Can Çelik - Academia.edu (original) (raw)

Papers by Can Çelik

This study aims to investigate whether the addition of the antioxidant complex including taurine,... more This study aims to investigate whether the addition of the antioxidant complex including taurine, ascorbic acid, and glutathione into the cryopreservation medium affects the damage to sperm during the freezing process. Material and Methods: Ejaculate samples of patients who applied for semen analysis to the Assisted Reproduction Unit of Private Adatip Hospital were used. Fresh samples were analyzed for standard semen quality parameters according to the World Health Organization guidelines. Samples within the normal range were evaluated for sperm DNA fragmentation using the Halosperm technique. Remaining ejaculates were washed with the gradient method before cryopreservation. Sperm samples of each patient were divided equally for freezing in a cryopreservation medium with or without the antioxidant supplementation. One month later, the samples were thawed. Post-thaw total motility and DNA fragmentation were determined for each sample. Results: Semen samples of 40 patients were analyzed. We observed decreased total motility (34.8 ±5.32 % vs. 65.5 ±6.42 %, P= 0.002) and increased sperm DNA fragmentation (52.3±5.42 % vs. 26.4±3.12 %, P= 0.002) in post-thaw semen samples following cryopreservation in comparison to fresh samples. The addition of antioxidants to the freezing medium did not have a statistically significant effect on sperm motility (38.3± 6.22 % vs. 34.8 ±5.32 %, P =0.07) and DNA damage (47.5±4.7 % vs. 52.3±5.42, P =0.08) when compared to control samples following the freezing process. Conclusions: We observed increased sperm DNA fragmentation and decreased total motility following cryopreservation. No significant improvement in sperm motility or DNA integrity was obtained after the addition of 5 µM of the antioxidants taurine, ascorbic acid, and glutathione to the freezing media.

Kosuyolu Heart Journal, 2019

Pediatrik kalp cerrahisi uygulanan hastalarda, postoperatif akut böbrek hasarının belirlenmesi ve... more Pediatrik kalp cerrahisi uygulanan hastalarda, postoperatif akut böbrek hasarının belirlenmesi ve mevcut hasarın derecesinin evrelenmesi için pRIFLE sınıflaması kullanılması ile bu hasta grubu ve böbrek hasarı olmayan hasta grupları arasında postoperatif sonuçların karşılaştırılması amaçlanmıştır. Hastalar ve Yöntem: Nisan 2012 ile Nisan 2013 tarihleri arasında kliniğimizde konjenital kalp hastalığı nedeniyle ameliyat edilen tüm hastalar geriye dönük olarak incelendi. Akut böbrek hasarının belirlenmesi ve evrelenmesi için pRIFLE kriterleri kullanıldı. Primer olarak önem verilen sonuçlar, postoperatif dönemde akut böbrek hasarı gelişen olguların pRIFLE kriterleri ile belirlenmesi, hasar derecesinin pRIFLE evreleri ile gösterilmesi, böbrek hasarı olguları ile böbrek hasarı olmayan olgular arasında operatif verilerin ve postoperatif sonuçların karşılaştırılması idi. Bulgular: Çalışmaya ardışık 105 hasta dahil edildi. Akut böbrek hasarı tespit edilen 45 (%42.9) hasta grup 1 olarak, diğerleri grup 2 olarak tanımlandı. Preoperatif verilerden ortalama yaş grup 1'de anlamlı olarak düşüktü (p= 0.001). Operatif verilerden kardiyopulmoner baypas süresi grup 1'de anlamlı olarak yüksekti (p= 0.04) ve hipotermi anlamlı olarak düşüktü (p= 0.001). Postoperatif dönemde, mortalite açısından gruplar arasında istatistiksel anlamlı fark gözlenmedi (p= 0.65). Hastaların mekanik ventilasyon ve yoğun bakım kalış süreleri, grup 1'de anlamlı olarak yüksek (sırasıyla p= 0.004 ve 0.04) iken, hastane kalış süreleri açısından gruplar arasında fark yoktu (p= 0.53). Sonuç: Pediatrik kalp cerrahisi uygulanan hastalarda postoperatif dönemde akut böbrek hasarı gelişme riski yüksektir ve bu durum postoperatif sonuçları etkilemektedir. Bu nedenle perioperatif dönemde bu hasardan korunma ve erken dönemde müdahale yönetiminin gerçekleştirilmesi için hasarın öngörüsünün yapılması amacıyla neredeyse maliyetsiz, kolay ve hızlı sonuç alınan pRIFLE kriterlerinin kullanılmasını önermekteyiz Anahtar Kelimeler: Akut böbrek hasarı; konjenital kalp hastalıkları; pRIFLE kriterleri

