Disc Rehydration after Dynamic Stabilization: A Report of 59 Cases

Atilla Yilmaz,Salim Senturk,Mehdi Sasani,Tunc Oktenoglu,Onur Yaman,Hakan Yildirim,Tuncer Suzer,Ali Fahir Ozer 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3

Study Design: A retrospective study investigating decrease in the nucleus pulposus signal intensity or disc height on magnetic resonance imaging (MRI) and disc degeneration. Purpose: Although a degenerated disc cannot self-regenerate, distraction or stabilization may provide suitable conditions for rehydration and possible regeneration. This study aimed to evaluate clinical outcomes and disc regeneration via MRI in a series of patients with degenerative disc disease (DDD) who underwent lumbar stabilization with a dynamic stabilization system (DSS). Overview of Literature: A dynamic system provides rehydration during early DDD. Methods: Fifty-nine patients (mean age, 46.5 years) who undedwent stabilization with DSS for segmental instability (painful black disc) between 2004 and 2014 were retrospectively evaluated. All patients underwent MRI preoperatively and 12 months postoperatively. Intervertebral disc (IVD) degeneration grades at the implanted segment were categorized using the Pfirrmann classification system. Patients were followed for a mean of 6.4 years, and clinical outcomes were based on visual analog scale (VAS) and Oswestry disability index (ODI) scores. Results: Significant improvements in back pain VAS and ODI scores from before surgery (7 and 68%, respectively) were reported at 6 (2.85 and 27.4%, respectively) and 12 months postoperatively (1.8 and 16.3%, respectively). Postoperative IVD changes were observed in 28 patients. Improvement was observed in 20 patients (34%), whereas progressive degeneration was observed in eight patients (13.5%). Thirty-one patients (52.5%) exhibited neither improvement nor progression. Single Pfirrmann grade improvements were observed in 29% of the patients and two-grade improvements were observed in 5%. Conclusions: Our observations support the theory that physiological movement and a balanced load distribution are necessary for disc regeneration. We conclude that DSS may decelerate the degeneration process and appears to facilitate regeneration.

Impacts of Different Objective Functions on Resource Leveling in Line-of-Balance Scheduling

Atilla Damci,David Arditi,Gul Polat 대한토목학회 2016 KSCE JOURNAL OF CIVIL ENGINEERING Vol.20 No.1

This study investigates the impacts of using different objective functions in leveling resources in schedules established by using Line-Of-Balance (LOB) methodology. A genetic algorithm-based model that considers different objective functions was used for leveling resources in LOB schedules. This model uses the principles of “optimum crew size” and “natural rhythm” that assume that the highest productivity can be achieved as long as an activity is performed in a unit of production by one or multiple crews of optimum size. Therefore, one needs to change the number of crews employed to shift the start times of an activity forwards or backwards at different units of production. The total project duration, the duration of an activity in any unit and the precedence relationships between activities remain the same during this procedure. Two LOB schedules are established for a pipeline project and are used to investigate the impacts of using different objective functions for resource leveling in LOB. It was observed that the objective functions provided the same optimal resource distribution. However, prudent schedulers should consider all ten objective functions because the distribution of resources depends on the number of activities, the float of each activity, and the precedence relationships between activities.

Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy

Atilla Kazanci,Ismail Hakkı Tekkök 대한신경외과학회 2015 Journal of Korean neurosurgical society Vol.58 No.2

The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

Ambient Lead Concentrations in Particulate Matter from the Metropolitan Cities of Korea

Atilla Mutlu,Byeong-Kyu Lee,Chi-Hyeon Lee 한국대기환경학회 2011 한국대기환경학회 학술대회논문집 Vol.2011 No.5월

Long-term Concentrations of Airborne Cadmium in Major Metropolitan Cities in Korea and Cancer Risk Analysis

Atilla Mutlu,Byeong-Kyu Lee,Gee-Hyeong Park,Bong-Gwan Yu,Chi-Hyeon Lee 한국대기환경학회 2011 한국대기환경학회 학술대회논문집 Vol.2011 No.10

Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle

Aynur Atilla,Zahide Doğanay,Hale Kefeli Çelik,Leman Tomak,Özgür Günal,S. Sırrı Kılıç 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.6

