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Yayın Akut sinüzitin orbital komplikasyonları(Istanbul University, 2004) Güven, Mehmet; Süoğlu, Yusufhan; Erdamar, Burak; Çölhan, İsmail; Demir, Deniz; Demir, DenizAmaç: Akut sinüzit kaynaklı orbital komplikasyonların morbidite ve mortalitesi araştırıldı. Hastalar ve Yöntemler: Çalışmada akut sinüzit kaynaklı orbital komplikasyonlar nedeniyle tedavi edilen 25 olgu (13 erkek, 12 kadın; ort. yaş 21; dağılım 2-56) retrospektif olarak değerlendirildi. Olguların hastaneye başvuru semptomları, bulguları ve hastanede kaldığı süredeki izlem bulguları dosya ve kayıtlardan çıkartıldı. Olgular yaş, cinsiyet, etyolojik etkenler, yerleşimleri, tedavi yöntemleri, morbidite ve mortalite oranlar› yönünden değerlendirildi. Bulgular: Yirmi olguda (%80) periorbital sellülit, iki olguda (%8) orbital sellülit, üç olguda (%12) subperiostal apse belirlendi. Orbital komplikasyon tespit edilen 16 yaş üzeri dokuz olgudan beşinde daha önce geçirilmiş cerrahi ve travma öyküsü mevcuttu. Olguların tümünde komplikasyon tespit edilir edilmez yüksek dozda intravenöz antibiyotik tedavisine başlandı. Subperiostal apse tespit edilen üç olgu ve orbital sellülit tespit edilen bir olgu endoskopik cerrahi uygulanarak tedavi edildi. iki olguda orbital komplikasyonlar rekürrens gösterdi. Akut sinüzit kaynaklı orbital komplikasyonlar› nedeniyle tedavi ettiğimiz olguların hiçbirinde körlük ve ölüm görülmedi. Olgulardan yalnızca ikisinde çift görme şikayeti devam etmekteydi. Sonuç: Erişkin hastalarda orbital komplikasyonların sıklıkla geçirilmiş travmaya bağlı olduğu tespit edildi. Orbital komplikasyonla karşılaşıldığında yüksek dozda geniş spektrumlu intravenöz antibiyotik tedavisine en kısa sürede başlanmalıdır. Subperiostal orbital abse, orbital sellülit ve abse görüntüleme teknikleri veya klinik izlem ile saptanırsa cerrahi tedavi edilmelidirYayın An analysis of neuropeptides at nasal contact points of patients with secondary headache(Wolters Kluwer, 2016) Demir, Deniz; Cengiz, Nureddin; Güven, Mehmet; Bulduk, Oğuzhan; Demir, DenizObjectives: This prospective research study was designed to analyze the surgical outcomes and the intensity of substance P (SP), neurokinin A (NA), and calcitonin gene-related peptide (CGRP) in contact and noncontact nasal mucosa of patients with headache. Methods: Twenty adults with secondary headache and correctible nasal obstruction were included in this study. The patients had nasal contact points between the nasal septum and the middle or inferior turbinates on nasal endoscopy and computed tomography scan. During surgical procedures, sample tissues were obtained from the nasal contact point and the noncontact area of the lateral nasal wall of these patients. Fluorescein staining intensity for antibodies against SP, NA, and CGRP was analyzed using image J software. Headaches were evaluated using a visual analog scale preoperatively and postoperatively. Results: The differences between the preoperative and the postoperative 3rd month (P < 0.001) and 12th month (P < 0.001) visual analog scale scores were statistically significant. However, fluorescein staining intensity for SP (P = 0.631), NA (P = 0.546), and CGRP (P = 0.683) did not show statistically significant differences between the contact mucosa and the noncontact mucosa groups. Conclusions: Although in selected patients significant relief of headache can be obtained by surgery, there is no evidence from this study that SP, NA, and CGRP are responsible for the initiation of headache.Yayın Approach to neck in early stage lip cancers(Sakarya University, 2017) Demir, Deniz; Genç, Sena; Güven, Mehmet; Yılmaz, Mahmut Sinan; Kara, Ahmet; Demir, DenizAMAÇ Bu çalışmanın amacı, erken evre dudak kanseri hastalarında, bekle-gör politikasının ve boyun diseksiyonunun prognoz üzerindeki rolünü araştırmaktır. GEREÇ - YÖNTEMLER: Mart 2007 - Nisan 2015 yılları arasında T1-2N0 alt dudak kanseri nedeniyle primer bölge ve boyun cerrahisi yapılan 20 hasta (5 kadın, 15 erkek; yaş ortalaması 62.64 yıl; 38-80 yaş aralığı) çalışmaya dahil edildi. Klinik özellikler, lezyonun lokalizasyonu, bölgesel lenf nodu durumu, tümör evrelemesi, cerrahi tedavi sonuçları ve patolojik inceleme verileri geriye dönük olarak incelendi. Tüm olgularda 1 cm cerrahi sınırla tümör eksize edildi. Doku defekti birincil kapatma ya da çeşitli rekonstriksiyon teknikleri ile onarıldı. Tüm T2N0 evre hastalara