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Öğe Acute Renal Failure Secondary to Malignant Hypertension Induced Thrombotic Microangiopathy(Saudi Med J, 2010) Türkmen, Kültigin; Solak, Yalçın; Esen, Hasan; Tonbul, Halil Z.The thrombotic microangiopathy (TMA) represents a discreet group of disorders with common pathological features including fibrinoid necrosis, endothelial cell injury, and obstruction of vessels.1 The clinical presentation ofTMA includes microangiopathic hemolytic anemia, thrombocytopenia, and functional impairment of various organ systems. Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are among the common causes of TMA. Patients with malignant hypertension are prone to TMA.Öğe Assessment of Myometrial Invasion in Endometrial Cancer by Transvaginal Sonography, Doppler Ultrasonography, Magnetic Resonance Imaging and Frozen Section(BMJ PUBLISHING GROUP, 2009) Ozdemir, Suna; Celik, Cetin; Emlik, Dilek; Kiresi, Demet; Esen, HasanObjective: We aimed to compare the diagnostic performance of transvaginal sonography (TVS), magnetic resonance imaging (MRI). and intraoperative frozen section in the assessment of myometrial invasion and to evaluate intratumoral blood flow in any myometrial invasion with transvaginal Color Doppler Ultrasonography (TV-CDU). Methods: This prospective Study included 64 women consecutively diagnosed with endometrial carcinoma. The Subjects were evaluated by TVS, MRI, and TV-CDU by 2 radiologists with a special training in gynecology. Intraoperatively, a frozen section was obtained and processed for interpretation by a blinded pathologist. Sensitivity, specificity, negative, and positive predictive values were calculated for each imaging modality and frozen section with regard to assessment of myometrial invasion. The intratumoral blood flow was evaluated by TV-CDU. Results: Transvaginal sonography, MRI, and frozen section showed no statistical significant differences in overall diagnostic performance for the preoperative and intraoperative assessment of any myometrial invasion, although frozen section seemed to be slightly superior to the imaging techniques. The positive rate of intratumoral blood flow was higher in deep myometrial invasion, but statistical significance was not obtained. The mean value of resistance index was significantly lower in the cases with deep myometrial invasion. Conclusions: Transvaginal sonography with concomitant TV-UCD is low-cost, easily performed, and repeated technique for particularly deep myometrial invasion. Because of its high costs and time-consuming, MRI may be recommended in the cases with poor quality of TVS. Because depending solely oil imaging methods Could lead to insufficient treatment Schedules, intraoperative frozen section should also be performed for myometrial assessment.Öğe Atypical gastrointestinal plasmacytomas presenting with gastrointestinal bleeding in a patient with multiple myeloma(TURKISH SOC GASTROENTEROLOGY, 2012) Gungor, Gokhan; Goktepe, M. Hakan; Kayacetin, Ertugrul; Tuna, Tuncer; Esen, Hasan; Demir, Ali[Abstract not Available]Öğe The Clinical Value of Preoperative and Intraoperative Assessments in the Management of Endometrial Cancer(LIPPINCOTT WILLIAMS & WILKINS, 2010) Çelik, Çetin; Özdemir, Suna; Esen, Hasan; Balcı, Osman; Yılmaz, OsmanObjective: In this study, we aimed to investigate the diagnostic accuracy of preoperative assessment and frozen-section analysis (FSA) in endometrial cancer by comparing postoperative histopathology. Methods: A total of 72 consecutive patients with endometrial cancer were included in this study. Comprehensive surgical staging was performed in all patients. After abdominal hysterectomy, the uterus was investigated for FSA. For preoperative analysis, histological grade and histological subtypes were investigated. In FSA, all the specimens were reviewed for histological subtype, histological grade, depth of myometrial invasion, lymphovascular space invasion (LVI), and cervical involvement. These results were compared with final histopathology. Data were statistically analyzed. Results: The accuracy of preoperative examination was 95.8% (69/72) for histological