Browsing by Author "Vural, S"

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    Glomus Tumor of the Stomach: Case Report
    Nalbant, OAK; Temiz, P; Vural, S; Keles, MC
    Glomus tumors are benign, solitary neoplasms originating from modified smooth muscle cells of the glomus body. These tumors are rare in the gastrointestinal system. We present a glomus tumor that arose in the antrum of a 43-year-old female. During laparoscopic cholecystectomy for cholelithiasis, an antral submucosal tumor was found incidentally and total excision with wedge resection was performed. Histopathological and immunohistochemical features of this tumor were similar to those of a glomus tumor in any localization. In this report, we discuss the differential diagnosis of gastric glomus tumor.
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    METASTATIC MALIGNANT MELANOMA OF THE BREAST: A CASE REPORT
    Nalbant, OA; Vural, S; Keles, MC; Nalbant, E; Kandiloglu, AR
    Metastasis of a malignant melanoma or any other type of tumour to the breast is rarely seen. A 70-year-old female patient came to the breast clinic due to a mass in her right breast. The case did not have any known history of malignincy. After the initial incisional biopsy, a right modified radical mastectomy and axillary lymph node dissection were performed. On the cut surface, a yellow to pink, solid and well-circumscribed tumoural lesion with a maximum diameter of 8 cm was observed. Given its histopathological and immunohistochemical attributes, the case was diagnosed as metastatic malign melanoma involving breast and ipsilateral axillary lymph nodes. This case was determined to be worthy of presentation due to the fact that the histological diagnosis of metastatic tumours can be more difficult than of primary breast cancers and that metastasis of malignant melanoma to breast is rarely seen.
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    Secondary chondrosarcoma arising from a solitary enchondroma at the index finger of the right hand: A case report\
    Demireli, P; Çavdar, DK; Vural, S; Ovali, GY; Özalp, T
    Enchondromas are benign cartilaginous tumors and tend to present in small bones of hands and feet. Malignant transformation, though rare, is seen more often in multiple rather than solitary enchondromatous. A 70year-old woman presented with swelling and pain lasting for years at the index finger of the right hand. Excisional curettage material of the mass revealed to be entirely an enchondroma. Seven months later, the lesion recurred at the same localization and amputation of the finger was performed. This time the tumor was found to be transformed into an intermediate grade (grade II) which demonstrated chondrosarcoma intermingled with classical enchondromatous areas. Enchondromas arising at the hands and feet very rarely transform into chondrosarcomas. Since enchondromas at this site often show histological and clinical features suggestive of malignancy, it is often is difficult to make a histological distinction between benign cartilaginous tumors and chondrosarcomas. Detection of radiological as well as pathological findings are essential for differential diagnosis. This case is remarkable for she has a solitary enchondroma located at the index finger of the right hand that transformed into chondrosarcoma in seven months.
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    Clinical aspects and risk factors of nosocomial Stenotrophomonas maltophilia Bacteremia episodes in a Turkish intensive care unit
    Tunger, O; Vural, S; Cetin, CB; Keles, G; Borand, H; Gazi, H
    Stenotrophomonas maltophilia is an important nosocomial pathogen with increasing frequency in recent years, especially in immunocompromised and clinically debilitated patients. The aim of this study is to describe the characteristics of 35 episodes of S. maltophilia bacteremia at Celal Bayar University hospital in Turkey over a 3-year period from January 2003 to December 2005. Cases were identified with microbiology laboratory records and clinical data were collected from the medical record of each patient. The source of bacteremia was central venous catheter (CVC) in 65.7% (23) and respiratory tract infection in 2.9% (1) of episodes while the source of bacteremia was unknown in 11 (31.4%) episodes of bacteremia. Factors significantly associated with mortality were age of >= 65 years, APACHE score of >= 16, the presence of the total parenterall nutrition, anemia, low creatinine clearance level and shock. The most sensitive antibiotic was found as trimethoprim-sulfamethoxazole (91.4%) in antibiotic susceptibility testing of the isolates. Susceptibilities of piperacillin-tazobactam and netilmicin which frequently used antibiotics as an empirical therapy were 62.8% and 68.6%, respectively.
