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7. A single-center experience of transsphenoidal endoscopic surgery for acromegaly in 73 patients: results and predictive factors for remission.

Author

Unal, Tugrul Cem, Aydoseli, Aydin, Ozgen, Utku, Dolas, Ilyas, Sabanci, Pulat Akin, Aras, Yavuz, Ozturk, Metehan, Ozata, Musa Samet, Gul, Nurdan, Kubat Uzum, Ayse, Mutlu, Ummu, Bilgic, Bilge, Saka, Esra, Yarman, Sema, and Sencer, Altay

Subjects
ENDOSCOPIC surgery, ACROMEGALY, CAVERNOUS sinus, DIABETES insipidus, SYMPTOMS, CONSERVATIVE treatment
Abstract

Transsphenoidal endoscopic surgery is the first-line treatment for growth hormone-secreting adenomas. To analyse the results of the transsphenoidal endoscopic approach for acromegaly and to determine the predictive factors of remission. A single-centre retrospective review was performed in patients who underwent endoscopic transsphenoidal surgery for acromegaly between January 2009 and January 2019. Demographic features, clinical presentation, histopathology records, complications and pre- and postoperative radiologic and endocrinological assessments were evaluated. The factors that influenced the remission rates were investigated. A total of 73 patients underwent surgery via the transsphenoidal endoscopic approach. Cavernous sinus invasion was detected in 32 patients (43.8%); and macroadenoma, in 57 (78%). The pathology specimens of the 27 patients (36.9%) showed dual-staining adenomas with prolactin. A total of 51 patients (69.8%) attained biochemical remission 1 year after surgery. A second operation was performed in 10 patients (13.6%) with residual tumours without biochemical remission in the first year. Six (60%) of the patients attained remission at the last follow-up. Transient diabetes insipidus was observed in 18 patients (24.6%); and rhinorrhoea, which was resolved with conservative treatment, in 4 (5.4%). None of the patients developed panhypopituitarism. The presence of cavernous sinus invasion and preoperative IGF-1, immediate postoperative GH and third-month IGF-1 levels were predictive of remission. Transsphenoidal endoscopic surgery is a safe and effective treatment for acromegaly. Reoperation should be considered in patients with residual tumours without remission. [ABSTRACT FROM AUTHOR]

Published
2024
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11. SURGICAL OUTCOME OF FULL-ENDOSCOPIC INTERLAMINAR BILATERAL DECOMPRESSION WITH UNILATERAL APPROACH FOR LUMBAR SPINAL STENOSIS: A CLINICAL STUDY OF 24 PATIENTS

Author

Dolaş, İlyas, primary, Ünal, Tuğrul Cem, additional, Yörükoğlu, Ali Güven, additional, Dölen, Duygu, additional, Öztürk, Onur, additional, Gülsever, Cafer İkbal, additional, Şahin, Duran, additional, Sabancı, Pulat Akın, additional, Aydoseli, Aydın, additional, Aras, Yavuz, additional, and Sencer, Altay, additional

Published
2023
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15. RETROSPECTIVE ANALYSIS OF PEDIATRIC HYDROCEPHALUS PATIENTS TREATED WITH ENDOSCOPIC THIRD VENTRICULOSTOMY.

Author

ÜNAL, Tuğrul Cem, ŞAHİN, Duran, DOLAŞ, İlyas, DÖLEN, Duygu, ÖZTÜRK, Sefa, ARAS, Yavuz, AYDOSELİ, Aydın, SABANCI, Pulat Akın, and SENCER, Altay

Subjects
CEREBROSPINAL fluid shunts, CHILD patients, SURGICAL complications, INTRACRANIAL tumors, SURGICAL anastomosis, RETROSPECTIVE studies
Abstract

Copyright of Journal of Istanbul Faculty of Medicine / İstanbul Tıp Fakültesi Dergisi is the property of Istanbul Tip Fakultesi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2024
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22. Immunoreactivity against SLC3A2 in high grade gliomas displays positive correlation with glioblastoma patient survival: Potential target for glioma diagnosis and therapy

Author

Karakaş, Nihal, primary, Topcu, Ozan, additional, Tüzün, Erdem, additional, Kahraman, Özlem Timirci, additional, Sabancı, Pulat Akın, additional, Aras, Yavuz, additional, Yetimler, Berrak, additional, Ünverengil, Gökçen, additional, Bilgiç, Mebrure Bilge, additional, Shah, Khalid, additional, and Körkaya, Hasan, additional

Published
2023
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26. SURGICAL OUTCOME OF FULL-ENDOSCOPIC INTERLAMINAR BILATERAL DECOMPRESSION WITH UNILATERAL APPROACH I FOR LUMBAR SPINAL STENOSIS: A CLINICAL STUDY OF 24 PATIENTS.

