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Ponna P, Tarraf NE, Dalci K, Wilmes B, Darendeliler MA, Dalci O. Dentoskeletal effects of mini-screw assisted, non-surgical palatal expansion in adults using a modified force-controlled polycyclic protocol: a single-centre retrospective study. Eur J Orthod 2024; 46:cjad080. [PMID: 38315572 PMCID: PMC10841106 DOI: 10.1093/ejo/cjad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVES This study assessed the dental and skeletal effects of pure bone-borne, non-surgical maxillary expansion, using a modified force-controlled polycyclic protocol. METHODS Records of 17 adult patients, mean age 24.1 years; range 18-39 years, who had undergone maxillary expansion using a bone-borne Quad-expander (with 4 mini-screws), were analysed. In all patients, 0.17 mm/day of expansion was completed for 1 week, followed by a cyclic protocol of expansion of forward and backward turns until the force needed to turn the expander was below 400 cN, assessed weekly. After this, expansion continued at a rate of 0.17 mm/day until the desired amount of expansion was achieved. Cone beam computer tomography scans were taken pre- and post-expansion. RESULTS The mid-palatal suture was successfully opened in 100% of patients included in this study. Axially, the amount of skeletal opening at the posterior nasal spine was 61% of the anterior nasal spine. Expansion was pyramidal in the coronal plane. Significant increases at the dental and skeletal levels were achieved, with changes at the skeletal level reaching 73%. The alveolar bone angle increased more than the angular changes at the molars and premolars. LIMITATIONS This is a retrospective study with short-term results. CONCLUSION The Quad-expander, with a force-controlled polycyclic expansion protocol, effectively produced a significant increase in maxillary width in skeletally mature subjects in the short term.
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Affiliation(s)
- Priyanka Ponna
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
| | - Nour Eldin Tarraf
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
| | - Kerem Dalci
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, 40225, Germany
| | - Mehmet Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
| | - Oyku Dalci
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
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Ulku A, Topal U, Erdogan O, Yavuz B, Yalav O, Dalci K, Eray IC, Saritas AG, Akcam AT. Effect of main pancreatic duct suture ligation on the prevention of clinically relevant pancreatic fistula after distal pancreatectomy: analysis of 82 consecutive patients. Eur Rev Med Pharmacol Sci 2023; 27:10522-10530. [PMID: 37975375 DOI: 10.26355/eurrev_202311_34328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE This study aimed to examine the factors linked to the development of clinically significant pancreatic fistulas following distal pancreatectomy (DP) and to assess the efficacy of suture ligation of the main pancreatic duct. PATIENTS AND METHODS A single-center retrospective study was performed on the medical records of 82 patients who underwent DP in our institution between January 2011 and December 2019. RESULTS There were 28 males (34.1%) and 54 females (65.9%). The patients' age ranged from 18 to 86 years (median: 55.5 years). Indications for DP included primary pancreatic disease (n=63, 76.8%) and non-pancreatic disease (n=19, 23.2%). Postoperative mortality and morbidity rates were 3.7% and 48%, respectively. Pancreatic parenchymal closure was accomplished by a hand-sewn technique or mechanical stapling in 89 and 13 patients, respectively. Identification of the pancreatic duct and suture ligation was performed in 46 patients (56.1%). Pancreatic fistula was developed in 20 patients (24.4%); 12 fistulas were classified as Grade B, and 8 as Grade C. Biochemical leaks (Grade A) were identified in 8 patients (9.8%). Multivariate analysis indicated that failure to ligate the main pancreatic duct was the only variable associated with an increased risk for pancreatic leak (p=0.031; odds ratio=0.233; 95% confidence interval, 0.062-0.879). CONCLUSIONS Pancreatic leak remains a common complication after DP. The incidence of leaks is reduced significantly when the main pancreatic duct is identified and directly ligated during DP.