boyun diseksiyonu uygulandı. Tümör dudağın ortasında yer alıyorsa, bilateral boyun diseksiyonu, aksi taktirde tek taraflı boyun diseksiyonu yapıldı. BULGULAR: Her olguda histopatolojik tanı skuamöz hücreli karsinomdu. Ortalama izlem süresi 45.82 ay idi. Klinik olarak T1N0 tümörü tanısı konan 15 hasta ve klinik olarak T2N0 tümörü tanısı konan 5 hasta vardı. T1N0 tümörleri için 3 suprahyoid, 2 bilateral supraomohyoid boyun diseksiyonu yapıldı. Üç T2N0 tümöründe supraomohyoid boyun disseksiyonu bilateral olarak yapıldı ve geriye kalan 2 hastada suprahyoid boyun diseksiyonu yapıldı. SONUÇ: Hastalıksız dört yıllık sağ kalım oranları, erken evre dudak kanseri vakalarında belirgin olarak daha yüksekti. Sonuçlarımız T1N0 alt dudak kanserlerinde boyun diseksiyonunun gerekli olmayabileceğini göstermektedir.Yayın Are calculated ratios and red blood cell and platelet distribution width really important for the laryngeal cancer and precancerous larynx lesions(Wolters Kluwer, 2019) Kara, Ahmet; Güven, Mehmet; Demir, Deniz; Yılmaz, Mahmut Sinan; Gündoğan, M.E.; Genç, Sena; Demir, DenizIntroduction: In this research, it is planned to investigate the differences in neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, reticulocyte distribution width, and platelet distribution width values of groups of benign laryngeal lesion, precancerous laryngeal lesion, and laryngeal squamous cell carcinoma and among patients with different stages of tumors in laryngeal carcinoma and precancerous laryngeal lesion groups, and whether these values carry a prognostic features. Materials and Methods: The investigated parameters determined from preoperative blood samples of patients have been compared among the groups and in the subgroups according to severity of illness in laryngeal carcinoma and precancerous laryngeal lesion groups. Also, the laryngeal carcinoma and precancerous laryngeal lesion groups were divided into two subgroups as good and poor prognosis and were compared with patients having good prognosis requiring no additional treatment during the follow-up, and the statistical significance of the differences was examined. Results: On comparison, statistically significant differences were only observed between the gross larynx carcinoma group and other lesions. Apart from that, when the values were evaluated in terms of prognosis, no significant statistical results were found in any of the values. Conclusion: Despite the significant statistical results seen in the gross tumors, it is known that there are more objective methods for identifying those lesions in clinical use. We conclude that caution should be exercised when using these new hematological parameters, which can be affected by many factors.Yayın Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis?(Springerlink, 2017) Kara, Ahmet; Güven, Mehmet; Yılmaz, Mahmut Sinan; Demir, Deniz; Elden, Halil; Demir, DenizIntroduction The aim of this study is to explore the relationship of neutrophil, platelet and eosinophil-to-lymphocyte ratios and red blood cell distribution width values with nasal polyposis, and whether this could be a predictive parameter that can be used for the severity and recurrence risk of the disease. Method Neutrophil/lymphocyte, platelet/lymphocyte, eosinophil/lymphocyte ratios and red blood cell distribution width values were compared between nasal polyposis patients who were reviewed in a retrospective manner and the control group comparable for age and sex. Moreover, the nasal polyposis group was grouped for nasal polyposis severity and recurrence, and these subgroups were statistically compared, too. Results When the nasal polyposis patient group and the control group are compared, no statistically significant difference was found between two groups except for eosinophil/lymphocyte ratio. While only the difference between nasal polyposis severity and eosinophil/lymphocyte ratio is statistically significant, there was no parameter with statistically significant difference for recurrence. Conclusion We think that caution should be exercised when using these new hematological parameters which can be affected by many factors for the presence, severity and recurrence risk of nasal polyposis, and literature data should be proven by conducting different and objective studies on this subject.Yayın Assessment of the correlation between nasal septal deviation and compensatory hypertrophy of the middle