly lower in the systemic TXA group, systemic and topical TXA groups than in the control group (p<0.05). In addion, the sum histologic score was significantly lower in the topical TXA group than in the control group (p<0.05). Conclusion : In this study, epidural fibrosis formation was prevented more by systemic application, but the topical application was found to be effective when compared to the control group. As a result, we recommend the systemic and topical use of TXA to prevent epidural fibrosis during spinal surgery.

Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer

Mustafa Haksal,Nuri Okkabaz,Ali Emre Atici,Osman Civil,Yasar Ozdenkaya,Ayhan Erdemir,Nihat Aksakal,Mustafa Oncel 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.92 No.1

Purpose: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. Methods: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. Results: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). Conclusion: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.

Preoperative Embolization in Surgical Treatment of a Primary Hemangiopericytoma of the Rib : A Case Report

Huseyin Akan,Sancar Baris,Atilla G. Atici,Oguz Uzun,Levent Erkan,Serhat Findik 대한의학회 2005 Journal of Korean medical science Vol.20 No.2

Economic Viability Analysis for Fresh Concrete Waste Reclaimers: The Capacity of Leftover Concrete

Aynur Kazaz,Serdar Ulubeyli,Murat Atici 대한토목학회 2018 KSCE Journal of Civil Engineering Vol.22 No.1

Many batching plants are reluctant in recycling the returned fresh concrete. However, leftover concrete may present great potential as it is always observed in truck-mixers. Therefore, viability of mechanical reclaimers was economically investigated considering the leftover concrete capacity. Toward this aim, availability of reclaimers in Turkey was revealed through a survey and the leftover concrete amount was measured. An economic selection algorithm for reclaimers was then introduced. Lastly, sensitivity and scenario analyses were performed for investment. In conclusion, most plants have poor views about recycling the leftover concrete although its percentage is 0.31%. With this amount, the annual leftover concrete amount in Turkey reaches a small plant’s annual production. Given viability, four inputs can have huge influence on viability and should be paid attention. Finally, the most likely and the best scenarios present an optimistic view even for small plants while the worst scenario has negative results and should be supported by incentives.