The Annals of The Royal College of Surgeons of England, 2020

Introduction Hypercalcaemic crisis is a rare manifestation of hyperparathyroidism and occurs in 1... more Introduction Hypercalcaemic crisis is a rare manifestation of hyperparathyroidism and occurs in 1.6–6% of patients with primary hyperparathyroidism (pHPT). Although such high serum calcium levels (>14mg/dl) are attributed to malignancy, it is also associated with benign disease of the parathyroid glands. The aim of this study was to evaluate the clinical features and treatment modalities of patients with severe hypercalcaemia who underwent surgery for pHPT. Methods The medical records of 537 patients who underwent parathyroidectomy in our department for pHPT between 2005 and 2019 were reviewed retrospectively. Twenty-four (4.4%) of the patients were described as having severe hypercalcaemia. Results Among 24 patients, 71% were female and the mean age was 55.7 years (range: 40–71 years). The mean serum calcium level at time of diagnosis was 15.9mg/dl (range: 14–22.7mg/dl). According to postoperative pathology reports, solitary adenoma, parathyroid cancer and parathyromatosis were ...

The Annals of The Royal College of Surgeons of England, 2020

Introduction Accurate localisation of the abnormal hyperfunctioning gland with preoperative imagi... more Introduction Accurate localisation of the abnormal hyperfunctioning gland with preoperative imaging has a critical role in parathyroid surgery to obtain a successful outcome. This study aimed to evaluate the diagnostic performance of second-line imaging and their contribution to the treatment success in primary hyperparathyroidism when the first-line methods were negative or discordant. Methods Among the patients who underwent parathyroidectomy due to primary hyperparathyroidism, 33 who underwent four-dimensional computed tomography and/or four-dimensional magnetic resonance imaging because of negative or discordant first-line imaging results were included. Persistent and recurrent cases were excluded. Results The majority of the patients were female (84.8%) and the mean age was 59.2 years. Seventeen patients had four-dimensional computed tomography and 25 had four-dimensional magnetic resonance imaging, respectively. Four-dimensional computed tomography and four-dimensional magneti...

Turkish Journal of Surgery, 2019

Objective: Although the Whipple operation is an essential surgical technique, its high morbidity ... more Objective: Although the Whipple operation is an essential surgical technique, its high morbidity (30% to 60%) and mortality (5%) are problems to be addressed. The incidence of postoperative hemorrhage has been reported between 5% and 16% in the literature. In this study, the data and results regarding postoperative hemorrhage complications from our clinic were evaluated. Material and Methods: The files of 185 patients who had undergone Whipple operation in our hospital in the last five years were evaluated retrospectively, and the causes of hemorrhage were attempted to be determined. Results: It was found that 6 out of the 13 (7%) patients who had hemorrhage died. In six of there 13 cases, hemorrhage occurred due to fistulas from the portal vein, gastroduodenal artery, and pancreatic arteries at variable periods. Two cases were found to have developed disseminated intravascular coagulation as a result of sepsis. Early intervention was performed in two cases who bled from the meso veins and in one case who bled from the portal vein. Laparotomy and hemostasis were performed in a patient who bled from the gastric anastomosis line. In a patient who had been taking low molecular weight heparin, bleeding from the drains and nasogastric tube stopped following the cessation of the drug. Conclusion: Preventive procedures such as connection of the vascular structures, use of vascular sealants, omental patching during surgery, and reducing the risk of complications by using somatostatin analogs were performed to prevent hemorrhages after Whipple operations. In addition to standard methods, angiography and embolization have emerged as effective methods in the diagnosis and treatment of hemorrhages. Furthermore, determination and elimination of independent risk factors, such as jaundice, affecting fistula formation and bleeding in the perioperative period, is important for prevention.