type and 90% (65/72) for histological grade. In the frozen section, the accuracies of histological grade and subtype were found to be 92% and 98%, respectively. However, histological grade had 43% sensitivity in preoperative and intraoperative assessments. Myometrial invasion and LVI were correctly diagnosed in 93% and 94% of the cases, respectively. The risk assessment was correctly determined in 63 (87%) of 72 patients. Five patients were underclassified, and there was no lymph node invasion in these patients after final histopathology. Lymph node invasion was higher in patients with grade 3 classification, deep myometrial invasion, positive cervical involvement, and LVI. Conclusions: Frozen-section analysis is a feasible method for the management of the patients with endometrial cancer. However, preoperative and intraoperative assessment of histological grade has lower sensitivity in endometrial cancer.Öğe Comparison of the Effects of an Adhesion Barrier and Chitin on Experimental Epidural Fibrosis(TURKISH NEUROSURGICAL SOC, 2010) Keskin, Fatih; Esen, HasanAIM: Epidural fibrosis is an important factor for postoperative failed back syndrome development and causes clinical complaints in 6-25% of cases. An effective treatment modality has not been found yet. The aim of this study is to investigate the anti-adhesive effects of a novel agent chitin and compare these effects with a popular adhesion barrier collagen matrix. MATERIAL and METHODS: 21 rabbits were allocated into three groups including 7 rabbits each. L5 total laminectomy was performed to all groups. No treatment was given to Group 1 (Control group). Collagen matrix was used in Group 2 and chitin was used in Group 3. Six weeks later all rabbits were sacrificed and the laminectomy areas were entirely resected and investigated histopathologically. RESULTS: He and Revel grade III epidural fibrosis was detected in the control group. Statistically significant reduction of epidural fibrosis was achieved with both of the anti-adhesive agents, collagen matrix and chitin, when compared with the control group (p<0.05). The results were not different between treatment groups (p>0.05). CONCLUSION: The novel agent chitin was found effective for preventing epidural fibrosis and this effect was not significantly different from the collagen matrix. In light of our findings we suggest that chitin is an effective alternative for adhesion barriers.Öğe The Effects of Alpha Lipoic Acid on Cerebral Vasospasm Following Experimental Subarachnoid Hemorrhage in the Rabbit(TURKISH NEUROSURGICAL SOC, 2011) Erdi, Mehmet Fatih; Guney, Onder; Kiyici, Aysel; Esen, HasanAIM: The aim of this study is to determine the effects of a strong dithiol antioxidant, alpha lipoic acid (ALA) on cerebral vasospasm following subarachnoid hemorrhage in a rabbit model. MATERIAL and METHODS: Twenty-one New Zealand white rabbits were assigned to one of three groups: group 1 (control), group 2 (SAH only), group 3 (SAH+ALA). ALA was administered (100 mg/kg/day, single dose, intraperitoneally). The rabbits were sacrificed 72 hours after SAH. The basilar artery lumen areas, arterial wall thickness and endothelial apoptosis in a cross section of basilar artery were measured in all groups. The tissue MDA, SOD, GSH-Px levels were also determined. RESULTS: The elevated tissue MDA levels after SAH were significantly reduced by ALA treatment. The reduced tissue SOD and GSH-Px levels after SAH were also elevated by ALA treatment. In the treatment group the average wall thickness and the mean percentages of apoptotic cells (apoptotic index) were reduced and the average cross-sectional areas of the basilar artery were increased statistically significantly. CONCLUSION: ALA treatment attenuates the severity of cerebral vasospasm by its strong antioxidant, antivasospastic and antiapoptotic properties. ALA may potentially serve as agents in the prevention of cerebral vasospasm after SAH.