turbinate(Springerlink, 2015) Demir, Deniz; Asil, Kıyasettin; Güven, Mehmet; Kayabaşoğlu, Gürkan; Yılmaz, Mahmut Sinan; Demir, DenizThe aim of the study was to investigate the relationship between nasal septal deviation and the middle turbinate hypertrophy using computed tomography. In this retrospective analysis, we examined 77 patients with nasal septal deviation. The mucosal and bone structures of the middle turbinate and the angle of the septum were measured using radiological analysis. Measurements of the middle turbinate on the convex side were compared to those on the concave side. Measurements of the bony and mucosal structure area of the middle turbinate were significantly greater than those on the concave side. The dimensions of medial mucosa thickness and bone thickness were not significantly different between the convex and concave sides. No significant correlation was found between the angle of deviation and other parameters. The present findings suggest that compensatory middle turbinate hypertrophy was caused both by conchal bone growth and mucosal hypertrophy in patients with nasal septal deviation.Yayın Assessment of the factors that affect the anatomic and functional success of cartilage tympanoplasty in children(Wolters Kluwer, 2017) Yılmaz, Mahmut Sinan; Kara, Ahmet; Güven, Mehmet; Demir, Deniz; Erkorkmaz, Ünal; Demir, DenizObjectives: Many factors may influence the surgical outcome of tympanoplasty in children, including age, the size and location of perforation, otorrhea, status of contralateral ear, surgical technique, and adenoid hypertrophy. This study aims to evaluate the outcomes of pediatric cartilage tympanoplasty and to assess the factors that affect the success of tympanoplasty in children. Methods: Children with chronic otitis media who underwent tympanoplasty using cartilage as graft material were evaluated retrospectively. Patient age, gender, size and site of the perforation, status of the contralateral ear, preoperative and postoperative hearing levels, surgical technique, and postoperative complications were noted. Results: Of the 72 patients included in the study, 27 were male and 35 were female. The average age was 13.22 ± 2.64 and mean follow-up time was 18.4 ± 8.62 months. Anatomic and functional success rates were 88.8% and 80.6%, respectively. Age, gender, and the status of the contralateral ear had no effect on surgical success rate. The mean preoperative and postoperative pure-tone averages were 33.2 6± 10.37 and 21.00 ± 13.25 dB, respectively. Conclusion: Anatomic and functional outcomes of cartilage tympanoplasty are quite satisfactory in pediatric patients. Chronic otitis media should be treated surgically as early as when patient cooperation is possible.Yayın Atan kalpte minimal invaziv aksillokoroner bypass greftleme: Orta dönem sonuçlar(Turkish Society of Cardiovascular Surgery, 2010) Göz, Mustafa; Andaç, Mehmet Halil; Şelli, Cüneyt; Aydın, Salih; Demir, Deniz; Demir, DenizBackground: The purpose of the study was to evaluate our surgical experience and midterm results with single vessel axillocoronary bypass grafting on beating heart. Methods: Five operations were carried out via left anterior minithoracotomy, making it a typical axillocoronary bypass procedure. The axillocoronary bypass grafting was performed on patients with significant coronary artery disease who exhibited a severely atherosclerotic ascending aorta, severe chronic obstructive pulmonary disease, serious walk (orthopedic) disorder and low cardiac ejection fraction. Results: Axillocoronary bypass grafting was carefully performed and no technical problems were encountered intraoperatively in all patients. The mean postoperative stay in the intensive care unit was 22.75±0.95 hours, and mean hospital stay was 7.3±1.0 days. No cases of brachial plexus injury, neurologic deficit or wound infection occurred. No cases needed vasopressors or intraaortic balloon pump. There was one mortality. Graft patency since surgery was 24.0±9.4 months and the mean two-year survival rate was 60%. Conclusion: Although our series is small, low graft patency results at mid-term make this surgical method look not too promising for use.Yayın Autologous fat augmentation for voice and swallow improvement after cordectomy(Karger, 2006) Güven, Mehmet; Süoğlu, Yusufhan; Kıyak, Erkan; Demir, Deniz; Demir, DenizSurgery for the treatment of early-stage glottic carcinoma