Istanbul Medical Journal, 2019

Lenfatik yaralanma cerrahi girişimler sırasında sıklıkla olmakla birlikte, olguların %1-11'inde ş... more Lenfatik yaralanma cerrahi girişimler sırasında sıklıkla olmakla birlikte, olguların %1-11'inde şilöz fistül olarak karşımıza çıkmaktadır. Karaciğer rezeksiyonları sonrasında yüksek debili şilöz fistül nadiren görülen bir durum olmakla beraber, protein kaybına bağlı olarak ortaya çıkan ciddi mekanik, nütrisyonel ve immünolojik bozukluklar sonucunda ampiyem ve peritonit gibi yaşamı tehdit eden ciddi komplikasyonlar tabloya eşlik edebilir.

Turkish Journal of Surgery, 2015

Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Althou... more Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3-4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient's symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment.

The Journal of Breast Health, 2014

Adenoid cystic carcinoma of the breast constitutes approximately 0.1% of all breast tumors. They ... more Adenoid cystic carcinoma of the breast constitutes approximately 0.1% of all breast tumors. They can be located in the trachea, bronchus, cervix, lacrimal gland, and skin as well as the breast. Tumors in the breast have better prognoses compared to those in other locations. The diagnosis and treatment planning of this tumor is challenging due to its rare incidence. In this article, we presented a case that was diagnosed with adenoid cystic carcinoma of the breast upon pathology evaluation. A 59-year-old female patient was admitted to our clinic due to a mass in her right breast. Her mammography revealed a 1 cm in diameter mass in the upper outer quadrant of the right breast, which was classified as BIRADS 4C (Breast Imaging Reporting and Data System). On magnetic resonance imaging (MRI) the lesion was also reported as BIRADS 4C. The patient underwent breast conserving surgery (BCS), and the pathology result was reported as adenoid cystic carcinoma of the breast. The patient received chemo-radiotherapy in the postoperative period. Adenoid cystic carcinoma of the breast has been first described in the salivary glands. They can be confused with benign lesions both on physical and radiological examinations. Sentinel lymph node biopsy (SLNB) can be used since axillary metastases are rare. Local recurrence and distant metastases are also very rare. Usually, BCS followed by radiotherapy is adequate to obtain local control. In selected patients with a poor prognosis, chemotherapy and hormonal therapy should be added to the treatment.