Öğe Effects of cafeic acid phenethyl ester, ellagic acid, sulforaphane and curcumin on diazinon induced damage to the lungs, liver and kidneys in an acute toxicity rat model(Veteriner Fakultesi Dergisi, 2011) Alp, Hayrullah; Aytekin, İsmail; Esen, Hasan; Başaralı, Kemal; Kul, SevalThe aim of this study was to investigate the possible protective efects of cafeic acid phenethyl ester (CAPE), ellagic acid (EA), sulforaphane (SFN) and curcumin (CUR) against the toxic efects of diazinon (DI). Sixty Sprague Dawley rats were randomly divided into 10 groups. Five groups were allocated as control groups comprising unmedicated control, CAPE, EA, SFN and CUR control groups. The remaining five groups were the study groups comprising DI, DI + CAPE, DI + EA, DI + SFN, and DI + CUR groups. The animals were sacrified 24 h after drug administrations. DI caused a decrease in acetyl cholinesterase (AChE) activity (P<0.05) and increases in ?-glutamyltransferase (GGT) and amylase activities. It also damaged the kidney, liver, and lung tissues. The negative efects of DI on these enzymes were confirmed histopathologically. Also, CAPE, EA, SFN and CUR reduced amylase and GGT activities and caused an increase in the AChE activities that were increased due to the toxic efects of DI. Thus, it was determined biochemically and histopathologically that these medication reduced the degenerative toxic efects created by DI in the lung, liver and kidney tissues. These findings led us to believe that CAPE, EA, SFN and CUR may be used as protective medicines in acute DI intoxication.Öğe Effects of Caffeic Acid Phenethyl Ester (CAPE) on Hepatopulmonary Syndrome(SPRINGER/PLENUM PUBLISHERS, 2011) Tekin, Ahmet; Turkyilmaz, Serdar; Kucukkartallar, Tevfik; Cakir, Murat; Yilmaz, Huseyin; Esen, Hasan; Ates, BurhanThe aim of this study was to investigate the effects of caffeic acid phenethyl ester (CAPE) on inflammatory and related histopathological changes in the lung and liver in experimental hepatopulmonary syndrome (HPS) model. Forty Sprague Dawley rats were used in this study. The animals were divided into four groups of ten rats each. Group 1 and 2 was subjected the common bile duct (CBD) but not ligated, Group 3; (cirrhosis + saline): the CBD was ligated and was given intraperitoneal saline infusion treatment during 5 weeks. Group 4; (cirrhosis + CAPE): the CBD was ligated and was given intraperitoneal CAPE infusion treatment during 5 weeks. A 5-week waiting period was observed for the development of cirrhosis and the rats' lungs and liver were taken for histopathological examination. The induction of HPS resulted in a significant increase in serum bilurubin, AST, ALT, and NO levels, and decrease PO2 and O-2 saturation. The use of CAPE significant decrease these parameters. Histopathological examination revealed less congestion, portal inflammation, and nodular formations of the liver, and less congestion, emphysematous and inflammatory changes and smallest perialviolar vascular diameters, in the lung in the cirrhosis + CAPE groups than in the other groups. CAPE treatment may be a potential approach for the treatment of hepatopulmonary syndrome in the future.Öğe Effects of caffeic acid phenethyl ester (CAPE) on sepsis in rats(SPRINGER/PLENUM PUBLISHERS, 2008) Tekin, Ahmet; Kuecuekkartallar, Tevfik; Tuerkyilmaz, Serdar; Dinckan, Ayhan; Esen, Hasan; Ates, Burhan; Yilmaz, HueseyinSepsis is still a major cause of the high mortality rate in the intensive care unit. Many studies have been published about the severity of sepsis, but the cause of mortality in sepsis and multiorgan failure is still obscure. This study investigated the effects of caffeic acid phenethyl ester (CAPE) particularly on the inflammatory and related histopathological changes in the lung, liver and kidney in an experimental sepsis model. Forty Sprague Dawley rats were used in this study, and were divided into four groups of ten rats each, as follows: Group I was given intraperitoneal saline infusion treatment. Group II was given intraperitoneal CAPE infusion treatment. Sepsis was induced in the animals in Group III (sepsis with saline infusion), while Group IV rats underwent induced sepsis plus CAPE infusion treatment (sepsis with CAPE infusion). Sampling was performed 48 h after treatment. The induction of sepsis resulted in a significant increase in serum glucose, leukocytes, urea, creatinine, LDH levels in BAL, plasma MDA, AST and ALT levels in the sepsis+saline group. The use of CAPE significantly decreased these parameters. Histopathological examination revealed less congestion, portal inflammation, and focal necrosis of the liver, and less congestion, edema, and emphysematous and inflammatory changes in the lung in the sepsis+CAPE group than in the other groups. These results support that CAPE may be used for the treatment of organ failure during sepsis.