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Öğe Approach to cancer patients of a clinical oncology surgery in Turkey during COVID-19 Pandemic(Sivas Cumhuriyet University, 2021) Mollaoğlu, Murat Can; Bostancı, Meriç; Karadayı, KürşatObjective: Covid-19 disease has increased rapidly since the day it appeared (December 2019), and has turned into an unpreventable pandemic all over the world, especially in Europe. As it spreads rapidly and started to show its effects in a short time, there was not enough time to conduct and implement effective studies on the subject. After the first case coronavirus was detected at 10 March 2020 in Turkey, various guidelines were published. Surgeons, especially regarding the safe treatment of patients in cancer surgery, have tried to find the way in which they can be the most beneficial for the patients in their clinics. In this study, we aimed to share the approach and results of our own clinic to the cancer patients during Covid-19 pandemics.Method: Between March 10 - July 15 2020, 52 patients who were operated in Sivas Cumhuriyet University Faculty of Medicine Surgical Oncology Department for oncological reasons were analyzed retrospectively. The analyzed patient data included tumor location, patient age, gender, surgery technique, histopathological of specimen, stage and whether neoadjuvant therapy treatment was applied.Results: 52 patients were operated with a diagnosis of cancer in our clinic during the pandemic. 25 patients were female and 27 were male, and their mean age was 60.45 years. None of the patients showed signs and symptoms of Covid-19 infection before, during and after the operation.Conclusions: In hospitals not used as a pandemic hospital, Covid-19 negative oncological patients can be operated safely without affecting the pandemic by providing suitable conditions.Öğe Assesment of blood parameters relevant to aterosclerosis and coronary artery disease after paratiroidectomy(2018) Bostancı, Meriç Emre; Mollaoğlu, Murat Can; Karadayı, KürşatObjective: The preoperative and postoperative calcium, parathormone levels, platelet counts, mean platelet volumevalues of the patients were compared in order to investigate the changes in the risk of atherosclerosis and coronaryartery disease in parathyroidectomy.Method: Twelve male and 43 female patients who underwent parathyroidectomy between 01.01.2008 and 01.01.2018at the Cumhuriyet University Surgical Oncology Clinic were included in the study. On the tenth preoperative andpostoperative day, blood was drawn for the platelet, mean platelet volume, calcium and parathyroid hormone levelsafter a fasting period of twelve hours. The preoperative and postoperative calcium, parathormone levels, platelet counts,mean platelet volume values of the patients were compared in order to investigate the changes in the risk ofatherosclerosis and coronary artery disease in parathyroidectomy.Results: The mean pre-operative blood calcium levels of the patients included in the study were 10.75 ± 1.49 mg / dl, .Mean postoperative blood calcium level was 8.59 ± 1.14 mg / dl. The mean preoperative mean platelet volume of thepatients was 26.1 ± 121.55 fL, Postoperative mean platelet volume was 9.36 ± 1.26 fL. The mean preoperativeparathormone level was 535,08 ± 711,08, The mean postoperative parathyroid hormone level was 74.47 ± 128.02 pg /ml. The mean preoperative blood platelet count of the patients included in the study was 418000 ± 8000 / mm³, Themean postoperative blood platelet count was 252000 ± 7000 / mm³.Conclusions: In our study, we found that the decrease in serum parathormone level, serum platelet level, mean plateletvolume, after parathyroidectomy was statistically significant. Mean platelet volume and platelet count were decreasedafter parathyroidectomy, which are indicators of atherosclerosis and coronary artery disease; Parathyroidectomy reducesthe risk of atherosclerosis and coronary artery disease. Additional clinical and laboratory studies are needed to supportthe risk of atherosclerosis and coronary artery disease after parathyroidectomy.