Journal of the American College of Cardiology, 2013

Purpose: Valvular heart diseases, particularly mitral stenosis, can potentially disturb quality o... more Purpose: Valvular heart diseases, particularly mitral stenosis, can potentially disturb quality of life. In this study, we aimed to search whether presence of atrial fibrillation (AF) influence the quality of life in patients with mitral stenosis. Methods: Eighty seven consecutive patients with mild to moderate rheumatic MS, who were admitted to outpatient department, were enrolled into the study. All patients underwent quality of life scoring via SF-36 after complete transthoracic echocardiographic evaluation. Patients were classified into two as those with mitral valve area (MVA) 1.5 cm2 (hemodynamically significant) and those with valve area >1.5 cm2. Results: Mean age was 49.3AE14.6 years (72 females, 15 males). Mean planimetric valve are was 1.55AE0.27 cm2, mean peak transmitral gradient was 14AE5.5 mmHg with a mean EF of 56AE8%. 51 patients were in sinus rhythm whereas 36 patients had atrial fibrillation during evaluation (persistent or permanent). Of note, as per protocol, all patients were well treated in terms of rate control before echocardiographic evaluation, and no patient was exceeding 100 beats/min. MVA was not related with AF such that 60.5% (26/43) of those with MVA 1.5 cm2 had AF versus 56.8% (25/44) of those with MVA >1.5 cm2 had AF (p¼0.898). In the group with MVA 1.5 cm2, presence or absence of AF did not influence total score of SF-36 (92AE18 vs. 90AE19, p¼0.437) including all subscales of SF-36. Those with AF were older than those without AF (58.5AE12.4 vs. 44.9AE12.4, p¼0.002). Those with and without AF were similar with regard to transmitral gradients, mitral valve area, EF. In the group with MVA>1.5 cm2, presence of AF influenced physical functioning subscale of SF-36 such that physical functioning score of those with AF was 19AE5, whereas, physical functioning score of those without AF was 24AE4 (p¼0.004). This also resulted in nonsignificant difference in total SF-36 score as well (90AE14 vs. 98AE16 respectively, p¼0.078). Also in this subgroup, those with AF were older compared to those without AF (55.8AE9.1 vs. 43.9AE16.4 years, p¼0.003). Of note, transmitral gradients, MVA, EF were similar again in those with and without AF. Conclusıon: It seems presence of AF influences quality of life with regard to severity of MVA. In those with significant mitral stenosis (MVA 1.5 cm2), presence or absence of AF seems not to influence quality of life, whereas, in those with milder forms of mitral stenosis presence of AF seems to worsen physical functioning.

This study aims to investigate whether the addition of the antioxidant complex including taurine,... more This study aims to investigate whether the addition of the antioxidant complex including taurine, ascorbic acid, and glutathione into the cryopreservation medium affects the damage to sperm during the freezing process. Material and Methods: Ejaculate samples of patients who applied for semen analysis to the Assisted Reproduction Unit of Private Adatip Hospital were used. Fresh samples were analyzed for standard semen quality parameters according to the World Health Organization guidelines. Samples within the normal range were evaluated for sperm DNA fragmentation using the Halosperm technique. Remaining ejaculates were washed with the gradient method before cryopreservation. Sperm samples of each patient were divided equally for freezing in a cryopreservation medium with or without the antioxidant supplementation. One month later, the samples were thawed. Post-thaw total motility and DNA fragmentation were determined for each sample. Results: Semen samples of 40 patients were analyzed. We observed decreased total motility (34.8 ±5.32 % vs. 65.5 ±6.42 %, P= 0.002) and increased sperm DNA fragmentation (52.3±5.42 % vs. 26.4±3.12 %, P= 0.002) in post-thaw semen samples following cryopreservation in comparison to fresh samples. The addition of antioxidants to the freezing medium did not have a statistically significant effect on sperm motility (38.3± 6.22 % vs. 34.8 ±5.32 %, P =0.07) and DNA damage (47.5±4.7 % vs. 52.3±5.42, P =0.08) when compared to control samples following the freezing process. Conclusions: We observed increased sperm DNA fragmentation and decreased total motility following cryopreservation. No significant improvement in sperm motility or DNA integrity was obtained after the addition of 5 µM of the antioxidants taurine, ascorbic acid, and glutathione to the freezing media.

