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Öğe Comment on "effects of reduction mammaplasty operations on the spinal column: clinical and radiological response"(Springer, 2016) Sağlam, İbrahim; Karabekmez, Furkan Erol; Yavuz, ŞerifDear Editor, We read with interest the manuscript entitled ‘Effects of reduction mammaplasty operations on the spinal column: Clinical and radiological response’ by Berberoglu and colleagues [1]. The authors point out that due to the mass effect of breasts spinal incline increases, the center of gravity of the body changes, and permanent contraction of the posterior spinal muscles occurs. If the increase in cervical lordosis and thoracic kyphosis is sustained for long periods, osteophytes on the posterior surface of the vertebrae, pain, and spondylosis develop. We strongly agree with these statements and would like to point out that we too recently looked into the effects of reduction mammaplasty on skeletal disturbances in the vertebral column [2]. However, there are many factors effecting the altered pain and angles of the spinal column after breast reduction surgery. Our results were very similar to those presented in Berberog˘lu et al.’s paper. In addition to improved thoracic and cervical Cobb angles after reduction mammaplasty procedures, we also found statistically significant improvement in the sagittal balance, which, as analyzed and described in the recent literature, is closely related to lumbar degenerative pathologies.Öğe Detection and localization of a nonpalpable subdermal contraceptive implant using ultrasonography: a case report(Elsevier (Singapore) Pte Ltd, 2012) Gürel, Kamil; Gideroğlu, Kaan; Topçuoğlu, Ata; Gürel, Safiye; Sağlam, İbrahim; Yazar, ŞükrüSubdermal contraceptive implants should be removed after the maximum duration of action or whenever desired. In some circumstances, such as improper insertion, migration, or fibrosis of the implant, the implant might become nonpalpable and the use of imaging techniques are required to localize and remove it. Ultrasonography with high-frequency transducers is recommended as the first-line method for localization. In this report, the ultrasonographic findings of a nonpalpable implant and the results of ultrasonography-guided skin localization are described.Öğe Does reduction mammaplasty revert skeletal disturbances in the vertebral column of patients with macromastia? A preliminary study(Springer, 2014) Karabekmez, Furkan Erol; Gökkaya, Ali; Işık, Cengiz; Sağlam, İbrahim; Efeoğlu, Fatih Burak; Görgü, MetinEnlarged breasts are associated with many physical and psychological symptoms. It is important to use objective criteria in documenting physical changes of a patient's body due to enlarged breasts and the benefits of surgery. This preliminary study aimed to determine whether the reduction mammaplasty procedure changes the angles of cervical lordosis, thoracic kyphosis, and lumbar lordosis. The study population consisted of 22 patients who underwent breast reduction surgery. All the patients had lateral cervicothoracolumbar radiographs taken preoperatively and at least 2 months postoperatively. Cervical lordosis, thoracic kyphosis, and lumbar lordosis angles, as well as sagittal balance, were examined. The body mass index (BMI), breast tissue volume, and excised tissue amount of each patient were recorded. All the patients had increased cervical lordosis and thoracic kyphosis angles preoperatively, and the angles were significantly decreased postoperatively. Of the 22 patients, 7 had decreased and 8 had increased lumbar lordosis angles. All the lordosis angles showed significant improvement at the last examination. Seven patients had disturbed sagittal balance preoperatively, and all had normal sagittal balance postoperatively. Preoperative total breast tissue volume was positively correlated with the differences in cervical lordosis angles, BMI, preoperative cervical lordosis angles, and cervical lordosis angles. Hypertrophic breasts are not only a cosmetic but also a functional problem complicated by pathologic conditions in the vertebral column such as increased cervical lordosis, thoracic kyphosis, and increased or decreased lumbar lordosis. Breast reduction may improve these pathologic angles. Reducing the nonphysiologic weight of enlarged breasts located anterior to the main axis of the body may correct pathologic angulation and disturbed sagittal balance of the vertebral column. 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 The effect of desflurane on postoperative olfactory memory(Verduci Publisher, 2016) Yıldız, İsa; Bayır, Hakan; Sağlam, İbrahim; Şereflican, Murat; Bilgi, Murat; Yurttaş, Veysel; Demirhan, Abdullah; Koçoğlu, HasanOBJECTIVE: In this study, we investigated the effects of desflurane 6%, on olfactory memory. PATIENTS AND METHODS: This is a prospective clinical study performed with 40 patients aged 18-60 who had elective surgery and American Society of Anesthesiologists (ASA) physical status I-III. The Brief Smell Identification Test (BSIT) was used for evaluating patients' olfactory memories before and after the surgery. Patients received standard general anesthesia protocol and routine monitoring. For induction, 1.5 mg/kg of fentanyl, 2 mg/kg of propofol, and 0.5 mg/kg of