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Öğe A case of renal cell carcinoma mimicking parotid tumor(Turkish Society of Plastic Reconstructive, and Aesthetic Surgery, 2015) Akatekin, Ahmet; Karameşe, Mehtap; Akdağ, Osman; Abacı, Malik; Tosun, ZekeriyaIntroduction: Renal cell carcinoma is a malignant tumor which arising from the renal cortex. Tumor has some symptoms such as flank pain, macroscopic hematuria, and a palpable abdominal mass. Rarely a group patients have metastasizes which cause paraneoplastic syndromes. Cutaneous metastases are quite rare. Case: In this article we will be discussed a rare renal cell carcinoma metastases case which mimicking parotid tumor. Results: After pathological examination, patient were diagnosed with renal cell carcinoma and for the primary tumor treatment, he was referred to the urology clinic. Conclusion: Clinics which are dealing with tumor, are very important to the pathological examination. Patients should be considered as a systemic and the surgeon should focus on other systemic point.Öğe An Easy Way for Congenital Symmastia Correction(SPRINGER, 2014) Karameşe, Mehtap; Hancı, Mustafa; Abacı, Malik; Akatekin, Ahmet; Tosun, ZekeriyaCongenital symmastia is described as a connection between the breasts without macromastia. In this condition, there is accumulation of fat and glandular tissue between the breasts, which produces a unified appearance of the breast tissue across the chest. We report a case of congenital symmastia in a 21-year-old woman with normal-sized and -shaped breasts. We achieved satisfying aesthetic results using suction-assisted lipectomy and the patient's complaint was resolved without scar or major surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.Öğe Endoscopic treatment of maxillofacial fractures(Turkish Society of Plastic Reconstructive, and Aesthetic Surgery, 2015) Akdağ, Osman; Karameşe, Mehtap; Selimoğlu, Muhammed Nebil; Akatekin, Ahmet; Abacı, Malik; Tosun, ZekeriyaEndoscopic treatment of maxillofacial fractures is a minimally invasive method and which is the application of a different way of open reduction internal fixation (ORIF) procedure. Between April 2013-December 2013, 13 patients admitted with maxillofacial trauma were treated with this method. All patients were evaluated clinically and radiographically. In the course of postoperative evaluation, two minor and one major complications were observed in 3 patients in total. In other patients, satisfactory results were obtained. In our study, in accordance with the data obtained from these patients, operative techniques have been described in detail and the results were compared with literature. We suppose that endoscopic surgery, which we consider as a different and innovative method for maxillofacial trauma surgery, will take part of standard treatment protocols with appropriate patient, equipment and experience.Öğe Extracorporeal Septoplasty Combined With Valve Surgery in Rhinoplasty Patients(LIPPINCOTT WILLIAMS & WILKINS, 2016) Karameşe, Mehtap; Akdağ, Osman; Akatekin, Ahmet; Koplay, Tuğba Gün; Koplay, Mustafa; Tosun, ZekeriyaExternal nasal deviation is caused primarily by severely a deformed septum. The nose functions as a whole composed of the septum, valve systems, and mucosal structures. Patients with severely deviated septums also have deformed nasal valve systems. Extracorporeal septoplasty is advocated for an extremely deviated nasal septum. Nasal valve dysfunctions can be resolved successfully with spreader grafts. Application of extracorporeal septoplasty in combination with spreader grafts in patients with nasal valve dysfunction not only enables nasal respiration but also supports aesthetic appearance. The 19 patients in our study had undergone aesthetic rhinoplasty and presented with breathing problems and septal deviations. The patients were treated with extracorporeal septoplasty and spreader grafts. The patients were followed with clinical measures and computed tomographic scanning. No complications such as relapse, perforation, or saddling were encountered during follow-up. Aesthetically and functionally satisfactory results were obtained.