Background: The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections (CLABSIs) and infectious complications related to placing a central venous catheter (CVC) in patients in the intensive care unit (ICU). Methods: A care bundle was implemented from July 2013 to June 2014 in a medical ICU and surgical ICU. Data were divided into three periods: the prior period (July 2012–June 2013), the intervention period (July 2013–June 2014; first and second periods), and the post-intervention period (July 2014–December 2014; third period). A care bundle consisting of optimal hand hygiene, skin antisepsis with chlorhexidine (2%) allowing the skin to dry, maximal barrier precautions for inserting a catheter (sterile gloves, gown, mask, and drapes), choice of optimal insertion site, prompt catheter removal, and daily evaluation of the need for the CVC was introduced. Results: The catheterization duration was longer and femoral access was more frequently observed in patients with CLABSIs. CLABSI rates decreased with use of the care bundle. The CLABSI rate in the medical ICU was 6.20/1,000 catheter days during the prior period, 3.88/1,000 catheter days during the intervention period, and 1.05/1,000 catheter days during the third period. The CLABSI rate in the surgical ICU was 8.27/1,000, 4.60/1,000, and 3.73/1,000 catheter days during these three periods, respectively. Conclusions: The choice of an optimal catheter insertion site, use of all barrier precautions, and removal of catheters when they are no longer needed are essential to decrease the CLABSI rate.

Airborne lead levels in the Korean peninsula: characterization of temporal and spatial patterns and cancer risk analysis.

Mutlu, Atilla,Lee, Byeong-Kyu Ecomed 2012 Environmental Science and Pollution Research Vol.19 No.6

<P>This study collected long-term airborne lead concentrations in the Korean peninsula and analyzed their temporal, spatial, and cancer risk characterization.</P>

Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy

Kazanci, Atilla,Tekkok, Ismail Hakki The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.46 No.5

The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

Relations of Platelet Indices with Endometrial Hyperplasia and Endometrial Cancer

Karateke, Atilla,Kaplanoglu, Mustafa,Baloglu, Ali Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.12

Background: Platelets are blood elements thought to play a role in the immune system and therefore tumor development and metastasis. Platelet activation parameters such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) can be easily evaluated with the whole blood count and have been studied as markers of systemic inflammatory responses in various cancer types. Our aim in this study was to evaluate the correlation between endometrial pathologies and MPV, PDW and PCT. Materials and Methods: A total of 194 patients who presented to our clinic with abnormal vaginal bleeding were included in our study. The patients were divided into 3 groups (endometrial hyperplasia, endometrial cancer, control) according to their pathology results. The groups were compared for MPV, PDW, and PCT values obtained from the blood samples taken on endometrial biopsy day. Results: The endometrial cancer patients were the oldest group (p=0.04). There was no significant difference between the three groups in terms of white blood cell count (WBC), platelet count (PC), and hemoglobin (Hb) level. The highest MPV (p<0.001), PDW (p=0.002), and PCT (p<0.001) levels were in the endometrial cancer group, and the lowest levels were in the control group. Conclusions: The easy evaluation of platelet parameters in patients who are suspected of having endometrial pathology is a significant advantage. We found MPV, PDW, and PCT to be correlated with the severity of endometrial pathology with the highest values in endometrial cancer. Studies to be conducted together with different laboratory parameters will further help evaluate the diagnosis and severity of endometrial cancer and precursor lesions.

Comparison of Image Patches Using Local Moment Invariants

Sit, Atilla,Kihara, Daisuke IEEE 2014 IEEE TRANSACTIONS ON IMAGE PROCESSING - Vol.23 No.5

<P>We propose a new set of moment invariants based on Krawtchouk polynomials for comparison of local patches in 2D images. Being computed from discrete functions, these moments do not carry the error due to discretization. Unlike many orthogonal moments, which usually capture global features, Krawtchouk moments can be used to compute local descriptors from a region-of-interest in an image. This can be achieved by changing two parameters, and hence shifting the center of interest region horizontally or vertically or both. This property enables comparison of two arbitrary local regions. We show that Krawtchouk moments can be written as a linear combination of geometric moments, so easily converted to rotation, size, and position independent invariants. We also construct local Hu-based invariants using Hu invariants and utilizing them on images localized by the weight function given in the definition of Krawtchouk polynomials. We give the formulation of local Krawtchouk-based and Hu-based invariants, and evaluate their discriminative performance on local comparison of artificially generated test images.</P>