Author

Dolaş, İlyas, Ünal, Tuğrul Cem, Yörükoğlu, Ali Güven, Dölen, Duygu, Öztürk, Onur, Gülsever, Cafer İkbal, Şahin, Duran, Sabancı, Pulat Akın, Aydoseli, Aydın, Aras, Yavuz, and Sencer, Altay

Subjects
ENDOSCOPY, POSTOPERATIVE care, MAGNETIC resonance imaging, COMPUTED tomography
Abstract

Objective: This study aimed to evaluate the surgical outcomes of 24 patients with lumbar spinal stenosis (LSS) treated by full-endoscopic interlaminar bilateral decompression using a unilateral approach. Materials and Methods: Twenty-four patients (seven males and 17 females) treated for LSS by the senior author and followed up for 18 months were included in the study. The pre-operative and postoperative clinical statuses were assessed using a neurological examination, a visual analog scale (VAS) score, and the Oswestry disability index (ODI). Preoperative lumbar magnetic resonance imaging, computed tomography (CT), and postoperative lumbar CT were performed. Results: Eight patients had isolated lateral recess stenosis, six had central lumbar stenosis, and 10 had both. A total of 31 spinal levels were treated using full endoscopic percutaneous interlaminar decompression. In patients undergoing a single-level procedure, the pre-operative mean VAS score was 9 and the postoperative mean VAS score was 2.5. The mean ODI was 43.5 before surgery and decreased to 11 after surgery. In patients with multi-level intervention, the mean VAS score was 8.5 and the mean ODI was 40 before surgery. Postoperatively, both decreased to 3.5 and 14.5, respectively. All pre- and postoperative values were significantly different. Conclusion: Full-endoscopic interlaminar bilateral decompression using a unilateral approach provided adequate decompression in selected patients. It also prevents unnecessary surgical trauma and tissue damage and enables better preservation of spine stability, even in patients operated on at multiple spinal levels. [ABSTRACT FROM AUTHOR]

Published
2023
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27. OUR EXPERIENCE OF ENDOSCOPIC TRANSSPHENOIDAL SURGERY FOR CUSHING’S DISEASE: OUTCOMES AND COMPLICATION RATES IN 48 PATIENTS

Author

Ünal, Tuğrul, primary, Öztürk, Metehan, additional, Dolaş, İlyas, additional, Özata, Musa, additional, Dölen, Duygu, additional, Mutlu, Ümmü, additional, Ok, Ayşe, additional, Gül, Nurdan, additional, Soyluk Selçukbiricik, Özlem, additional, Kubat Üzüm, Ayşe, additional, Yarman, Sema, additional, Sabancı, Pulat, additional, Aras, Yavuz, additional, Sencer, Altay, additional, and Aydoseli, Aydın, additional

Published
2022
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29. Endovascular treatment of posterior circulation aneurysms: Results from a single-team experience of 81 cases including 13 flow diversion treatment

Author

Dolas, Ilyas, primary, Unal, Tugrul Cem, additional, Gulsever, Cafer Ikbal, additional, Sahin, Duran, additional, Huseynov, Heydar, additional, Barburoglu, Mehmet, additional, Ozturk, Onur, additional, Can, Halil, additional, Adiyaman, Ali Ekrem, additional, Dagdeviren, Huseyin Emre, additional, Sabanci, Pulat Akin, additional, Aydoseli, Aydin, additional, Aras, Yavuz, additional, Sencer, Altay, additional, and Sencer, Serra, additional

Published
2022
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30. Surgical treatment in refractory epilepsy: seizure outcome results based on invasive EEG monitorization

