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Öğe Factors affecting the accuracy of18f-fdg pet/ct in detecting additional tumor foci in breast cancer(BETA Medical Publishers Ltd, 2021) Simsek A.; Kutluturk K.; Comak A.; Akatli A.; Kekilli E.; Unal B.OBJECTIVE To evaluate the effectiveness of18F-FDG PET/CT for detecting additional tumor foci in breast cancer. MATERIAL-METHOD The data were reviewed retrospectively of 232 women who underwent18F-FDG PET/CT examination prior to breast cancer surgery between January 2013 and December 2018. RESULTS Additional tumor foci were suspected in 95 cases on18F-FDG PET/ CT, which were confirmed by histopathological analysis in 81 cases. The sen-sitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of18F-FDG PET/CT in detection of additional tumor foci were 77.7%, 79.48%, 66.3%, 87.32%, and 79.23%, respectively. The false negative and false positive rates were 22.22% and 20.51%, respectively. In univariate analysis, only the patient’s age was positively associated with accuracy of 18 F-FDG PET/CT in detecting additional tumor foci. The accuracy was lower in women aged ?50 years, with a substantial increase in false positive findings in women in that age group. CONCLUSIONS18F-FDG PET/CT alone cannot replace conventional diagnostic procedures for evaluating additional tumor foci in breast cancer, as a substantial increase in false positive findings is recorded with this method in women aged ?50 years old. © Athens Medical Society.Öğe Isolated cecal necrosis mimicking acute appendicitis: A case series(2009) Dirican A.; Unal B.; Bassulu N.; Tatl F.; Aydin C.; Kayaalp C.Introduction. Spontaneous non-occlusive ischemic colitis involving the cecum alone (isolated cecal necrosis) is a rare condition that is generally due to a low-flow state: shock. It presents with right lower quadrant abdominal pain and may resemble acute appendicitis. Little is known about postoperative ischemic necrosis of the remaining colon after surgical treatment of isolated cecal necrosis. We report four cases of isolated cecal necrosis mimicking acute appendicitis seen at our institution within a 4-year period. Case presentation. The patients were two men and two women with a mean age at diagnosis of 59 years (range 46-68). The patients were of Turkish ethnic origin. All patients presented to the emergency room with acute abdominal pain and had symptoms of nausea and vomiting. The medical histories for three of the patients revealed end-stage renal failure requiring hemodialysis. The other patient had chronic obstructive pulmonary disease. Right hemicolectomy with anastomosis was performed in three patients and cecal resection with ileocolostomy was performed in the remaining one patient. All of the patients healed without complications. Median follow-up of patients was 24.5 (range: 17-37) months. There was no recurrence of ischemia in the remaining colon during the follow-up period of the patients. Conclusion. Isolated cecal infarction should be included in the differential diagnosis of acute pain in the right lower quadrant of the abdomen, especially in those patients on chronic hemodialysis. While diffuse ischemic disease of the intestine has high morbidity, mortality and recurrence rates, patients with isolated cecal necrosis have a good prognosis with early diagnosis and surgical treatment compared to those with diffuse ischemic disease. © 2009 licensee BioMed Central Ltd.Öğe Liver transplantation from an upper midline incision(2011) Kayaalp C.; Aydin C.; Unal B.; Baskiran A.; Ozgor D.; Aydinli B.; Yilmaz S.Objectives: To evaluate the minimally invasive incision to the recipient of a liver transplant. Materials and Methods: A 55-year-old man with cirrhosis due to hepatitis B accompanied by hepatocellular carcinoma underwent a right lobe, living-donor liver transplant using an 18-cm long, upper midline incision. The recipient hepatectomy was performed from the left to the right side (from medial to lateral). Deep retractors and long surgical instruments were preferred. Results: The surgical procedure was completed without problem. Both the recipient hepatectomy and implantation of the right liver took 8 hours. Postoperative recovery of the patient was rapid, and he was discharged 8 days after surgery, uneventfully. Conclusions: An upper midline incision can be preferred for liver transplant for selected cases. Minimally invasive surgery is an option for liver transplant recipients as well. © Başkent University 2011 Printed in Turkey. All Rights Reserved.Öğe Living related donor liver transplantation with atrio-caval anastomosis of inferior vena cava graft stored in deep-freeze for budd-chiari syndrome(Iranian Society for Organ Transplantation, 2015) Yaylak F.; Ince V.; Barut B.; Unal B.; Kilic M.; Yilmaz S.We have previously reported our experience in inferior vena cava resection and reconstruction techniques during liver transplantation for Budd-Chiari syndrome. Herein, we present on a case that demonstrates the importance of experience in complex vascular reconstruction techniques for living donor liver transplantation. A 15-year-old boy was scheduled for living donor liver transplantation for Budd-Chiari syndrome. Venous occlusion was extended up to the right atrial orifice of the supra-hepatic vena cava. Retro- and supra-hepatic segments of the vena cava was resected. Inferior vena cava graft stored in deep-freeze was available. Venous reconstruction was performed with end-to-end atrio-caval anastomosis. Surgical treatment was completed with the implantation of the right liver lobe donated by the patient's mother. Post-surgical course was uneventful.