Öğe CERRAHİ TEDAVİ VE DESTEKLEYİCİ UYGULAMALAR(İksad Yayınevi, 2021) Mollaoğlu, Murat Can; Mollaoğlu, MukadderHastalıkların yönetimini geniş bir perspektif ve takım anlayışı ile el alan bu kitapta, kapsamlı teşhis çalışmaları, hastalık tedavisi, güncellenmiş bakım uygulamaları ve bitkilerin tedavideki yeri ile ilgili örnekler sunulmaktadır. Teorik bilgi ve uygulamaları bütünleştirerek sağlık çalışanları ve bu alanda uğraş veren diğer profesyoneller için güncellenmiş bir kaynak niteliğinde olan bu kitapta, yaygın olarak görülen bazı sağlık sorunlarının cerrahi tedavisi ve bakım yaklaşımlarının yanı sıra destekleyici tedavilerle ilgili bilgi ve uygulamalar yer almaktadır.Öğe Deneysel yanık modeli oluşturulan ratlarda yanık staz zonunun pentoksifilin ve milrinon kullanımıyla kurtarılması(Cumhuriyet Üniversitesi, 2016) Mollaoğlu, Murat Can; Karadayı, KürşatTermal yaralanma sonucu yanık yarası meydana gelir. Yanık yarası, hem yaralanma yeri ve çevresinde lokal etkilere hem de yanık şoku ve sistemik enflamatuar cevaptan oluşan ve tüm vücudu ilgilendiren jeneralize yanıta neden olur.Yanık yarasında gelişen lokal olaylar ve hastada gözlenen tüm sistemik etkiler belirgin bir ayrım noktası olmadan devamlılık gösterir. Yanık tedavisinin kompleks yapısı cerrahları zorlayan konulardan biridir. Patofizyolojik değişikliklerin daha iyi anlaşılması yanık tedavisinde daha başarılı olunmasına olanak sağlar. Jackson yanığı destrüksiyonun şiddeti ve kan akımı değişimlerini baz alarak üç farklı zona ayırmıştır. Santraldeki koagülaysyon zonu koagülasyon nekrozu ile karekterizedir.Santral zonu çevreleyen orta zon staz zonu olarak isimlendirilmiştir.En dış tabaka ise artmış kan akımını içeren hiperemi zonudur. Yanık sonrası doku hasarının bu paterni en azından 24-48 saat hatta daha uzun süre devam eder. Yanığın erken evresinde Staz zonundaki değişiklikler geri dönüşümlüdür. Staz zonundaki hücrelerin canlılığını yitirmemesi için hastanın destekleyici tedavisinde geç kalınmamalıdır.Uygun koşullar sağlandığı takdirde, Staz zonundaki hücreler bir hafta içerisinde yeniden canlılığını kazanır.Bu zondaki patolojik değişiklikler durdurulabilirse, tam hasara uğramamış yanıkların nekroze olması önlenebilir.Buzonu kurtarmak için birçok farmakolojik ajan araştırılmıştır ve bir çoğu da deneme aşamasındadır. Son dönem yanık araştırmaları bu zonun kurtarılmasına odaklanmıştır. Biz bu çalışmada deneysel yanık modeli oluşturulan ratlarda 5-fosfodiesteraz inhibitörlerinden pentoksifilin ve milrinonun staz zonuna etkisini araştırdık. Bu farmakolojik ajanları oral ve intraperitoneal olarak uygulayıp etkilerini ve bu etkilerin birbirleriyle karşılaştırılmasını amaçlayan bir çalışma hedefledik. Çalışmada 200 ± %10 gr ağırlığında Wistor Albino cinsi 4 aylık 56 adet dişi rat kullanıldı. Ratlar 7 gruba ayrıldı. 48 rata anestezi altında Regas ve Erlich iii tarafından tanımlanan yanık modeli uygulandı. Gup 1 sham grubu, grup 2 intraperitoneal kontrol grubu, grup 3 oral kontrol grubu olarak belirlendi. Grup 4'e pentoksifilin günlük olarak 50 mg/kg dozunda intraperitoneal olarak, grup 5'e pentoksifilin günlük olarak 50mg/kg dozunda oral olarak, Grup 6'ya milrinon günlük olarak 1mg/kg intraperitoneal olarak, Grup 7'ye milrinon günlük olarak 1mg/kg dozunda oral olarak, 10 gün süreyle uygulandı. Tüm ratlar deneyin 10. gününde sakrifiye edildi. Malondialdehit (MDA), glutatyonperoksidaz (GPx), süperoksitdismutaz (SOD) ve katalazın biyokimyasal düzeyleri için serum ve bunların histopatolojik çalışması için doku