Author

Gürses, Rabia Candan (ORCID 0000-0002-3752-1825 & YÖK ID 110149), Mail Gürkan, Zahide; Şirin, Nermin Görkem; Kara, Bülent; Gül, Günay; Şengül Eren, Fulya; Tekin Güveli, Betül; Velioğlu, Sibel; Sabancı, Akin; Aydoseli, Aydın; Aras, Yavuz; Bebek, Nerses; Baykan, Betül; Sencer, Altay; Canbolat, Ali Tuncay; Gökyigit, Ayşen; Aydoğan Culha, Ülger, School of Medicine, Gürses, Rabia Candan (ORCID 0000-0002-3752-1825 & YÖK ID 110149), Mail Gürkan, Zahide; Şirin, Nermin Görkem; Kara, Bülent; Gül, Günay; Şengül Eren, Fulya; Tekin Güveli, Betül; Velioğlu, Sibel; Sabancı, Akin; Aydoseli, Aydın; Aras, Yavuz; Bebek, Nerses; Baykan, Betül; Sencer, Altay; Canbolat, Ali Tuncay; Gökyigit, Ayşen; Aydoğan Culha, Ülger, and School of Medicine

Abstract

Aim: to discuss seizure outcomes of patients with invasive electroencephalography (EEG) monitorization (IEM) following their epilepsy surgery at our centre. Material and Methods: forty-seven patients suffering from refractory epilepsy and who were evaluated by invasive EEG were included in this retrospective study at Istanbul Faculty of Medicine from 2003 to 2017. We examined the Video EEG and invasive EEG monitorization, cranial MRI, SPECT, PET and neuropsychological tests of all patients. Postoperative seizure outcome results were evaluated according to Engel classification. The factors affecting seizure outcomes were discussed. Results: twenty-six of the patients were female (55.3%), 21 were male (44.7). The average age was 32.0 (+/- 12.4). Forty-three patients had surgery and the average age of these patients was 26,6 (+/- 11.15). 38.3% of the patients had hippocampal sclerosis (HS), 23.4% had focal cortical dysplasia (FCD), 8.5% had a tumor, 14.9% had sequela lesion and 14.9% had unknown etiology. Postoperative seizure status according to the Engel classification showed that 81.6% of the patients were class I, 10.5% were class II, 2.6% were class III and 5.3% were class IV. Conclusion: a significant relation was statistically determined between structural MRI lesion and favorable seizure outcome (p<0.05). The most frequent etiology was HS in our patients. Of the patients with Engel I, the averages of their ages, ages at onset of epilepsy and ages at surgery were lower than other groups, but the difference was not statistically significant (p>0.05). We argue that IEM is an essential examination for favorable outcomes for determining the epileptogenic zone and/or the proximity of the functional structures., NA

Published
2022

37. A single-center experience of transsphenoidal endoscopic surgery for acromegaly in 73 patients: results and predictive factors for remission

Author

Unal, Tugrul Cem, primary, Aydoseli, Aydin, additional, Ozgen, Utku, additional, Dolas, Ilyas, additional, Sabanci, Pulat Akin, additional, Aras, Yavuz, additional, Ozturk, Metehan, additional, Ozata, Musa Samet, additional, Gul, Nurdan, additional, Kubat Uzum, Ayse, additional, Mutlu, Ummu, additional, Bilgic, Bilge, additional, Saka, Esra, additional, Yarman, Sema, additional, and Sencer, Altay, additional

Published
2021
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38. An early warning system using machine learning for the detection of intracranial hematomas in the emergency trauma setting

Author

Aydoseli, Aydin, primary, Unal, Tugrul Cem, additional, Kardes, Onur, additional, Doguc, Ozge, additional, Dolas, Ilyas, additional, Adiyaman, Ali Ekrem, additional, Ortahisar, Emircan, additional, Silahtaroglu, Gokhan, additional, Aras, Yavuz, additional, Sabanci, Pulat Akin, additional, Sencer, Serra, additional, and Sencer, Altay, additional

Published
2021
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39. Surgical treatment in refractory epilepsy: seizure outcome results based on invasive eeg monitorization