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    LIMPRINT Study: The Turkish Experience
    Borman, P; Moffatt, C; Murray, S; Yaman, A; Denizli, M; Dalyan, M; Unsal-Delialioglu, S; Eyigör, S; Ayhan, F; Çakit, BD; Vural, S; Özdemir, O; Kurt, E; Çelik, EC; Cerrahoglu, L; Kepekçi, M; Terzioglu, F; Donmez, AA
    Background: Lymphedema and chronic edema is a major health care problem in both developed and nondeveloped countries The Lymphoedema Impact and Prevelance - International (LIMPRINT) study is an international health service-based study to determine the prevalence and functional impact in adult populations of member countries of the International Lymphoedema Framework (ILF). Methods and Results: A total of 1051 patients from eight centers in Turkey were recruited using the LIMPRINT study protocol. Data were collected using the core and module tools that assess the demographic and clinical properties as well as disability and quality of life (QoL). Most of the Turkish patients were recruited from specialist lymphedema services and were found to be women, housewives, and having secondary lymphedema because of cancer treatment. The duration of lymphedema was commonly <5 years and most of them had International Society of Lymphology (ISL) grade 2 lymphedema. Cellulitis, infection, and wounds were uncommon. The majority of patients did not get any treatment or advice before. Most of the patients had impaired QoL and decreased functionality, but psychological support was neglected. Although most had social health security access to lymphedema centers, nevertheless access seemed difficult because of distance and cost. Conclusion: The study has shown the current status and characteristics of lymphedema patients, treatment conditions, the unmet need for the diagnosis and treatment, as well as burden of the disease in both patients and families in Turkey. National health policies are needed for the prevention, diagnosis, and treatment in Turkey that utilize this informative data.
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    The clinical and demographical characteristics of Turkish pediatric lymphedema patients: a multicenter study
    Borman, P; Balcan, A; Eyigör, S; Coskun, E; Ayhan, F; Çakit, BD; Vural, S; Vural, M; Çakir, EDP; Çagdas, D; Yaman, A; Cerrahoglu, L; Dogan, SC
    Background/aim: Reducing lymphedema-associated burden and disability in the pediatric setting requires improved awareness and understanding clinical properties of the lymphedema. The aim of this study was to evaluate the clinical and demographic characteristics of patients with pediatric lymphedema presented to different lymphedema centers in Turkey. Materials and methods: The socio-demographic and clinical characteristics of the children including age, gender, presence of genetic syndromes, duration of edema, site and stage of lymphedema and the received therapies were determined. Parental and children education on self-management techniques were recorded. Results: A total of 122 children (female: 66, male: 56) with a mean age of 120.7 +/- 71.2 months were included from 7 centers. Of them; 92% had primary, 8% had secondary lymphedema mostly due to infection and trauma. Lymphedema was part of a syndrome in 18% of the children. The most common site of involvement was the lower extremity, followed by upper extremity and genital involvement. Lymphedema was complicated in 17 % of children, mainly with a clinical picture of cellulitis, infection, and pain. The median duration of lymphedema was 41 (5-216) months. Although most of the children had stage 2 lymphedema, only 40% of them received treatment. The most commonly received treatment was compression therapy. No family or child was educated for self-care management before. Conclusion: In conclusion, pediatric lymphedema has a comparable gender distribution and usually involves the lower extremities. Although most of the children had advanced disease, more than half of the patients did not receive any treatment indicating the unmet need for management of lymphedema. The education of patients and/or children about self-management methods were lacking. We suggest educational activities for both families of children with lymphedema and health care providers, in order to facilitate early reference to lymphedema units and to receive prompt preventive and therapeutic approaches for this suffering condition.