Öğe Effects of caffeic acid phenethyl ester, ellagic acid, sulforaphane and curcumin on diazinon induced damage to the lungs, liver and kidneys in an acute toxicity rat model(KAFKAS UNIV, VETERINER FAKULTESI DERGISI, 2011) Alp, Harun; Aytekin, Ismail; Esen, Hasan; Basarali, Kemal; Kul, SevalThe aim of this study was to investigate the possible protective effects of caffeic acid phenethyl ester (CAPE), ellagic acid (EA), sulforaphane (SFN) and curcumin (CUR) against the toxic effects of diazinon (DI). Sixty Sprague Dawley rats were randomly divided into 10 groups. Five groups were allocated as control groups comprising unmedicated control, CAPE, EA, SFN and CUR control groups. The remaining five groups were the study groups comprising DI, DI + CAPE, DI + EA, DI + SFN, and DI + CUR groups. The animals were sacrified 24 h after drug administrations. DI caused a decrease in acetyl cholinesterase (AChE) activity (P<0.05) and increases in gamma-glutamyltransferase (GGT) and amylase activities. It also damaged the kidney, liver, and lung tissues. The negative effects of DI on these enzymes were confirmed histopathologically. Also, CAPE, EA, SFN and CUR reduced amylase and GGT activities and caused an increase in the AChE activities that were increased due to the toxic effects of DI. Thus, it was determined biochemically and histopathologically that these medication reduced the degenerative toxic effects created by DI in the lung, liver and kidney tissues. These findings led us to believe that CAPE, EA, SFN and CUR may be used as protective medicines in acute DI intoxication.Öğe Effects of platelet rich plasma on colonic anastomosis(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2008) Yol, Serdar; Tekin, Ahmet; Yilmaz, Hueseyin; Kuecuekkartallar, Tevfik; Esen, Hasan; Caglayan, Osman; Tatkan, YuekselPurpose. To investigate the effect of platelet-rich plasma (PRP) on tissue maturation and wound healing in experimental colonic anastomosis. Materials and methods. Thirty Sprague Dawley rats were divided into three groups of 10 rats each. Group I (control group) was subjected to colon anastomosis only. Group II (PRP group) was subjected to colon anastomosis and topical PRP was applied. Group III (Bioglue group) was subjected to colon anastomosis and topical tissue sealant was applied (Bioglue; Cryo-life, Kennesaw, GA). The rats were sacrificed on postoperative day 7, and the bursting pressure of the anastomosis and tissue hydroxyproline levels were measured; histopathological changes on the anastomosis line were also examined. Results. The bursting pressure was statistically higher in the PRP group than in the control and Bioglue groups (P < 0.05). The hydroxyproline levels were also statistically higher in the PRP group than in the control and Bioglue groups (P < 0.05). Histopathologically, there was less inflammatory cell infiltration, intensive fibroblast development, and rich collagen production in the PRP group. Conclusion. PRP may be used in colon anastomosis, especially in patients with impaired wound healing, to obtain a better anastomotic strength. (c) 2008 Elsevier Inc. All rights reserved.