Author

Mail Gurkan, Zahide, primary, Sirin, Nermin Gorkem, additional, Kara, Bulent, additional, Gul, Gunay, additional, Sengul Eren, Fulya, additional, Tekin Guveli, Betul, additional, Velioglu, Sibel, additional, Sabanci, Akin, additional, Aydoseli, Aydin, additional, Aras, Yavuz, additional, Bebek, Nerses, additional, Baykan, Betul, additional, Sencer, Altay, additional, Canbolat, Ali Tuncay, additional, Gokyigit, Aysen, additional, Aydogan Culha, Ulger, additional, and Gurses, Candan, additional

Published
2021
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40. Microsurgery results in vestibular schwannoma patients: retrospective clinical study

Author

Can, Halil, Dolgun, Müge, Özgen, Utku, Gömleksiz, Cengiz, Diren, Furkan, Aydoseli, Aydın, Aras, Yavuz, Sencer, Altay, and Biruni Üniversitesi

Subjects
Vestibular Schwannoma, Cerebellopontine Angle Tumor, Cranial Nerve Paresis, Serebellopontin Köşe Tümörü, Radyocerrahi, Vestibüler Svannom, Kranial Sinir Parezisi, Radiosurgery
Abstract

Amaç: Vestibüler şvannoma vakaları, gelişen görüntüleme teknikleri sebebiyle günümüzde daha sık izlenmektedir. Bu çalışmada, İstanbul Üniversitesi İstanbul Tıp Fakültesi Nöroşirurji Anabilim Dalı’nda retrosigmoid kranyektomi tekniğiyle ameliyat edilen hastaların sonuçları retrospektif olarak değerlendirildi. Yöntemler: Kliniğimizde 2012-2017 tarihleri arasında opere edilen vestibuler şvannoma tanılı 18 hastanın radyolojik ve klinik bulguları değerlendirildi. Hastalara olası tedavi yöntemleri detaylı olarak anlatıldıktan sonra hepsinden oral ve yazılı aydınlatılmış onam alındı. Bulgular: Çalışmamızda, 13 kadın ve 5 erkekten oluşan toplam 18 hasta incelendi. Kitle çapı 3cm’nin altında olan 11 hasta; 3cm’nin üstünde olan 7 hasta saptandı. Tüm hastalara retrosigmoid kranyektomi ile kitle rezeksiyonu yapıldı. Hastaların 11’inde total rezeksiyon, 7’sinde subtotal rezeksiyon yapıldı. Total rezeksiyon yapılan hastaların yedisinde (%63,6) yeni gelişen fasyal parezi izlendi. Üçer hastada (%27,2) yeni gelişen glossofarengeal ve abdusens sinir parezisi izlendi. 3cm’den büyük çaplı tümörlerde %42 oranında fasyal sinir korundu. Tüm hastaların içerisinde bir hastada (%5,5) BOS fistülü; bir hastada (%5,5) da hidrosefali gelişti. Sonuç: Vestibüler şvannom olgularında, mikrocerrahi, radyocerrahi ve ‘bekle/takip et’ olmak üzere üç yaklaşım izlenmektedir. Her ne kadar 3cm’nin üstündeki tümörlerde altın standart mikrocerrahi olsa da, 3cm’nin altındaki tümörlerde tedavi planı tartışmalıdır. Yaptığımız bu çalışmada, kitle boyutu 3cm’nin altında olan ve total rezeksiyon yapılan hastaların hepsinde postoperatif fasyal parezi gelişmiştir. Total rezeksiyon yapılan hastalarda gelişen 6. ve 9. kafa çifti parezilerinin, subtotal rezeksiyon yapılan hastalarda daha az sıklıkla görülmüş olması, total-subtotal rezeksiyon kararını etkileyebilecek bir faktördür. Bu nedenle 3cm’den büyük çaplı tümörlerde mevcut nöromonitörizasyon imkanları da göz önünde bulundurularak (total rezeksiyon/subtotal rezeksiyon + radyocerrahi) tedavi planı göz önünde bulundurulmalıdır. Anahtar kelimeler: Vestibüler şvannom, serebellopontin köşe tümörü, kranial sinir parezisi, radyocerrahi, Objective: Nowadays due to developing imaging techniques, vestibular schwannoma cases are monitored more frequently. In this study, the results of the patients who underwent surgery in the Department of Neurosurgery, Istanbul University Istanbul School of Medicine were retrospectively evaluated. Methods: Radiological and clinical findings of 18 patients with vestibular schwannoma diagnosed in our clinic from 2012 to 2017 were evaluated. After describing the possible treatment methods of the disease in detail, oral and written informed consent was obtained from all of them. Results: In our study, 18 patients, consisting of 13 women and 5 males, were examined. Eleven patients were found with a mass diameter below 3 cm, and seven patients were found with mass diameter above 3 cm. All patients underwent mass resection with retrosigmoid craniotomy. Total resection was performed in 11 patients, and subtotal resection was done in 7 patients. In seven patients with total resection (63.6%), a newly developed facial paresis was observed. The newly developed glossopharyngeal nerve paresis was observed in three patients (27.2%), and also abducens nerve paresis in three patients (27.2%). The facial nerve was preserved at a rate of 42% in tumors larger than 3 cm in size. The CSF fistula developed in one patient (5.5%); hydrocephalus developed in one patient (5.5%). Conclusion: In cases of vestibular schwannoma, microsurgery, radiosurgery, and "wait/follow" approaches are monitored. Although gold is standard microsurgery in tumors sized above 3 cm, the treatment plan for tumors under 3 cm in size is controversial. In this study, postoperative facial paresis was developed in all patients with total resection, which were below the mass size of 3 cm. The fact that the abducens and glossopharyngeal nerve paresis in patients with total resection have been seen less frequently in patients with subtotal resection is a factor that can affect the decision of total-subtotal resection. Therefore, the treatment plan should be taken into consideration (total resection/subtotal resection + radiosurgery) considering the existing neuromonitoring facilities in tumors larger than 3 cm in size.