Kosuyolu Heart Journal, 2019

Pediatrik kalp cerrahisi uygulanan hastalarda, postoperatif akut böbrek hasarının belirlenmesi ve... more Pediatrik kalp cerrahisi uygulanan hastalarda, postoperatif akut böbrek hasarının belirlenmesi ve mevcut hasarın derecesinin evrelenmesi için pRIFLE sınıflaması kullanılması ile bu hasta grubu ve böbrek hasarı olmayan hasta grupları arasında postoperatif sonuçların karşılaştırılması amaçlanmıştır. Hastalar ve Yöntem: Nisan 2012 ile Nisan 2013 tarihleri arasında kliniğimizde konjenital kalp hastalığı nedeniyle ameliyat edilen tüm hastalar geriye dönük olarak incelendi. Akut böbrek hasarının belirlenmesi ve evrelenmesi için pRIFLE kriterleri kullanıldı. Primer olarak önem verilen sonuçlar, postoperatif dönemde akut böbrek hasarı gelişen olguların pRIFLE kriterleri ile belirlenmesi, hasar derecesinin pRIFLE evreleri ile gösterilmesi, böbrek hasarı olguları ile böbrek hasarı olmayan olgular arasında operatif verilerin ve postoperatif sonuçların karşılaştırılması idi. Bulgular: Çalışmaya ardışık 105 hasta dahil edildi. Akut böbrek hasarı tespit edilen 45 (%42.9) hasta grup 1 olarak, diğerleri grup 2 olarak tanımlandı. Preoperatif verilerden ortalama yaş grup 1'de anlamlı olarak düşüktü (p= 0.001). Operatif verilerden kardiyopulmoner baypas süresi grup 1'de anlamlı olarak yüksekti (p= 0.04) ve hipotermi anlamlı olarak düşüktü (p= 0.001). Postoperatif dönemde, mortalite açısından gruplar arasında istatistiksel anlamlı fark gözlenmedi (p= 0.65). Hastaların mekanik ventilasyon ve yoğun bakım kalış süreleri, grup 1'de anlamlı olarak yüksek (sırasıyla p= 0.004 ve 0.04) iken, hastane kalış süreleri açısından gruplar arasında fark yoktu (p= 0.53). Sonuç: Pediatrik kalp cerrahisi uygulanan hastalarda postoperatif dönemde akut böbrek hasarı gelişme riski yüksektir ve bu durum postoperatif sonuçları etkilemektedir. Bu nedenle perioperatif dönemde bu hasardan korunma ve erken dönemde müdahale yönetiminin gerçekleştirilmesi için hasarın öngörüsünün yapılması amacıyla neredeyse maliyetsiz, kolay ve hızlı sonuç alınan pRIFLE kriterlerinin kullanılmasını önermekteyiz Anahtar Kelimeler: Akut böbrek hasarı; konjenital kalp hastalıkları; pRIFLE kriterleri

The Annals of The Royal College of Surgeons of England, 2020

Introduction Hypercalcaemic crisis is a rare manifestation of hyperparathyroidism and occurs in 1... more Introduction Hypercalcaemic crisis is a rare manifestation of hyperparathyroidism and occurs in 1.6–6% of patients with primary hyperparathyroidism (pHPT). Although such high serum calcium levels (>14mg/dl) are attributed to malignancy, it is also associated with benign disease of the parathyroid glands. The aim of this study was to evaluate the clinical features and treatment modalities of patients with severe hypercalcaemia who underwent surgery for pHPT. Methods The medical records of 537 patients who underwent parathyroidectomy in our department for pHPT between 2005 and 2019 were reviewed retrospectively. Twenty-four (4.4%) of the patients were described as having severe hypercalcaemia. Results Among 24 patients, 71% were female and the mean age was 55.7 years (range: 40–71 years). The mean serum calcium level at time of diagnosis was 15.9mg/dl (range: 14–22.7mg/dl). According to postoperative pathology reports, solitary adenoma, parathyroid cancer and parathyromatosis were ...

The Annals of The Royal College of Surgeons of England, 2020

Introduction Accurate localisation of the abnormal hyperfunctioning gland with preoperative imagi... more Introduction Accurate localisation of the abnormal hyperfunctioning gland with preoperative imaging has a critical role in parathyroid surgery to obtain a successful outcome. This study aimed to evaluate the diagnostic performance of second-line imaging and their contribution to the treatment success in primary hyperparathyroidism when the first-line methods were negative or discordant. Methods Among the patients who underwent parathyroidectomy due to primary hyperparathyroidism, 33 who underwent four-dimensional computed tomography and/or four-dimensional magnetic resonance imaging because of negative or discordant first-line imaging results were included. Persistent and recurrent cases were excluded. Results The majority of the patients were female (84.8%) and the mean age was 59.2 years. Seventeen patients had four-dimensional computed tomography and 25 had four-dimensional magnetic resonance imaging, respectively. Four-dimensional computed tomography and four-dimensional magneti...