still remains a valid option. In most patients, newly formed neocord tissue preserves glottic functions, but in some patients an important glottic gap leading to glottic insufficiency may occur. In our study, 11 patients who had serious glottic insufficiency after endoscopic laser and laryngofissure cordectomy were treated with autologous fat injection (AFI) into the neocord tissue for voice and swallowing rehabilitation. One patient did not attend the first control visit and was excluded from the study. The remaining 10 patients were evaluated in the preoperative and postoperative periods for phonatory functions and efficacy of AFI by videolaryngostroboscopy and computerized acoustic analysis. Phonatory functions showed statistically significant improvement in the shimmer, noise-to-harmonic ratio, maximum phonation time and fundamental frequency. Perceptual ratings (GRBAS scale) also showed statistically significant improvement in all 5 parameters. Despite improvement in glottic closure, the mucosal wave deteriorated. Due to recurrence of symptoms of glottic insufficiency, AFI was repeated in 2 patients at the third and fifth months, respectively. One year later, the AFI resulted in successful rehabilitation of swallowing in all patients. The probability of resorption of autologous fat and the deterioration of the mucosal wave after AFI remain a problem, but re-injection can be done easily. As AFI is an easy, safe and cheap method, we concluded that it is a promising alternative procedure for managing voice problems after laser or laryngofissure cordectomy defects.Yayın Baş ve boyun kitlelerinde ince iğne aspirasyon biopsisinin tanısal değeri(Anatomi Araştırmaları Derneği, 2006) Demir, Deniz; Akçam, Murat Timur; Karakoç, Ömer; Öngürü, Önder; Yetişer, Sertaç; Demir, DenizAmaç: İnce iğne aspirasyon biyopsisi (İİAB) sonuçlarımız eksizyonel biyopsi sonuçları ile karşılaştırılarak sitolojinin tanısal değerinin araştırılması amaçlanmıştır. Hastalar ve Yöntemler: Baş ve boyun bölgesinde tiroid dokusu hariç değişik kitlelerden elde edilen 164 aspirasyon materyalinin sitoloji sonuçları, histopatolojik tanıları ile karşılaştırıldı. Hastalar kitlenin kaynaklandığı yere göre tükürük bezleri, lenf nodları ve kistik kitleler olarak üç gruba ayrılarak İİAB’nin duyarlılık, özgüllük, tanı doğruluğu değerleri her grup için araştırılmıştır. Bulgular: Baş ve boyun kitlelerini birlikte değerlendirdiğimizde duyarlılık, özgüllük, tanı doğruluğu değerleri sırasıyla, %80.64, %100, %96.34’tür. Bu değerler sırasıyla tükürük bezlerinde %69.2, %100, %96; lenf nodu patolojilerinde %88.8, %100, %94.1 ve kistik lezyonlarda ise her üç değer % 100’dür. Yalancı pozitif sonuca hiç rastlanmazken, yalancı negatiflik oranı %3.6 (6 olgu) olarak bulunmuştur. Sonuç: İnce iğne aspirasyon biyopsisi baş ve boyun kitlelerinin tanısında güvenli, kolay ve faydalı bir tanı yöntemidir.Yayın Clinical results of surgical treatment in parotid tumors(Medcrave, 2017) Kara, Ahmet; Yılmaz, Mahmut Sinan; Demir, Deniz; Genç, Sena; Güven, Ebru Mihriban; Demir, DenizObjective: In this study, we aimed to evaluate clinical presentations, histopathological diagnosis, surgical treatment modalities and complications of patients operated for a parotid gland mass. Methods: Medical records of 100 patients who were operated for a parotid gland mass between 2010 and 2016 years evaluated retrospectively. Results and discussion: 49 (49%) of these patients were female and 51 (51%) were male. The mean age of the patients was 47.9. Post-operative histopathologic assessement, 89 of the cases were found to be primary benign, 7 of the cases primary malignant and 4 of the cases secondary malignant. For benign tumors the most common histopathology was pleomorphic adenoma in 45 (45%) patients, and the second was whartin tumor in 32 (32%) patients. Mucoepidermoid carsinoma was seen as the most common primary malign tumor (3 patients). All cases with primary malignancy continue to follow-up visits and the average follow-up period is 37months. However, all of the cases with secondary malignant parotid tumors were died due to malignancy. Complication ratio was 12% and facial paresis was the most common complication. Conclusion: Subtotal parotidectomy is an adequate and efficient surgical procedure for the benign parotid tumors and complication risk is considerably low when applied carefully. However it may be required complementary