örnekleri alındı. Patolojik olarak ödem, hiperemi, epitelyum dejenerasyonu, nekroz, iltihabi infiltrasyon, fibrozis ölçümleri yapıldı. Kontrol grubu ile karşılaştırıldığında tedavi edilen tüm gruplarda doku hasar skoru düşük bulundu. . İntraperitoneal ve oral pentoksifilin uygulanan grupta MDA düzeyi kontrol grubuna göre düşük bulundu. İntraperitoneal ve oral pentoksifilin uygulanan grupta SOD, katalaz ve GPx düzeyleri, kontrol grubuna göre yüksek bulundu. İntraperitoneal ve oral milrinon uygulanan grupta MDA düzeyi kontrol grubuna göre düşük bulundu. İntraperitoneal ve oral milrinon uygulanan grupta SOD, katalaz ve GPxdüzeyleri, kontrol grubuna göre yüksek bulundu.İntraperitoneal pentoksifilin uygulanan grupta MDA düzeyleri intraperitoneal milrinon uygulanan gruba göre düşük bulundu. İntraperitoneal pentoksifilin uygulanan grupta SOD, katalaz, GPx düzeyleri intraperitoneal milrinon uygulanan gruba göre yüksek bulundu.Oral pentoksifilin uygulanan grupta MDA düzeyleri oral milrinon uygulanan gruba göre düşük bulundu. oral pentoksifilin uygulanan grupta SOD, katalaz, GPx düzeyleri oral milrinon uygulanan gruba göre yüksek bulundu. Çalışmamızın sonucu ratlarda oluşturulan deneysel yanık modelinde pentoksifilin ve milrinonun oksidatif stresi azalttığı ve yara iyileşmesini arttırıcı olumlu etkileri olduğu gösterilmiştir. Bu konu üzerinde ileri klinik ve deneysel çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Yanık, stazzonu, 5-fosfodiesteraz inhibitörü, pentoksifilin, milrinonÖğe Gastric Diverticulum On The Greater Curvature: a Case Report(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2016) Mollaoğlu, Murat Can; Bozkurt, Birkan; Soylu, Sinan; Bostancı, Meriç Emre; Karadayı, KürşatGastric diverticulum is a rare pathological condition of the gastrointestinal system. It is seen in approximately 0.01% of all endoscopic examinations. Gastric diverticulum is commonly asymptomatic and usually detected incidentally during upper endoscopic examination. Gastric diverticulum is often located on the posteromedial wall of the fundus. Rarely, upper abdominal discomfort and pain may be presented. In this case, we report a 57 years old female patient with a gastric diverticulum on the greater curvatureÖğe Mide Kanseri Ve Preoperatif Anemi Arasındaki İlişkinin Değerlendirilmesi(2021) Mollaoğlu, Murat Can; Bostancı, Meriç Emre; Karadayı, KürsatGiriş Amaç: Kanser hastalarının preoperatif en sık görülen klinik problemlerinden biri preoperatif anemidir. Preoperatif aneminin en sık görüldüğü kanser türlerinden biri mide kanseridir. Fakat, mide kanserinin anemi ile ilişkisi net değildir. Bu çalışmanın amacı mide kanserli hastaların bağımsız prognostik risk faktör olan patolojik evrelerinin ve tümör boyutlarının ameliyat öncesi hemoglobin değerleriyle karşılaştırarak preoperatif anemi ile tümör boyutu ve tümör evresi arasındaki ilişkiyi incelemek ve prognostik belirteçleri zayıf olan mide kanseri için preoperatif aneminin prognostik değerini araştırmaktır. Materyal ve Metod : XX üniversitesi XX bölümünde 1 ocak 2017 ile 1 aralık 2019 yılları arasında mide kanseri dolayısıyla küratif D2 gastrektomi ve Ro rezeksiyon uygulanmış hastaların klinikopatolojik ve demografik özellikleri retrospektif olarak incelendi.Bulgular : Toplam 85 hasta incelendi. Hastaların 66 (%77,6)’sı erkek 19 (%22,4)’u kadındı. Hastaların yaş ortalaması 68,1(41-87) idi. 55(%64,7) hastaya total gastrektomi 30 (%35,2) hastaya subtotal gastrektomi uygulandı. Hastaların tümü adenokarsinom tanılı idi. Hastaların 48(%56,5)’i evre 3, 29(%34,1)’u evre 2, 8(%9,4)’i evre 1 idi. 51(%60) hastanın tümör boyutu büyük 34(%40) hastanın küçüktü.51(%60) hastanın anemisi vardı. Sonuç : Preoperatif anemisi bulunan mide kanserli hastaların tümör boyutları daha büyük ve ileri evre tümörlerdir. Mide kanserli hastaların tedavisi planlanırken preoperatif anemisi bulunan hastaların tümör özelliklerinin daha agresif olabileceği gözardı edilmememidir.