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Öğe Analysis of the magneto-transport properties of superconducting/ferromagnetic YBa2Cu3O7/La0.7Sr0.3MnO3 bilayer thin films(Elsevier Science Sa, 2010) Topal, Ugur; Birlikseven, Cengiz; Yakinci, M. Eyuephan; Nurgaliev, TimurY1Ba2Cu3O7-delta (100 nm)/La0.7Sr0.3MnO3 (20 nm) double-layered films and La0.7Sr0.3MnO3 (20 nm) single layer films were prepared on LaAlO3 substrates by magnetron sputtering and their electrical and magnetic properties were examined. It was observed that the interactions between magnetic and superconducting layers lead to some peculiar electrical and magnetic properties such as a semiconducting-like behavior above superconducting transition temperature. Possible reasons of this behavior and others are discussed in the text. Additionally, it is observed that the SC/FM film has a quite low coercivity (50 Oe) and large M-r/M-s ratio (0.8) at 300 K. The extraordinary properties of these materials may give rise to their utilization of these films for temporary recording of information on magnetic surfaces. (C) 2009 Elsevier B.V. All rights reserved.Öğe Clinical and surgical approach to parathyroid adenomas: A single-center experience(2019) Topal, Ugur; Dalci, Kubilay; Unal, Ayse Gizem; Saritas, Ahmet Gokhan; Gunay, Isa Burak; Uguz, Aysun Hatice; Sakman, GurhanAim: Primary hyperparathyroidism is a clinical condition caused by excessive parathyroid secretion of the parathyroid glands and related hypercalsemia. Hyperparathyroidism is a common cause of hypercalcemia. In this study, we aimed to present the results of patients operated on due to parathyroidadenoma in our clinic.Material and Methods: IPatients who underwent surgery for parathyroid adenoma in our clinic between January 2007 and January 2019 were included in the study. Clinical characteristics, biochemical data, treatment methods and results of the patients were analyzed retrospectively.Results: 156 patients with a mean age of 50.8 years participated in the study. Female sex was 76.2%. Preoperative calcium level was found as 11.2+1.02 mg/dl, Parathormone level was found as 114.7+109.5 pg / ml. The most common clinical presentation was asymptomatic hypercalcemia (48.7%). While 89.7% of the patients had only parathoridectomy, 3.2% had total thyroidectomy and 7.1% had lobectomy due to associated thyroid pathology (10.3%). Intraoperative rapid parathormone was used in 54.4% of the patients. Frozen examination was performed in all patients. The most common localization was inferior left 39.7%. The most common ectopic localization was intratymic at 2.6%. The mean duration of postoperative hospital stay was 3.81+2.69 days. Three patients (1.9%) had persistent hyperparathyroidism and 6 patients (3.8%) had recurrent hyperparathyroidism. The mean follow-up was 57.2+39.5 months. Conclusion: Proper preoperative evaluation, careful exploration, frozen examination and rapid parathormone test increase the success of parathyroid adenoma surgery.Öğe Clinical value of neutrophil/lymphocyte ratio in predicting postoperative complications, lymph node positivity and prognosis in gastric cancer patients who underwent curative surgical resection(2019) Topal, Ugur; Unal, Ayse Gizem; Yalav, OrcunAim: In this study, we aimed to determine the clinical value of neutrophil / lymphocyte ratio (NLR) in predicting postoperative complications, lymph node positivity and prognosis in patients who underwent curative surgical resection.Material and Methods: Patients who underwent total gastrectomy for gastric adenocarcinoma between 2015 and 2018 were included in the study. Two groups, Group 1 (LowNLR) and Group 2 (HighNLR), were formed. Demographic and clinical characteristics, intraoperative and postoperative outcomes, and mean survival were compared. The value of NLR in predicting lymph node positivity and postoperative complications was evaluated at the cutoff value determined for NLR.Results: Patients were divided into two groups according to the cutoff value of 2.14. Group 1 consisted of 36 patients and Group 2 consisted of 68 patients. Female sex was higher in Group 2 (72% vs 52%) (p:0.41). Postoperative complication rates according to Clavien Dindo classification were similar (p:0.9). The number of dissected positive lymph nodes was higher in Group 2 than in Group 1 (9 vs 6) (p:0.041). Pathological stage (p:0.188), and overall survival (24.61vs21.12,p:0.206) were similar between the groups. We found NLR as a risk factor for survival in multivariate analysis (HR=0.255, 95%CI: 0.024–0.427, p:0.029). If the NLR value was less than 2.14, the patient had According to Clavien Dindo classification Grade 2 and above complications, with a sensitivity of 46.3% and specificity of 76.0%. A positive lymph node was detected with 44.26% sensitivity and 65.12% specificity. Conclusion: Preoperative high NLR is a risk factor for survival in patients with gastric cancer. High NLR is also closely associated with the risk of postoperative complications.