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Öğe Chronic hematoma on the forearm mimicking soft tissue sarcoma(Springer, 2013) Köse, Rustu; Erkut, Adem; Mordeniz, Cengiz; Karantinaci, A. Burce T.Chronically expanding hematoma is a rare entity, characterized by its persistence and increasing size. Chronic hematoma may be misdiagnosed as a soft tissue neoplasm due to its large size and slow progression and enlargement. A 77-year-old man presented with a large, protuberant mass in the anterior left forearm. There was no clear history of trauma, bleeding disorder, or coumadin or anti-platelet medication. This case had initially been considered to be a soft tissue sarcoma, determined by means of clinical and radiological examinations. An incisional biopsy was found to be insufficient for a histopathological diagnosis. Hematoma was also found taking over the arteria brachialis, so it was excised with arterial resection. In order to rescue the circulation of the hand, an anastomosis was performed between the brachial and radial arteries with a graft from the saphenous vein. To differentiate the diagnosis of expanding hematoma from sarcoma can be very difficult, either clinically or radiologically. Incisional biopsies taken from the necrotic tissues or hemartoma do not always reveal tumoral cells. In order to attain a correct diagnosis, a surgical procedure should be performed in an operating room under the supervision of an anesthesiologist.Öğe Comparison of intravenous paracetamol and tramadol for postoperative analgesia in patients with septo-rhinoplasty(2011) Toğrul, Turhan; Baysal Yıldırım, Zeynep; Cengiz, Mustafa; Çiğdem, Ali; San, İmran; Kar, Murat; Aycan, İlker Öngüç; Mordeniz, CengizObjective: The aim of the study was to compare the efficacy of i.v. tramadol and i.v. paracetamol for postoperative analgesia after septo-rhinoplasty operation. Method: Fifty American Society of Anesthesiology (ASA) physical status I-II patients, aged between 18-50, receiving septo-rhinoplasty operation are included in the study. The patients were randomly divided into two groups for postoperative analgesia. In Group I; i.v. paracetamol 1 gr was infused 30 minutes before the end of the operation. In Group II; i.v. tramadol 1 mg kg -1 was given 20 minutes before the end of the operation. A blinded observer recorded the pain intensity, analgesic need, patient satisfaction and side effects of drugs for postoperative at 1 h, 6 h and 24 h hours. Results: The VAS values are similar in both groups at postoperative 1st hour, no statistically significant differences were found (p> 0.05). VAS values for group II were significantly lower than group 1 at 6 h and 24 h postoperatively (p< 0.05). No serious side-effects were recorded during the study. The most frequent adverse effect was nausea (25%) in group II. No significant difference was found between groups in terms of vomiting (p>0.05), whereas the rate of nausea was significantly lower in group I than group II. Cortisol levels significantly decreased in both groups at postoperative period. Conclusion: Intravenous paracetamol administration provided adequate analgesia as opioids especially at early postoperative period for mild-moderate pain therapy in perioperative period.Öğe EFFECT OF BREAST CANCER AND BREAST CANCER TREATMENT ON THE BLOOD SERUM CONCENTRATIONS OF TRACE ELEMENTS AND SELENOPROTEINS(Polish Society Magnesium Research, 2022) Öğüt, Selim; Bahtiyar, Nurten; Mordeniz, Cengiz; Cinemre, Fatma Behice; Aydemir, Birsen; Karaçetin, Didem; Bektaş, MuhammetTrace elements (TEs) playing critical roles in chemical events that occur at the cellular level in the body are necessary for biological processes in human health. The role of TEs and selenoproteins and their relationship with breast cancer (BC) have not been studied thoroughly and therefore remain relatively unknown. Our study aimed to investigate possible changes in the serum selenoproteins (Glutathione Peroxidase 1 (GPX1), Glutathione Peroxidase 6 (GPX6), Selenoprotein F (Sel-F), Selenoprotein H (Sel-H), Selenoprotein S (Sel-S), Selenoprotein V (Sel-V), Selenoprotein M (Sel-M)), and TEs (Se, Zn, Mn, Cu, and Fe) levels, and TEs ratios (Fe/Se, Fe/Zn, Fe/Mn, Cu/Se, Cu/Zn, and Cu/Mn) in patients with BC before and after treatment (surgery, radiotherapy, and chemotherapy), and to evaluate the results in the patient groups with healthy controls. A total of 35 patients with BC and 25 healthy subjects were included in the study. Blood samples were collected from the patient group on the day prior to treatment, and on the day treatment was completed. Serum GPX1, GPX6, Sel-F, Sel-H, and Sel-S levels were decreased in both before and after treatment groups compared to the control. The treatment of BC resulted in increasing the concentration of Sel-V compared to before treatment levels. The treatment of BC resulted in lowering serum Se, Zn, and Fe concentrations compared to before treatment levels. Also, serum Se, Zn, and Fe levels were decreased in both before and after treatment groups compared to the control. The ratios of Cu/Se, Cu/Zn, and Cu/Mn were increased after treatment compared to the values before treatment. Cu/Se and Cu/Zn ratios were increased, but Fe/Mn ratios were decreased after treatment compared to healthy control. This study indicates that changes in serum levels of TEs such as Zn, Mn, Cu, and Se, as well as their ratios and selenoproteins, may be related to the treatments of BC. Further studies are required to clarify the exact specific mechanisms involved in the status of TEs and selenoproteins in therapeutic strategies of BC.Öğe Effect of waist circumference and body mass index on the level of spinal anesthesia(Springer, 2022) Gunkaya, Mustafa; Arar, Makbule Cavidan; Mordeniz, Cengiz; Baran, Onur; Topçu, BirolBackground: We aimed to determine the effects of waist circumference and body mass index on spinal anesthesia levels. In total, 120 surgical patients who were between 18 and 65 years old and in the American Society of Anesthesiologists' (ASA) I-III risk groups enrolled in this study. Patients were classified into three groups, depending on their weight. After a spinal block, we noted the time needed for the sensory block to reach the T10 level, the maximum sensory block level, the time needed for the sensory block to reach the maximum sensory block level, the time needed before the start of the motor block, and the Bromage scale for each patient. Results: We observed no significant demographic differences in age, gender, or ASA risk class between the groups; however, we found a statistically significant difference between the groups' BMIs and waist circumferences. For the time needed for the spinal block to reach the T10 level, we observed a statistically significant difference between groups I, II, and III, and we also found a statistically significant difference between the groups' comparing Bromage scales. Moreover, we found a statistically significant difference between the groups' time needed (in minutes) for the block to reach the maximal upper dermatomal block level and, as BMIs and waist circumferences increased, the time needed to reach the maximal upper dermatomal block level. We also noted a statistically significant difference in waist circumference variability. Conclusions: This study shows that body mass index and waist circumference can be used and interpreted as independent parameters reflecting the increasing incidence of obesity.Öğe Pain Perception Within Consciousness(Anka Publisher, 2016) Mordeniz, CengizAs a psychological state, pain is perceived by the affected individual and it corresponds to a form of conscious awareness as a subjective conscious experience mediated in part by beliefs or emotions. Regardless of its 'physical' origins, pain, like all other perceptions, is a mental experience at different degrees of consciousness. The experience of pain requiring a stimulus, a feeling or emotion, and an effect or result, consists of an intermingling of chemical, biological, psychological, physiologic, socioeconomic, cultural, ethnic backgrounds, and emotional and cognitive factors. Not only the activation but also the connections are involved in conscious pain perception. Moreover, interconnectivity between the periaqueductal matter and orbitofrontal cortex is the key to cognitive-emotional responses associated with pain. Thus, the central pain control processes arising from interactions among the cognitive-evaluative, motivational-affective, and sensory-discriminative systems characterize the pain response, being also influenced by both noxious input and cognitive self-regulation. Neuroimaging studies (Davis et al., 2015) in healthy volunteers showed that pain cannot be localized in an isolated pain center in the brain, but it rather encompasses a neural circuitry.