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Affiliation(s)
- A Ulku
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Tarraf NE, Dalci O, Dalci K, Altug AT, Darendeliler MA. A retrospective comparison of two protocols for correction of skeletal Class III malocclusion in prepubertal children: hybrid hyrax expander with mandibular miniplates and rapid maxillary expansion with face mask. Prog Orthod 2023; 24:3. [PMID: 36683080 PMCID: PMC9868197 DOI: 10.1186/s40510-022-00446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND This study compared the skeletal and dental effects of a hybrid maxillary expander with mandibular miniplates (HE-MP) and Class III elastics to conventional tooth-borne rapid maxillary expander and face mask (RME-FM) in skeletal Class III treatment. METHODS This retrospective study included 36 skeletal Class III patients. Eighteen patients (mean age 10.24 ± 1.31 years) were treated with a hybrid expander, two mandibular L-shaped miniplates and full-time Class III elastics (HE-MP group). Their results were compared to a group of patients treated with conventional RME-FM (n = 18; mean age 10.56 ± 1.41 year). Radiographs were taken before (T1) and after treatment (T2). All patients were in cervical maturation stages CS1-CS3 at T1. The measured outcomes were the changes in sagittal and vertical skeletal and dental cephalometric measurements. RESULTS Treatment time was approximately 15.5 ± 2.8 months with the HE-MP and 11.85 ± 3.41 months for the RME-FM. The Class III malocclusion was corrected in both groups with significant changes. The maxilla advanced more in the HE-MP group, with an increase in SNA of 4.26° ± 2.15° compared to 1.14 ± 0.93 in the RME-FM group (p < 0.001). The effect on the mandible was similar in both groups, while the overall skeletal change was significantly greater with HE-MP, with an increase in the ANB of 5.25° ± 2.03° and a Wits appraisal increase of 6.03 ± 3.13 mm, as opposed to 2.04° ± 1.07° and 2.94 ± 1.75 mm with the RME-FM (p < 0.001). Dental changes were significantly higher with RME-FM, with an increase in incisor inclination (U1-SN) of 5.02° ± 3.93° (p < 0.001), with no significant changes in the HE-MP group. The mandibular incisors retroclined by 5.29° ± 3.57° at L1-MP with the RME-FM, while they advanced slightly with the HE-MP by 2.87° ± 5.37° (p < 0.001). CONCLUSION The use of skeletal anchorage for maxillary expansion and protraction significantly increases skeletal effects and reduces dental side effects compared to tooth-borne maxillary expansion and protraction. These results need to be investigated in the long term.
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Affiliation(s)
- Nour Eldin Tarraf
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Oyku Dalci
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kerem Dalci
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ayse Tuba Altug
- Department of Orthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - M Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Dalci K, Gumus S, Saritas AG, Onan HB, Akeam AT, Ulku A, Sakman G. Multimodal Treatment of Chylous Fistula: A Retrospective Case-Control Study. Lymphology 2023; 56:82-90. [PMID: 38621386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Chylous fistulas (CF) are rare surgical complications and there is no standard treatment. This study presents the treatment modalities performed on patients who developed CF over a 10-year period. During the observation period, CF developed in 29 patients, 16 of whom were women. The mean age was 55.76± 13.48. Lymphatic duct injury was mostly seen in the abdomen (58.6%) and the most common reason was nephrectomy (20.7%). Extended lymphatic dissection due to malignancy was performed in 82.7% of all cases. Chylous leakage started postoperatively on 3.78±3.94 days (range: 1-19 days). Fasting, total parenteral nutrition (TPN), and somatostatin treatment were applied to all patients, and 75.8% of the fistulas were resolved completely with medical treatment. Surgical ligation of the lymphatic canal was performed in 7 patients. One was not successful and underwent percutaneous embolization of the thoracic lymphatic leakage cavity. All fistulas were resolved in 18.18±10.4 days. The resolution time and hospital stay were significantly higher in thoracic fistulas (p=0.017; p=0.003, respectively). In addition, malignant cases had longer resolution time (32.40±28.72 vs 16.27±11.25, p=0.036) and hospital stay (35.0±29.74 vs 16.25±14.05p= 0.002 respectively) than non-malignant. There was no chylothorax, chylous ascites, or recurrence at 20.55±22.88 months follow-up. Treatment of CF with fasting, TPN, and somatostatin analogs are effective. Other interventions such as surgical ligation with or without fibrin glue and interventional radiology treatments may be considered when conservative treatments fail.
