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Öğe The learning curve for pure retroperitoneoscopic donor nephrectomy by using cumulative sum analysis(Canadian Urological Association, 2023) Mercimek, Mehmet Necmettin; Özden, Ender; Gülşen, Murat; Kalaycı, Onur; Yakupoğlu, Yarkın Kamil; Bostancı, Yakup; Sarıkaya, ŞabanIntroduction: This study aimed to identify a precise learning curve for pure retroperitoneoscopic donor nephrectomy (RDN). Methods: Data from 172 consecutive kidney donors who underwent pure RDN between January 2010 and July 2019 were prospectively collected and evaluated. CUSUM (cumulative sum) analysis was used for testing the operation time. Changepoints were determined by using the r program and Binseg method. The cohort was divided into three groups — group 1: competence, including the first 10 cases; group 2: 11–48 cases as proficiency; and group 3: the subsequent 124 cases as expert level. Continuous variables were evaluated using one-way ANOVA, and categorical data were evaluated using the Chi-squared test. Results: Right RDN was performed in 39 (22.7%) donors. The eighth patient was converted to open surgery due to vena cava injury and excluded from the CUSUM analysis. Depending on experience in pure RDN, a significant decrease was detected in operative time (p<0.001), warm ischemia time (p=0.006), and blood loss (p<0.001). Recipient complications and graft function were found to be statistically comparable. Conclusions: In our study, the attainment of expertise in pure RDN was observed after performing 50 cases. The transperitoneal technique, which is a feasible alternative, is far more widely used than pure RDN. We believe that understanding the learning curve associated with pure RDN could facilitate the adoption of this approach as a viable alternative to the transperitoneal approach.Öğe Dermatopathological C,correlation of clinically challenging cutaneous lesions: a single center experience of 2184 cases(2022) Özcan, Yunus; Özlü, Emin; Karagün, Ebru; Uyar, Belkız; Gamsızkan, MehmetAbstract Introduction: Although a trained eye can easily identify typical skin lesions, histopathological exam-ABSTRACT ination and clinicopathological correlation are critical in challenging cases. Objectives: The primary objective is to organize the final diagnoses reached following clinicopathological consensus in clinically challenging cutaneous lesions, identifying the most common diagnostic scenarios encountered by dermatopathologists and discussing their diverse differentials submitted by clinicians. The secondary objective is to investigate how the case profile and clinician decision-making processes evolved during the COVID-19 pandemic. Methods: Skin and mucosa samples collected by the dermatology department between 2016 and 2020 were classified based on pathology reports. For frequent diagnoses, preliminary diagnoses stated by clinicians on pathology requisition forms were reviewed. The years preceding and following the first nationally reported COVID-19 case were compared to investigate the pandemic’s impact on the distribution of dermatology and dermatopathology cases. Results: One thousand nine hundred and eighty-nine reports were classified into 4 major categories: inflammatory (49.8%), neoplastic (30.1%), other diseases (7.1%), and non-diagnostic (12.8%). We further classified inflammatory diseases based on major tissue reaction patterns and neoplasms based on cell origin. We analyzed the leading diagnoses in each category, discussed their differential diagnoses, and provided clinicians with clues to reduce errors in practice. Following the pandemic, the overall number of pathology reports and patient admissions dropped dramatically, with significant changes in case profiles. Conclusions: We presented and discussed the frequently encountered confounding cases to sketch the diagnostic landscape. In the authors’ experience, clinicopathological correlation can increase the rate of reaching the diagnosis by up to 75.3%. © 2022 Ozcan et al.Öğe Poly(L-lactic acid)/poly(ethylene oxide) based composite electrospun fibers loaded with magnesium-aluminum layered double hydroxide nanoparticles(Elsevier, 2022) Öztürk, Esra Altay; Ege, Zeynep Rüya; Murat, Semiha; Erdemir, Gökçe; Kuruca, Serap; Erkmen, Ziya Engin; Duygulu, Özgür; Gündüz, Oğuzhan; Çaykara, Tuncer; Eroğlu, Mehmet STwo types of MgAl layered double hydroxide nanoparticles, MgAl LDH, at Mg:Al ratio of 2:1 and 3:1were prepared and used as inorganic fillers to improve the mechanical properties of poly(lactic acid)/poly(ethylene oxide) (PLA/PEO) electrospun composite fibers. Their detailed structural characterization was performed using X-ray diffraction (XRD) and transmission electron spectroscopy (TEM) techniques. Spectroscopic, thermal, mechanical, and morphological properties of the electrospun composite fibers, and cell proliferation on their surface, were examined. XRD and TEM analyses showed that the LDH nanoparticles were 50 nm in size and the Mg:Al ratio did not affect the average spacing between crystal layers. Fourier transform infrared (FTIR) and thermal analyses (TA) revealed the compatibility of the filler and the polymer matrix. The nanoparticles considerably improved the mechanical properties of the electrospun mats. The tensile strength and elongation at break values of the composite samples increased from 0.22 MPA to 0.40 MPa and 12.2 % to 45.66 %, respectively, resulting from the interaction between LDH and the polymer matrix. Scanning electron microscopy (SEM) and MTT analyses demonstrated that the electrospun composite fibers supported the SaOS-2 cells attachment and proliferation on the fiber surfaces, along with their suitable cytocompatibility.