Öğe Fingertip Reconstruction With Reverse Adipofascial Homodigital Flap(LIPPINCOTT WILLIAMS & WILKINS, 2015) Karameşe, Mehtap; Akatekin, Ahmet; Abacı, Malik; Koplay, Tuğba Gün; Tosun, ZekeriyaDue to the importance of hand functions, fingertip injuries should be reconstructed by flap coverage. Although reverse homodigital island flap is an option that is widely used, the classical homodigital flap, which includes a skin graft for the donor site, leads to many donor-site problems such as maceration, and primary or secondary contraction. Reverse homodigital adipofascial flap (RHAF) has been chosen to prevent donor-site complications. To emphasize the efficacy of this flap, we report the outcome of 14 RHAFs, which were used for fingertip reconstruction following traumatic amputations. Materials and Methods From May 2010 to June 2012, 14 fingertip amputations were reconstructed with reverse adipofascial homodigital flap. Six months following surgery, the patients were evaluated with examination using 2-point discrimination, measurement of the range of motion of the proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP), pain [evaluated with the Visual Analogue Scale (VAS)], and the time to return to their previous activities. Results All flaps survived completely. Donor sites healed without any complication. Two-point discrimination was a mean of 4.86 +/- 0.95 mm. The range of motion of the PIP and DIP joints was similar to that of the contralateral finger. The VAS score was a mean of 0.9 (range 0-2). All patients returned to their previous occupations within 30 to 60 days (average 40 days). The operation did not impair functional and other activities. Conclusions Reverse adipofascial homodigital flaps maintain the perpetuation of digital length, volume of pulp, and service of finger function. The donor site on the lateral surface of the proximal phalanx can be primarily closed. For traumatic fingertip amputation, this flap delivers consistent aesthetic and functional results.Öğe Kompozit doku allotransplantasyonu yapılan sıçanlarda, yağ doku kaynaklı mezenekimal kök hücrelerin ilk 24 saatte meydana gelen sistemik yanıta etkisi(Selçuk Üniversitesi Tıp Fakültesi, 2015-01-19) Akatekin, Ahmet; Akdağ, OsmanAMAÇ: Kompozit doku nakilleri eş zamanlı birçok farklı doku türünün rekonstrüksiyonu açısından avantajlıdır. Ancak bu işlemin önündeki en büyük sorun tüm doku çeşitlerine karşı ayrı ayrı oluşan sistemik ve immün yanıttır. Biz bu çalışmamızda kompozit doku nakillerine bağlı ilk 24 saatte meydana gelen sistemik yanıtı ve oluşan sistemik yanıta yağ doku kaynaklı mezenkimal kök hücrenin (MKH) etkisini gözlemlemeyi amaçladık. YÖNTEM: Çalışmada 29 adet Wistar Albino (WA) , 29 adet Sprague Dawley (SD) türü sıçan kullanılmıştır. 24 adet WA sıçan 12'şerli 2 ayrı gruba ayrılmıştır. ( Grup I, Grup III), 24 adet SD sıçan 12'şerli 2 ayrı gruba ayrılmıştır. ( Grup II, Grup IV) . Kalan 5 adet WA ve 5 adet SD türü sıçan MKH eldesi ve bazal karaciğer apoptoz değerlerinin ölçülmesinde kullanılmıştır. Bu gruplardan elde edilen MKH süspansiyonları kendi türlerinden sıçanlara enjekte edilmek üzere -80 ºC de saklanmış ve enjeksiyondan 40 dakika önce uygun koşullarda eritilmiştir. Grup I ile Grup II arasında, Grup III ile Grup IV arasında çapraz sol arka ekstremite transferi planlanmıştır. Transfer öncesi tüm sıçanlardan kuyruk kanı alınarak bazal AST, ALT, Üre ve Kreatinin değerleri ölçülmüştür. Transfer esnasında anastomoz açılıp ekstremite dolaşımı gözlenen Grup III ve Grup IV sıçanlara kendi t ürlerinden elde edilen adipoz kaynaklı MKH içeren süspansiyon intraperitoneal olarak enjekte edilmiştir. Grup I ve Grup II sıçanlara aynı miktar serum fizyolojik intraperitoneal olarak enjekte edilmiştir. Transfer işleminden 24 saat sonra bacak