rocuronium bromide were administered. Anesthesia was maintained with the inhalational of anesthetic desflurane (6%). The scores are recorded 30 minutes before the surgery and when the Aldrete Recovery Score reached 10 in the postoperative period. Preoperative and postoperative results were compared and p-values <0.05 were considered statistically significant. RESULTS: The patients' mean age was 41.1 +/- 12.0. Preoperative total correct answer rate to odorous substances was 92.7%, and postoperative rate was 92.1%. Percentage of the odor substance identification by the patients revealed no statistically significant difference when pre and post-operative rates have been compared (p-value > 0.05). CONCLUSIONS: We have observed for the first time in the literature that general anesthesia using desflurane (6%) did not affect short-term olfactory memory. Further studies will be necessary to confirm our findings with larger sample size.Öğe Montelukast protects axial pattern rat skin flaps against ischemia/reperfusion injury(Academic Press Inc Elsevier Science, 2009) Gideroğlu, Kaan; Yılmaz, Fahrettin; Aksoy, Fadullah; Buğdaycı, Güler; Sağlam, İbrahim; Yılmaz, FahriBackground. Recent studies have shown that neutrophils play an important role in the pathogenesis of reperfusion injury. Using an inferior epigastric artery skin flap as a flap ischemia/reperfusion (I/R) injury model, we investigated whether the administration of montelukast sodium, a selective reversible cysteinyl leukotriene 1 (Cy5LT1) receptor antagonist, decreases neutrophil infiltration and promotes flap survival. Methods. Eighteen rats were used and randomly divided into three groups (n = 6 for each group). Group I was the sham group and did not undergo ischemic insult; rather, normal saline (1mL) was administrated intraperitonealy (i.p.) 30 min before surgery and continued for 6 d. Group II (control) and Group III (montelukast) underwent 12 h of ischemic insult. For Group II, normal saline (1mL) was injected i.p. 30 min before the surgery and immediately before reperfusion, and this continued for 6 d. In Group III, 1mL of montelukast (10mg/kg) was injected i.p. and continued for 6 d. Malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) enzyme activities were investigated. Histological evaluation was made to investigate the tissue neutrophil count. Survival areas were assessed at 7 d postoperatively. Results. Group III (montelukast- treated) showed a significantly higher survival rate than Group II (control) (P = 0.029) but a lower survival rate than Group I (sham). Histological and biochemical assays corroborated this data. Conclusion. This study suggests that montelukast CysLT1 receptor antagonist montelukast reversed I/R-induced oxidant responses and improved flap survival by inhibiting neutrophil infiltration and balancing oxidant and antioxidant status. (C) 2009 Elsevier Inc. All rights reserved.Öğe Trombositten zengin plazma ve yağ dokusu kaynaklı stromal vasküler fraksiyonun flep yaşayabilirliği üzerine etkilerinin incelenmesi(Bolu Abant İzzet Baysal Üniversitesi, 2012) Sağlam, İbrahim; Karabekmez, Furkan ErolFlep cerrahisi plastik cerrahide defekt kapamada en sık kullanılan doku onarım tekniklerindendir. Flep cerrahisinin başarısı flep yaşayabilirliği ile paralel seyretmektedir. Bu nedenle birçok çalışmada flep yaşayabilirliğini arttıran ajanlar ve yöntemler denenmiştir. Plateletten zengin plazma ve adipoz doku kaynaklı stromal vasküler fraksiyon da içeriklerindeki çok sayıda büyüme faktörü ve pluripotent hücreler nedeni ile tıbbın her alanında olduğu gibi plastik cerrahide de giderek artan sıklıkta kullanılmaktadır. Bu çalışmada amacımız flep yaşayabilirliğini arttırmada, ayrı ayrı ve birlikte kullanıldıklarında, PRP ve SVF'nin random paternli deri flepleri üzerindeki etkilerini değerlendirmek ve karşılaştırmaktı.Bu amaçla 24 adet 250-350 gr. dişi sıçan rastgele 4 guruba ayrıldı. Donör olarak seçilen 10 adet başka sıçandan PRP ve SVF hazırlanması amacı ile tüm vücut kanları ve bilateral inguinal yağ yastıkları toplandı. Alınan dokulardan hazırlanan ürünler flep yapılması planlanan alanlara deri altına enjekte edildi (Gurup I:Kontrol, GurupII:PRP, GurupIII:SVF, GurupIV:PRP+SVF). Değerlendirme amacı ile postoperatif 3. günde ve 7. günde doku örnekleri toplandı. Ayrıca flep alanları fotoğraflanarak nekroza giden alanlar hesaplandı.Tüm denekler prosedürleri iyi tolere etti. Tüm tedavi guruplarında flep yaşayan oranları, nötrofil invazyonu, yeni oluşan damar sayısı, VEGF ve bFGF ekspresyonu düzeyleri bakımından kontrol gurubuna göre istatistiksel olarak anlamlı farklılık gözlendi. Tedavi guruplarının arasında ise anlamlı fark bulunamadı.PRP ve SVF kolay elde edilen, yan etki profilleri düşük otolog ürünlerdir. Etkilerini içerdikleri büyüme faktörleri ve proaktif hücreler yolu ile gösterirler. Çalışmamızda, bu iki ürünün flep yaşayabilirliğini anlamlı derecede arttırdığını gösterdik. İki ürünün flep yaşamını arttırmada birbirlerine üstünlüğünü saptayamadık. İki ürün birlikte kullanıldığında ise yaşayabilen flep oranında artış olsa da bu artış istatistiki olarak anlamlı bulunamadı. Yapılacak daha ileri araştırmalar ile kolay elde edilebilen bu iki otolog ürünün flep yaşayabilirliğini arttırmada daha güvenle kullanılabileceğini düşünüyoruz.