Öğe Perioperative Considerations in Urgent Surgical Care and Operating Room Practice and Guidance During COVID-19 Pandemic; Our Experiences(2020) Şahin, Ayhan; Gültekin, Ahmet; Yıldırım, İlker; Mordeniz, Cengiz; Arar, Makbule CavidanAim: The novel coronavirus SARS-CoV-2 (COVID-19) can infect healthcare workers. We developed an institutional algorithm to protect operating room team members during the COVID-19 pandemic and rationally conserve personal protective equipment (PPE). We aimed to review the latest data on the COVID-19 pandemic and essential information for practice in emergency surgery and the operating room.Materials and Methods: An interventional platform (operating room, interventional suite, and endoscopy) with our committee formed with our doctors consisting of different branches, we developed our guidelines based on potential patterns of spread, risk of exposure, and conservation of PPE. We aimed to share our experiences with 128 patients who were taken into operation in a 2-month period.Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in Medical Faculty of Namık Kemal University.Results: A decision tree algorithm describing our institutional guidelines for precautions for operating room team members was created. This algorithm is based on the urgency of operation, anticipated viral burden at the surgical site, the opportunity for a procedure to aerosolize virus, and the likelihood a patient could be infected based on symptoms and testing.Conclusion: Despite COVID-19 being a new threat, we have shown that by developing an easy-to-follow decision algorithm for the interventional platform teams, we can ensure optimal healthcare worker safety.Öğe Pre-emptive analgesia with preoperative oral gabapentin and pregabalin in lumbar narrow canal surgery(Pharmamed Mado Ltd, 2024) Mordeniz, Cengiz; Ozdemir, Fatma; Karaarslan, Numan; Yıldırım, Ilker; Demirkapu, Mahluga Jafarova; Arar, Makbule CavidanThe success of pre-emption depends on the strategy pertaining to the choice of agent and when and how, to use. This study was aimed to evaluate the efficacy of preemptive analgesia regarding the postoperative pain management in lumbar spinal stenosis surgery. The oral gabapentin 800 mg or pregabalin 225 mg or placebo were administered 1 h before surgery. The pain and sedation scores were measured through Visual Analogue Scale (VAS) and Ramsay Sedation Scale (RSS). Three groups of 30 patients each were included in the study. Group 1 was administered with gabapentin 800 mg, Group 2 with pregabalin 225 mg, and Group 3 with placebo 1 hour before the surgery. VAS scores at the 1st, 2nd, 4th, 6th, 8th, 10th, 12th, 14th, 16th, 18th, 20th, 22nd and 24th hours of surgery, and RSS scores and analgesic drug usage in the 1st to 24 hours of surgery were recorded. There were statistically significant differences between the 1st, 2nd and 4th hour VAS score averages. RSS scores changed among the three groups in postoperative period. The total analgesics employed in gabapentin and pregabalin groups were lower than those in placebo group. Pre-emptive analgesia of oral pregabalin or gabapentin minimized the postoperative pain in patients undergoing lumbar stenosis surgery. © 2024 The Author(s).