Turkish Journal of Surgery, 2019

Objective: Although the Whipple operation is an essential surgical technique, its high morbidity ... more Objective: Although the Whipple operation is an essential surgical technique, its high morbidity (30% to 60%) and mortality (5%) are problems to be addressed. The incidence of postoperative hemorrhage has been reported between 5% and 16% in the literature. In this study, the data and results regarding postoperative hemorrhage complications from our clinic were evaluated. Material and Methods: The files of 185 patients who had undergone Whipple operation in our hospital in the last five years were evaluated retrospectively, and the causes of hemorrhage were attempted to be determined. Results: It was found that 6 out of the 13 (7%) patients who had hemorrhage died. In six of there 13 cases, hemorrhage occurred due to fistulas from the portal vein, gastroduodenal artery, and pancreatic arteries at variable periods. Two cases were found to have developed disseminated intravascular coagulation as a result of sepsis. Early intervention was performed in two cases who bled from the meso veins and in one case who bled from the portal vein. Laparotomy and hemostasis were performed in a patient who bled from the gastric anastomosis line. In a patient who had been taking low molecular weight heparin, bleeding from the drains and nasogastric tube stopped following the cessation of the drug. Conclusion: Preventive procedures such as connection of the vascular structures, use of vascular sealants, omental patching during surgery, and reducing the risk of complications by using somatostatin analogs were performed to prevent hemorrhages after Whipple operations. In addition to standard methods, angiography and embolization have emerged as effective methods in the diagnosis and treatment of hemorrhages. Furthermore, determination and elimination of independent risk factors, such as jaundice, affecting fistula formation and bleeding in the perioperative period, is important for prevention.

Istanbul Medical Journal, 2019

Lenfatik yaralanma cerrahi girişimler sırasında sıklıkla olmakla birlikte, olguların %1-11'inde ş... more Lenfatik yaralanma cerrahi girişimler sırasında sıklıkla olmakla birlikte, olguların %1-11'inde şilöz fistül olarak karşımıza çıkmaktadır. Karaciğer rezeksiyonları sonrasında yüksek debili şilöz fistül nadiren görülen bir durum olmakla beraber, protein kaybına bağlı olarak ortaya çıkan ciddi mekanik, nütrisyonel ve immünolojik bozukluklar sonucunda ampiyem ve peritonit gibi yaşamı tehdit eden ciddi komplikasyonlar tabloya eşlik edebilir.

Turkish Journal of Surgery, 2015

Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Althou... more Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Although it is common in women in the reproductive age, intestinal endometriosis is extremely rare and may lead to serious clinical problems. In this article, we present two rare cases of endometriosis localized in the sigmoid colon lumen. The first case is a 45 year-old female complaining of rectal bleeding for 6 months. A polypoid lesion with suspicion of malignancy, 3-4 cm in size was identified at colonoscopy. Laparoscopic anterior resection was performed since it was not suitable for colonoscopic polypectomy. The pathology examination revealed extragenital endometriosis. The second case is a 36 year-old female admitted for lower abdominal pain and rectal bleeding for the last 3 months. She was diagnosed with sigmoid diverticulitis. The patient's symptoms regressed with medical treatment, but due to early and multiple recurrent episodes it was decided to perform an elective laparoscopic anterior resection. The pathology report stated diverticulosis coli and intraluminal endometriosis. Intestinal endometriosis should be considered as part of the differential diagnosis in female patients of the reproductive age who present with constipation, gastrointestinal bleeding, nausea, vomiting, cramp-like abdominal pain, diarrhea and pelvic pain. In these patients, resection and anastomosis of the effected bowel segment is accepted as the choice of treatment.