Öğe OPERE MEME KANSERLİ HASTALARDA SANAT TERAPİSİNİN AĞRI, EMEZİS, ANKSİYETE VE YAŞAM KALİTESİ ÜZERİNE ETKİSİ(2023) Mollaoğlu, Murat Can; Mollaoğlu, MukadderAmaç: Bu çalışma opere meme kanserli hastalarda sanat terapisinin ağrı, bulantı kusma, anksiyete ve yaşam kalitesi üzerindeki etkisini belirlemek amacıyla yapılmıştır. Gereç ve Yöntem: Deneysel nitelikteki araştırma Sivas Cumhuriyet Üniversitesi Uygulama ve Araştırma Hastanesi'nde Onkoloji Merkezi'nde tedavi alan 30 Girişim Grubu (GG), 30 Kontrol Grubu (KG) olmak üzere toplam 60 hasta ile yapılmıştır. Araştırma verileri Kişisel Bilgi Formu, Ağrı Şiddeti Ölçümü- Visuel Analog Skala, Rho des bulantı kusma ve öğürme indeksi, Beck Anksiyete Ölçeği, FACT-G Yaşam Kalitesi Ölçeği uygulanmıştır. Araştırma kapsamında GG’na ikişer hafta ara ile 10 hafta boyunca (5 seans) kemoterapi seansı ney dinletisi eşliğinde ebru sanatı sanat uzmanı tarafından yaptırılmıştır. Kontrol grubuna herhangi bir girişimde bulunulmamıştır. Çalışmadan elde edilen veriler SPSS (22.0) programına yüklenerek, istatistiksel değerlendirme yapılmıştır. Bulgular: Ney eşliğinde yapılan sanat terapisi sonrası GG’daki hastaların ağrı düzeylerinde, bulantı-kusma, anksiyete düzeylerinde azalmanın ve yaşam kalitesi düzeylerindeki artmanın ilk izleme göre istatistiksel olarak anlamlı düzeyde olduğu belirlenmiştir.Öğe Relationship Between Serum CA 19-9 Levels and Lymphovascular and Perineural Invasion of the Tumor and Lymph Node Metastasis in Patients Operated due to Pancreatic Carcinoma(2022) Bostancı, Meriç Emre; Mollaoğlu, Murat Can; Karadayı, KürsatObjectives: The aim of this study was to determine the relationship between serum CA 19-9 levels and lymphovascular and perineural invasion and lymph node metastasis in patients operated due to pancreatic cancer. Materials and Methods: A total of 32 patients underwent pancreaticoduodenectomy or distal pancreatectomy at Sivas Cumhuriyet University Department of Surgical Oncology. CA 19-9 values were evaluated by retrospectively examining the data of the patients. By examining the pathology reports, the presence of lymphovascular and perineural invasion and lymph node metastasis was evaluated. Results: The mean serum CA 19-9 level in patients with lymphovascular invasion was 242.38 U/mL, and the mean serum CA 19-9 level in patients without lymphovascular invasion was 31.73 U/mL. The mean serum CA 19-9 level was 220.93 U/mL in patients with perineural invasion and 15.23 U/mL in patients without perineural invasion. The mean serum CA 19-9 level was 238.52 U/mL in patients with lymph node metastasis and 35.16 U/ mL in patients without lymph node metastasis. A value of 16.25 U/mL of serum CA 19-9 gives a positive result of 84.7% for lymphovascular invasion and 91.8% for perineural invasion. A value of 27.06 U/mL of serum CA 19-9 gives a positive result of 85.9% for lymph node metastasis. Conclusion: Lymphovascular invasion was detected in 94.44% and perineural invasion was detected in 90.48% of our patients with serum CA19- 9 values above 16.25 U/mL. Lymph node metastasis was detected in 80.7% of our patients with serum CA19-9 values above 27.06 U/mL. Before surgery, it is important to predict the probability of lymphovascular and perineural invasion of the tumor and lymph node metastasis, and to make the decision to perform broader surgery and perform adjuvant, neoadjuvant therapy and serum CA19-9 levels are of great benefit in this regard.