dolaşımı yeterli olan sıçanlar sakrifiye edilerek hem kan hemde karaciğer doku örneği alınmıştır. Elde edilen veriler hem grup içinde hemde gruplar arasında istatistiksel olarak analiz edilmiştir. BULGULAR: İskemi süreleri ile 24 saat sonunda kandan ölçülen AST, ALT, Üre, Kreatinin değerleri ve karaciğer dokusundan akım sitometrisi ile elde edilen ölü hücre, canlı hücre, erken ve geç apoptotik hücre oranları arasında korelasyon olmadığı görülmüştür. Kompozit doku nakli sonrası tüm gruplarda AST değerlerinde artış olmasına rağmen bu artış sadece 1 grupta anlamlı bulunmuştur. Kreatinin ve ALT değerlerinde tüm gruplarda anlamlı oranda azalma gözlenmiştir. Üre değerleri MKH enjeksiyonu yapılmayan gruplarda azaldığı halde enjeksiyon yapılan gruplarda artmış olarak gözlendi. Akım sitometrisi incelemesinde MKH enjeksiyonu yapılan gruplarda canlı hücre, erken ve geç apoptotik hücre oranları arasında fark gözlenmedi. Sadece 1 grupta MKH enjeksiyonu sonrası ölü hücre oranında azalma olduğu gözlendi. MKH eldesi için kullanılan sıçanlardan alınan karaciğer örneklerinin akım sitometrik incelemesi sonuçları, cerrahi işlem yapılıp MKH enjeksiyonu yapılmayan ve 24 saat sonunda sakrifiye edilerek karaciğer örnekleri alınan sıçanlar ile karşılaştırıldığında ölü hücre, canlı hücre, erken ve geç apoptotik hücre oranları açısından anlamlı fark gözlenmemiştir. SONUÇ: Kompozit doku nakilleri sonrası ilk 24 saatte meydana gelen sistemik yanıtın izlenmesinde AST, ALT, Üre ve Kreatinin değerlerinin anlamlı bulgu vermediği, iskemi süresinin karaciğer ve böbrek fonksiyon testleri ile korelasyon göstermediği, AST ve ALT değerlerinin karaciğerde mevcut apoptoz ve ölü hücre miktarı ile korelasyon göstermediği bu nedenle takip açısından yeterli olmadığı, MKH' lerin kompozit doku nakli yapılan sıçanlarda ilk 24 saatte meydana gelen sistemik yanıta belirgin olumlu etkisinin olmadığı hatta bazı parametrelerde olumsuz etki oluşturabileceği sonucuna varılmıştır.Öğe The Worth of Sound Recording as Evaluation Criteria of Response to Surgery in Non-Reduced Anterior Disc Dislocation(LIPPINCOTT WILLIAMS & WILKINS, 2014) Karameşe, Mehtap; Akdağ, Osman; Selimoğlu, Muhammed Nebil; Akatekin, Ahmet; Abacı, Malik; Tosun, ZekeriyaAim: The objective of the present study was to examine whether joint sounds are objective criteria for evaluating the success of surgery for non-reduced anterior disc dislocation. Method: Twenty-seven patients (age, 35.6 +/- 10.6 years; female/male, 22:5) with non-reduced disc dislocation, as confirmed by MRI, were included in the study. Temporomandibular joint (TMJ) sounds were assessed and digitized by custom-made device. As a surgical treatment, all patients underwent "disc plication technique". The success of surgery was evaluated with maximal interincisial opening (MIO), pain, patient satisfaction scores, MRI examination, and TMJ sound intensity. Recording of sounds of TMJ and pain and satisfaction scores were repeated again at postoperative 12 months and compared to preoperative results. Results: Mean preoperative sound intensities with jaw opening and closing and left-right movement were 79.37 +/- 3.52 dB and 81.0 +/- 4.99 dB, respectively. Mean postoperative sound intensity with jaw opening and closing was 64.81 +/- 4.54 dB whereas that with left-right movement was 65.6 +/- 5.38 dB. Examination of preoperative and postoperative sounds showed that decreased volume level related with clinical improvement and postoperative replaced disc image in MRI. MIO values increased from 25.89 +/- 1.76 mm to 34.26 +/- 1.403 mm. Postoperative pain scores were lower than pre-operative period and patient satisfaction improved markedly. Conclusion: The results of this study showed that patients who underwent plication for non-reduced disc dislocation had clinical improvement, which was related with the decreasing volume level of the click sound, reducing the pain, improving satisfaction, and replacing the disc to normal position in MRI.