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Affiliation(s)
- K Dalci
- Cukurova University, Department of General Surgery, Adana, Turkey
| | - S Gumus
- Education and Research Hospital, Department of Oncology, Hatay, Turkey
| | - A G Saritas
- Cukurova University, Department of General Surgery, Adana, Turkey
| | - H B Onan
- Cukurova University Department of Radiology, Adana, Turkey
| | - A T Akeam
- Cukurova University, Department of General Surgery, Adana, Turkey
| | - A Ulku
- Cukurova University, Department of General Surgery, Adana, Turkey
| | - G Sakman
- Cukurova University, Department of General Surgery, Adana, Turkey
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Soran A, Ozbas S, Ozcinar B, Isik A, Dogan L, Senol K, Dag A, Karanlik H, Aytac O, Karadeniz Cakmak G, Dalci K, Dogan M, Sezer YA, Gokgoz S, Ozyar E, Sezgin E. ASO Visual Abstract: Intervention for Hepatic and Pulmonary METastases in Breast Cancer Patients-Prospective, Multi-Institutional Registry Study: IMET; Protocol MF 14-02. Ann Surg Oncol 2022; 29:6337-6338. [PMID: 35933547 DOI: 10.1245/s10434-022-12320-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Atilla Soran
- Division of Surgical Oncology, Breast Surgical Oncology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA.
| | - S Ozbas
- Breast Surgery, Private Practice, Ankara, Turkey
| | - B Ozcinar
- General Surgery Department, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - A Isik
- General Surgery Department, Training and Research Hospital, Medeniyet University Goztepe, Istanbul, Turkey
| | - L Dogan
- Department of Surgical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - K Senol
- General Surgery Department, Uludag University Faculty of Medicine, Bursa, Turkey
| | - A Dag
- General Surgery Department, Mersin University Faculty of Medicine, Mersin, Turkey
| | - H Karanlik
- Surgical Oncology Unit, Istanbul University Institute of Oncology, Istanbul, Turkey
- Breast Oncology Unit, American Hospital, Istanbul, Turkey
| | - O Aytac
- General Surgery Department, Baskent University Faculty of Medicine, Adana, Turkey
| | - G Karadeniz Cakmak
- General Surgery Department, Zonguldak Bulent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
| | - K Dalci
- General Surgery Department, Cukurova University Faculty of Medicine, Adana, Turkey
| | - M Dogan
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Y A Sezer
- General Surgery Department, Trakya University Faculty of Medicinee, Edirne, Turkey
| | - S Gokgoz
- General Surgery Department, Uludag University Faculty of Medicine, Bursa, Turkey
| | - E Ozyar
- Department of Radiation Oncology, Acibadem Hospitals Group, Istanbul, Turkey
| | - E Sezgin
- Department of Food Engineering, Izmir Institute of Technology, Izmir, Turkey
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Soran A, Ozbas S, Ozcinar B, Isik A, Dogan L, Senol K, Dag A, Karanlik H, Aytac O, Karadeniz Cakmak G, Dalci K, Dogan M, Sezer YA, Gokgoz S, Ozyar E, Sezgin E. Intervention for Hepatic and Pulmonary Metastases in Breast Cancer Patients: Prospective, Multi-institutional Registry Study-IMET, Protocol MF 14-02. Ann Surg Oncol 2022; 29:6327-6336. [PMID: 35876920 DOI: 10.1245/s10434-022-12239-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND One fourth of early-stage breast cancer cases become metastatic during the follow-up period. Limited metastasis is a metastatic disease condition in which the number of metastatic sites and the extent of the disease both are limited, and the disease is amenable to metastatic intervention. This prospective study aimed to evaluate intervention for limited metastases in the lung, liver, or both. METHODS The study enrolled luminal A/B and/or human epidermal growth factor receptor 2 (HER2)-neu+ patients with operable lung and/or liver metastases in the follow-up assessment after completion of primary breast cancer treatment and patients with a diagnosis of metastasis after 2014. Demographic, clinical, tumor-specific, and metastasis detection-free interval (MDFI) data were collected. Bone metastasis in addition to lung and liver metastases also was included in the analysis. The patients were divided into two groups according to the method of treatment for metastases: systemic therapy alone (ST) group