Öğe The Effect of Microsatellite Instability on Clinicopathological Data and Survival in Colorectal Cancer(2022) Bostancı, Meriç Emre; Mollaoğlu, Murat Can; Özer, Hatice; Karadayı, KürsatObjectives: Colorectal cancer is known as the third most common type of cancer worldwide. The microsatellite instability (MSI) pathway is effective in the development of 15-20% of colorectal cancers. MSI is mainly caused by mutational inactivation of one of the four main MMR genes (MSH2, MLH1, MSH6 or PMS2). This study was planned to investigate clinicopathological features of MSI in colorectal cancer and its effect on prognosis. For this purpose, demographic and clinicopathological data of patient groups with MSI and microsatellite stability (MSS) were compared. Materials and Methods: In this study, the pathology reports of 109 patients who were diagnosed with colorectal cancer and were operated on between 01.01.2015 and 01.01.2019 in the Surgery Oncology Clinic of Cumhuriyet University Medical Faculty Hospital were analyzed retrospectively. MLH-1, MSH-2, MSH-6, and PMS-2 antibodies were evaluated together with demographic and histopathological features and survival time of the patients. Results: The histological grade distribution difference between the MSS and MSI groups was not statistically significant (p=0.838). Mostly observed T-stage was T3 in both groups, and the differences between the groups were not statistically significant (p=0.405). Regarding the N stage, N0 was more common in MSS and N2 in MSI; however, no significant difference was observed between the two groups (p=0.844). Lymphovascular invasion (LVI) was not observed in most cases in both groups, and the differences between the groups were not statistically significant (p=0.493). Perineural invasion (PNI) was present in most cases in both groups, and the differences between the groups were not statistically significant (p=0.987). Survival rates according to the groups were evaluated using the Kaplan Meier test, and no statistically significant difference was found in the 2-year survival rates (p>0.05). Conclusion: In this study, the relationship of MLH1, MSH2, MSH6, and PMS2’s immunohistochemical expression with clinicopathological parameters and survival in patients with colorectal cancer was investigated. According to study results, the losses of expression in the cases were 13.7% for MLH1, 9.1% for MSH2, 12.8% for MSH6, and 14.6% for PMS2. Although it was not statistically significant in the study, we think that the survival rate is higher in cases with MSI. However, there was no statistical difference in MSI in terms of gender, age, grade, localization, LVI, and PNI. More parameters should be studied to detect MSI.Öğe The effect of parathyroidectomy on kidney functions in primary hyperparathyroidism(2020) Mollaoğlu, Murat Can; Bostancı, Meriç Emre; Karadayı, KürsatAim: The purpose of this study is to investigate the changes in renal function of the patients having primary hyperparathyroidismwith GFR <60 ml/min/1.73 m2 and GFR>60 ml/ min/1.73 m2 before and after PTX. A. Prolonged hypercalcemia leads to impaired renalfunction and the associated glomerular filtration rate (GFR) decrease. One of the indications of surgery in primary hyperparathyroidismis decreased renal function (GFR <60 ml/min). Discussions about the effect of parathyroidectomy (PTX) on renal function stillcontinue.Materials and Methods: The archive files of 59 patients diagnosed with primary hyperparathyroidism (PHPT), to whom PTX have beenperformed between January 2008 and October 2019 at Cumhuriyet University Surgical Oncology Clinic, were reviewed retrospectively.GFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients were divided intotwo groups according to their GFR values, as GFR<60 ml/min/1.73 m2 and GFR>60 ml/min/1.73 m2. Laboratory outcomes of thepatients one week before and after PTX were compared. The data of the study were analyzed in SPSS (ver. 23.0) program.Results: Regarding the patients to whom PTX have been performed, 