Emirhan, Necati; Yapici, Furkan

Objective: The aim of this study is to compare clinically and radiologically the subvatus (SV) and medial parapatellar (MPP) approaches performed in patients undergoing total knee arthroplasty (TKA) due to severe gonarthrosis. Method: Patients who underwent TKA between 2015 and 2019 were divided into two groups as SV and MPP, according to the type of approach performed. Demographic, clinical, and surgical information of the patients were evaluated. Knee Society Clinical Rating System (KSS) and visual analogue scale (VAS) scores were used for functional evaluation. AP and lateral orthoroentgenograms and knee radiographs taken at the last follow-up were used for radiological evaluation. Results: The mean duration of surgery and tourniquet was significantly higher in the SV group. (p <.001 and p <.001, respectively). Mean blood loss and number of blood transfusions were significantly higher in the MPP group. (p <.001 and p <.001, respectively). Opiate analgesic need, straight leg raising time and hospitalization time were also significantly higher in the MPP group. (p <.001, p <.001 and p <.001, respectively). Although the KSS, VAS scores, and the range of motion (ROM) at the first month were better in the SV group, there was no difference between the two groups at 6 and 12 months. Conclusion: According to this study, with the SV approach used for TKA, postoperative blood loss and the need for transfusion decreased, the duration of hospitalization was shortened, postoperative pain was less, and functional scores were better. Its only disadvantage was the prolonged operation time.

Yildirim, Nilgun; Aldemir, Mehmet Naci; Simsek, Melih; Bilici, Mehmet; Tekin, Salim Basol

Objective: Invasive breast cancer is a heterogeneous disease group that has different biological and pathological features, and characterized with different clinical behavior, treatment results, and consequences. The rarity of most specific neoplasies does not allow large or randomized studies to determine optimal treatment. With this study, we aimed to evaluate the clinical and pathological features and treatment options and results of rare breast carcinoma patients that followed and treated in our clinic. Methods: Files of 1280 breast cancer patients admitted to our center between years 2000 and 2016 were evaluated. From these patients, who have rare breast carcinoma subtypes were included and patients with pathological diagnosis of invasive ductal carcinoma and invasive lobular carcinoma were excluded. Seventy-three patients that included in the study were analyzed retrospectively in terms of age, menopausal status, family history, tumor-lymph node-metastasis stage, histological grade, hormone receptor level, human epidermal growth factor receptor2 expression, operation type and overall survival (OS). Results: Eight histological subtypes of breast tumors were evaluated. Significant difference wasn't found between groups in terms of mean age of the patients. In terms of histological subtypes, the most eldest patients were in papillary group, the youngest patients were in tubular group. The mean tumor diameter was also significantly different between groups (p=0.02). The mean age of the patients diagnosed with tubular and mucinous type breast carcinomas were younger than the one reported in literature and the mean tumor diameter was also larger in these tumors. Ratio of patients diagnosed at advanced stages was high (43%). While mucinous and tubular carcinomas were the histological subtypes with the best prognosis, the shortest OS was in primary breast sarcoma and neuroendocrine carcinoma group. Conclusion: Rare breast cancers are a heterogeneous malignity group with different behavior and prognosis. Our results, except some cases, were generally concordant with the data obtained from other studies. These exceptions may be related to race, regional factors, different pathological evaluation, and environmental factors. Nevertheless, comprehensive clinical studies are required because of the rare occurrence these tumors.

Eken, Huseyin; Kurnaz, Eray; Balci, Mecdi Gurhan; Arslan, Mithat Kerim

Objective: The prevalence of thyroid nodules is absolutely high. The incidence of malignancy development from that nodules and the mortality in thyroid cancers are low. It is very important to distinguish between malignant nodules and benign nodules because of the choice of treatment and follow-up of patients. Ultrasound-guided fine needle aspiration biopsy (FNAB) is the most appropriate method for the evaluation of thyroid nodules. Methods: The aim of the study is to evaluate the postoperative pathology results of patients with atypia of undetermined significance with FNAB results, to share the results with the literature and to contribute to the treatment and follow-up of patients. Results: The study included 3148 patients who underwent thyroid FNAB between the years of 2013-2018. The patients who had atypia of undetermined significance of FNAB results and who had at least two radiological malignant suspicious appearance, or the second FNAB performed after 3 months was reported as atypia of undetermined significance, were treated with thyroidectomy. FNAB results and postoperative diagnosis were comparatively examined. Results: It was reported that 134 patients with an atypia of undetermined significance of FNAB results. Malignancy was detected in 9 patients (23.1%) after histopathological examination. We conclude that surgical planning will be the correct approach in patients with atypia of undetermined significance and in patients who have radiological malignancy criteria to prevent diagnostic delays due to follow-up difficulties.