Öğe Comparison of obese and non-obese patients in terms of sharp object injuries: A retrospective evaluation(2020) Topal, Ugur; Sozuer, Erdogan Mutevelli; Talih, Tutkun; Dal, Fatih; Akyildiz, Hizir YakupAim: Few studies have evaluated real-world clinical experience with sofosbuvir (SOF) plus ribavirin (RBV) in hepatitis C virus (HCV) genotypes 2 and 3 infections from Turkey. Thus, this study aimed to investigate the results of sofosbuvir plus ribavirin therapy in genotype 2 and 3 cases followed in an infectious disease clinic at a university hospital in Hatay, southern Turkey. Material and Methods: In this single-centre, retrospective, observational study, 58 eligible patients treated with SOF/RBV (400 mg of SOF plus weight-based RBV) therapy between October 2016 and February 2019 were examined. Forty-three patients who had completed the duration of treatment and had known virological response status were evaluated for treatment outcomes. Results: SOF/RBV achieves a sustained virological response (SVR) rate of 96.3% and 100% in the HCV genotype 2 and 3 groups, respectively, with treatment duration of 12-24 weeks. No patient experienced a virologic breakthrough while only one experienced virologic relapse after the completion of therapy. The incidence of adverse events was 25.5% (11/43) while the most common (11.6%) adverse event was ribavirin-related hemolytic anemia. Conclusion: The current study revealed that the SOF/RBV therapy achieved excellent response rates with a good safety profile in non-cirrhotic Turkish patients infected with HCV genotype 2 or 3Öğe Comparison of results of laparoscopic and open surgical techniques in adrenal masses larger than 6 cm(2019) Topal, Ugur; Dalci, Kubilay; Yalav, Orcun; Unal, Ayse Gizem; Eray, Ismail Cem; Sakman, GurhanAim: In this study, we aimed to compare the results of conventional and laparoscopic adrenalectomy in patients with adrenal masses greater than 6 cm.Material and Methods: Thirty-six patients with tumor size greater than 6 cm who underwent adrenalectomy between January 2011 and January 2018 were included in the study. Patients were divided into two groups as Group 1 conventional and Group 2 Laparoscopic surgery. The two groups were retrospectively compared in terms of age, sex, mass localization, mass size, duration of operation, amount of bleeding, duration of hospitalization, duration of onset of food intake, perioperative mortality, early period complications and re-admission to the hospital within 90 days. P0.05 was considered statistically significant.Results: There were 13 patients in Group 1 and 23 patients in Group 2. There was no statistically significant difference between the groups in terms of age, sex, tumor localization, tumor size, indications for operation, postoperative complications, perioperative mortality and readmission within 90 days. Duration of operation (min), amount of bleeding (ml), duration of oral intake (day) and duration of hospitalization (day) were higher in Group 1 and statistically significant.Conclusion: Laparoscopic adrenalectomy has demonstrated advantages in patients with a mass greater than 6 cm compared to conventional surgery, such as short operation duration, less blood loss, early onset of oral food intake and shorter hospital stay. It can be safely used in patients with a mass larger than 6 cm.Öğe Effects of grain boundaries on electrical and magnetic properties of melt-processed SmBa2Cu3Ox superconductors(Elsevier Science Sa, 2010) Topal, Ugur; Yakinci, M. EyyuphanIn the present study, we examine the energy dissipation mechanisms and grain boundary effects on the superconducting properties of high-T-c SmBa2Cu3O7-x samples. Sm-123 was synthesized with the top-seeded-melt-growth technique. Grain sizes, as determined by optical microscopy, ranged between 0.5 mm and 1.5 mm. Thus, each specimen, on which the electrical and magnetic measurements were carried out, contained several grains. Some of our findings are as follows: (1) the intragrain T-c is 93.5 K and the intergrain T-c is 87.5 K. Superconducting transition width is narrow and is not affected much by the magnetic field. (2) The intragrainjc is 110,000A cm(-2) while the intergrainjc is 210 A cm(-2) at 10 K. (3) The intergrain J(c) shows a secondary peak with the increase in temperature from 10 K to 30 K. The main reasons behind these observations are discussed in detail. (C) 2009 Elsevier B.V. All rights reserved.