12 patients (20.3%) were male and 47 (79.7%) were female. Themean age was 54.7 years. In patients with GFR<60 ml/min/1.73 m2, pre-op mean Parathormone (PTH) value was 1227.36 pg/ml,Calcium (Ca) 10.60 mg/dl, Creatine (Cr) 5.12 mg/dl: while mean PTH value in post-op period was found to be 131.69 (SS: 2.99), Ca:8.29, Cr: 3.57. In the patient group with GFR>60 ml/min/1.73 m2, pre-op mean PTH was 309.34, Ca: 11.05, Cr: 0.73 (SD: 0.15); whereaspost-op PTH was 48.51, Ca: 8.88, Cr: 0.68. In addition, GFR increased in patients in both groups and statistically significant resultswere obtained between pre and post PTX values.Conclusion: In this study, an improvement was observed after PTX in the renal function of the patients with impaired renal function,whereas GFR values of the patients with normal renal function were increased.Öğe The relationship between Ki-67 index and axillary lymph node metastasis in breast carcinoma(2020) Bostancı, Meriç Emre; Mollaoğlu, Murat Can; Karadayı, KürsatAim: Breast cancer is the most common type of cancer in women. The presence and number of metastatic lymph nodes in the axillaare the most signifiant prognostic factors in breast cancer. In addition, tumor size, lymphovascular invasion, perineural invasion,histopathological type and grade of the tumor are among the best-known prognostic factors. Ki-67 is expressed in G1, S, G2 andM phases of the cell cycle but not in the G0 phase, which allows it to be used as a marker for proliferating cells. The purpose ofthis study is to determine the relationship between Ki-67 Index and classical prognostic factors in breast cancer patients and toinvestigate its effect on axillary lymph node metastasis.Material and Methods: 46 patients, who were diagnosed as breast carcinoma in Sivas Cumhuriyet University Medical Faculty SurgicalOncology Department and who underwent a modifid radical mastectomy and axillary lymph node dissection between 2017 and2019 were included in this study. Histological tumor type, stage, status of axillary lymph nodes and Ki-67 Index were evaluatedretrospectively from the pathology reports of the patients. The patients were grouped under three categories according to Ki-67Index.Results: Regarding the grouping of the patients according to Ki-67 Index, the ones below 15% formed the fist group, between 15-29% the second group, and above 30% the third group. The distribution of the patients according to negativity-positivity of axillarylymph node metastasis in the groups was as fallow: First group, 7 (41.2%) negative - 10 (58.8%) positive; Second group 4 (33.3%)negative - 8 (66.7%) positive; Third Group 3 (17.6%) negative - 14 (82.4%) positive. Of the 46 patients included in the study, 14 (30.4%)were negative for axillary lymph node metastasis and 32 (69.9%) were positive. In our study, the relationship between the increaseof Ki-67 Index and axillary lymph node positivity was found to be statistically signifiant.Conclusion: In this study, we investigated the relationship between Ki-67 Index and classical prognostic markers, especially lymphnode metastasis. Proliferation is an important indicator used to predict prognosis and treatment response in breast cancer. In ourstudy, Ki-67 Index, one of the cell proliferation markers, was found to be positively correlated with axillary lymph node metastasisand other prognostic factors. Therefore, Ki-67 Index was shown to be a signifiant prognostic indicator in breast cancer.Öğe Yaşlıda Yara Bakımı(Nobel Yayınevi, 2021) Mollaoğlu, Mukadder; Mollaoğlu, Murat Can; Başer, EsraYaşlılarda yara gelişimini önlemek ve oluşan yaralara daha etkili bakım ve tedavi verebilmek için yara iyileşme sürecinde yaşa bağlı oluşan değişiklikler ve yara iyileşmesini etkileyen faktörlerin iyi bilinmesi yaranın etkili tedavisi için önemlidir.