Öğe Predictive value of hemogram parameters in malignant transformation of the endometrium in patients with different risk factors(Public Library Science, 2023) Fırat, Aysun; Ercan, Ayşegül; Mordeniz, Cengiz; Verit Atmaca, Fatma FerdaObjectivesTo investigate whether the pretreatment hemogram parameters and their ratios can be used in predicting the endometrial transformation in patients with abnormal uterine bleeding. Material and methodsRecords of all patients who underwent an endometrial histopathological evaluation between 2011 and 2021 were investigated. Hemogram, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were analyzed. Chi square and Mann Whitney U tests were used for analysis. PResults427 patients were included, of whom 117 were presented with endometrial hyperplasia without atypia (27.4%; mean age, 42 +/- 9.7; Group II), 70 with atypia (16.3%; mean age, 53.4 +/- 9; Group III), 102 with early endometrial cancer (EC) (23.8%; mean age, 63 +/- 7.8; Group IV) and 38 with advanced disease (8.8%; mean age, 63.3 +/- 10.5; Group V). Patients without pathology constituted the control group (23.4%; mean age, 42.2 +/- 9.5; Group I). Risk factors for atypia and carcinoma were determined as age, postmenopausal state, obesity, diabetes, and increased estrogen exposure (each, p<0.05). There was no significant difference in NLR and PLR (p>0.05). However, hemoglobin and hematocrit levels were higher in Groups IV and V (13.9 vs 13.1 mg/dL, and 39.1 vs 38.8%, respectively; p<0.01). Platelet value was significantly higher in Groups III to V (282x10(9)/L, 283x10(9)/L and 295x10(9)/L; p<0.05, p<0.05 and p<0.01, respectively). ConclusionsOur findings support the impact of inflammation on malign transformation from normal endometrial mucosa to atypia and carcinoma. NLR and PLR values showed no statistical difference. Instead, thrombocytosis may have a predictive role in EC.Öğe Status of High-risk Oncogenic Human Papillomavirus Subtypes Harbored in the Prepuce of Prepubertal Boys(Elsevier Science Inc, 2012) Verit, Ayhan; Zeyrek, Fadile Yıldız; Mordeniz, Cengiz; Çiftçi, Halil; Savaş, MuratOBJECTIVE To evaluate whether the high-risk human papillomavirus (HPV) subtypes that are strongly related to cervical cancer are harbored in the prepuce of the circumcised tissue of prepubertal boys in the period just before active sexual life. METHODS The present study enrolled 30 healthy boys (age range 4-11 years, mean age 8.1 +/- 1.6) who underwent a standard circumcision procedure, with hypospadias repair in 3 patients. All prepuceal samples were studied using real-time polymerase chain reaction and grouped according to HPV subtype prevalence as groups 1 (types 16 and 18), 2 (types 31, 33, 45, 52, and 58), and 3 (types 35, 39, 51, 56, 59, 66, and 68). RESULTS HPV DNA was reported in 25 (83.3%) of the 30 subjects. All samples showed a negative result for group 2. Although most of the positive findings were for group 3 (25 [83.3%] of 30), a positive result was reported for only 1 subject for group 1 (3.3%). CONCLUSION The results of the present study have shown that the prepuce harbored the rarest HPV types, including types 35, 39, 51, 56, 59, 66, and 68 in preadolescence boys with a high rate (83%). These findings are in contrast to the common knowledge of HPV prevalence in adults that points to the dominance of HPV subtypes 16 and 18. UROLOGY 80: 423-426, 2012. (c) 2012 Elsevier Inc.Öğe The Effect of Video Information on Preoperative Anxiety Levels in Patients Undergoing Total Knee Replacement(2020) Baran, Onur; Mordeniz, Cengiz; Arar, Makbule Cavidan; Günkaya, MustafaObjective: The preoperative anxiety rate in patients waiting for elective surgery varies between 60% and 80%. We aimed to reduce preoperativeanxiety in patients undergoing total knee replacement using a video demonstration of combined spinal-epidural anesthesia on a tablet computer.Methods: Fifty adult patients, scheduled to undergo total knee replacement, were enrolled in a randomized controlled study. Anxiety levels wereassessed using the State-trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information scale. The assessment was basedon questionnaires completed by the patients. Patients were randomly divided into two groups: video and control groups. In the video group, a videodemonstration of combined spinal-epidural anesthesia was provided, along with verbal information about the procedure. On the day of surgery, thesame questionnaires were again completed for the assessment of anxiety levels.Results: There were no significant differences between groups regarding age, sex, occupation, education, and previous history of anesthesia andsurgery. The STAI scale scores were found to be significantly lower in the video group than in the control group (p=0.000; p<0.005). The AmsterdamPreoperative Anxiety and Information scale scores were found to be significantly lower in the video group compared to the control group (p=0.000;p<0.05).Conclusion: New devices and technologies may be used in daily anesthetic practice to offer patient information more efficiently. This may helpreduce preoperative anxiety levels among patients undergoing elective surgery.