or intervention (IT) group. RESULTS Until June 2020, 200 patients were enrolled in the study. The demographic data were similar between the two groups. The median follow-up time was 77 months (range 55-107 months) in the IT group (n = 119; 59.5%) and 57 months (range 39-84) in the ST-only group (n = 81; 40.5%). The median MDFI was 40 months (range 23-70 months) in the IT group, and 35 months (range 13-61 months) in the ST-only group (p = 0.47). The groups had similar surgeries for the primary tumor and axilla. Most of the patients had liver metastases (49.5%, n = 99), and 42% (n = 84) of the patients had lung metastases. Both lung and liver metastases were found in 8.5% (n = 17) of the patients. The primary tumor was estrogen receptor/progesterone receptor-positive in 75% (n = 150) of the patients, and 32% (n = 64) of the patients had HER2-neu+ tumors. Metastatic-site resection was performed for 32% (n = 64) of the patients, and 27.5% (n = 55) of the patients underwent metastatic ablative interventions. In the Kaplan-Meier survival analysis, the hazard of death (HoD) was 56% lower in the IT group than in the ST-only group (hazard ratio [HR], 0.44; 95% confidence interval [CI] 0.26-0.72; p = 0.001). The HoD was lower in the IT group than in the ST-only group for the patients younger than 55 years (HR, 0.32; 95% CI 0.17-0.62; p = 0.0007). In the multivariable Cox regression model, HoD was significantly lower for the patients who underwent intervention for metastases and had an MDFI longer than 24 months, but their liver metastases doubled the risk of death compared with lung metastases. CONCLUSION Metastasis-directed interventions have reduced the risk of death for patients with limited lung/liver metastases who are amenable to interventions after completion of primary cancer treatment. For a select group of patients, such as those with luminal A/B or HER2-neu+ breast cancer who are younger than 55 years with limited metastases to the lung and liver or an MDFI longer than 24 months, surgical or ablative therapy for metastases should be considered and discussed on tumor boards.
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Affiliation(s)
- Atilla Soran
- Division of Surgical Oncology, Breast Surgical Oncology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA.
| | - S Ozbas
- Breast Surgery, Private Practice, Ankara, Turkey
| | - B Ozcinar
- General Surgery Department, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - A Isik
- General Surgery Department, Training and Research Hospital, Medeniyet University Goztepe, Istanbul, Turkey
| | - L Dogan
- Department of Surgical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - K Senol
- General Surgery Department, Uludag University Faculty of Medicine, Bursa, Turkey
| | - A Dag
- General Surgery Department, Mersin University Faculty of Medicine, Mersin, Turkey
| | - H Karanlik
- Surgical Oncology Unit, Istanbul University Institute of Oncology, Istanbul, Turkey.,Breast Oncology Unit, American Hospital, Istanbul, Turkey
| | - O Aytac
- General Surgery Department, Baskent University Faculty of Medicine, Adana, Turkey
| | - G Karadeniz Cakmak
- General Surgery Department, Zonguldak Bulent Ecevit University, Faculty of Medicine, Zonguldak, Turkey
| | - K Dalci
- General Surgery Department, Cukurova University Faculty of Medicine, Adana, Turkey
| | - M Dogan
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Y A Sezer
- Department of Medical Oncology, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - S Gokgoz
- General Surgery Department, Uludag University Faculty of Medicine, Bursa, Turkey
| | - E Ozyar
- Department of Radiation Oncology, Acibadem Hospitals Group, Istanbul, Turkey
| | - E Sezgin
- Department of Food Engineering, Izmir Institute of Technology, Izmir, Turkey