Öğe Evaluation of factors related to postoperative mortality in patients who underwent pancreatoduodenectomy due to periampullary region tumors(2020) Arikan, Bahadir; Sozuer, Erdogan Mutevelli; Topal, Ugur; Dal, Fatih; Bozkurt, Gamze KubraAim: In this study, we aimed to investigate the factors related to postoperative mortality after pancreatoduodenectomy in our clinic.Materials and Methods: Patients who underwent pancreatoduodenectomy due to a periampullary region tumor between 2010 and 2019 were included in the study. Mortality that occurred within 30 days after PD was defined as postoperative mortality and groups were formed according to this definition Group 1(Postoperative Mortality) and Group 2(No mortality). The demographic and clinical features, laboratory parameters, and tumor features of the patients were compared between the groups. Risk factors for mortality were analyzed by univariate analysis and multivariate logistic regression analysis.Results: 155 patients participated in our study. We found our postoperative mortality rate as 11.6%. Accordingly, Group 1 consisted of 18 and Group 2 consisted of 137 patients. The sex was similar (p: 0.235). The average age was higher in Group 1 than 2 (71.2 vs 63.7, p:0.013). Tumor localizations were similar in groups (p:0.275). Lymph node positivity was similar in the groups (50% vs 41.6%, p:0.333). The pancreatic fistula was higher in Group 1, but not statistically significant (33% vs 18.2%, p:0.119). Preoperative white blood cell count (9490 mm3 vs 8050 mm3) and neutrophil count (6898 mm3 vs5442 mm3) were higher in Group 1. In multivariate analysis, no parameters were single-handedly risk factors. Conclusion: No factor was found to be effective alone in the development of mortality after pancreaticoduodenectomy. We think that postoperative mortality may decrease by revealing the factors in the preoperative, intraoperative and postoperative periods.Öğe The impact of previous open abdominal surgery on the outcome of laparoscopic colorectal surgery(2021) Eray, Ismail Cem; Topal, Ugur; Yalav, Orcun; Dalci, Kubilay; Saritas, Ahmet Gokhan; Rencuzogullari, AhmetAim: Although the laparoscopic approach is increasingly being used in colorectal surgery, it is anticipated that the technical problems caused by previous abdominal open surgery (PAOS) will adversely affect the outcomes. The aim of this study was to evaluate the outcomes of previous abdominal surgery in patients with colorectal cancer who underwent laparoscopic surgery for treatment. Material and Methods: Among the patients who underwent laparoscopic surgery for colorectal cancer between January 2015 and December 2018, those who had a history of previous abdominal surgery and those who did not were compared. Those with a history of laparoscopic abdominal surgery are not included in the PAOS group and short-term postoperative complications, conversion to open surgery, reoperations, hospital readmissions, and mortality rates were analyzed between the groups. Results: 21 of 140 patients who underwent laparoscopic surgery for colorectal cancer had PAOS. The groups with and without PAOS were similar in terms of age, sex, body mass index, ASA score, and comorbid disease. No difference was observed regarding conversion to open surgery (p = 0.513), postoperative complications (p> 0.05), reoperations (p = 0.162), unplanned hospital readmissions (p = 0.154), and perioperative mortality (p = 0.136) between the two groups. Conclusion: We believe that laparoscopy can be safely performed in patients with colorectal cancer who had previous abdominal open surgery with similar clinical and postoperative complication rates as in patients without a history of PAOS.