Published
2019

41. Decreased therapeutic effects of noscapine combined with imatinib mesylate on human glioblastoma in vitro and the effect of midkine

Author

Aktas Esin, Sabanci Akin, Ermis Ezgi, Yazihan Nuray, Bilir Ayhan, Erguven Mine, Aras Yavuz, and Alpman Vehbi

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Cytology, QH573-671
Abstract

Abstract Background Glioblastoma (GBM) develops resistance to the advances in chemotherapy leading to poor prognosis and life quality. Consequently, new treatment modalities are needed. Our aims were to investigate the effects of combined noscapine (NOS) and imatinib mesylate (IM) on human GBM in vitro and the role of midkine (MK) in this new combination treatment. Methods Monolayer and spheroid cultures of T98G human GBM cell line were used to evaluate the effects of IM (10 μM), Nos (10 μM) and their combination on cell proliferation and apoptotic indexes, cell cycle, the levels of antiapoptotic MK, MRP-1, p170, PFGFR-α, EGFR, bcl-2 proteins, apoptotic caspase-3 levels, morphology (SEM) and ultrastructure (TEM) for 72 hrs. Results were statistically analyzed using the Student's t-test. Results The combination group induced highest decrease in cell proliferation and apoptotic indexes, caspase-3 levels, MRP-1 and PDGFR-α levels. The decrease in p170 levels were lower than IM but higher that NOS. The highest increases were in EGFR, MK, bcl-2 and cAMP levels in the combination group. The G0+G1 cell cycle arrest at the end of 72nd hr was the lowest in the combination group. Apoptotic appearence was observed rarely both in the morphologic and ultrastructural evaluation of the combination group. In addition, autophagic vacuoles which were frequently observed in the IM group were observed rarely. Conclusions The combination of Nos with IM showed antagonist effect in T98G human GBM cells in vitro. This antagonist effect was correlated highly with MK levels. The effects of NOS on MRP-1, MK and receptor tyrosine kinase levels were firstly demonstrated in our report. In addition, we proposed that MK is one of the modulator in the switch of autophagy to cell death or survival/resistance.

Published
2011
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47. Vestibüler Şvannom Hastalarında Mikrocerrahi Sonuçları: Retrospektif Klinik Çalışma.

Author

Can, Halil, Dolgun, Müge, Özgen, Utku, Gömleksiz, Cengiz, Diren, Furkan, Aydoseli, Aydın, Aras, Yavuz, and Sencer, Altay

Abstract

Copyright of Journal of Academic Research in Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019
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