Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution

Onur Saydam,Deniz Serefli,A. Yaprak Engin,Mehmet Atay 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.5

Purpose: The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP. Methods: We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms. Results: Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01). Conclusion: We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery.

Assessment of Cervical Cancer Risk in Women between 15 and 49 Years of Age: Case of Izmir

Sogukpınar, Neriman,Saydam, Birsen Karaca,Can, Hafize Ozturk,Hadımli, Aytul,Bozkurt, Ozlem Demirel,Yucel, Ummahan,Kocak, Yeliz Cakir,Akmese, Zehra Baykal,Demir, Dogan,Ceber, Esin,Ozenturk, Gulsun Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

Background: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. Methods: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. Results: While the average age of the women was $31.9{\pm}9.77$ (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. Conclusions: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

Midterm results of kissing stent reconstruction of the aortoiliac bifurcation

Deniz Serefli,Onur Saydam,A. Yaprak Engin,Mehmet Atay 대한외과학회 2021 Annals of Surgical Treatment and Research(ASRT) Vol.101 No.4

Purpose: One subset of peripheral arterial disease is aortoiliac occlusive diseases (AIOD). AIOD is the term for all arterial lesions between the infrarenal distal aorta and common femoral artery. Implantation of kissing stents (KS) with covered stents (CS), bare-metal stents (BMS) is one of the endovascular treatment (ET) modalities for AIOD involving aortic bifurcation. In this study, we report the outcomes of the KS technique in infrarenal AIOD. Methods: Between January 2014 and September 2017, 31 patients who underwent ET were treated with KS technique either with balloon-expandable BMS or balloon-expandable CS. Technical details, clinical success, complications, and patency at follow-up were documented. Results: The majority of patients were male (77.4%), and the median age was 62 years (range, 45–78 years). All patients were classified according to the TASC II criteria. Eight patients (25.8%) were classified as TASC B. Fifteen patients (48.4%) were classified as TASC C, and 8 patients (25.8%) were classified as TASC D. These 23 patients were classified as complex AIOD group. BMS was used in 17 patients (54.8%), and CS was used in 14 patients (45.2%). Technical and clinical success was achieved in 100% of treated cases. The median follow-up was 24 months (range, 24–34 months). Primary patency rates at 12, 18, and 24 months after ET were 100%, 96.8%, and 90.3%, respectively. Conclusion: We found that the KS technique has satisfying 24-month results, even in complex AIOD lesions, with high technical success and acceptable midterm patency.

Validation of Three Breast Cancer Nomograms and a New Formula for Predicting Non-sentinel Lymph Node Status

Derici, Serhan,Sevinc, Ali,Harmancioglu, Omer,Saydam, Serdar,Kocdor, Mehmet,Aksoy, Suleyman,Egeli, Tufan,Canda, Tulay,Ellidokuz, Hulya,Derici, Solen Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.12

Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.

Association between Taql polymorphism of vitamin D receptor gene and vertical growth of the mandible: A cross-sectional study

Baris Can Telatar,Gul Yildiz Telatar,Faruk Saydam 대한치과교정학회 2023 대한치과교정학회지 Vol.53 No.5

Objective: To determine whether the gonial angle on digital panoramic radiographs is associated with vitamin D receptor (VDR) Taql polymorphism. Methods: Genomic DNA samples were collected from the buccal mucosa of patients aged 26–43 years. TaqMan assay for single nucleotide polymorphism genotyping was used to detect the genotype of Taql polymorphism. The gonial angle was measured bilaterally on panoramic radiography. The normal gonial angle was fixed as 121.8°, and it represented the cutoff value for the high gonial angle (HGA) and low gonial angle (LGA) groups. Various genetic models were analyzed, namely dominant (homozygous [AA] vs. heterozygous [AG] + polymorphic [GG]), recessive (AA + AG vs. GG), and additive (AA + GG vs. AG), using the chi-squared test. Results: The reliability of the gonial angle measurement was analyzed using a random sample (26%) of the tests, with the intra-examiner correlation showing an intra-class correlation coefficient of 0.99. The frequencies of the AA, AG, and GG genotypes of rs731236 polymorphism were 40.5%, 41.9%, and 17.6% in the HGA group and 21.8%, 51.0%, and 27.2% in the LGA group, respectively (P = 0.042). A statistically significant difference was observed in the allele frequencies between the two groups (P = 0.011). Moreover, a significant correlation was observed in the dominant genetic model. Conclusions: Taql polymorphism in the VDR gene plays a critical role in the vertical growth of the mandible and decreased gonial angle.