Öğe Management of rectovaginal fistulas secondary to use of stapling device for rectal cancer surgery(2019) Topal, Ugur; Rencuzogullari, Ahmet; Eray, Ismail Cem; Alabaz, OmerAim: Scarce data are available for rectovaginal fistula (RVF) as a serious complication of low anterior resection with a double-stapled anastomosis for rectal cancer. In this study, we aimed to evaluate our surgical management of RVFs formed due to stapler use.Material and Methods: Between 2010 and 2018, patients who developed rectovaginal fistula after the use of circular stapler during rectal surgery were included. Clinic characteristics, type of surgical treatment performed and details of surgery in patients were retrospectively evaluated.Results: Ten patients for whom stapler device was used for rectal cancer surgery and diagnosed with RVF were included in our study. The mean age of the patients was 45.7±11.8 and mean BMI value was 27±2.4. For 9 patients who had primary repair for RVFs, 7 patients experienced recurrence after their first operation. For this subgroup, muscle flap was performed in 3, vaginal mucosa advancement flap 2, sartius flap one, and another primary repair plus fibrin glue application one patient. After the second interventions, two patients were managed with muscle flap creation and primary repair plus fibrin glue was required for one patient, for their recurrence. For patient who had primary repair plus fibrin glue application for her second operation, sigmoid colostomy followed by abdominoperineal resection was required for persisting complaints.Conclusion: The management of postoperative (RVF) after low anterior resection for rectal cancer is difficult and the results are often unsatisfactory. Endoanal mucosal flaps and muscle flaps are the treatment modalities we recommend, especially in patients with recurrence.Keywords: Circular stapler; rectovaginal fistula; rectal cancer.Öğe Our surgical experience in cholangiocellular carcinoma(2020) Saritas, Ahmet Gokhan; Ulku, Abdullah; Topal, Ugur; Dalci, Kubilay; Aydin, Erdi; Akcam, TolgaAim: Cholangiocellular carcinomas are rare bile duct tumors. They are categorized as intrahepatic(iCCA), perihilar(pCCA) or distal(dCCA) cholangiocarcinomas according to their anatomical location. In this study, we aimed to present our clinical experience in patients with cholangiocellular carcinoma. Material and Methods: Patients who underwent curative surgery with the diagnosis of cholangiocellular carcinoma between 2010 and 2019 were retrospectively reviewed. Demographic and clinical characteristics, surgical procedures, tumor characteristics, short- and long-term results and survival of the patients were analyzed.Results: Twentynine patients were included in the study. The mean age of the patients was 63.3(±10.8) years, and 52% of the patients were older than 65 years. Male sex was 79.3%. Percutaneous biliary drainage was performed in 52% of the patients before the operation. Tumor localizations were distal (dCCA) in 12 (41.4%) patients, perihilar (pCCA) in 11 (38%) patients, and intrahepatic (iCCA) in 6 (20.6%) patients. Only biliary resection was performed in 69%, hepatic + biliary resection in 27.6%, and only hepatic resection in 3.4% of the patients. The mean tumor size was 3.08 cm (±1.91), tumor stage was commonly stage II (58.6%) and postoperative complication was seen in 13.8% of the patients. Ninety-day unplanned readmission was observed in 31.3%, postoperative mortality in 6.9%, and recurrence during postoperative follow-up in 24.2% of the patients. The mean survival time was 22.82(±13.72) months. Conclusion: The type of surgical approach to be performed in cholangiocellular carcinoma is related to the localization of the tumor. With the right patient selection, curative surgical treatment can be performed at low morbidity and mortality rates.Öğe Phase stabilization of magnetite (Fe3O4) nanoparticles with B2O3 addition: A significant enhancement on the phase transition temperature(Elsevier, 2016) Topal, Ugur; Aksan, Mehmet AliMagnetite nanoparticles (MNPs) are extensively investigated for biomedical applications, particularly as contrast agents for Magnetic Resonance Imaging and as drug delivery agent and heat mediators for cancer therapy. Tuning the magnetic properties of the magnetite nanoparticles with doping of foreign atoms has a crucial importance for determining the application areas of these materials and so attracts much interests. On the other hand the doping with foreign atoms requires high temperature annealing, and it causes a phase transition to the hematite phase above 400 degrees C. In this work the phase transition temperature from the magnetite to the hematite phase has been increased by 200 degrees C, which is the highest enhancement reported in literature. It was achieved by addition of the appropriate amounts of B2O3 Our experiments indicates that the 5.0 wt% of B2O3 addition stabilizes and keeps the existence of single phase magnetite up to 600 degrees C. (C) 2016 Elsevier B.V. All rights reserved.