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Li J, Papadopoulou AK, Gandedkar N, Dalci K, Darendeliler MA, Dalci O. The effect of micro-osteoperforations on orthodontic space closure investigated over 12 weeks: a split-mouth, randomized controlled clinical trial. Eur J Orthod 2022; 44:427-435. [PMID: 35134142 DOI: 10.1093/ejo/cjab079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate the effects of minimally invasive micro-osteoperforations (MOPs) on orthodontic tooth movement and pain. DESIGN Prospective, split-mouth, randomized controlled trial. SETTING Single-centre, university hospital. METHODS Twenty subjects requiring maxillary first premolar extractions were included. Right and left sides of the maxilla were randomly allocated into experimental and controls. Space closure was initiated following alignment on 0.20″ stainless steel archwires, using 150 g force, applied by coil springs on power arms. Nance-TPA was used for anchorage. On the experimental side, two 5 mm deep MOPs in vertical alignment on distal aspect of the maxillary canine mid-root region were performed prior to space closure. OUTCOMES The primary outcome was the amount of tooth movement during space closure, measured every 4 weeks for 12 weeks (T1, T2, and T3). Secondary outcome was the pain levels related to MOP, measured using Visual Analogue Scale (VAS) questionnaires. Significance was set at P < 0.01. RANDOMIZATION Randomization was generated using a randomization table, and allocation was concealed in sequentially numbered, opaque, sealed envelopes. BLINDING Blinding was not possible during the experiment but assessor was blinded during outcome assessment. RESULTS All subjects completed the study, with tooth movement measurements available for all 20 patients for T0-T2. In three patients, space was closed on one side at T2. The average tooth movement between sides at three intervals (T0-T1, T1-T2, and T2-T3) were not significantly different. Overall difference following 12 weeks (T0-T3) was 0.69 mm higher on the experimental side (P < 0.001). No harms were observed. LIMITATIONS Short-term study, cast measurements done with digital callipers. CONCLUSION This 12-week randomized split-mouth controlled clinical trial showed two MOPs that are 5 mm deep, applied once prior to space closure, did not create clinically significant increase in maxillary premolar space closure. PROTOCOL The protocol was not published before trial commencement. REGISTRATION Trial was not registered. FUNDING The Australian Society of Orthodontists Foundation for Research and Education.
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Affiliation(s)
- Jiaojiao Li
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
| | - Alexandra K Papadopoulou
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
| | - Narayan Gandedkar
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
| | - Kerem Dalci
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
| | - Mehmet Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
| | - Oyku Dalci
- Discipline of Orthodontics and Paediatric Dentistry Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia
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Abstract
Malignant melanoma of the gastrointestinal tract is usually a metastasis from a cutaneous source. Primary gastric melanoma is an extremely rare clinical entity, with few reported cases worldwide. It is often advanced at the time of diagnosis and is associated with a poor outcome. We report a case of a 57-year-old male who presented to the emergency department with complaints of fatigue, haematemesis and melena. Laboratory investigation indicated a haemoglobin level of 7.4g/dl, for which the patient received a transfusion. Upper gastrointestinal endoscopy revealed a bleeding mass in the body of stomach which provisional histology was suggestive of a malignant mesenchyimal tumour but subsequent cytomorphology and immunophenotyping were consistent with malignant melanoma, with positive S-100, HMB-45 and Melan-A. Dermatological exam indicated two lesions suspicious for the primary site of metastasis but were ultimately diagnosed as benign lesions, one junctional nevus and other one seborrheic keratosis, on biopsies. Ophthalmologic exam showed no other probable sites of origin. PET/CT showed accumulation of tracer in the stomach, jejunum and perigastric lymph nodes. For this reason, primary advanced gastric melanoma was suspected in this patient. Since the patient had recurrent upper gastrointestinal bleeding that required frequent blood transfusion, a total gastrectomy with partial small bowel resection was performed. We report this case to present initial diagnostic challange and discuss performing surgery for recurrent tumour bleeding.