The Journal of Breast Health, 2014

Adenoid cystic carcinoma of the breast constitutes approximately 0.1% of all breast tumors. They ... more Adenoid cystic carcinoma of the breast constitutes approximately 0.1% of all breast tumors. They can be located in the trachea, bronchus, cervix, lacrimal gland, and skin as well as the breast. Tumors in the breast have better prognoses compared to those in other locations. The diagnosis and treatment planning of this tumor is challenging due to its rare incidence. In this article, we presented a case that was diagnosed with adenoid cystic carcinoma of the breast upon pathology evaluation. A 59-year-old female patient was admitted to our clinic due to a mass in her right breast. Her mammography revealed a 1 cm in diameter mass in the upper outer quadrant of the right breast, which was classified as BIRADS 4C (Breast Imaging Reporting and Data System). On magnetic resonance imaging (MRI) the lesion was also reported as BIRADS 4C. The patient underwent breast conserving surgery (BCS), and the pathology result was reported as adenoid cystic carcinoma of the breast. The patient received chemo-radiotherapy in the postoperative period. Adenoid cystic carcinoma of the breast has been first described in the salivary glands. They can be confused with benign lesions both on physical and radiological examinations. Sentinel lymph node biopsy (SLNB) can be used since axillary metastases are rare. Local recurrence and distant metastases are also very rare. Usually, BCS followed by radiotherapy is adequate to obtain local control. In selected patients with a poor prognosis, chemotherapy and hormonal therapy should be added to the treatment.

Journal of the American College of Cardiology, 2013

Purpose: Valvular heart diseases, particularly mitral stenosis, can potentially disturb quality o... more Purpose: Valvular heart diseases, particularly mitral stenosis, can potentially disturb quality of life. In this study, we aimed to search whether presence of atrial fibrillation (AF) influence the quality of life in patients with mitral stenosis. Methods: Eighty seven consecutive patients with mild to moderate rheumatic MS, who were admitted to outpatient department, were enrolled into the study. All patients underwent quality of life scoring via SF-36 after complete transthoracic echocardiographic evaluation. Patients were classified into two as those with mitral valve area (MVA) 1.5 cm2 (hemodynamically significant) and those with valve area >1.5 cm2. Results: Mean age was 49.3AE14.6 years (72 females, 15 males). Mean planimetric valve are was 1.55AE0.27 cm2, mean peak transmitral gradient was 14AE5.5 mmHg with a mean EF of 56AE8%. 51 patients were in sinus rhythm whereas 36 patients had atrial fibrillation during evaluation (persistent or permanent). Of note, as per protocol, all patients were well treated in terms of rate control before echocardiographic evaluation, and no patient was exceeding 100 beats/min. MVA was not related with AF such that 60.5% (26/43) of those with MVA 1.5 cm2 had AF versus 56.8% (25/44) of those with MVA >1.5 cm2 had AF (p¼0.898). In the group with MVA 1.5 cm2, presence or absence of AF did not influence total score of SF-36 (92AE18 vs. 90AE19, p¼0.437) including all subscales of SF-36. Those with AF were older than those without AF (58.5AE12.4 vs. 44.9AE12.4, p¼0.002). Those with and without AF were similar with regard to transmitral gradients, mitral valve area, EF. In the group with MVA>1.5 cm2, presence of AF influenced physical functioning subscale of SF-36 such that physical functioning score of those with AF was 19AE5, whereas, physical functioning score of those without AF was 24AE4 (p¼0.004). This also resulted in nonsignificant difference in total SF-36 score as well (90AE14 vs. 98AE16 respectively, p¼0.078). Also in this subgroup, those with AF were older compared to those without AF (55.8AE9.1 vs. 43.9AE16.4 years, p¼0.003). Of note, transmitral gradients, MVA, EF were similar again in those with and without AF. Conclusıon: It seems presence of AF influences quality of life with regard to severity of MVA. In those with significant mitral stenosis (MVA 1.5 cm2), presence or absence of AF seems not to influence quality of life, whereas, in those with milder forms of mitral stenosis presence of AF seems to worsen physical functioning.