Öğe Predictive factors associated mortality after gastrectomy(2020) Yalav, Orcun; Topal, UgurAim: In this study, we aimed to identify the risk factors associated with postoperative mortality after gastrectomy.Surgical resection is the only potentially curative method for gastric cancer and is associated with severe morbidity and mortality. Material and Methods: Patients who underwent gastrectomy for gastric cancer in a single center between September 2015 and September 2018 were evaluated retrospectively. The relationship between postoperative mortality and clinical variables of the patients, tumor characteristics and 10 variables related to intraoperative characteristics were analyzed.Results: 133 patients were included in our study. Postoperative mortality occurred in 10 patients. Our postoperative mortality rate was 7.5%. Male sex (HR = 0.664, 95% CI =0.460–0.961, p=0.030), tumor localization (linitis plastica (HR = 3.594, 95% CI =1.375–9.390, p=0.009), tumor stage 3C (HR =1.713, 95% CI =0.906–3.239, p=0.0032) total gastrectomy (HR = 1.918 95% CI =1.042–3.532, p=0.036), conventional (open) surgery (HR = 2.807 95% CI =1.546–5.096, p= 0.001), operation duration >240 min (HR = 1.758, 95 % CI =1.064–2.906, p= 0.028), was independently associated with an increased risk of postoperative mortality. Age >60 (p=0.463), body mass index (p=0.414), ASA score >3 p=0.862, intraoperative blood loss >300 (p=0.083) and additional organ resection (p=0.649) were not independent risk factors for mortality.Conclusion: Anastomotic leakage was associated with male sex, obesity, and tumor localization. Anastomotic leakage is related with poor survival. Determining the risk factors after gastrectomy guides us in the management of patients at risk for postoperative mortality.Öğe Prognostic value of neutrophil-to-lymphocyte ratio in patients undergoing curative surgical resection for hepatocellular carcinoma(2020) Saritas, Ahmet Gokhan; Ulku, Abdullah; Topal, Ugur; Dalci, Kubilay; Eray, Ismail Cem; Akcam, TolgaAim: the purpose of this study is to determine the prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) in patients who underwent curative surgical treatment for hepatocellular carcinoma (HCC). Materials and Methods: Patients who underwent curative resection for HCC between 2004 and 2015 were included in the study. Patients were divided into two groups based on the cut-off value: Group 1 (NLR low) and Group 2 (NLR elevated). Demographics and clinical characteristics, tumor characteristics, and mean survival of patients were compared between the groups.Results: 41 patients were included in our study and Group 1 (NLR low) consisted of (n:11) patients; Group 2 (NLR elevated) consisted of (n:30) patients based on a cut-off value of 2.43. The number of males was higher in both groups (90.9% vs 90%, p:0.712). The Child-Plug class A was the most common one in both groups (81.8%vs76.7%, p:0.680). HBV infection was the most common etiological cause (81.8% vs 53.3%, p:0.344). Lesions were predominantly located in the right lobe (63.6% vs 66.7%, p:0.568). The total tumor diameter was similar (6.56 cm vs 8.69 cm, p:0.258). In the multivariate analysis for survival, tumor diameter greater than 5 cm (HR 1.412 95% - Cl0.345-5.780, p:0.018) and NLR higher than 2.43 (HR 0.100 95% -Cl 0.011-0.882, p:0.038) were independent risk factors. Overall survival time was found to be lower in Group 2 compared to Group 1 (171 vs 106 months p:0.033). Disease-free survival rates were similar in the groups (37 vs 43 months, p:0.485).Conclusion: Although the elevated NLR level was found to be a risk factor for decreased overall survival in our study, this was not related to clinicopathological variables.