total parotidectomy for malignant tumors. The prognosis is very good especially for the primary malign parotid tumors. However, it is not satisfactory for the secondary malign tumors.Yayın Comparison of clinical outcomes of three different packing materials in the treatment of severe acute otitis externa(Cambridge University Press, 2018) Demir, Deniz; Yılmaz, Mahmut Sinan; Güven, Mehmet; Kara, Ahmet; Elden, Halil; Erkorkmaz, Ünal; Demir, DenizObjective To analyse the clinical outcomes of biodegradable synthetic polyurethane foam versus ribbon gauze and ear wick in the treatment of severe acute otitis externa. Methods Ninety-two adults with severe acute otitis externa were randomly assigned to groups receiving ear wick (n = 28), ribbon gauze (n = 34) or biodegradable synthetic polyurethane foam (n = 30). Clinical efficacy, in terms of otalgia, oedema, erythema and tenderness of the external auditory canal, was assessed before packing was applied and at follow up on the 3rd and 7th days of presentation. Results All packing materials were associated with improved otalgia and oedema on the 3rd day; however, there were significant differences between biodegradable synthetic polyurethane foam and the other packing materials, and there was no significant reduction in tenderness in the biodegradable synthetic polyurethane foam group on the 3rd day. In the ribbon gauze and ear wick groups, improvements in all clinical efficacy scores were statistically significant for all pairwise comparisons. Conclusion The three packing materials were all quite effective in treating severe acute otitis externa, but ear wick and ribbon gauze were superior to biodegradable synthetic polyurethane foam for relieving signs and symptoms, especially on the 3rd day.Yayın The comparison of del nido cardioplegia and crystalloid-based blood cardioplegia in adult isolated coronary bypass surgery: A randomized controlled trial(Wolters Kluwer, 2022) Demir, Deniz; Balcı, A.B.; Kahraman, Nail; Sünbül, S.A.; Gücü, A.; Seker, I.B.; Badem, Serdar; Yüksel, Ahmet; Özyazıcıoğlu, A.F.; Göncü, M.T.; Demir, DenizBackground and Aim: In our study, patients who underwent isolated coronary artery bypass surgery (CABG) using Del Nido cardioplegia (DNC) and crystalloid-based cold blood cardioplegia (CBC) were compared. Subject and Methods: In this study, two groups of patients who underwent isolated CABG using DNC (n = 106) and CBC (n = 107) were prospectively randomized. Groups were compared in terms of many results such as troponin T, returning spontaneous rhythm, and cardioplegia volume. Results and Conclusions: Median troponin T levels of the DNC and CBC groups were compared for the 0th hour (baseline), 12th, 36th, and 60th hours. There was no statistical difference between groups in troponin T levels of the baseline 0th hour (18[33] vs. 22[27] pg/ml; P = 0.724). Troponin T levels at the 12th hour were less in the DNC group than the CBC group but no statistical difference between the groups (790[735] vs. 826[820] pg/ml; P = 0.068), respectively. Troponin T levels at 36th and 60th hours were higher in the CBC group compared to the DNC group, and a statistical difference was observed (580[546] vs. 650[550] pg/ml; P = 0.030) and (359[395] vs. 421[400] pg/ml; P = 0.020), respectively. After X-clamping, the spontaneous rhythm rate was statistically higher in the DNC group than the CBC group (72.60% vs. 37.40%; P < 0.001). There was no statistical difference between the groups in terms of postoperative arrhythmia, hospital stay, and mortality rates (P > 0.05). Based on data we acquired from the study, we think that DNC is at least as safe and effective as CBC in adult CABG cases.Yayın Comparison of the results of caloric and video head impulse tests in patients with Meniere's disease and vestibular migraine(Springerlink, 2021) Yılmaz, Mahmut Sinan; Kara, Ahmet; Güven, Mehmet; Demir, Deniz; Genç Elden, Sena; Eğilmez, Oğuz Kadir; Demir, DenizPurpose To compare the results of video head impulse test (vHIT) and caloric testing (CT) in patients with vestibular migraine (VM) and Ménière’s disease (MD) and to investigate the relationship between these two tests. Methods Patients with definite unilateral MD and VM were included in the study. All patients underwent both vHIT and CT. The vestibulo-ocular reflex (VOR) gains of lateral semicircular canals and saccadic waves in vHIT and the canal paresis factor for