Öğe The effects of preoperative chemotherapy and beta glucan on bronchial anastomosis in rabbits: a preliminary study(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2015) Altuntaş, Bayram; Ceran, Sami; Sunam, Güven; Gültekin, Mustafa; Esen, HasanBackground: This study aims to investigate the effects of an immunostimulant, beta glucan, on the bronchial anastomosis in rabbits that received chemotherapy in preoperative period. Methods: Forty-five New Zealand male rabbits were used in this study. The rabbits were divided into three groups as group 1 (control), group 2 (chemotherapy), and group 3 (chemotherapy + beta glucan) with 15 rabbits in each group. The left main bronchus was incised completely and then end-to-end anastomosis was performed in all groups. Cisplatin was administered on the preoperative first day and etoposide was administered on the preoperative first, second, and third days in group 2. In group 3, in addition to the same chemotherapy protocol, 10 mg/kg/day beta glucan was administered via enteral route starting from seven days before operation until one day before sacrifications. The rabbits were sacrificed at postoperative third, fifth, and seventh days by groups of five. The bronchial anastomosis lines were removed and tissue sections were stained with hematoxylin and eosin. Results: In pathological analysis, while there were statistically significant differences between group 1 and group 2 and between group 2 and group 3, there was no difference between group 1 and group 3 in terms of bronchial healing. Conclusion: The use of beta glucan during chemotherapy treatment may improve bronchial healing at postoperative period.Öğe Evaluation of Endometrial Thickness with Transvaginal Ultrasonography and Histopathology in Premenopausal Women with Abnormal Vaginal Bleeding(Springer Heidelberg, 2010) Özdemir, Suna; Çelik, Çetin; Gezginç, Kazım; Kıreşi, Demet; Esen, HasanObjective This study was undertaken to investigate cut-off value of the endometrial thickness by transvaginal ultrasonography (TvUSG), and to detect the accuracy of preoperative Pipelle biopsy in premenopausal women with abnormal vaginal bleeding. Study design This study was included 144 premenopausal women with abnormal bleeding. Their endometrial thickness was measured by TvUSG and then Pipelle endometrial biopsy was performed. Preoperative histopathologic findings of 57 women who were operated were compared with final histolopathologic examination. Results Of the 144 women, 113 (78.4%) had normal and 31 (21.6%) had an abnormal endometrium. The abnormal endometrium was composed of 11.8% hyperplasia (simple + atypical complex), 4.2% endometrial polyp, and 5.5% adenocarcinoma. An optimal sensitivity and specificity (83.6 and 56.4%, respectively) and negative predictive value with 95.6% for detection of abnormal endometrium were obtained with an endometrial thickness of 8 mm. The accuracy rate of preoperative Pipelle biopsy was 94.7% in a total of 57 women. Conclusion An endometrial thickness >8 mm is more likely than that of 8 mm or less to be indicated with endometrial biopsy in premenopausal uterine bleeding. Pipelle endometrial biopsy is an accurate diagnostic procedure for the detection of high-grade endometrial lesions in premenopausal women.Öğe Evaluation of the effects of ankaferd blood stopper on rabbits with paranchyme damage: an experimental study(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2013) Metin, Bayram; Altınok, Tamer; Menevşe, Esma; Esen, HasanBackground: In this study, we aimed to evaluate the effects of Ankaferd Blood Stopper (ABS), a herbal extract used as a hemostatic agent in traditional Turkish medicine, on hemostasis, wound healing, air leakage and the efficiency over pleural adhesions in rabbits with pulmonary parenchymal damage. Methods: Sixteen New Zelland Albino type male and female rabbits with a mean weight of 2500 g were used. The rabbits were divided into two groups as study group and control group. One rabbit in each group died during anesthesia. We performed wedge resections in equal size to the left lower lobes of all rabbits. No additional procedure was performed on the control group, while the study group received 5 puffs (similar to 1 cc) of ABS to the resection area. Tube thoracostomy, which was performed in both groups, was terminated postoperatively at the sixth hours after drainage and air leakage follow-up. The rabbits were sacrificed with high dose anesthetic at the postoperative eight-day. Pleural inflammation and fibrosis in the hemithorax were examined macroscopically and microscopically. Biochemical measurements of tissue malondialdehyde (MDA) and hydroxyprolin (HPR) levels were done. Results: There was a