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Affiliation(s)
- K Dalci
- Cukurova University, Adana, Turkey
| | - Z Teke
- Cukurova University, Adana, Turkey
| | - C Atar
- Cukurova University, Adana, Turkey
| | - F Doran
- Cukurova University, Adana, Turkey
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Dalci O, Dalci K, Papadopoulos D, Ng A, Darendeliler M. Prevalence of malocclusion in an orthodontic population of pre-adolescent and adolescent children with sleep disordered breathing. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yüksel AG, Iskender SY, Kuitert R, Papadopoulou AK, Dalci K, Darendeliler MA, Dalci O. Differences in attractiveness comparing female profile modifications of Class II Division 1 malocclusion. Am J Orthod Dentofacial Orthop 2017; 152:471-476. [PMID: 28962730 DOI: 10.1016/j.ajodo.2017.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 01/01/2017] [Accepted: 01/01/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Our objective was to study the perceptions of laypeople for digital alterations and the amount of nasolabial angle increase that is tolerable and how much chin-neck length increase is needed to achieve a desirable profile in Class II Division 1 women with mandibular retrognathia. METHODS The profile image of a white woman with a Class II Division 1 mandibular rethrognatic profile was digitally modified to create 6 images: 3 with stepwise increased nasolabial angles of 113°, 121°, and 129°, and 3 with stepwise increased chin-neck distances of 51, 54, and 57 mm. These images were assessed and ranked by 155 white laypeople. RESULTS The baseline profile was judged significantly as the least attractive. A nasolabial angle of 129° was judged as unattractive as the baseline profile. Profiles with a chin-neck length of 54 and 57 mm were equally judged as most attractive. CONCLUSIONS The untreated (baseline) profile was found to be least esthetic, as well as the profile with the largest nasolabial angle. Nasolabial angle increases up to 121° seem to be acceptable. Profiles simulating a chin-neck length increase as produced by surgery seem to be most favored.
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Affiliation(s)
- Aylin Gözde Yüksel
- Department of Orthodontics, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands.
| | - Sebahat Yesim Iskender
- Department of Orthodontics, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | - Reinder Kuitert
- Department of Orthodontics, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | - Alexandra K Papadopoulou
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney South West Area Health Service, Sydney, Australia; Department of Oral Surgery and Implantology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kerem Dalci
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - M Ali Darendeliler
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Oyku Dalci
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
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Ulku A, Akcam AT, Rencuzogullari A, Dalci K, Yalav O, Eray IC, Saritas G. Effect of Dosage and Type of Hepatitis B Immunoglobulin on Hepatitis Antibody Levels in Liver Transplant Recipients. Transplant Proc 2017; 49:575-579. [PMID: 28340836 DOI: 10.1016/j.transproceed.2017.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The current study aimed to evaluate the effect of dosage and type (intramuscular [IM] vs intravenous [IV]) of hepatitis B immunoglobulin (HBIG) on hepatitis antibody level in liver transplant recipients. METHODS Between September 2000 and August 2016, patients who underwent orthotropic liver transplantation for chronic liver failure or hepatocellular carcinoma secondary to chronic hepatitis B virus (HBV) were retrospectively reviewed from a prospectively maintained database. The analyses of risk factors for postoperative short- and long-term anti-hepatitis B surface antibody levels (as classified level I: 0 to 100 U; II: 100 to 500 U; III: 500 to 1000 U; IV: >1000 U) were performed based on demographic characteristics, hepatitis B envelope antigen, hepatitis B core antibody, HBV DNA, delta antigen, HBIG administration dosage during unhepatic phase (5000 or 10,000 I/U; IM or IV), and type of administration in post-transplant period. Patients who were followed for less than 12 months were excluded from long-term analysis. RESULTS The mean follow-up of 58 orthotropic liver transplant patients was 72 (±45) months. No adverse events were observed during both IM and IV type of administration. Compared with IM type, IV administration was associated with a significantly higher HBV antibody level in the short term (for IM and IV: level I: 24% vs 6%; II: 49% vs 18%; III: 12% vs 35%; IV: 15% vs 41%, respectively, P = .007). In the long term, IV administration of hepatitis B immunoglobulin (HBIG) was reported as the sole factor causing higher antibody level (P = .002). Longer follow-up was associated with decreased levels of anti-hepatitis B surface antibody. CONCLUSION IV HBIG administration in preoperative anhepatic phase and postoperative prophylaxis is associated with higher antibody level both the short and long term without any adverse event.