Exposure of Surgical Staff to Radiation During Surgical Probe Applications in Breast Cancer

Recep Bekis,Pinar Celik,Banu Uysal,Mehmet Ali Kocdor,Ali Sevinc,Serdar Saydam,Omer Harmancioglu 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

Purpose: The aim of study was to determine the level of the radiation exposure of surgical staff during surgical probe applications in breast cancer. Methods: Three operations of a sentinel lymph node biopsy were randomly selected. Spaced circles (50 cm apart) were drawn surrounding the operation bed on the floor. Tc-99m nanocolloid was injected peritumorally and intradermally into a patient. The radiation dose was measured with a GeigerMueller counter placed according to the drawn circles at distances of 50-200 cm from the side of patient's head and bilateral chest while the patient lay on the operation bed. All of the surgical procedures were recorded with a video camera and were monitored. Results: The whole body dose to the senior surgeon was calculated as 2.00-4.70 µSv which means that a senior surgeon can perform 212-500 procedures per year to reach the annual International Commission on Radiological Protection radiation dose limit for a member of the public. Conclusion: We concluded that radiation risk to the surgical staff is low from sentinel node detection with the use of radiocolloids.

Which Dosing Scheme is Suitable for the Taxanes\ulcorner An in Vitro Model

Sanli, Ulus-Ali,Uslu, Ruchan,Karabulut, Bulent,Sezgin, Canfeza,Saydam, Guray,Omay, Serdar-Bedii,Goker, Erdem The Pharmaceutical Society of Korea 2002 Archives of Pharmacal Research Vol.25 No.4

The discovery and development of the taxane class of antitumor compounds represent significant advances in the treatment of patients with a variety of malignancies. These drugs are effectively used in the treatment of breast cancer. In this study we evaluated the efficacy of fractionated usage of both paclitaxel and docetaxel as a single agent in the breast cancer cell line MCF-7. It has been shown that the cytotoxic effect of paclitaxel was increased when the divided $IC_{50}$ concentrations were used sequentially and in contrast to paclitaxel, cytotoxic effect of docetaxel was decreased with the same schema and the single dose of $IC_{50}$ concentration was optimal. The cause of the difference between the cytotoxic effects of two agents with this schedule is obscure. Demonstrating mechanisms, which are responsible for these differences, will be important for more rational use of taxoids and to provide basis for the following clinical trials.

Determination of Knowledge of Turkish Midwifery Students about Human Papilloma Virus Infection and its Vaccines

Genc, Rabia Ekti,Sarican, Emine Serap,Turgay, Ayse San,Icke, Sibel,Sari, Dilek,Saydam, Birsen Karaca Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11

Human papilloma virus (HPV) is one of the most common sexually transmitted agents and its infection is the most established cause of cervical cancer. Midwives play a key position in the implementation of cervical cancer. This descriptive study aimed to determine the level of knowledge concerning HPV and HPV vaccination among 268 midwifery students. Data were collected between November 15 and 30, 2011, through a self-reported questionnaire. The mean age of participants was $20.75{\pm}1.60$. Among all students, 44.4% had heard of HPV, while 40.4% had heard of HPV vaccinatiob. The relationship between the midwifery student knowledge on HPV and HPV vaccine and their current educational year was significant (p=0.001). In conclusion midwifery students have moderate level of knowledge about HPV and its vaccine and relevant information should be included in their teaching curriculum.