the CT were examined. Results CT was found abnormal in 39 (66.1%) patients with MD and in 17 (34%) patients with VM, while abnormal gain of the lateral canal was obtained in 23 MD (39%) patients and 9 (18%) VM patients. In all, 11.9% of patients with an abnormal vHIT had a normal CT, whereas 33.9% of those with an abnormal CT had a normal vHIT. Conclusion Loss of VOR detected by caloric testing is more common and severe in MD than VM. Although vHIT is useful and can give complementary information, vestibular testing with the caloric test still seems more sensitive for detecting hVOR pathology.Yayın Comparison of two different bone anchored hearing instruments: Baha-5 vs Ponto-plus(Taylor & Francis Online, 2019) Kara, Ahmet; Güven, Mehmet; Yılmaz, Mahmut Sinan; Demir, Deniz; Adigul, Çağlayan; Durgut, Merve; Elden, Halil; Mutlu, Fatih; İşeri, Mete; Demir, DenizBackground: To our knowledge, there is no study comparing Ponto Plus® (Oticon Medical AB, Askim, Sweden) and Baha® 5 (Cochlear Bone Anchored Solutions AG, Mölnlycke, Sweden) available in the literature. Aims/objectives: The primary aim was to compare the performance of the Baha 5 with the Ponto Plus device in terms of speech understanding in quiet and in noise. In addition, to determine statistically whether or not the difference between the abutment systems created any variation in terms of skin reaction. Materials and methods: Twenty bone-anchored hearing instrument users, ten in each group, were evaluated for speech understanding in quiet and several signal-to-noise ratios using the Turkish Matrix Test in a two-speaker setup. The Holger classifications were also reviewed to determine adverse skin reactions. Results: It was revealed that the hearing results of both devices were similar and, when the skin reactions were compared, there was no statistically significant difference between the two-implant systems. Conclusions and significance: Because of the similar results of the groups, it can be interpreted as the key different device features such as the size, weight, colour alternatives, and the ease of use of the devices might be important in terms of device preference.Yayın Comparison of ıncidence and severity of chronic postsurgical pain following ear surgery(Wolters Kluwer, 2018) Güven, Mehmet; Kara, Ahmet; Yılmaz, Mahmut Sinan; Demir, Deniz; Güven, Ebru Mihriban; Demir, DenizObjectives: Literature review shows a limited number of studies investigating chronic pain following ear surgeries. The effect of mastoidectomy on chronic postsurgical pain, however, has never been investigated. The present study investigates not only the incidence and severity of chronic pain following ear surgeries with and without mastoidectomy, but also predisposing diseases for pain. Patients and Methods: The study was performed in a total of 150 patients who underwent tympanoplasty or tympanomastoidectomy through a retroauricular incision in a single tertiary health care center. During the routine postoperative 3rd-month examination, the patients were questioned for the presence and severity of chronic pain, as well as the diseases that might predispose the pain. Results: The difference between the visual analog scale scores of the groups was not statistically significant. Comparison of pain character revealed that neuropathic pain is more prevalent in both the groups. Evaluating the relationship between concomitant diseases and chronic pain, it was observed that migraine, cervical pathology, and acute postsurgical pain were closely associated with chronic pain. Conclusion: It was demonstrated that mastoidectomy does not pose an additional risk for chronic postsurgical pain. However, patients with migraine, cervical pathology, and acute postsurgical pain are at risk for chronic postsurgical pain.Yayın Complications of arteriovenous fistula with polytetraflouroethylen grafts in hemodialysis patients(Wolters Kluwer, 2015) Demir, Deniz; Çeviker, K.; Aydın, M.S.; Şahinalp, S.; Demir, DenizPurpose: Vessels with high venous flow rate are needed for the application of hemodialysis in patients needing chronic hemodialysis. The increase in the number of chronic hemodialysis patients has led to an increase in the number of vascular surgical operations. The aim of this study was to evaluate the results of polytetraflouroethylen (PTFE) graft arteriovenous fistula (AVF) applications. Materials and methods: Files of 596 patients