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Affiliation(s)
- A Ulku
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - A T Akcam
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - A Rencuzogullari
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - K Dalci
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - O Yalav
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - I C Eray
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - G Saritas
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
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12
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Dalci K, Cetine S. Soft tissue profiles of 3-5 year old preschool children. J Clin Pediatr Dent 2011; 35:339-44. [PMID: 21678681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVE Identifying the characteristics of soft-tissue profiles in 3-5 year old children. METHODS Children that participated in the study were selected from the 6 major districts of Ankara. In the selected schools, 3-5 year old 1513 children with primary dentition were examined and profile photographs were obtained. Facial convexity angle (FCA) and Total facial convexity angle (TFCA) were measured from profile photographs. RESULTS The mean values for the total facial convexity (145.9 degrees +/- 4.2) and facial convexity (165.3 degrees +/- 4.5) angles were determined. FCA and TFCA were significantly influenced by primary second molar terminal plane relationship. CONCLUSION Finding of this study may be used as clinical references for pediatric dental patients and also, the significant relationship between soft tissue profile and primary occlusion is important for orthodontic diagnosis and treatment of pediatric dental patients.
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Affiliation(s)
- Kerem Dalci
- Department of Pediatric Dentistry, Faculty of Dentistry, The University of Sydney, New South Wales, Australia.
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13
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Sönmez D, Dalci K, Şen Tunç E. Treatment of an avulsed maxillary permanent central incisor by autotransplantation of a primary canine tooth. Int Endod J 2008; 41:623-32. [DOI: 10.1111/j.1365-2591.2008.01405.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Yildirim G, Dalci K. Treatment of lateral root perforation with mineral trioxide aggregate: a case report. ACTA ACUST UNITED AC 2006; 102:e55-8. [PMID: 17052627 DOI: 10.1016/j.tripleo.2006.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Revised: 04/06/2006] [Accepted: 04/06/2006] [Indexed: 11/18/2022]
Abstract
Root perforations are undesired complications of endodontic treatment which result in loss of integrity of the root and further destruction of the adjacent periodontal tissues. In recent literature mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair. In this case iatrogenic perforation was observed in a maxillary central incisor. It was not possible to reach the perforation from the access cavity due to the angulation and excessive bleeding even though the root canal was filled with calcium hydroxide paste between appointments. Therefore, surgical intervention was preferred. After the root canal was filled with gutta percha and AH plus, the perforation site was subsequently sealed with MTA. The restoration was made with strip crown and composite resin. The symptoms were ceased and the results were satisfactory after 15 months follow-up.
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Affiliation(s)
- Gözde Yildirim
- Department of Pedodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
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15
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Bayrak S, Dalci K, Sari S. Case report: Evaluation of supernumerary teeth with computerized tomography. ACTA ACUST UNITED AC 2005; 100:e65-9. [PMID: 16182154 DOI: 10.1016/j.tripleo.2005.05.065] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Revised: 05/10/2005] [Accepted: 05/20/2005] [Indexed: 12/29/2022]
Abstract
Radiographs play an important role in assessment of both the location and the typing of supernumerary teeth. In general, periapical, occlusal, and/or panoramic radiographs are sufficient for providing the information required by the clinician. These modalities, however, do not provide detailed information concerning the 3-dimensional relationship between supernumerary or ectopically impacted teeth and adjacent structures. This case report discusses the value of computerized tomography (CT) for evaluation of the root relationships of supernumerary teeth located palatally to maxillary permanent central incisors. CT accurately demonstrated the relationship between the supernumerary teeth and the permanent tooth roots.
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Affiliation(s)
- Sule Bayrak
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
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