Öğe The effects of etomidate on testicular ischemia reperfusion injury in ipsilateral and contralateral testes of rats(Verduci Editore s.r.l, 2022) Jafarova Demirkapu, Mahluga; Karabağ, Sevil; Akgül, Hacı Murat; Mordeniz, Cengiz; Yananli, H.R.OBJECTIVE: Testicular torsion is a condition that manifests with acute pain and can lead to infertility despite urgent surgical intervention. The aim of this study is to investigate the protective and preventive effects of etomidate, an imidazole derivative, a non-barbiturate general anesthetic agent, without analgesic effect, on testicular ischemia-reperfusion injury. MATERIALS AND METHODS: Twenty-four adult male Wistar rats weighing 200-250 g were used in the study. Torsion was created in all rats by rotating left testes 720° clockwise on the day of the experiment. 30 minutes before detorsion, 4 mg/kg etomidate and 10 mg/kg propofol were administered intraperitoneally to the etomidate and propofol groups, respectively. After an hour of ischemia, the left testis was reinstated, and the tissues were repaired according to their physiology. Following 24 hours of reperfusion, the animals were euthanized after ipsilateral and contralateral testes were removed. RESULTS: Etomidate applied before testicular detorsion significantly suppressed germ cell damage and Leydig cell loss in ipsilateral tissue. It did not cause any significant changes in the percentage of necrosis, histological score, and tubule rupture in ipsilateral tissue. Propofol administered before testicular detorsion significantly suppressed the percentage of necrosis only in the ipsilateral tissue. In addition, no signs of damage were observed in the contralateral testis. CONCLUSIONS: These findings show that etomidate administered before detortion creates a protective effect by preventing testicular ischemia- reperfusion injury. © 2022 Verduci Editore s.r.l. All rights reserved.Öğe The Effects of Fentanyl on Testicular Ischemia-Reperfusion Injury(2021) Mordeniz, Cengiz; Demirkapu, Mahluga Jafarova; Akgül, Murat; Karabağ, Sevil; Çelikkol, Aliye; Yananlı, Hasan RaciObjective: Testicular torsion is a condition that often occurs as a result of the rotation of the spermatic cord in childhood and adolescence in men, manifests with acute pain and causes infertility in the future even if emergency intervention is performed. The aim of this study is to investigate the protective and preventive effects of fentanyl, a potent analgesic agent frequently used in anaesthesia practice, on testicular ischemia–- reperfusion injury, which manifests through acute pain. Methods: A total of 16 adult male Wistar rats, weighing 200-250 g, were used in this study. They were divided into two groups, consisting of eight animals in each group. Torsion was created in all rats by rotating left testicles 720 clockwise on the day of the experiment. 3 mM of fentanyl was applied intraperitoneally 30 minutes before detorsion to the fentanyl group. Following an hour of ischemia, the left testicle was reinstated, and tissues were repaired according to their physiology. Following 24 hours of reperfusion, the animals were euthanised after taking left testes and blood samples. Results: Fentanyl, administered prior to testicular detorsion, significantly suppressed germ cell damage in torsioned tissue, catalase activity and malondialdehyde levels in blood samples taken from the heart. No significant differences were observed in plasma total thiol concentration, histological score, Leydig cell counts, percentage of necrosis and tubule rupture. Conclusion: These findings show that fentanyl administered before detortion creates a protective effect by preventing testicular ischemia–- reperfusion injury leading to infertility in the future.