who received hemodialysis treatment at the Nephrology Unit of the Şanliurfa Mehmet Akif İnan State Hospital between September 2009 and 2013 were retrospectively analyzed. PTFE grafts and autogenous AVFs applied in 22 patients were analyzed, and demographic data and PTFE graft associated complications of these patients were evaluated. Results: We found that the graft patency duration (months ± standard deviation) and the patency after graft revision were 16 ± 13 and 83.3%. Complications were detected in 14 patients (63%). One patient developed hematoma in early stages. Conclusions: We conclude that even if PFTE graft AVF applications cause significant complications, the procedure has a high patency rate after graft revision.Yayın Concomitant aortic valve replacement and mitral valve repair: A case of endocarditis of brucella(Medeniyet Üniversitesi, 2009) Göz, Mustafa; Gürsoy, Bensu; Hazar, Abdussemet; Demir, Deniz; Koçarslan, Aydemir; Söylemez, Nihat; Demir, DenizBrucella endocarditis is a disease with high morbidity and mortality. The congenital or acquired primary pathology frequently facilitates the invasion of the active microorganism into the cardiac tissues. In our case, 43 years old male patient having high fever and dyspnea showed severe aortic insufficiency, moderate aortic stenosis and severe mitral insufficiency in his echocardiography. Rose-Bengal and Brucella tube agglutination was found positive. Antibiotics therapy was administered during preoperative three weeks. In operation, brucella endocarditis was diagnosed on the aortic valve with rheumatic involvement. Aortic valve was replaced by mechanical prosthesis and mitral valve was repaired. In this study we aimed to emphasize the importance of valvular repair in an active brucella endocarditis.Yayın Do Staphylococcus aureus superantigens play a role in the pathogenesis of otitis media with effusion in children?(Elsevier, 2016) Demir, Deniz; Karabay, Oğuz; Güven, Mehmet; Kayabaşoğlu, Gürkan; Yılmaz, Mahmut Sinan; Demir, DenizObjectives Staphylococcal enterotoxins (SEs), acting as superantigens, have been reported to be involved in the pathogenesis of chronic inflammatory diseases of the upper and lower airway. There has been no previous study investigating the role of SEs in otitis media with effusion (OME). Therefore, this study was designed to analyze middle ear aspirates from children with and without OME for the presence of SEs. Methods Middle ear aspirates were obtained from 24 patients and 24 controls. All samples were processed for bacterial culture and detection of five staphylococcal SEs (SEA, SEB, SEC and SED) and toxic shock syndrome toxin-1 using the Rapid Latex Agglutination Test. Results In bacterial culture assays, six samples (25%) of the study group and five samples (20.8%) of the control group showed bacterial growth. At least one SE was demonstrated in 6 of 24 patients and in 3 of 24 controls. There was no statistically significant difference between the two groups with respect to the presence of SEs. Conclusion Although there is evidence that SEs have a potential role in the pathogenesis of chronic inflammatory diseases, there is no evidence that the inflammation process is initiated by SEs in patients with OME.Yayın Does septoplasty change the dimensions of compensatory hypertrophy of the middle turbinate?(Cambridge University Press, 2016) Demir, Deniz; Asil, K.; Güven, Mehmet; Erkorkmaz, Ü.; Demir, DenizObjective: To measure the dimensions of compensatory hypertrophy of the middle turbinate in patients with nasal septal deviation, before and after septoplasty. Methods: The mucosal and bony structures of the middle turbinate and the angle of the septum were measured using radiological analysis before septoplasty and at least one year after septoplasty. All pre- and post-operative measurements of the middle turbinate were compared using the paired sample t-test and Wilcoxon rank sum test. Results: The dimensions of bony and mucosal components of the middle turbinate on concave and convex sides of the septum were not significantly changed by septoplasty. There was a significant negative correlation after septoplasty between the angle of the septum and the middle turbinate total area on the deviated side (p = 0.033). Conclusion: The present study findings suggest that compensatory hypertrophy of the middle turbinate is not affected by septoplasty, even after one year.