statistically significant difference in postoperative air leakage and the amount of drainage between the groups (amount of hemorrhage p<0.05, air leakage p<0.001). A higher rate of macroscopic and microscopic fibrosis was observed in the study group. When both groups are compared according to tissue MDA levels, decreased MDA level was seen in the group which ABS was administered, where the difference was statistically non-significant. Conclusion: Ankaferd Blood Stopper reduces postoperative bleeding and prolonged air leakages without any toxic effects and has an effective role at pleurodesis, increasing the pleural fibrosis level.Öğe Gastric Heterotopia Together with Intestinal Metaplasia in the Gallbladder: Case Report and Review of Literature(2005) Tavlı, Lema; Belviranlı, Metin; Erikoğlu, Mehmet; Esen, Hasan; Toy, HaticeHeterotopic gastric mucosa in the gallbladder is extremely unusual. In this study, we aimed to report a case of gastric heterotopia together with intestinal metaplasia in the gallbladder of a 16-year-old male patient who experienced a sudden onset of epigastric pain with nausea. He was admitted to the hospital with a prediagnosis of mild degree obstructive jaundice. Cholecystectomy and hepaticoduodenostomy were carried out. In the microscopical examination of the gallbladder, an antral and pyloric type gastric mucosa together with intestinal metaplasia were clearly evident in the gallbladder submucosa, and the adjacent gallbladder mucosa showed typical features of chronic cholecystitis.Öğe A Hepatitis C-Positive Patient with New Onset of Nephrotic Syndrome and Systemic Amyloidosis Secondary to Common Variable Immunodeficiency(K Faisal Spec Hosp Res Centre, 2010) Türkmen, Kültigin; Anıl, Melih; Solak, Yalçın; Atalay, Hüseyin; Esen, Hasan; Tonbul, Halil Z.Common variable immunodeficiency (CVID) is a heterogenous group of predominantly antibody deficiency disorders that make up the greatest proportion of patients with symptomatic primary hypogam maglobulinemia The rare coincidence of amyloidosis and hypogamma globulinemia has been reported previously Contrary to the usual insidious slowly progressive disease following hepatitis C infection a rapidly progressive cirrhotic form can develop in hypogammaglobulinemic patients We report a HCV positive patient with a new onset of nephrotic syndrome and systemic amyloidosis secondary to CVID Blood analyses showed serum creatininne of 1 8 mg/dL and serum albumin of 3 1 gm/dL 24 h urinary protein was 11 800 mg/day Serum immunoglobulin levels were IgG 340 mg/dL IgM 18 mg/dL IgA 11 mg/dL Duodenal biopsy revealed AA type amvloidosis with potassium permanganite and Congo red staining After a month of antiprotemuric therapy the proteinurin was reduced to 3350 mg/dayÖğe Hipotermiye bağlı ölümlerin değerlendirilmesi(2013) Doğan, Kamil Hakan; Esen, Hasan; Demirci, Şerafettin; Gündoğmuş, Ümit NaciSistemik hipotermi terimi insan vücudunun 35 C'den daha aşağı düşecek kadar soğuduğunu belirtmek için kullanılır. Bu durum, vücudun ısı kaybının ısı yapımını aştığı zaman meydana gelir. Kaza sonucu meydana gelen hipoterminin en sık nedeni ısı derecesi düşük olan bir ortama maruz kalmadır. Hipotermi tehlikeli fizyolojik değişikliklere ve hatta ölüme neden olabilir. Bu çalışmada hipotermiye bağlı ölüm olgularının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 2000-2008 yılları arasında Konya Adli Tıp Şube Müdürlüğü tarafından ve Konya'ya bağlı ilçelerde adli tıp uzmanı tarafından otopsileri yapılan olgular retrospektif olarak taranmış ve ölümü hipotermiye bağlı olan olgular çalışma kapsamına alınmıştır. Bulgular: Çalışmaya dahil edilen dönemde 12 hipotermiye bağlı ölüm olgusu saptanmıştır. Olguların 11'i erkek, 1'i kadındır. Olguların yaşları 41 ile 85 arasında değişmekte olup, ortalama yaş 57.015.4 bulunmuştur. Ölümler en sık 5 olgu ile Ocak ayında meydana gelmiştir. Olguların 4'ü tarlada, 3'ü metruk binada bulunmuştur. 