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Öğe Can mastalgia be another somatic symptom in fibromyalgia syndrome?(Hospital Clinicas, Univ Sao Paulo, 2015) Sen, Meral; Kilic, Murat Ozgur; Cemeroglu, Ozlem; Icen, DuyguOBJECTIVE: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome. METHODS: Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically. RESULTS: Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome. CONCLUSIONS: We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.Öğe Differentially regulated ADAMTS1, 8, 9, and 18 in pancreas adenocarcinoma(Termedia Publishing House Ltd, 2017) Kilic, Murat Ozgur; Aynekin, Busra; Bozer, Mikdat; Kara, Adem; Haltas, Hacer; Icen, Duygu; Demircan, KadirIntroduction: Despite recent diagnostic and therapeutic improvements, pancreas cancer remains one of the highly lethal cancers. The extracellular matrix (ECM) is a physiological barrier that limits the spread of cancer cells into surrounding tissues and distant organs. Disintegrin and metalloprotease with thrombospondin motifs (ADAMTS) is a family of 19 proteases, which is involved in various biological processes such as ECM remodelling and anti-angiogenesis. Aim: To investigate the expression of ADAMTS1, 8, 9, and 18 proteinases in pancreas adenocarcinoma and its nodal metastasis. Material and methods: The immunostaining status of ADAMTS1, 8, 9, and 18 were investigated in formalin-fixed paraffin-embedded samples of 25 patients who underwent pancreaticoduodenectomy for an adenocarcinoma located at the head of the pancreas. Results: In semi-quantitive grading pathologically, ADAMTS1, 8, 9, and 18 were found to be highly stained in all cancerous pancreas samples compared with normal pancreas. In addition, the immune positivity of ADAMTS1, 9, and 18 was found to be higher in metastatic lymph nodes than in non-metastatic lymph tissue. Tumour size was correlated with ADAMTS9 and 18 expressions in cancerous pancreas. Conclusions: According to the data obtained from the study, we suggest that these four ADAMTSs may have significant roles in the tumorigenesis and nodal spread of pancreas adenocarcinoma.Öğe EVALUATION OF TWENTY-SEVEN PATIENTS WITH TUBERCULOUS PERITONITIS(Carbone Editore, 2016) Kilic, Murat Ozgur; Saglam, Cemile; Caner, Sevkan Sultan; Kilic, Yeliz; Icen, DuyguIntroduction: Tuberculosis (TB) remains a public health problem worldwide. Peritoneal tuberculosis or tuberculous peritonitis (TBP) is an uncommon form of extrapulmonary infection with a proportional increasing of its incidence. This disease is seen most commonly in young adults, and has a highly variable clinical symptomatology. Our aim is to highlight the nonspecific presentation and diagnostic difficulties of the TBP. Materials and methods. We retrospectively reviewed 27 TBP cases diagnosed between 2003 and 2014. Clinical features, all diagnostic methods, and the outcomes of treatment were analyzed in view of literature. Results: Abdominal distension and pain were the most frequent symptoms. A past history of pulmonary TB was obtained in 4 patients. Additionally, concomitant extraperitoneal TB was found in 15 cases. Ascites was the most sonographic finding. Acid-fast staining of ascitic fluid was positive in 1/19. Peritoneal biopsy via laparoscopy or laparotomy was positive for TBP in 13/14. Duration of symptoms prior to diagnosis was found to be associated with prolongation of the treatment (p<0.001). In addition, pretreatment c-reactive protein was found to be significantly different between the patients requiring a standard therapy of 9 months and the patients requiring additional therapy of 3 months (p=0.023). Conclusion: The diagnosis of TBP is often difficult due to diverse presentation. The patient's anamnesis and the presence of ascites are the most significant marks in diagnosis. Laparoscopy with peritoneal biopsy seems to be the gold standard diagnostic method.Öğe The Clinicopathological Factors Associated with Multicentricity in Papillary Thyroid Cancer(Derman Medical Publ, 2016) Kilic, Murat Ozgur; Bilgic, Celal Ismail; Dener, Cenap; Icen, DuyguAim: Multicentricity is a frequent feature of papillary thyroid cancer, and is generally associated with advanced stage, increased risk of regional and distant metastasis. In this study, we aimed to determine the associated clinicopathological factors on multicentricity in papillary thyroid cancer. Material and Method: One hundred and thirty patients with papillary thyroid cancer were included in this retrospective study. The affecting clinical and histopathological factors on multicentricity were investigated. Results: Total thyroidectomy with or without central/lateral neck dissection was performed in 130 patients (101, 77.7% were female and 29, 22.3% were male) with a mean age of 43.03 years. The diagnosis of papillary thyroid cancer was confirmed by final histopathology in all cases. Multicentricity and bilaterality were detected in 54 (41.5%) and 16 (12.3%) patients, respectively. Tumor size (p= 0.046) and perineural invasion (p= 0.020) were significantly different between the patients with multicentric cancer and those with solitary cancer. Discussion: According to the findings obtained from this study, tumor size and perineural invasion were the affecting factors on multicentricity in papillary thyroid cancer. However, large-scale, multicenter clinical and genetic studies are needed to clearly determine the affecting factors on multicentricity of these cancers.Öğe Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia(Korean Surgical Society, 2016) Surgit, Onder; Cavusoglu, Nadir Turgut; Kilic, Murat Ozgur; Unal, Yilmaz; Kosar, Pinar Nergis; Icen, DuyguPurpose: Seroma is among the most common complicatidns of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space. Methods: Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups. Results: Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001). Conclusion: Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.