Öğe The relation between preoperative ultrasonographic thyroid volume analysis and thyroidectomy complications(2009) Karabeyoglu M.; Unal B.; Dirican A.; Kocer B.; Serhat Gur A.; Bozkurt B.; Cengiz O.Objective. To determine the relation between thyroid volume (ThV) and thyroidectomy complications using preoperative ultrasound and ellipsoid volumetric analysis in Turkish patients. Patients and Methods. This prospective study included a total of 500 patients (401 females =80.2% and 99 males = 19.8%) who were operated for benign goiter. According to their ThV estimated by ultrasound hey were classified in three groups: 1.less than 50 ml (n = 269; 53.8%), 2. between 50 and 100 ml (n = 151; 30.2%), 3. more than 100 ml (n = 80; 15.6%). By comparing the association of thyroid volume with peroperative and postoperative complications it was evaluated whether the thyroid volume could be an effective factor participating in morbidity and mortality of patients. Results. Total peroperative complication rate was 2% (n= 10) with trachea injury in 2 (0.4%), bleeding in 8 (1.6%) patients. Peroperative complications were significantly more frequent in patients with large volume (p=0.003). Temporary hypocalcemia rate in patients with less than 50 ml volume was highly significant (p<0.001). Volume average was low in patients with hypocalcemia as compared to patients without hypocalcemia (p<0.001). Both the temporary and permanent vocal cord paralysis (VCP) were significantly more frequent in patients with larger volumes (p=0.002). All four patients with permanent VCP had more than 100 ml volume. Conclusion. Thyroid volume is an important factor affecting thyroidectomy complications. In patients with smaller ThV increased risk of hypocalcemia was found, whereas in those with larger ThV increased risk of recurrent nerve damage and peroperative bleeding was observed.Öğe Screening of gastric cancer in liver transplantation patients: A case report and review of literature(2010) Dirican A.; Unal B.; Bassulu N.; Ozgor D.; Kayaalp C.; Yilmaz S.Liver and other solid organ transplant recipients are at an increased risk of developing several malignancies because of the immuno-suppressive treatment. Generally, patients who had a liver transplant have upper gastrointestinal tract complaints, which makes identification of gastric carcinoma symptoms in those patients difficult. A 58 years old liver transplant male patient presented to the hospital for his routine checkup and dyspeptic complaints. He had received a liver from a cadaver 18 months ago and his postoperative period had been uneventful. An esophagogastroduodenoscopy (EGD) revealed gastric cancer. A subtotal gastric resection with a D2 lymph node dissection was carried out. There was no recurrence during three years follow up. In order to make a timely identification of the occurrence of common malignancies such as gastric cancer, liver transplant recipients must be followed closely.Öğe Subcutaneous hydatid cysts occurring in the palm and the thigh: Two case reports(2008) Dirican A.; Unal B.; Kayaalp C.; Kirimlioglu V.Introduction: Hydatid cyst disease is common in some regions of the world and is usually located in the liver and lungs. This report presents two cases of primary hydatid cysts located subcutaneously: one in the medial thigh and one in the left palm between the index and middle fingers. Case presentations: A 64-year-old male farmer visited our hospital because a swelling on the right medial thigh had grown during the last year. Superficial ultrasound and computed tomography revealed a lesion resembling a hydatid cyst. A germinative membrane was encountered during surgical excision. Pathological examination was compatible with a hydatid cyst. The second case involved a 67-year-old male farmer who complained of a swelling that had grown in his left palm in the last year. The preliminary diagnosis was a lipoma. However, a hydatid cyst was diagnosed during surgical excision and after the pathological examination. The patient did not have a history of hydatid cyst disease and hydatid cysts were not detected in other organs. There has been no disease recurrence after following both patients for 3 years. Conclusion: A hydatid cyst should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic, and should be excised totally, with an intact wall, to avoid recurrence. © 2008 Dirican et al; licensee BioMed Central Ltd.Öğe Surgical Management of Inflammatory Breast Cancer(Springer Science+Business Media, 2019) Soran A.; Unal B.; Grahovac T.Inflammatory breast cancer (IBC) is a rare clinicopathological entity but remains one of the most aggressive types of breast cancer. The acute edematous infiltration of the skin and breast is met with occasionally, and it is without doubt the most acute and fatal form of cancer found in the breast. Such cases as these have been mistaken for inflammation, but knowledge of the probability of this affection being cancerous should prevent such a mistake from being made. Here, we review the current epidemiology, clinical characteristics, diagnostic modalities, and treatment of IBC. © Springer Nature Switzerland AG 2019. All rights reserved.Öğe Surgical management of inflammatory breast cancer(Springer International Publishing, 2016) Soran A.; Unal B.; Grahovac T.Inflammatory breast cancer (IBC) is a rare clinicopathological entity but remains one of the most aggressive types of breast cancer. The acute edematous infiltration of the skin and breast is met with occasionally, and it is without doubt the most acute and fatal form of cancer found in the breast. Such cases as these have been mistaken for inflammation, but knowledge of the probability of this affection being cancerous should prevent such a mistake from being made. Here, we review the current epidemiology, clinical characteristics, diagnostic modalities, and treatment of IBC. © Springer International Publishing Switzerland 2016.