6 olguda psikiyatrik hastalık öyküsü mevcuttur. Histopatolojik incelemede 5 olguda enzimatik yağ nekrozu bulguları tespit edilmiştir. Sonuç: Hipotermiye bağlı ölümler, toplum sağlığı açısından önemli olduğu gibi, adli tıbbi açıdan da önemlidir. Bu tür olgularda, olay yeri incelemesi, olgunun tıbbi özgeçmişinin ayrıntılı bir şekilde incelenmesi, dikkatli bir şekilde yapılacak otopsi ve histopatolojik inceleme tanı konulmasını kolaylaştırırÖğe Intradural Intramedullary Conus Medullaris Metastasis of Colorectal Adenocarcinoma: A Case Report(Ege University Press, 2012) Keskin, Fatih; Kalkan, Erdal; Erdi, Mehmet Fatih; Esen, HasanSpinal cord metastasis is rarely seen. Intramedullary spinal metastasis has been defined between the rates of 0,9 -2,1% in the autopsies performed on the cancerous cases. And also intramedullary spinal metastases are defined at a rate of 8,5% in the cases which have metastasis at central nervous system. The male patient, who was at the age of 62, was admitted to our clinic with the complaints of serious back and left leg pain and weakness at the left leg which had begun 15 days before. Low anterior resection + total mesorectal excision + ileostomy were applied to the patient five years ago due to colorectal adenocarcinoma. The carcinoma was reported as adenocarcinoma grade II. Chemotherapy and radiotherapy were applied after postoperative period. Left SLR was positive and 3/5 monoparesis at left leg was determined in the patients neurological examination. Conus medullaris located tumor was determined in the magnetic resonance imaging of the patient. Intradural intramedullary tumor which was infiltrated to the conus medullaris was totally removed with microneurosurgical technique via Th12-L1-2 total laminectomy. Th11-L3 posterior instrumentation and fusion were added because of expansive laminectomy and L1 corpus involvement of the tumor. The histopathological examination was reported as colorectal adenocarcinoma metastasis. In this manuscript we report a colorectal adenocarcinoma metastasis to the conus medullaris for the first time in the literature.Öğe Intradural Intramedullary Conus Medullaris Metastasis of Colorectal Adenocarcinoma: A Case Report(2012) Keskın, Fatıh; Kalkan, Erdal; Erdi, Mehmet Fatih; Esen, HasanOmurilik metastazları nadiren görülür. Kanserli olgularda yapılan otopsilerde %0.9 ile %2.1 arasında intramedüller spinal metastaz tanımlanmıştır ve de santral sinir sistemi metastazı olan olgularda %8.5 oranında intramedüller omurilik metastazı görülür. 62 yaşında erkek hasta 15 gün önce başlayan şiddetli bel ve sol bacak ağrısı, sol bacakta kuvvetsizlik şikayeti ile kliniğimize yatırıldı. Hastaya beş yıl önce alt anterior rezeksiyon, total mezorektal eksizyon, ileostomi uygulanmıştı. Patolojisi kolorektal adenokarsinom grade II idi. Nörolojik muayenesinde sol SLR (), solda 3/5 monoparezi tespit edildi. Hastanın manyetik rezonans görüntülemesinde konus medullarisde tümoral kitle tespit edildi. Th12-L1-L2 total laminektomi ile mikroskopik olarak konus medullarise infiltre olan kitle total çıkarıldı. L1 korpus tutulumu ve geniş laminektomi uygulandığı için Th11-L3 arası posterior enstrumantasyon ve füzyon uygulandı. Histopatolojisi kolorektal adenokarsinom metastazı olarak değerlendirildi. Konus medullarise metastaz yapmış kolorektal adenokarsinom olgusunu literatürde ilk kez rapor etmekteyiz.Öğe Metastatic prostate adenocarcinoma presenting as supraclavicular lymphadenopathy: a report of two cases(TERMEDIA PUBLISHING HOUSE LTD, 2012) Davarcı, Mürsel; Gökçe, Ahmet; Güven, E. Oğuz; Yalçınkaya, Fatih R.; Esen, Hasan; Sevinç, AlperClinical examination is very important in the practice of medicine. In patients presenting with a supraclavicular mass, a number of diseases including cancer should be ruled out. Two patients who presented with a bulky left supraclavicular mass were evaluated. Their medical history revealed complaints attributed to lower urinary tract infection. We performed histopathological examination of the lymph nodes with radiological evaluation of the thorax and abdomen. The final diagnoses were prostate cancer in both patients. It should always be kept in mind that prostate cancer is the most frequent cancer in elderly men, and although very unusual, the presenting finding can be cervical or supraclavicular lymphadenopathy; thus clinicians should be aware of urological examinations in such cases.