Öğe A rare cause of acute abdominal pain: Torsion of wandering spleen(2020) Topal, Ugur; Dalci, KubilayWandering spleen is a rare condition presenting as the spleen being found somewhere different from its usual location due to the looseness of the peritoneal ligaments of the spleen. Its occurrence rate among the major splenectomy series in medical literature is less than 0.5%. It usually presents itself between the ages of 20 and 40 and the majority of the patients are women. A 20-yearold female patient with recurrent abdominal pain was admitted to our emergency clinic with abdominal pain going on for 3 days, nausea, vomiting and loss of appetite. Computerised Tomography (CT) indicated a pelvis localised spleen and an infarctus due to a non-homogenous parenchyma area. The patient was operated on with a provisional diagnosis of wandering spleen. During exploration a relatively large, congested and mobile spleen was found in the pelvis and a splenectomy was performed. The wandering spleen presents itself on a spectrum ranging from asymptomatic to acute abdomen. Symptoms usually arise from complications related to torsion. The surgical methods performed on wandering spleen are splenorraphy and splenectomy. The deciding factor for determining the treatment method is the existence of infarction in spleen. Wandering spleen is very rare and a cause for acute abdominal pain, we think it is important to consider it for differential diagnosis in cases with acuteabdominal pain, especially the cases with intra-abdominal mass findings, for an accurate diagnosis and treatment plan.Öğe Risk factors for leakage after total gastrectomy(2020) Yalav, Orcun; Topal, UgurAim: Although many studies report risk factors for anastomotic leakage after gastrectomy for gastric cancer (GC), there are conflicting results in the literature. In this study, we aimed to identify the risk factors associated with anastomotic leakage after gastrectomy. Material and Methods: Patients who underwent total gastrectomy for gastric cancer in a single center between September 2015 and September 2018 were evaluated retrospectively. The relationship between anastomotic leakage and clinical variables, tumor characteristics and intraoperative characteristics of 18 parameters were analyzed. The relationship between anastomotic leakage and survival was evaluated.Results: A total of 102 patients were included in the study. Anastomotic leakage rate was 9.81% (10/102). A significant relationship was not determined between anastomotic leakage and age >60 (p:0.232), diabetes mellitus (p:0.334), ASA score >3 (p:0.587), albumin 300 (p:0.582), and operation duration >300 min (p:0.176). Multivariate regression analysis, showed female sex (p: 0.05), body mass index (BMI) >30 (p:0.024) and tumor localization (p:0.005) are independent risk factors for anastomotic leakage. There was a significant difference in mean survival between patients with and without anastomotic leakage (13.9 vs 34.9 months, p: 0.006). Conclusion: Anastomotic leakage was associated with female sex, obesity, and tumor location. We also found that anastomotic leakage adversely affects long-term survival. Detecting risk factors after gastrectomy guides us in the management of patients at the risk for anastomotic leakage.Öğe The value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients undergoing pancreaticoduodenectomy for periampullary tumors(2020) Arikan, Turkmen Bahadir; Sozuer, Erdogan Mutevelli; Topal, Ugur; Dal, Fatih; Bozkurt, Gamze KubraAim: In this study, we aimed to determine the clinical value and prognostic significance of neutrophil / lymphocyte ratio in predicting pancreatic fistula in patients who underwent pancreatoduodenectomy due to periampullary tumor.Material and Methods: Patients who underwent pancreatoduodenectomy for periampullary tumor between 2010-2019 were included in the study. Group 1 (LowNLR) and Group 2 (HighNLR) were formed. Demographic and clinical characteristics, intraoperative and postoperative outcomes, and mean survival were compared between the groups. The significance of NLR in predicting pancreatic fistula at the cut off value was examined.Results: Patients were divided into two groups according to the 3.15 cut off value. Group 1 consisted of 61 patients and Group 2 consisted of 62 patients. In Group 2, albumin gr/dl value was lower (3.25 vs 3.70, p:000). in Group 2 pancreas tumors were more common (59.7% vs 42.6%, p: 0.041). The number of metastatic lymph nodes was higher in Group 1 (1.21 vs 0.63, p: 0.043), and the postoperative pancreatic fistula rate was similar (14.8% vs 21%, p: 0.254). Postoperative complications were higher in Group 2 (41.9% vs 14.8%, p: 0.032) NLR predicted pancreatic fistula with a sensitivity of 31.8% and specificity of 86.4%. In multivariate analysis, we found NLR to be a risk factor for survival (HR 1.760, 95% CI,1.179-2.627; p:0.006).Conclusion: Patients with a preoperative high NLR have a worse prognosis than patients with low NLR. It cannot be used alone to predict pancreatic fistula. NLR has the potential to be used in the management of patients.
