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        Unilateral Posterior Surgery for Severe Osteoporotic Vertebrae Fractures’ Sequelae in Geriatric Population: Minimum 5-Year Results of 109 Patients

        Tuna Pehlivanoglu,Yigit Erdag,Ismail Oltulu,Umut Dogu Akturk,Emre Korkmaz,Kerem Yildirim,Ender Sarioglu,Kerem Gun,Ender Ofluoglu,Mehmet Aydogan 대한척추신경외과학회 2021 Neurospine Vol.18 No.2

        Objective: This study aimed to evaluate the efficacy and safety of modified posterior vertebral column resection (PVCR) combined with anterior column restoration in elderly patients presenting with thoracic or thoracolumbar osteoporotic fractures with spinal cord compression and severe pain. Methods: One hundred nine patients with one level thoracolumbar osteoporotic fracture and at least 5 years of follow-up were included. They underwent posterior instrumentation performed with polymethymetachrylate augmented pedicle screws. A modified PVCR (unilateral costotransversectomy+hemilaminectomy) combined with the insertion of an expandable titanium cage for anterior column restoration was undertaken. Patients were evaluated clinically and radiographically. Results: Patients had a mean age of 74.1 and a follow-up duration of 92.3 months. Mean duration of operations, hospital stays, and mean loss of blood were 172.3 minutes, 4.3 days, and 205.4 mL. All of the patients were mobilized immediately after surgery. The mean preoperative local kyphosis angle improved from 39.3° to 4.7° at the last follow-up (p=0.003). Patients preoperative mean visual analogue score, Japanese Orthopaedic Association, and Oswestry Disability Index scores improved from 7.7/8.6/76.3 to 1.6/26.1/17.4 (p<0.001 for all), respectively. The average 36-item Short-Form survey physical component summary/mental component summary scores at the last follow-up were 55.1/56.8. A dural tear was detected intraoperatively in 1 patient and repaired immediately. Conclusion: Subtotal PVCR combined with the insertion of an expandable titanium cage was detected as a safe and effective method for osteoporotic vertebrae fractures’ sequelae in the older population involving spinal cord compression by enabling the decompression of the spinal canal and reconstruction of the resected segment, resulting in significant improvement in clinical and radiographic outcomes.

      • SCIESCOPUSKCI등재

        Microbial Flora of Normal and Abnormal Cervical Mucous Discharge Associated with Reproductive Performance of Cows and Heifers in Estrus

        Ata, Ayhan,Turutoglu, Hulya,Kale, Mehmet,Gulay, Mehmet Sukru,Pehlivanoglu, Faruk Asian Australasian Association of Animal Productio 2010 Animal Bioscience Vol.23 No.8

        The aim of the present study was to describe whether abnormal cervical mucus discharge (A-CMD) or pathogens in cervical mucus discharge (CMD) have effects on reproductive performance of cows and heifers in estrus. Animals having clear discharges (68 cows, 38 heifers) with normal viscosity and without bad odor were grouped as normal cervical mucous discharge (N-CMD) group. The other animals (84 cows, 32 heifers) were grouped as A-CMD group. Microorganisms isolated from samples were divided into three groups as uterine pathogens (UP), potential uterine pathogens (PUP) or opportunistic uterine pathogens (OUP). Presence of PUP was associated with A-CMD for both cows (p<0.01) and heifers (p<0.02). First service conception rates (FS-CR) were lower in cows positive for PUP (p<0.01). Moreover, presence of PUP and OUP affected FS-CR in heifers (p<0.01). Although A-CMD significantly affected FS-CR in cows (p<0.04), it did not affect FS-CR in heifers. Differences in average open day for cows (p<0.02) and first service age for heifers (p<0.01) were significant between N-CMD and A-CMD groups, respectively. The current study suggested that CMD should be evaluated more carefully when there are infertility problems. In addition to the known microorganism that causes sterility and infertility in the UP group, pathogens in the PUP group should be considered for their potential to cause infertility.

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        Performance of F-18 Fluorocholine PET/CT for Detection of Hyperfunctioning Parathyroid Tissue in Patients with Elevated Parathyroid Hormone Levels and Negative or Discrepant Results in Conventional Imaging

        Lebriz Uslu-Bes¸li,Kerim Sonmezoglu,Serkan Teksoz,Elife Akgun,Emre Karayel,Huseyin Pehlivanoglu,Baresh Razavi Khosroshahi,Meltem Ocak,Levent Kabasakal,Sait Sager,Yusuf Bukey 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.2

        Objective: Our aim was to assess the diagnostic performance of F-18 fluorocholine (FCH) positron emission tomography/ computed tomography (PET/CT) in detecting hyperfunctioning parathyroid tissue (HPT) in patients with elevated parathyroid hormone levels with negative or inconclusive conventional imaging results and to compare the findings with those obtained using technetium-99m sestamibi (MIBI) scintigraphy and neck ultrasonography (US). Materials and Methods: Images of 105 patients with hyperparathyroidism who underwent FCH PET/CT, dual-phase MIBI parathyroid scintigraphy (median interval: 42 days), and neck US were retrospectively analyzed. The gold standard was histopathological findings for 81 patients who underwent parathyroidectomy and clinical follow-up findings in the remaining 24 patients. Sensitivities, positive predictive values (PPVs), and accuracies were calculated for all imaging modalities. Results: Among the 81 patients who underwent parathyroidectomy, either parathyroid adenoma (n = 64), hyperplasia (n = 9), neoplasia (n = 4), or both parathyroid adenoma and hyperplasia (n = 1) were detected, except 3 patients who did not show HPT. Of the 24 (23%) patients who were followed-up without operation, 22 (92%) showed persistent hyperparathyroidism. FCH PET/CT showed significantly higher sensitivity than MIBI scintigraphy and US in detection of HPT (p < 0.01). Sensitivity, PPV, and accuracy of FCH PET/CT were 94.1% (95/101), 97.9% (95/97), and 92.4% (97/105), respectively. The corresponding values for MIBI scintigraphy and US were 45.1% (46/102), 97.9% (46/47), and 45.7% (48/105) and 44.1% (45/102), 93.8% (45/48), and 42.9% (45/105), respectively. Among the 35 patients showing negative MIBI scintigraphy and neck US findings, 30 (86%) showed positive results on FCH PET/CT. FCH PET/CT could demonstrate ectopic locations of HPT in 11 patients whereas MIBI and US showed positive findings in only 6 and 3 patients, respectively. Conclusion: FCH PET/CT is an effective imaging modality for detection of HPT with the highest sensitivity among the available imaging techniques. Therefore, FCH PET/CT can be recommended especially for patients who show negative or inconclusive results on conventional imaging.

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